The serum uric acid to serum creatinine ratio is an independent risk factor for type 2 diabetes in community-dwelling elderly: A longitudinal analysis

Nutr Metab Cardiovasc Dis. 2024 Dec;34(12):2749-2756. doi: 10.1016/j.numecd.2024.08.018. Epub 2024 Aug 30.

Abstract

Background and aim: Elevated serum uric acid (SUA) levels are an important marker of metabolic disorders. However, SUA levels largely depend on renal clearance function. This study aims to investigate the relationship between renal function-normalized SUA [SUA to serum creatinine (SCr) ratio] and the risk of developing type 2 diabetes in a community-dwelling elderly population.

Methods and results: A retrospective cohort study was conducted on elderly, non-diabetic individuals from the Kunshan community in China, who participated in annual health check-ups between January 2018 and December 2023. The relationship between the baseline SUA/SCr ratio and the risk of type 2 diabetes was examined using Cox regression models, restricted cubic splines (RCS), and subgroup analyses. After a median follow-up of 3.88 years, 778 cases of type 2 diabetes were identified among 7671 elderly non-diabetic individuals. Adjusting for confounding variables, the baseline SUA/SCr ratio was significantly linked to type 2 diabetes risk (P < 0.001). Individuals in the highest SUA/SCr ratio quartile had a 1.323 times higher risk of developing type 2 diabetes compared to those in the lowest quartile (HR = 1.323, 95% CI 1.053-1.661, P = 0.016). RCS analysis further confirmed this positive association. Additionally, subgroup analyses suggested that this relationship was particularly pronounced in female individuals.

Conclusions: In Chinese elderly community residents, the baseline SUA/SCr ratio is linked to the risk of type 2 diabetes. Monitoring this ratio could aid in predicting and assessing the risk of type 2 diabetes.

Keywords: Community; Elderly population; Serum creatinine; Serum uric acid; Type 2 diabetes.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers* / blood
  • China / epidemiology
  • Creatinine* / blood
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Humans
  • Hyperuricemia / blood
  • Hyperuricemia / diagnosis
  • Hyperuricemia / epidemiology
  • Incidence
  • Independent Living*
  • Kidney / physiopathology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Uric Acid* / blood

Substances

  • Uric Acid
  • Biomarkers
  • Creatinine