Background
The role of uric acid in the development of diabetic peripheral neuropathy remains unclear. This study aimed to determine the association between uric acid and peripheral neuropathy among type 2 diabetes mellitus (T2DM) patients.
Methods
We conducted a nationwide cross-sectional study based on the diabetes and hypertension study of the Medical Research Network of the Consortium of Thai Medical Schools. Adult T2DM patients from 831 public hospitals in Thailand were evaluated. The serum uric acid level was categorized into five groups based on quintiles (<4.4, 4.4–5.3, 5.3–6.2, 6.2–7.3, and >7.3 mg/dL). A multivariate logistic regression model was used to assess the independent association between serum uric acid level and peripheral neuropathy.
Results
In total, 7,511 T2DM patients with available data about serum uric acid levels were included in the analysis. The mean age of the participants was 61.7±10.9 years, and approximately 35.6% were men. The prevalence rate of peripheral neuropathy was 3.0%. Moreover, the prevalence rates of peripheral neuropathy stratified according to uric acid levels <4.4, 4.4–5.3, 5.3–6.2, 6.2–7.3, and >7.3 mg/dL were 2.5%, 2.8%, 2.4%, 2.5%, and 4.7%, respectively. A serum uric acid level ≥7.3 mg/dL was found to be associated with an increase in odds ratio (1.54; 95% confidence interval, 1.02–2.32) for peripheral neuropathy compared with a serum uric acid level <4.4 mg/dL.
Conclusion
Serum uric acid level is independently associated with peripheral neuropathy in T2DM patients, and elevated serum uric acid levels should be considered a risk factor for diabetic peripheral neuropathy in clinical practice.

Citations

• Systemic inflammatory markers and epicardial fat volume as predictors of cardiometabolic risk in type 2 diabetes
  Mehmet Cosgun, Zeliha Cosgun, Melike Elif Kalfaoglu, Gulali Aktas
  Postgraduate Medical Journal.2026; 102(1206): 342.     CrossRef
• Serum Uric Acid-to-Creatinine Ratio Is Independently Associated with Sudomotor Dysfunction in Type 2 Diabetes: A Cross-Sectional Study
  Jie Peng, Shangyan Liang, Xiaoyun Tang, Xueyan Chen, Huan Xu, Jia Liu, Wen Xu, Xing Shui, Xubin Yang
  Diabetes, Metabolic Syndrome and Obesity.2026; Volume 19: 1.     CrossRef
• The role of clinical laboratory parameters in diabetic neuropathy: correlations and recent advances
  Ruitong Guo, Pingping Lou, Min Li, Meimei Tian, Lu Gao, Huijie Ma, Yan Liu, Xinli Jiang
  Frontiers in Endocrinology.2026;[Epub]     CrossRef
• Exploring the relationship between triglyceride-glucose index and peripheral neuropathy in Nigerian patients with type 2 diabetes: a comparison with other metabolic markers
  Blessing Kenechi Myke-Mbata, Bruno Basil, Izuchukwu Nnachi Mba, Terna Gav Ambrose
  International Journal of Research in Medical Sciences.2026; 14(5): 1812.     CrossRef
• Uric acid in diabetic microvascular complications: Mechanisms and therapy
  Xin Li, Bo Huang, Yue Liu, Meng Wang, Jing-Qiu Cui
  Journal of Diabetes and its Complications.2025; 39(2): 108929.     CrossRef
• An overview of the role of serum uric acid to high-density lipoprotein cholesterol ratio in type 2 diabetes mellitus and in other inflammatory and metabolic conditions
  Gulali AKTAS
  Minerva Medica.2025;[Epub]     CrossRef
• Causality between serum uric acid and diabetic microvascular complications - a mendelian randomization study
  Hongli Wu, Xuefeng Li, Wenning Zhang, Huifang Peng, Hongwei Jiang
  Diabetology & Metabolic Syndrome.2024;[Epub]     CrossRef
• Association between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes: a systematic review and meta-analysis
  Xieyu Zhang, Xinwen Zhang, Xiaoxu Li, Xin Zhao, Guangcheng Wei, Jinjie Shi, Yue Yang, Su Fan, Jiahe Zhao, Ke Zhu, Jieyang Du, Junyi Guo, Wei Cao
  Frontiers in Endocrinology.2024;[Epub]     CrossRef
• Comparison of Serum Uric Acid-to-HDL Ratio and Triglyceride Glucose Index in Relation to Glycemic Control Among Patients with Type 2 Diabetes Mellitus
  Hafiza Farah Masood, Qurratul Ain, Hifza Noor Lodhi, Bilal Rafique Malik, Faheem Usman Sulehri, . Khushbakht, Mirza Zeeshan Sikandar, Sharoona Fatima
  Pakistan Journal of Health Sciences.2024; : 130.     CrossRef
• Serum uric acid and diabetic peripheral neuropathy: a double-edged sword
  Yong Zhuang, Huibin Huang, Xin Hu, Jinying Zhang, Qingyan Cai
  Acta Neurologica Belgica.2023; 123(3): 857.     CrossRef
• The Ratio of Serum Uric Acid to Glycosylated Haemoglobin as a Predictor of All-Mortality in Elderly Patients with Diabetic Foot Ulcers: A Longitudinal Cohort Study
  Xiuxian Huang, Licai Deng, Jianhao Huang, Jingxia Sun, Qiu Wang, Jiacheng Mo, Zhenwei Zhai, Yuechou Nong, Wensheng Lu
  Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2779.     CrossRef
• Uric acid and diabetes mellitus: an update
  Shailendra K Singh, Rina Singh, Santosh K Singh, Mir A Iquebal, Sarika Jaiswal, Pradeep K Rai
  Postgraduate Medical Journal.2023; 99(1178): 1220.     CrossRef
• Serum uric acid and risk of diabetic neuropathy: a genetic correlation and mendelian randomization study
  Youqian Zhang, Zitian Tang, Ling Tong, Yang Wang, Lin Li
  Frontiers in Endocrinology.2023;[Epub]     CrossRef
• The relation between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes in Guilan, north of Iran
  Haniye Sadat Fayazi, Maryam Yaseri, Seyyede Sahere Mortazavi, Zahra Sharifhassan, Ali-Sina Assadinia
  BMC Endocrine Disorders.2022;[Epub]     CrossRef
• Prevalence and Risk Factors for Peripheral Neuropathy in Chinese Patients With Gout
  Kaifeng Guo, Nan Liang, Mian Wu, Lihui Chen, Haibing Chen
  Frontiers in Neurology.2022;[Epub]     CrossRef
• Diabetic corneal neuropathy as a surrogate marker for diabetic peripheral neuropathy
  WeiZheng So, NatalieShi Qi Wong, HongChang Tan, MollyTzu Yu Lin, IsabelleXin Yu Lee, JodhbirS Mehta, Yu-Chi Liu
  Neural Regeneration Research.2022; 17(10): 2172.     CrossRef
• Sodium Glucose Cotransporter-2 Inhibitor Protects Against Diabetic Neuropathy and Nephropathy in Modestly Controlled Type 2 Diabetes: Follow-Up Study
  Fukashi Ishibashi, Aiko Kosaka, Mitra Tavakoli
  Frontiers in Endocrinology.2022;[Epub]     CrossRef
• The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study
  Yimeng Hu, Qinge Li, Rui Min, Yingfeng Deng, Yancheng Xu, Ling Gao
  PeerJ.2021; 9: e10691.     CrossRef