European Journal of Epidemiology

, Volume 18, Issue 6, pp 523–530 | Cite as

Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers

  • N. Nakanishi
  • M. Okamoto
  • H. Yoshida
  • Y. Matsuo
  • K. Suzuki
  • K. Tatara


We examined the association of serum uric acid (SUA) with development of hypertension (blood pressure ≥ 140/90 mmHg and/or medication for hypertension) and impaired fasting glucose (IFG) (a fasting plasma glucose level 6.1–6.9 mmol/l) or Type II (non-insulin-dependent) diabetes (a fasting plasma glucose level ≥ 7.0 mmol/l and/or medication for diabetes) over a 6-year follow-up among 2310 Japanese male office workers aged 35–59 years who did not have hypertension, IFG, Type II diabetes, or past history of cardiovascular disease at study entry. After controlling for potential predictors of hypertension and diabetes, the relative risk for hypertension compared with quintile 1 of SUA level was 1.27 [95% confidence interval (CI): 1.00–1.62] for quintile 2, 1.34 (95% CI: 1.08–1.74) for quintile 3, 1.48 (95% CI: 1.18–1.89) for quintile 4, and 1.58 (95% CI: 1.26–1.99) for quintile 5 (p for trend <0.001). The respective multivariate-adjusted relative risks for IFG or Type II diabetes compared with quintile 1 of SUA level were 1.55 (95% CI: 0.95–2.63), 1.62 (95% CI: 0.98–2.67), 1.61 (95% CI: 1.01–2.58), and 1.78 (95% CI: 1.11–2.85) (p for trend = 0.030). The association between SUA level and risk for hypertension and IFG or Type II diabetes was stronger among men with a body mass index (BMI) <24.2 kg/m2 than among men with a BMI ≥ 24.2 kg/m2, although the absolute risk was greater in more obese men. These results indicate that SUA level is closely associated with an increased risk for hypertension and IFG or Type II diabetes.

Hypertension Impaired fasting glucose Japanese men Longitudinal study Serum uric acid Type II diabetes 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia: Risks and consequences in the Normative Aging Study. Am J Med 1987; 82: 421–426.Google Scholar
  2. 2.
    Frohlich ED. Uric acid. A risk factor for coronary heart disease. JAMA 1993; 270: 378–379.Google Scholar
  3. 3.
    Freedman DS, Williamson DF, Gunter EW, Byers T. Relation of serum uric acid to mortality and ischemic heart disease. The NHANES I Epidemiologic Followup Study. Am J Epidemiol 1995; 141: 637–644.Google Scholar
  4. 4.
    Franse LV, Pahor M, Di Bari M, et al. Serum uric acid, diuretic treatment and risk of cardiovascular events in the Systolic Hypertension in the Elderly Program (SHEP). J Hypertens 2000; 18: 1149–1154.Google Scholar
  5. 5.
    Goldbourt U, Medalie JH, Herman JB, Neufeld HN. Serum uric acid: Correlation with biochemical, anthropometric, clinical and behavioral parameters in 10,000 Israeli men. J Chron Dis 1980; 33: 435–443.Google Scholar
  6. 6.
    Cook DG, Shaper AG, Thelle DS, Whitehead TP. Serum uric acid, serum glucose and diabetes: Relationships in a population study. Postgrad Med J 1986; 262: 1001–1006.Google Scholar
  7. 7.
    Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol 1988; 127: 321–336.Google Scholar
  8. 8.
    Modan M, Halkin H, Karasik A, Lusky A. Elevated serum uric acid - a facet of hyperinsulinaemia. Diabetologia 1987; 30: 713–718.Google Scholar
  9. 9.
    Heyden S, Borhani NO, Tyroler HA, et al. The relationship of weight change to changes in blood pressure, serum uric acid, cholesterol and glucose in the treatment of hypertension. J Chronic Dis 1985; 38: 281–288.Google Scholar
  10. 10.
    Nakanishi N, Yoshida H, Nakamura K, Suzuki K, Tatara K. Predictors for development of hyperuricemia: An 8-year longitudinal study in middle-aged Japanese men. Metabolism 2001; 50: 621–626.Google Scholar
  11. 11.
    Huang Z, Willett WC, Manson JE, et al. Body weight, weight change, and risk for hypertension in women. Ann Int Med 1998; 128: 81–88.Google Scholar
  12. 12.
    Brancati FL, Wang NY, Mead LA, Liang KY, Klag MJ. Body weight patterns from 20 to 49 years of age and subsequent risk for diabetes mellitus: The Johns Hopkins Precursors Study. Arch Int Med 1999; 159: 957–963.Google Scholar
  13. 13.
    Nakanishi N, Nakamura K, Suzuki K, Tatara K. Effects of weight variability on cardiovascular risk factors; a study of nonsmoking Japanese male office workers. Int J Obes Relat Metab Disord 2000; 24: 1226–1230.Google Scholar
  14. 14.
    Selby JV, Friedman GD, Quesenberry CP Jr. Precursors of essential hypertension: Pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries. Am J Epidemiol 1990; 131: 1017–1127.Google Scholar
  15. 15.
    Jossa F, Farinaro E, Panico S, et al. Serum uric acid and hypertension: The Olivetti heart-study. J Hum Hypertens 1994; 8: 677–681.Google Scholar
  16. 16.
    Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K. Serum uric acid and the risk for hypertension and Type 2 diabetes in Japanese men: The Osaka Health Survey. J Hypertens 2001; 19: 1209–1215.Google Scholar
  17. 17.
    Kirkendall WM, Feinleib M, Freis ED, Mark AL. Recommendations for human blood pressure determination by sphygmomanometers. Subcommittee of the AHA Postgraduate Education Committee. Circulation 1980; 62: 1146A–1155A.Google Scholar
  18. 18.
    Kabasakalian P, Kalliney S, Westcott A. Determination of uric acid in serum, with use of uricase and a tribromophenol-aminoantipyrine chromogen. Clin Chem 1973; 19: 522–524.Google Scholar
  19. 19.
    World Health Organization. Arterial hypertension. Report of a WHO expert committee. World Health Organ Tech Rep Ser 1978; 628: 7–56.Google Scholar
  20. 20.
    The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20: 1183–1197.Google Scholar
  21. 21.
    Matsuzawa Y, Tokunaga K, Kotani K, Keno Y, Kobayashi T, Tarui S. Simple estimation of ideal body weight from body mass index with the lowest morbidity. Diabetes Res Clin Pract 1990; Suppl 1: S159–S164.Google Scholar
  22. 22.
    Nakanishi N, Nakamura K, Suzuki K, Tatara K. Body mass index as a measure of health care for Japanese male office workers. J Occup Health 2000; 42: 14–19.Google Scholar
  23. 23.
    Messerli FH, Frohlich ED, Dreslinski GR, Suarez DH, Aristimuno GG. Serum uric acid in essential hypertension: An indicator of renal vascular involvement. Ann Intern Med 1980; 93: 817–821.Google Scholar
  24. 24.
    Vasquez-Vivar J, Santos AM, Junqueira VB, Augusto O. Peroxynitrite-mediated formation of free radicals in human plasma: EPR detection of ascorbyl, albuminthiyl and uric acid-derived free radicals. Biochem J 1996; 314: 869–876.Google Scholar
  25. 25.
    Anker SD, Leyva F, Poole-Wilson PA, Kox WJ, Stevenson JC, Coats AJ. Relation between serum uric acid and lower limb blood flow in patients with chronic heart failure. Heart 1997; 78: 39–43.Google Scholar
  26. 26.
    Leyva F, Anker S, Swan JW, et al. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J 1997; 18: 858–865.Google Scholar
  27. 27.
    Auch-Schwelk W, Katusic ZS, Vanhoutte PM. Contractions to oxygen-derived free radicals are augmented in aorta of the spontaneously hypertensive rat. Hypertension 1989; 13: 859–864.Google Scholar
  28. 28.
    Salonen JT, Salonen R, Ihanainen M, et al. Blood pressure, dietary fats, and antioxidants. Am J Clin Nutr 1988; 48: 1226–1232.Google Scholar
  29. 29.
    Quinones Galvan A, Natali A, Baldi S, Frascerra S, Sanna G, Ciociaro D, Ferrannini E. Effect of insulin on uric acid excretion in humans. Am J Physiol 1995; 268: E1–E5.Google Scholar
  30. 30.
    Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 1991; 266: 3008–3011.Google Scholar
  31. 31.
    Reaven GM. Banting Lecture: Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–1607.Google Scholar
  32. 32.
    Ward HJ. Uric acid as an independent risk factor in the treatment of hypertension. Lancet 1998; 352: 670–671.Google Scholar
  33. 33.
    Puig JG, Ruilope LM. Uric acid as a cardiovascular risk factor in arterial hypertension. J Hypertens 1999; 17: 869–872.Google Scholar
  34. 34.
    Stamler J, Rose G, Stamler R, Elliott P, Dyer A, Marmot M. INTERSALT study findings. Public health and medical care implications. Hypertension 1989; 14: 570–577.Google Scholar
  35. 35.
    Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–1124.Google Scholar
  36. 36.
    Anderson JW, Gustafson NS, Bryart CA, Tietyen-Clark J. Dietary fiber and diabetes. J Am Diet Assoc 1987; 87: 1189–1197.Google Scholar
  37. 37.
    Mayer EJ, Newman B, Quesenberry CP Jr, Selby JV. Usual dietary fat intake and insulin concentrations in healthy women twins. Diabet Care 1993; 16: 1459–1469.Google Scholar
  38. 38.
    Miller JC. Importance of glycemic index in diabetes. Am J Clin Nutr 1994; 59(Suppl 3): 747S–752S.Google Scholar
  39. 39.
    Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 1997; 277: 472–477.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • N. Nakanishi
    • 1
  • M. Okamoto
    • 1
  • H. Yoshida
    • 1
  • Y. Matsuo
    • 1
  • K. Suzuki
    • 2
  • K. Tatara
    • 1
  1. 1.Department of Social and Environmental Medicine, Course of Social MedicineOsaka University Graduate School of Medicine F2Suita-shi, OsakaJapan
  2. 2.Japan Labor and Welfare AssociationShibuya-ku, TokyoJapan

Personalised recommendations