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, body mass index (BMI), HbA1c, estimated glomerular filtration rate (eGFR) and metformin use. Results Out of 25 526 individuals with prediabetes, 1,521 met the SU cohort requirements, contributing to 6,832 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：

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糖尿病前期血清尿酸盐的纵向分析


目的 尽管糖尿病前期和高尿酸血症之间存在明确的关联，但对糖尿病前期血清尿酸 (SU) 趋势的了解仍然有限。因此，我们的目的是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 年）的电子健康记录来识别糖尿病前期个体，其定义为初始糖化血红蛋白 (HbA1c) 水平在 5.7% 至 6.4% 之间。在糖尿病前期诊断之前和之后，我们至少需要进行一项 SU 测试。主要结果是随访期间的纵向 SU 趋势，通过多变量混合效应模型进行估计。患者在糖尿病发作时接受检查。估计了协变量对 SU 变化的边际影响。随后的分析检查了按年龄、性别、体重指数 (BMI)、HbA1c、估计肾小球滤过率 (eGFR) 和二甲双胍使用情况分层的亚组中 SU 的变化。结果 在 25,526 名糖尿病前期患者中，1,521 人符合 SU 队列要求，贡献了 6,832 个 SU 观察结果。基线时，中位年龄为 63 岁，其中 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 水平增加的显着预测因素。与 BMI 值较低的个体相比，BMI ≥30 kg/m2 的个体表现出更高的 SU 水平。结论 在糖尿病前期患者中，几个基线变量是 SU 水平随时间增加的显着预测因素。 SU 的这些纵向趋势支持在糖尿病前期阶段进行早期干预的潜力，可能降低痛风的风险。