Objectives Despite the well-established association between prediabetes and hyperuricaemia, knowledge about serum urate (SU) trends during the prediabetic phase is limited. Therefore, we aimed to assess the longitudinal changes of SU in individuals with prediabetes. Methods Individuals with prediabetes, defined by initial haemoglobin A1c (HbA1c) levels between 5.7% and 6.4%, were identified using electronic health records from an academic health system (2007–2022). We required at least one SU test before and after the prediabetes diagnosis. The primary outcome was the longitudinal SU trends during the follow-up period, estimated with a multivariable mixed-effects model. Patients were censored at diabetes onset. Marginal effects of covariates on SU changes were estimated. Subsequent analyses examined SU variations in subgroups stratified by age, sex, BMI, HbA1c, estimated glomerular filtration rate and metformin use. Results Out of 25 526 individuals with prediabetes, 1521 met the SU cohort requirements, contributing to 6832 SU observations. At baseline, median age was 63 years and 40% were female. Median values were SU 6.3 mg/dl, HbA1c 5.9% and BMI 30 kg/m2. Median follow-up was 7.4 years. Older age, male sex, greater BMI and higher HbA1c were significant predictors of increased longitudinal SU levels. Individuals with a BMI ≥30 kg/m2 exhibited higher SU levels compared with those with lower BMI values. Conclusion Among individuals with prediabetes, several baseline variables were significant predictors of increased SU levels over time. These longitudinal trends in SU, support the potential for early intervention during the prediabetic phase, possibly reducing the risk of gout.

中文翻译：

---

糖尿病前期血清尿酸盐的纵向分析


目标 尽管糖尿病前期和高尿酸血症之间存在公认的关联，但对糖尿病前期血清尿酸盐 （SU） 趋势的了解有限。因此，我们旨在评估糖尿病前期个体 SU 的纵向变化。方法使用学术卫生系统 （2007-2022） 的电子健康记录确定糖尿病前期个体，定义为初始血红蛋白 A1c （HbA1c） 水平在 5.7% 至 6.4% 之间。我们要求在糖尿病前期诊断前后至少进行一次 SU 测试。主要结局是随访期间的纵向 SU 趋势，使用多变量混合效应模型估计。患者在糖尿病发作时被审查。估计协变量对 SU 变化的边际效应。随后的分析检查了按年龄、性别、BMI、HbA1c 、估计肾小球滤过率和二甲双胍使用分层的亚组中的 SU 变化。结果 在 25 526 名糖尿病前期患者中，1521 名符合 SU 队列要求，共计 6832 例 SU 观察。基线时，中位年龄为 63 岁，40% 为女性。中位值为 SU 6.3 mg/dl，HbA1c 5.9% 和 BMI 30 kg/m2。中位随访时间为 7.4 年。年龄较大、男性、BMI 较高和 HbA1c 较高是纵向 SU 水平升高的重要预测因子。与 BMI 值较低的个体相比，BMI ≥30 kg/m2 的个体表现出较高的 SU 水平。结论 在糖尿病前期个体中，几个基线变量是 SU 水平随时间增加的重要预测因子。SU 的这些纵向趋势支持在糖尿病前期进行早期干预的潜力，可能降低痛风的风险。