Hyperuricemia Ups Diabetes Risk in Veterans with Gout

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STANFORD, CA — Among veterans with gout, hyperuricemia was associated with excess risk for developing diabetes, according to a Stanford University-led study using records from the VA’s South Central region.

In fact, according to the report published earlier this year in QJM: An International Journal of Medicine, one in 11 new cases of diabetes was statistically attributed to hyperuricemia.1

Background in the article noted that hyperuricemia is known to be a risk factor for incident type 2 diabetes mellitus, but the absolute magnitude of the association was not previously known.

Researchers looked at VA patients with two or more clinical encounters with gout diagnoses, no history of inflammatory diseases or diabetes and two serum urate (sUA) measurements Jan. 1, 2002, and Jan. 1, 2011. The 1,923 patients in the study had average age of 62.9, body mass index of 30.6 kg/m2, and follow-up time of 80 months.

For the study, diabetes was identified using ICD-9 codes, use of anti-diabetic medications or HbA1 at 6.5% or over. Also, sUA levels were assessed at six-month cycles, with hyperuricemia defined as sUA greater than 7 mg/dl.

Results showed that diabetes rates were 19% for sUA less than or equal to 7 mg/dl, 23% for  sUA less than or equal to 9 mg/dl and 27% for sUA greater than 9 mg/dl at the end of follow-up period.

 “Hyperuricemia was associated with a significantly higher risk of developing diabetes, after adjusting for confounding factors,” according to the authors, who noted that about 8.7% of all new cases of diabetes were statistically attributed to hyperuricemia.

“The association between hyperuricemia and diabetes is not fully established and has not been studied extensively in gout-specific populations,” the report noted. “As gout patients are at higher risk for diabetes and hyperuricemia, understanding the relationship between these conditions is important for clinicians.”

1Krishnan E, Akhras KS, Sharma H, Marynchenko M, Wu EQ, Tawk R, Liu J, Shi L. Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout. QJM. 2013 Aug;106(8):721-9. doi: 10.1093/qjmed/hct093. Epub 2013 Apr 24. PubMed PMID: 23620537; PubMed Central PMCID: PMC3713590.

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