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Cited by 49Gout, Hyperuricemia, Uric AcidDiet, Metabolism, and DiseaseAdipokines, Inflammation, and Metabolic Diseases

Elevation of serum uric acid and incidence of type 2 diabetes: A systematic review and meta‐analysis

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Xu, Yi‐Li, Xu, Kuan‐Feng, Bai, Jian‐Ling, Liu, Yun, Yu, Rong‐Bin, Liu, Chun‐Lan, Shen, Chong, Wu, Xiao‐Hong·2016·Chronic Diseases and Translational Medicine
DOI 10.1016/j.cdtm.2016.09.003PMC PMC5643744
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Abstract

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 I 2 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 1 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: 1.084–1.179) with significant heterogeneity among studies (I2 = 51.9%, P = 0.018). Adjusted RR to evaluate the stability of the relationship between SUA and T2DM in the sensitivity analysis was similar (RR = 1.140, 95% CI: 1.087–1.197), with statistically significant heterogeneity (I2 = 54.5%, P = 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.

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  • Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (22%, 2/9).

    “Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (SMBG) (22%, 2/9) [10,20,23], [25,26,30,31,34,37].”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [30]

    The Results (‘Included and excluded articles’; page unavailable) describe 16 studies of serum uric acid and type 2 diabetes, not nine technology-assisted studies. A search for technology-assisted studies, medication adherence, dietary behaviors, and blood-glucose self-monitoring found no passage reporting the claimed behavior counts or percentages. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • [30] found that self-efficacy and health beliefs mediated the relationship between demographic factors and self-care behavior in patients with both T2DM and hypertension.

    “For example, [30] found that selfefficacy and health beliefs mediated the relationship between demographic factors and self-care behavior in patients with both T2DM and hypertension.”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [30]

    The Results and Discussion examine serum uric acid and the incidence of T2DM, with hypertension discussed as a potential confounder. Searches for self-efficacy, health beliefs, self-care behavior, and mediation found no passage addressing the attributed finding in patients with both T2DM and hypertension. (LLM, conf=0.78)

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Cited by

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Authors
Xu, Y., Xu, K., Bai, J., Liu, Y., Yu, R., Liu, C., Shen, C., & Wu, X.
Affiliations
  • Jiangsu Province Hospital (CN)
  • Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University Nanjing Jiangsu 210029 China
  • Department of Biostatistics School of Public Health Nanjing Medical University Nanjing Jiangsu 211166 China
  • Nanjing Medical University (CN)
Corresponding author
Shen, Chong
ORCID
Venue
Chronic Diseases and Translational Medicine
Publisher
Wiley
Published
2016-06
Volume
2
Issue
2
Pages
81-91
ISSN
  • 2095-882X (ISSN-L)
  • 2589-0514
DOI
10.1016/j.cdtm.2016.09.003
PMC
PMC5643744
OpenAlex
W2546445564
Cited by
49
References
3
Citations by year
2026: 1 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 8 · 2021: 9 · 2020: 5 · 2019: 6 · 2018: 7
FWCI
0.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Chronic Diseases and Translational Medicine (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Natural Science Foundation of China (81261120566)
  • Technology Program of Jiangsu Province (BE2009681)
  • Priority Academic Program for the Development of Jiangsu Higher Education Institutions (Public Health and Preventive Medicine)
  • Jiangsu Province key medical personnel project (RC2011068)
  • 333 projects in the fourth phase of Jiangsu Province (BRA2015389)
Topics
  • Health Sciences › Medicine › Nephrology › Gout, Hyperuricemia, Uric Acid
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
serum uric acid, type 2 diabetes, hyperuricemia, insulin resistance, diabetes incidence, confounding factors, body mass index, fasting blood glucose, blood pressure, alcohol consumption, smoking, serum cholesterol, waist circumference, hepatic steatosis

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