Elevated levels of uric acid are associated with an increased likelihood of diabetes, but uric acid levels decline after diabetes is diagnosed, according to the findings of a new study that are consistent with those of previous investigations.

Researchers led by Elizabeth Selvin, PhD, of Johns Hopkins University in Baltimore, analyzed data from 11,134 participants in the Atherosclerosis Risk in Communities Study who did not have diabetes at study enrollment. Each 1 mg/dL increment in uric acid was associated with a significant 18% increased risk of diabetes, after adjusting for potential confounders. The association remained significant even after adjusting for fasting glucose and insulin levels, the researchers reported online ahead of print in the American Journal of Epidemiology.

In addition, among subjects with diabetes, each additional five years’ duration of diabetes was associated with a 0.10 mg/dL lower uric acid level in adjusted analyses. Dr. Selvin and her colleagues pointed out that it is believed elevations in serum glucose or insulin promote excretion of uric acid. “However, we observed that the association between diabetes and lower uric acid level was independent of estimated glomerular filtration rate, fasting glucose, and insulin,” they wrote. “It is possible that lifestyle changes or medication use subsequent to a diabetes diagnosis alters uric acid production; however, ongoing alterations in metabolism due to the chronic effects of diabetes cannot be ruled out.”

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The researchers cited previous research suggesting that uric acid has a causal role in the development of diabetes, but it also is possible that uric acid level is a marker for other diabetes risk factors.