Objective  To explore the relationship between serum uric acid (SUA) and diabetes among residents of Zhongshan city, Guangdong province and to provide evidences for diabetes prevention and control.

  Methods  We enrolled 721 diabetic cases diagnosed in a survey on prevalence and risk factor of chronic diseases conducted during August – December 2016 among permanent adult residents ( ≥ 18 years) in 24 districts/towns across Zhongshan city of Guangdong province. The controls were 1 : 2 gender- and age ( ± 2)-matched 1 442 nondiabetic residents recruited in the districts/towns. Questionnaire interview, physical examination and laboratory test were carried among all the participants. Multivariate logistic regression model was adopted to analyze the correlation of SUA with diabetes.

  Results  The SUA was significantly higher in the cases than that in the controls (376.80 ± 106.10 vs. 283.40 ± 75.02 μmol/L, t = – 23.64; P < 0.001). For all the participants, the diabetes prevalence was higher among those with higher SUA, with the prevalence of 15.02%, 18.86%, 32.40%, and 67.60% for the participants with the SUA values in the lowest, the second, the third, and the highest quartile, respectively. The results of conditional multivariate logistic regression analysis demonstrated that compared to those with the SUA in the lowest quartile, the participants with the SUA in the third and the highest quartile had significantly increased risk of diabetes (odds ratio OR = 3.101, 95% confidence interval 95% CI: 2.150 – 4.471 and OR = 16.236, 95% CI: 10.659 – 24.731) after adjusting for confounding variables such as gender, age, waist circumference, hip circumference, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C).

  Conclusion  High serum uric acid may increase the risk of diabetes among community residents of Zhongshan city.