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Objective  To explore whether cumulative serum urate (cumSU) is correlated with diabetes type II mellitus incidence.    Methods  In this study, we recruited individuals participating in all Kailuan health examinations from 2006 to 2013 without stroke, cancer, gestation, myocardial infarction, and diabetes type II diagnosis in the first three examinations. CumSU was calculated by multiplying the average serum urate concentration and the time between the two examinations (umol/L × year). CumSU levels were categorized into five groups:  Q  1 – Q  5 . The effect of cumSU on diabetes type II incidence was estimated by logistic regression.    Results  A total of 36,277 individuals (27,077 men and 9200 women) participated in the final analysis. The multivariate logistic regression model showed the odds ratios (95% confidence intervals) of diabetes type II from  Q  1  to  Q  5  were 1.00 (reference), 1.25 (1.00 to 1.56), 1.43 (1.15 to 1.79), 1.49 (1.18 to 1.87), and 1.80 (1.40 to 2.32), respectively. Multivariable odds ratios per 1-standard deviation increase in cumSU were 1.26 (1.17 to 1.37) in all populations, 1.20 (1.10 to 1.32) for men, and 1.52 (1.27 to 1.81) for women, respectively.    Conclusions  CumSU is a significant risk factor for diabetes type II. Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II independent of other known risk factors.Key Points  • Cumulative exposure to serum urate is a significant risk factor for diabetes type II.  • Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II.

Association between cumulative serum urate and development of diabetes type II: the Kailuan Study