Serum Uric Acid Is Associated with Insulin Resistance in Non-Diabetic Subjects

Background: Glucose metabolism disorders are major contributors to morbidity and mortality. Elevated serum uric acid (SUA) is closely linked to the cardiometabolic consequences of glucose metabolism disorders, various other comorbidities, and mortality. In this study, we explore the relationship between SUA and fasting plasma glucose (FPG), insulin levels, and insulin resistance in an older Finnish adult cohort. Methods: We used data from the GOAL (GOod Ageing in Lahti region) study-a prospective, population-based study of Finnish individuals aged 52-76 years. A total of 2322 non-diabetic subjects were included in the study. Data of SUA, FPG, and other laboratory parameters, comorbidities, lifestyle habits, and socioeconomic factors were collected. Subjects with SUA values of >410 μmol/L (≈6.9 mg/dL; 75th percentile) were regarded as hyperuricemic. We investigated the relationship between SUA and FPG, insulin levels, and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.65]. Results: We found statistically significant sex-, age- and BMI-adjusted small to moderate relationships (Cohen's standard for β values above 0.10 and 0.30, respectively) between SUA and FPG, insulin levels, and insulin resistance in the whole study population as well as in the female and male subgroups. The higher the SUA level, the higher the HOMA-IR [(adjusted β = 0.21 (95% CI: 0.17 to 0.25)], and it rises drastically if SUA is above 400 μmol/L (≈6.7 mg/dL). The probability of a subject having insulin resistance is related to SUA level. Conclusions: Hyperuricemia is associated with elevated FPG and insulin resistance, emphasizing the importance of addressing both conditions. Further research may explore hyperuricemia treatment's role in preventing glucose metabolism disorders and their cardiometabolic consequences.