Uric acid and future complications in young individuals with type 1 diabetes: results from the Diabetes Incidence Study in Sweden (DISS) and the National Diabetes Registry of Sweden (NDR).

AIMS/HYPOTHESIS: The aim of this work was to investigate whether baseline uric acid (UA) is associated with future complications among young individuals with newly diagnosed type 1 diabetes. METHODS: UA levels were analysed in individuals, aged 15-34 years with newly diagnosed type 1 diabetes, from the nationwide Diabetes Incidence Study in Sweden (DISS) cohort to assess the relationship with macro- and microvascular complications later in life. Information on complications was obtained by record linkage to the National Diabetes Registry of Sweden and the National Patient Registry of Sweden. Individuals who developed complications during follow-up (n = 94) were matched for year and age at diagnosis (±2 years), sex and HbA1c with control individuals (n = 94) without complications. RESULTS: Plasma UA levels at the time of diabetes diagnosis were significantly higher in individuals who later developed diabetes-related complications compared with those who did not, after a median follow-up of 19.0 years (IQR 16.3-21.0): 209.2 ± 68.9 vs 171.7 ± 50.2 µmol/l (p<0.001). The odds of developing complications were 1% higher for every 1 μmol/l rise in baseline UA, and individuals within the highest quartile of UA were more than three times more likely to develop diabetes-related complications later in life after adjusting for age, HbA1c, smoking and eGFR. CONCLUSIONS/INTERPRETATION: This study indicates that higher baseline UA levels at the time of type 1 diabetes diagnosis may be linked to both macrovascular and microvascular complications later in life.