A Mendelian randomization study of circulating uric acid and type 2 diabetes

Ivonne Sluijs*, Michael V. Holmes, Yvonne T. Van Der Schouw, Joline W.J. Beulens, Folkert W. Asselbergs, José María Huerta, Tom M. Palmer, Larraitz Arriola, Beverley Balkau, Aurelio Barricarte, Heiner Boeing, Françoise Clavel-Chapelon, Guy Fagherazzi, Paul W. Franks, Diana Gavrila, Rudolf Kaaks, Kay Tee Khaw, Tilman Kühn, Esther Molina-Montes, Lotte Maxild MortensenPeter M. Nilsson, Kim Overvad, Domenico Palli, Salvatore Panico, J. Ramón Quirós, Olov Rolandsson, Carlotta Sacerdote, Núria Sala, Julie A. Schmidt, Robert A. Scott, Sabina Sieri, Nadia Slimani, Annemieke M.W. Spijkerman, Anne Tjonneland, Ruth C. Travis, Rosario Tumino, L. A. Van Der Daphne, Stephen J. Sharp, Nita G. Forouhi, Claudia Langenberg, Elio Riboli, Nicholas J. Wareham

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

We aimed to investigate the causal effect of circulating uric acid concentrations on type 2 diabetes risk. A Mendelian randomization study was performed using a genetic score with 24 uric acid-associated loci. We used data of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, comprising 24,265 individuals of European ancestry from eight European countries. During a mean (SD) follow-up of 10 (4) years, 10,576 verified incident case subjects with type 2 diabetes were ascertained. Higher uric acid was associated with a higher diabetes risk after adjustment for confounders, with a hazard ratio (HR) of 1.20 (95% CI 1.11, 1.30) per 59.48 mmol/L (1 mg/dL) uric acid. The genetic score raised uric acid by 17 |xmol/L (95% CI15,18) per SD increase and explained 4% of uric acid variation. By using the genetic score to estimate the unconfounded effect, we found that a 59.48 n-mol/L higher uric acid concentration did not have a causal effect on diabetes (HR 1.01 [95% CI 0.87, 1.16]). Including data from the Diabetes Genetics Replication And Metaanalysis (DIAGRAM) consortium, increasing our dataset to 41,508 case subjects with diabetes, the summary odds ratio estimate was 0.99 (95% CI 0.92,1.06). In conclusion, our study does not support a causal effect of circulating uric acid on diabetes risk. Uric acid-lowering therapies may therefore not be beneficial in reducing diabetes risk.

Original languageEnglish
Pages (from-to)3028-3036
Number of pages9
JournalDiabetes
Volume64
Issue number8
DOIs
Publication statusPublished - Aug 2015

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