The purpose of this study is to examine the relation of serum uric acid with prediabetes in Korea. We conducted a cross-sectional study in 4633 individuals aged 20 to 81 years who participated in the 2016 Korean National Health and Nutrition Examination Survey. Participants are considered to have prediabetes if they have one or more of the following: impaired fasting glucose (fasting blood glucose levels between 5.6 and 6.9 mmol/L); impaired hemoglobin A1c (hemoglobin A1c ranges of 5.7% to 6.4% [39-46 mmol/mol]). Multiple logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). Prediabetes was more prevalent in the hyperuricemia group compared with the normal-range group among men (OR = 1.51; 95% CI = 1.11-2.05; P < .01) and women (OR = 1.84; 95% CI = 1.01-3.37; P = .04) after adjustment for age, body mass index, abdominal obesity, blood pressure, triglyceride, high-density lipoprotein cholesterol, renal function, alcohol consumption, smoking, and physical activity level. For a standard deviation increment in uric acid, the odds of having prediabetes as compared with that of not having prediabetes increased about 114% in men (P = .05) and 116% in women (P = .01). Higher levels of uric acid were associated with an increased risk of prediabetes among the general Korean population.
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513-1530.
2.
National Health Insurance Service. Health Insurance Statistical Yearbook 2015-2016. http://www.nhic.or.kr/. Published 2017. Accessed November 13, 2018.
3.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(suppl 1):S81-S90.
4.
TabakAGHerderCRathmannWBrunnerEJKivimäkiM.Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379:2279-2290.
5.
PerreaultLPanQMatherKJWatsonKEHammanRFKahnSE; Diabetes Prevention Program Research Group. Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study. Lancet. 2012;379:2243-2251.
6.
KimTHLeeSSYooJH, et al. The relationship between the regional abdominal adipose tissue distribution and the serum uric acid levels in people with type 2 diabetes mellitus. Diabetol Metab Syndr. 2012;4:3.
7.
WangTBiYXuM, et al. Serum uric acid associates with the incidence of type 2 diabetes in a prospective cohort of middle-aged and elderly Chinese. Endocrine. 2011;40:109-116.
8.
BholeVChoiJWKimSWde VeraMChoiH.Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med. 2010;123:957-961.
9.
KodamaSSaitoKYachiY, et al. Association between serum uric acid and development of type 2 diabetes. Diabetes Care. 2009;32:1737-1742.
10.
AnothaisintaweeTLertrattananonDThamakaisonSReutrakulSOngphiphadhanakulBThakkinstianA.Direct and indirect effects of serum uric acid on blood sugar levels in patients with prediabetes: a mediation analysis. J Diabetes Res. 2017;2017:6830671.
11.
van der SchaftNBrahimajAWenKXFrancoOHDehghanA.The association between serum uric acid and the incidence of prediabetes and type 2 diabetes mellitus: the Rotterdam Study. PLoS One. 2017;12:e0179482.
12.
LiuYJinCXingA, et al. Serum uric acid levels and the risk of impaired fasting glucose: a prospective study in adults of north China. PLoS One. 2013;8:e84712.
13.
KrishnanEPandyaBJChungLHaririADabbousO.Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study. Am J Epidemiol. 2012;176:108-116.
14.
VucakJKatićMBielenI, et al. Association between hyperuricemia, prediabetes, and prehypertension in the Croatian adult population—a cross-sectional study. BMC Cardiovasc Disord. 2012;12:117.
15.
YamadaTFukatsuMSuzukiSWadaTJohT.Elevated serum uric acid predicts impaired fasting glucose and type 2 diabetes only among Japanese women undergoing health checkups. Diabetes Metab. 2011;37:252-258.
16.
KawamotoRTabaraYKoharaKKusunokiTAbeMMikiT.Serum uric acid is more strongly associated with impaired fasting glucose in women than in men from a community-dwelling population. PLoS One. 2013;8:e65886.
17.
MeisingerCDoringAStöcklDThorandBKowallBRathmannW.Uric acid is more strongly associated with impaired glucose regulation in women than in men from the general population: the KORA F4-study. PLoS One. 2012;7:e37180.
18.
HaqueTRahmanSIslamSMollaNHAliN.Assessment of the relationship between serum uric acid and glucose levels in healthy, prediabetic and diabetic individuals. Diabetol Metab Syndr. 2019;11:49.
19.
Korea Center for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey. http://knhanes.cdc.go.kr/. Published 2018. Accessed January 4, 2019.
20.
MinDLChoEH.Risk factors for underdiagnosis of diabetes based on the Korean National Health and Nutrition Examination Survey 2013-2015. Asia Pac J Public Health. 2019;31:404-412.
21.
ChoiBGKimDJBaekMJ, et al. Hyperuricaemia and development of type 2 diabetes mellitus in Asian population. Clin Exp Pharmacol Physiol. 2018;45:499-506.
22.
LeveyASCoreshJGreeneT, et al; Chronic Kidney Disease Epidemiology Collaboration. Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem. 2007;53:766-772.
23.
LeeSYParkHSKimDJ, et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007;75:72-80.
24.
AgakuITKingBADubeSR; Centers for Disease Control and Prevention. Current cigarette smoking among adults—United States, 2005-2012. MMWR Morb Mortal Wkly Rep. 2014;63:29-34.
25.
NiuLLiuYLuoDXiaoS.Current smoking behavior among medical students in mainland China: a systematic review and meta-analysis. Asia Pac J Public Health. 2018;30:610-623.
26.
CraigCLMarshallALSjöströmM, et al. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381-1395.
27.
FangJAldermanMH.Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404-2410.
28.
SautinYYNakagawaTZharikovSJohnsonRJ.Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative/nitrosative stress. Am J Physiol Cell Physiol. 2007;293:C584-C596.
29.
FurukawaSFujitaTShimabukuroM, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004;114:1752-1761.
30.
KahnBBFlierJS.Obesity and insulin resistance. J Clin Invest. 2000;106:473-481.
31.
ZhangYYamamotoTHisatomeI, et al. Uric acid induces oxidative stress and growth inhibition by activating adenosine monophosphate-activated protein kinase and extracellular signal-regulated kinase signal pathways in pancreatic beta cells. Mol Cell Endocrinol. 2013;375:89-96.
32.
CicerchiCLiNKratzerJ, et al. Uric acid-dependent inhibition of AMP kinase induces hepatic glucose production in diabetes and starvation: evolutionary implications of the uricase loss in hominids. FASEB J. 2014;28:3339-3350.
