August 05, 2019
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Serum uric acid presents cardiovascular, mortality dangers in type 2 diabetes

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Rising levels of serum uric acid can amplify the odds of stroke and all-cause death in adults with type 2 diabetes, according to findings from a meta-analysis published in the Journal of Diabetes and its Complications.

Lizheng Shi

“Although some studies have been published to investigate the association between [serum uric acid] and the risk of cardiovascular diseases and all-cause mortality, these findings exclusively among [the] diabetes population were controversial and poorly synthesized,” Lizheng Shi, PhD, MsPharm, MA, professor and vice chair of the department of health policy and management at Tulane University School of Public Health and Tropical Medicine in New Orleans, told Endocrine Today. “Therefore, this study aims to conduct a meta-analysis to ascertain the effect of [serum uric acid] on the progression of [coronary heart disease], stroke and all-cause mortality among subjects with diabetes.”

Shi and colleagues searched for studies that dealt with type 2 diabetes and CV outcomes that also included serum uric acid measures in adults from the Web of Science and PubMed databases. Studies from 1980 to May 2019 were included, with 12 studies ultimately incorporated into the meta-analysis.

Serum uric acid and all-cause mortality were the focus of six of the studies, which included 11,750 combined participants (mean age, 59.3-68.8 years). The combined results from these studies showed that all-cause mortality risk rose with each corresponding rise in serum uric acid level of 59 µmol/L (HR = 1.06; 95% CI, 1.03-1.09), according to the researchers, who noted that “the unit of HRs was standardized to a percentage per 59 μmol/L [serum uric acid] increase in each study to quantify the dose-response relationship between the baseline [serum uric acid] level and the development of diabetic complications and all-cause mortality.”

Diabetes Words 2019 
Rising levels of serum uric acid can amplify the odds of stroke and all-cause death in adults with type 2 diabetes.
Source: Adobe Stock

Two of the included studies dealt with serum uric acid and stroke risk. The two studies included 7,792 participants (mean age range, 45-64 years) and illustrated a marked increase in the chance of stroke for participants when serum uric acid levels rose by 59 µmol/L (HR = 1.19; 95% CI, 1.08-1.31).

The four remaining studies were focused on serum uric acid and coronary heart disease and included 3,044 participants (mean age range, 57.68-69 years). Results from these studies indicated a trend toward higher CHD likelihood with a 59 µmol/L rise in serum uric acid level, but the researchers noted that this did not reach significance.

“Findings from this study might be helpful for diabetes management, especially diabetes with elevated [serum uric acid] level,” Shi said. – by Phil Neuffer

For more information:

Lizheng Shi, PhD, MsPharm, MA, can be reached at lshi1@tulane.edu.

Disclosures: The authors report no relevant financial disclosures.