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Erschienen in: Diabetologia 7/2010

01.07.2010 | Article

Serum uric acid does not predict cardiovascular or all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study

verfasst von: G. Ong, W. A. Davis, T. M. E. Davis

Erschienen in: Diabetologia | Ausgabe 7/2010

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Abstract

Aims/hypothesis

To determine whether serum uric acid: (1) is associated with cardiovascular disease (CVD) death and/or all-cause mortality in type 2 diabetes; and (2) consistent with published data, predicts these outcomes in older patients and those of southern European ethnicity.

Methods

We studied those 1,268 (98%) of 1,294 type 2 participants in the observational Fremantle Diabetes Study who had a fasting serum uric acid measured at baseline. Mortality data were collected over a mean (±SD) 10.3 ± 3.9 years. Cox proportional hazards modelling was used to determine independent baseline predictors of CVD and all-cause death including fasting serum uric acid as a continuous variable and quartiles.

Results

During follow up, 525 deaths occurred (41.4% of the cohort) of which 271 (51.6%) were attributed to CVD. In univariate analyses, patients in the highest uric acid quartile had the greatest CVD and all-cause mortality (p = 0.007 and p = 0.001). After adjustment for significant variables in the most parsimonious model, baseline serum uric acid was not an independent associate of CVD or all-cause mortality whether entered as a continuous variable (HR 1.11 [95% CI 0.96–1.27] and 1.10 [95% CI 0.98–1.22] for a 0.1 mmol/l increase, respectively) or as quartiles (p > 0.10). Analyses of 638 patients >65 years of age and 231 of southern European ethnicity produced similar results.

Conclusions/interpretation

Serum uric acid was not an independent predictor of CVD or all-cause mortality in our community-based type 2 patients. Fasting serum uric acid concentrations do not appear to be prognostically useful in type 2 diabetes.
Literatur
1.
Zurück zum Zitat Feig DI, Kang DH, Johnson RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359:1811–1821CrossRefPubMed Feig DI, Kang DH, Johnson RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359:1811–1821CrossRefPubMed
2.
Zurück zum Zitat Zoppini G, Targher G, Negri C et al (2009) Elevated serum uric acid concentrations independently predict cardiovascular mortality in type 2 diabetic patients. Diabetes Care 32:1716–1720CrossRefPubMed Zoppini G, Targher G, Negri C et al (2009) Elevated serum uric acid concentrations independently predict cardiovascular mortality in type 2 diabetic patients. Diabetes Care 32:1716–1720CrossRefPubMed
3.
Zurück zum Zitat Ioachimescu AG, Brennan DM, Hoar BM, Kashyap SR, Hoogwerf BJ (2007) Serum uric acid, mortality and glucose control in patients with Type 2 diabetes mellitus: a PreCIS database study. Diabet Med 24:1369–1374CrossRefPubMed Ioachimescu AG, Brennan DM, Hoar BM, Kashyap SR, Hoogwerf BJ (2007) Serum uric acid, mortality and glucose control in patients with Type 2 diabetes mellitus: a PreCIS database study. Diabet Med 24:1369–1374CrossRefPubMed
4.
Zurück zum Zitat Mazza A, Zamboni S, Rizzato E et al (2007) Serum uric acid shows a J-shaped trend with coronary mortality in non-insulin-dependent diabetic elderly people. The CArdiovascular STudy in the ELderly (CASTEL). Acta Diabetol 44:99–105CrossRefPubMed Mazza A, Zamboni S, Rizzato E et al (2007) Serum uric acid shows a J-shaped trend with coronary mortality in non-insulin-dependent diabetic elderly people. The CArdiovascular STudy in the ELderly (CASTEL). Acta Diabetol 44:99–105CrossRefPubMed
5.
Zurück zum Zitat Hsu SP, Pai MF, Peng YS, Chiang CK, Ho TI, Hung KY (2004) Serum uric acid levels show a ‘J-shaped’ association with all-cause mortality in haemodialysis patients. Nephrol Dial Transplant 19:457–462CrossRefPubMed Hsu SP, Pai MF, Peng YS, Chiang CK, Ho TI, Hung KY (2004) Serum uric acid levels show a ‘J-shaped’ association with all-cause mortality in haemodialysis patients. Nephrol Dial Transplant 19:457–462CrossRefPubMed
6.
Zurück zum Zitat Suliman ME, Johnson RJ, Garcia-Lopez E et al (2006) J-shaped mortality relationship for uric acid in CKD. Am J Kidney Dis 48:761–771CrossRefPubMed Suliman ME, Johnson RJ, Garcia-Lopez E et al (2006) J-shaped mortality relationship for uric acid in CKD. Am J Kidney Dis 48:761–771CrossRefPubMed
7.
Zurück zum Zitat Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P (2000) Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension 36:1072–1078PubMed Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P (2000) Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension 36:1072–1078PubMed
8.
Zurück zum Zitat Davis TM, Zimmet P, Davis WA, Bruce DG, Fida S, Mackay IR (2000) Autoantibodies to glutamic acid decarboxylase in diabetic patients from a multi-ethnic Australian community: the Fremantle Diabetes Study. Diabet Med 17:667–674CrossRefPubMed Davis TM, Zimmet P, Davis WA, Bruce DG, Fida S, Mackay IR (2000) Autoantibodies to glutamic acid decarboxylase in diabetic patients from a multi-ethnic Australian community: the Fremantle Diabetes Study. Diabet Med 17:667–674CrossRefPubMed
9.
Zurück zum Zitat Norman PE, Davis WA, Bruce DG, Davis TM (2006) Peripheral arterial disease and risk of cardiac death in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 29:575–580CrossRefPubMed Norman PE, Davis WA, Bruce DG, Davis TM (2006) Peripheral arterial disease and risk of cardiac death in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 29:575–580CrossRefPubMed
10.
Zurück zum Zitat Holman CD, Bass AJ, Rouse IL, Hobbs MS (1999) Population-based linkage of health records in Western Australia: development of a health services research linked database. Aust N Z J Public Health 23:453–459CrossRefPubMed Holman CD, Bass AJ, Rouse IL, Hobbs MS (1999) Population-based linkage of health records in Western Australia: development of a health services research linked database. Aust N Z J Public Health 23:453–459CrossRefPubMed
11.
Zurück zum Zitat Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470PubMed Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470PubMed
12.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef
13.
Zurück zum Zitat Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364:937–952CrossRefPubMed Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364:937–952CrossRefPubMed
14.
Zurück zum Zitat Clifford RM, Davis WA, Cull CA, Bruce DG, Batty KT, Davis TM (2004) Greater use of insulin by southern European compared with Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study. Eur J Endocrinol 151:579–586CrossRefPubMed Clifford RM, Davis WA, Cull CA, Bruce DG, Batty KT, Davis TM (2004) Greater use of insulin by southern European compared with Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study. Eur J Endocrinol 151:579–586CrossRefPubMed
15.
Zurück zum Zitat Bruce DG, Davis WA, Davis TM (2000) Glycemic control in older subjects with type 2 diabetes mellitus in the Fremantle Diabetes Study. J Am Geriatr Soc 48:1449–1453PubMed Bruce DG, Davis WA, Davis TM (2000) Glycemic control in older subjects with type 2 diabetes mellitus in the Fremantle Diabetes Study. J Am Geriatr Soc 48:1449–1453PubMed
16.
Zurück zum Zitat Culleton BF, Larson MG, Kannel WB, Levy D (1999) Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 131:7–13PubMed Culleton BF, Larson MG, Kannel WB, Levy D (1999) Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 131:7–13PubMed
17.
Zurück zum Zitat Fang J, Alderman MH (2000) Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA 283:2404–2410CrossRefPubMed Fang J, Alderman MH (2000) Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA 283:2404–2410CrossRefPubMed
18.
Zurück zum Zitat Tsouli SG, Liberopoulos EN, Mikhailidis DP, Athyros VG, Elisaf MS (2006) Elevated serum uric acid levels in metabolic syndrome: an active component or an innocent bystander? Metabolism 55:1293–1301CrossRefPubMed Tsouli SG, Liberopoulos EN, Mikhailidis DP, Athyros VG, Elisaf MS (2006) Elevated serum uric acid levels in metabolic syndrome: an active component or an innocent bystander? Metabolism 55:1293–1301CrossRefPubMed
19.
Zurück zum Zitat George J, Struthers AD (2008) The role of urate and xanthine oxidase inhibitors in cardiovascular disease. Cardiovasc Ther 26:59–64PubMed George J, Struthers AD (2008) The role of urate and xanthine oxidase inhibitors in cardiovascular disease. Cardiovasc Ther 26:59–64PubMed
20.
Zurück zum Zitat Norman PE, Semmens JB, Laurvick CL, Lawrence-Brown M (2003) Long-term relative survival in elderly patients after carotid endarterectomy: a population-based study. Stroke 34:e95–e98CrossRefPubMed Norman PE, Semmens JB, Laurvick CL, Lawrence-Brown M (2003) Long-term relative survival in elderly patients after carotid endarterectomy: a population-based study. Stroke 34:e95–e98CrossRefPubMed
21.
Zurück zum Zitat Bradshaw PJ, Jamrozik K, Jelfs P, Le M (2000) Mobile Australians: a moving target for epidemiologists. Med J Aust 172:566PubMed Bradshaw PJ, Jamrozik K, Jelfs P, Le M (2000) Mobile Australians: a moving target for epidemiologists. Med J Aust 172:566PubMed
23.
Zurück zum Zitat Lippi G, Montagnana M, Franchini M, Favaloro EJ, Targher G (2008) The paradoxical relationship between serum uric acid and cardiovascular disease. Clin Chim Acta 392:1–7CrossRefPubMed Lippi G, Montagnana M, Franchini M, Favaloro EJ, Targher G (2008) The paradoxical relationship between serum uric acid and cardiovascular disease. Clin Chim Acta 392:1–7CrossRefPubMed
24.
Zurück zum Zitat Kuzuya M, Ando F, Iguchi A, Shimokata H (2002) Effect of aging on serum uric acid levels: longitudinal changes in a large Japanese population group. J Gerontol A Biol Sci Med Sci 57:M660–M664PubMed Kuzuya M, Ando F, Iguchi A, Shimokata H (2002) Effect of aging on serum uric acid levels: longitudinal changes in a large Japanese population group. J Gerontol A Biol Sci Med Sci 57:M660–M664PubMed
25.
Zurück zum Zitat Jee SH, Lee SY, Kim MT (2004) Serum uric acid and risk of death from cancer, cardiovascular disease or all causes in men. Eur J Cardiovasc Prev Rehabil 11:185–191CrossRefPubMed Jee SH, Lee SY, Kim MT (2004) Serum uric acid and risk of death from cancer, cardiovascular disease or all causes in men. Eur J Cardiovasc Prev Rehabil 11:185–191CrossRefPubMed
26.
Zurück zum Zitat Krishnan E, Svendsen K, Neaton JD, Grandits G, Kuller LH (2008) Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med 168:1104–1110CrossRefPubMed Krishnan E, Svendsen K, Neaton JD, Grandits G, Kuller LH (2008) Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med 168:1104–1110CrossRefPubMed
27.
Zurück zum Zitat Sakata K, Hashimoto T, Ueshima H, Okayama A (2001) Absence of an association between serum uric acid and mortality from cardiovascular disease: NIPPON DATA 80, 1980–1994. National Integrated Projects for Prospective Observation of Non-communicable Diseases and its Trend in the Aged. Eur J Epidemiol 17:461–468CrossRefPubMed Sakata K, Hashimoto T, Ueshima H, Okayama A (2001) Absence of an association between serum uric acid and mortality from cardiovascular disease: NIPPON DATA 80, 1980–1994. National Integrated Projects for Prospective Observation of Non-communicable Diseases and its Trend in the Aged. Eur J Epidemiol 17:461–468CrossRefPubMed
Metadaten
Titel
Serum uric acid does not predict cardiovascular or all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study
verfasst von
G. Ong
W. A. Davis
T. M. E. Davis
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 7/2010
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-010-1735-7

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