Arthritis Research Centre of Canada, Vancouver, BC, Canada.
Am J Med. 2010 Oct;123(10):957-61. doi: 10.1016/j.amjmed.2010.03.027.
To evaluate the impact of serum uric acid levels on the future risk of developing type 2 diabetes independent of other factors.
We used prospective data from the Framingham Heart Study original (n=4883) and offspring (n=4292) cohorts to examine the association between serum uric acid levels and the incidence of diabetes. We used Cox proportional hazards models to estimate the relative risk of incident diabetes adjusting for age, sex, physical activity, alcohol consumption, smoking, hypertension, body mass index, and blood levels of glucose, cholesterol, creatinine, and triglycerides.
We identified 641 incident cases of diabetes in the original cohort and 497 cases in the offspring cohort. The incidence rates of diabetes per 1000 person-years for serum uric acid levels <5.0, 5.0-5.9, 6.0-6.9, 7.0-7.9 and ≥8.0 mg/dL were 3.3, 6.1, 8.7, 11.5, and 15.9, respectively, in the original cohort; and 2.9, 5.0, 6.6, 8.7, and 10.9, respectively, in the offspring cohort (P-values for trends <.001). Multivariable relative risks per mg/dL increase in serum uric acid levels were 1.20 (95% confidence interval; 1.11-1.28) for the original cohort and 1.15 (95% confidence interval; 1.06-1.23) for the offspring cohort.
These prospective data from 2 generations of the Framingham Heart Study provide evidence that individuals with higher serum uric acid; including younger adults, are at a higher future risk of type 2 diabetes independent of other known risk factors. These data expand on cross-sectional associations between hyperuricemia and the metabolic syndrome, and extend the link to the future risk of type 2 diabetes.
评估血清尿酸水平对 2 型糖尿病未来发病风险的影响，排除其他因素的影响。
我们使用弗雷明汉心脏研究原始队列（n=4883）和后代队列（n=4292）的前瞻性数据，研究血清尿酸水平与糖尿病发病之间的关系。我们使用 Cox 比例风险模型，在调整年龄、性别、体力活动、饮酒、吸烟、高血压、体重指数以及血糖、胆固醇、肌酐和甘油三酯血水平后，估计糖尿病发病的相对风险。
我们在原始队列中发现了 641 例糖尿病新发病例，在后代队列中发现了 497 例。血清尿酸水平<5.0、5.0-5.9、6.0-6.9、7.0-7.9 和≥8.0 mg/dL 的患者，每 1000 人年的糖尿病发病率分别为 3.3、6.1、8.7、11.5 和 15.9，在原始队列中；在后代队列中，相应的发病率分别为 2.9、5.0、6.6、8.7 和 10.9（趋势 P 值<.001）。血清尿酸水平每增加 1 mg/dL，多变量相对风险为 1.20（95%置信区间，1.11-1.28），原始队列为 1.15（95%置信区间，1.06-1.23）。
这些来自弗雷明汉心脏研究 2 代人的前瞻性数据提供了证据，表明血清尿酸水平较高的个体，包括较年轻的成年人，未来患 2 型糖尿病的风险更高，独立于其他已知的危险因素。这些数据扩展了高尿酸血症与代谢综合征之间的横断面关联，并将其与 2 型糖尿病的未来风险联系起来。
