Background: Recent studies found elevated serum uric acid (SUA) level were associated with type 2 diabetes mellitus (T2DM) progression. However, whether SUA level was relevant to the development of cardiovascular events was inconclusive.

Objective: To explore the association between SUA level and risk of cardiovascular events and all-cause mortality among patients with T2DM.

Method: A systematic literature search was conducted using the Web of Science and PubMed database (1980-2017). Search terms and strategies for PubMed were as follows: using [Title/Abstract] or [MeSH Terms] to search “diabetes”, “serum uric acid”, “cardiovascular disease”, and “all-cause mortality.” Studies that reported associations between SUA and cardiovascular events (i.e., coronary heart disease (CHD) and stroke), and all-cause mortality in patients with T2DM were identified, and these associations were extracted and converted into hazard ratio (HR) of cardiovascular events per 59μmol/l SUA increase. Meta-analysis was conducted to synthesize the associations between SUA level and risk of cardiovascular events, using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2, and the meta-analysis was performed using Stata 12.0. This study was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline.

Results: 6 (n=11,750 patients), 4 (n=3034 patients) and 2 studies (n=7792 patients) were identified reporting associations between SUA level and all-cause mortality, CHD and stroke respectively. HR for all-cause mortality, CHD, and stroke per 59 μmol/l increase was 1.150 (95% CI: 1.134, 1.165), 1.002 (95% CI: 0.983, 1.021) and 1.177 (95% CI: 1.070, 1.284), respectively. Heterogeneity bias was found in the analyses.

Conclusion: Overall, SUA were associated with higher risk of all-cause mortality and stroke. However, we found no significant association between SUA level and CHD among T2DM population.


Y. Shao: None. H. Shao: None. L. Shi: None.

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