A Mendelian Randomization Study of Circulating Uric Acid and Type 2 Diabetes

  • Ivonne Sluijs
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Michael V. Holmes
    Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, U.K.
  • Yvonne T. van der Schouw
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Joline W.J. Beulens
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Folkert W. Asselbergs
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • José María Huerta
    Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
  • Tom M. Palmer
    Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K.
  • Larraitz Arriola
    CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  • Beverley Balkau
    Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
  • Aurelio Barricarte
    CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  • Heiner Boeing
    German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • Françoise Clavel-Chapelon
    Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
  • Guy Fagherazzi
    Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
  • Paul W. Franks
    Lund University, Malmö, Sweden
  • Diana Gavrila
    Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
  • Rudolf Kaaks
    German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Kay Tee Khaw
    University of Cambridge, Cambridge, U.K.
  • Tilman Kühn
    German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Esther Molina-Montes
    CIBER Epidemiología y Salud Pública (CIBERESP), Spain
  • Lotte Maxild Mortensen
    Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
  • Peter M. Nilsson
    Lund University, Malmö, Sweden
  • Kim Overvad
    Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
  • Domenico Palli
    Cancer Research and Prevention Institute (ISPO), Florence, Italy
  • Salvatore Panico
    Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
  • J. Ramón Quirós
    Public Health Directorate, Asturias, Spain
  • Olov Rolandsson
    Umeå University, Umeå, Sweden
  • Carlotta Sacerdote
    Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Center for Cancer Prevention (CPO), Turin, Italy
  • Núria Sala
    Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, and Translational Research Laboratory, Catalan Institute of Oncology (IDIBELL), Barcelona, Spain
  • Julie A. Schmidt
    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, U.K.
  • Robert A. Scott
    MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Sabina Sieri
    Epidemiology and Prevention Unit, Milan, Italy
  • Nadia Slimani
    International Agency for Research on Cancer, Lyon, France
  • Annemieke M.W. Spijkerman
    National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
  • Anne Tjonneland
    Danish Cancer Society Research Center, Copenhagen, Denmark
  • Ruth C. Travis
    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, U.K.
  • Rosario Tumino
    ASP Ragusa, Ragusa, Italy
  • Daphne L. van der A
    National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
  • Stephen J. Sharp
    MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Nita G. Forouhi
    MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Claudia Langenberg
    MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Elio Riboli
    School of Public Health, Imperial College London, U.K.
  • Nicholas J. Wareham
    MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K.

抄録

<jats:p>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 µmol/L (1 mg/dL) uric acid. The genetic score raised uric acid by 17 µmol/L (95% CI 15, 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 µmol/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 Meta-analysis (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.</jats:p>

収録刊行物

  • Diabetes

    Diabetes 64 (8), 3028-3036, 2015-04-27

    American Diabetes Association

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