Tian Xue, Wang Anxin, Zuo Yingting, Chen Shuohua, Zhang Licheng, Zhao Yuhan, Liu Lulu, Wu Shouling, Luo Yanxia, Gao Jingli
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
Nutr Diabetes. 2022 Jan 10;12(1):1. doi: 10.1038/s41387-021-00179-8.
The impact of long-term serum uric acid (SUA) exposure and time course of SUA accumulation on diabetes mellitus (DM) is unknown. This study aimed to evaluate the association of cumulative SUA (cumSUA) exposure and its accumulation time course with risk of DM.
This prospective study included 46,434 participants without DM and underwent three examinations at 2006, 2008, and 2010. CumSUA from 2006 to 2010 was calculated, multiplying mean values between consecutive examinations by time intervals between visits. Time course of SUA accumulation was categorized as the slope of SUA versus time from 2006 to 2010, or by splitting the overall accumulation into an early (cumSUA) and late accumulation (cumSUA).
During 6.99 years of follow-up, we identified 2971 incident DM cases. In the fully adjusted model, a higher risk of DM was observed in participants with the highest quartile of cumSUA (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.17-1.46), cumulative burden >0 (HR, 1.23; 95% CI, 1.08-1.40), and with 6 year of hyperuricemia exposure duration (HR, 1.25; 95% CI, 1.01-1.55). When considering the time course of SUA accumulation, participants with a negative slope (HR, 1.05; 95% CI, 1.01-1.12), or combined with cumSUA ≥ median and a negative slope had elevated risk of DM (HR, 1.58; 95% CI, 1.18-2.11).
Incident DM risk depends on cumulative exposure of SUA and time course of SUA accumulation. Early SUA accumulation resulted in a greater risk increase compared with later accumulation, emphasizing the importance of optimal SUA control early in life.
长期血清尿酸（SUA）暴露以及SUA积累的时间进程对糖尿病（DM）的影响尚不清楚。本研究旨在评估累积SUA（cumSUA）暴露及其积累时间进程与DM风险的关联。
这项前瞻性研究纳入了46434名无DM的参与者，并于2006年、2008年和2010年进行了三次检查。计算2006年至2010年的cumSUA，将连续检查之间的平均值乘以就诊时间间隔。SUA积累的时间进程被分类为2006年至2010年SUA与时间的斜率，或通过将总体积累分为早期（cumSUA）和晚期积累（cumSUA）。
在6.99年的随访期间，我们确定了2971例新发DM病例。在完全调整模型中，cumSUA处于最高四分位数的参与者患DM的风险更高（风险比[HR]，1.31；95%置信区间[CI]，1.17 - 1.46），累积负担>0（HR，1.23；95%CI，1.08 - 1.40），以及有6年高尿酸血症暴露持续时间（HR，1.25；95%CI，1.01 - 1.55）。当考虑SUA积累的时间进程时，斜率为负的参与者（HR，1.05；95%CI，1.01 - 1.12），或cumSUA≥中位数且斜率为负的参与者患DM的风险升高（HR，1.58；95%CI，1.18 - 2.11）。
新发DM风险取决于SUA的累积暴露和SUA积累的时间进程。与后期积累相比，早期SUA积累导致的风险增加更大，强调了在生命早期进行最佳SUA控制的重要性。
