Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis
Objective: Recently, several cohort studies suggested a positive relationship between serum uric acid (SUA) and type 2 diabetes mellitus (T2DM), which is inconsistent with the results of functional research. Our aim was to further evaluate this correlation by conducting a systematic review. Methods:...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-06-01
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| Series: | Chronic Diseases and Translational Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095882X16300457 |
| _version_ | 1828823229917036544 |
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| author | Yi-Li Xu Kuan-Feng Xu Jian-Ling Bai Yun Liu Rong-Bin Yu Chun-Lan Liu Chong Shen Xiao-Hong Wu |
| author_facet | Yi-Li Xu Kuan-Feng Xu Jian-Ling Bai Yun Liu Rong-Bin Yu Chun-Lan Liu Chong Shen Xiao-Hong Wu |
| author_sort | Yi-Li Xu |
| collection | DOAJ |
| description | Objective: Recently, several cohort studies suggested a positive relationship between serum uric acid (SUA) and type 2 diabetes mellitus (T2DM), which is inconsistent with the results of functional research. Our aim was to further evaluate this correlation by conducting a systematic review. Methods: Computerized literature searches of the Medline database, EMBASE database, and PubMed were used to evaluate the relationship between SUA and T2DM in cohort studies. Cochran's Q and I2 statistics were used to evaluate heterogeneity among studies, and pooled relative risk (RR) and odds ratio (OR) with 95% confidence intervals (CIs) were calculated using random-effects and fixed-effects models. The summary RR and OR of per 1Â mg/ml-SUA increase were calculated separately because of their different epidemiological implications and calculation methods. Additionally, sensitivity analysis, stratified analysis, meta-regression, and multiple meta-regression were applied to investigate the heterogeneity among studies. Results: A total of 970 articles were retrieved from the searches. Sixteen publications of cohort studies containing 61,714 participants were included. The pooled RR was 1.131 (95% CI: 1.084â1.179) with significant heterogeneity among studies (I2Â =Â 51.9%, PÂ =Â 0.018). Adjusted RR to evaluate the stability of the relationship between SUA and T2DM in the sensitivity analysis was similar (RRÂ =Â 1.140, 95% CI:Â 1.087â1.197), with statistically significant heterogeneity (I2Â =Â 54.5%, PÂ =Â 0.015). Stratified analysis and meta-regression showed that the positive relationship remained irrespective of age, sex, region, and adjustment for confounding factors including body mass index, fasting blood glucose, systolic blood pressure, diastolic blood pressure, alcohol consumption, smoking, blood cholesterol, waist circumference, fatty liver, and drugs affecting SUA. Conclusion: Although SUA is independently associated with development of T2DM, insulin resistance increased as the baseline SUA concentration increased; thus, the correlation between SUA and T2DM requires further evaluation and the baseline insulin resistance status should also be considered. Keywords: Uric acid, Diabetes, Meta-analysis |
| first_indexed | 2024-12-12T13:31:03Z |
| format | Article |
| id | doaj.art-bca3b6d61cba455d974760416a3680b4 |
| institution | Directory Open Access Journal |
| issn | 2095-882X |
| language | English |
| last_indexed | 2024-12-12T13:31:03Z |
| publishDate | 2016-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Chronic Diseases and Translational Medicine |
| spelling | doaj.art-bca3b6d61cba455d974760416a3680b42022-12-22T00:23:04ZengWileyChronic Diseases and Translational Medicine2095-882X2016-06-01228191Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysisYi-Li Xu0Kuan-Feng Xu1Jian-Ling Bai2Yun Liu3Rong-Bin Yu4Chun-Lan Liu5Chong Shen6Xiao-Hong Wu7Department of Nephrology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, ChinaDepartment of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, ChinaDepartment of Geriatrics, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, ChinaDepartment of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, ChinaDepartment of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, ChinaDepartment of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Corresponding author. Fax: +86 25 86527613.Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, China; Corresponding author.Objective: Recently, several cohort studies suggested a positive relationship between serum uric acid (SUA) and type 2 diabetes mellitus (T2DM), which is inconsistent with the results of functional research. Our aim was to further evaluate this correlation by conducting a systematic review. Methods: Computerized literature searches of the Medline database, EMBASE database, and PubMed were used to evaluate the relationship between SUA and T2DM in cohort studies. Cochran's Q and I2 statistics were used to evaluate heterogeneity among studies, and pooled relative risk (RR) and odds ratio (OR) with 95% confidence intervals (CIs) were calculated using random-effects and fixed-effects models. The summary RR and OR of per 1Â mg/ml-SUA increase were calculated separately because of their different epidemiological implications and calculation methods. Additionally, sensitivity analysis, stratified analysis, meta-regression, and multiple meta-regression were applied to investigate the heterogeneity among studies. Results: A total of 970 articles were retrieved from the searches. Sixteen publications of cohort studies containing 61,714 participants were included. The pooled RR was 1.131 (95% CI: 1.084â1.179) with significant heterogeneity among studies (I2Â =Â 51.9%, PÂ =Â 0.018). Adjusted RR to evaluate the stability of the relationship between SUA and T2DM in the sensitivity analysis was similar (RRÂ =Â 1.140, 95% CI:Â 1.087â1.197), with statistically significant heterogeneity (I2Â =Â 54.5%, PÂ =Â 0.015). Stratified analysis and meta-regression showed that the positive relationship remained irrespective of age, sex, region, and adjustment for confounding factors including body mass index, fasting blood glucose, systolic blood pressure, diastolic blood pressure, alcohol consumption, smoking, blood cholesterol, waist circumference, fatty liver, and drugs affecting SUA. Conclusion: Although SUA is independently associated with development of T2DM, insulin resistance increased as the baseline SUA concentration increased; thus, the correlation between SUA and T2DM requires further evaluation and the baseline insulin resistance status should also be considered. Keywords: Uric acid, Diabetes, Meta-analysishttp://www.sciencedirect.com/science/article/pii/S2095882X16300457 |
| spellingShingle | Yi-Li Xu Kuan-Feng Xu Jian-Ling Bai Yun Liu Rong-Bin Yu Chun-Lan Liu Chong Shen Xiao-Hong Wu Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis Chronic Diseases and Translational Medicine |
| title | Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis |
| title_full | Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis |
| title_fullStr | Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis |
| title_full_unstemmed | Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis |
| title_short | Elevation of serum uric acid and incidence of type 2 diabetes: AÂ systematic review and meta-analysis |
| title_sort | elevation of serum uric acid and incidence of type 2 diabetes aa systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2095882X16300457 |
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