Association Between Serum Uric Acid Level and Components of the Metabolic Syndrome

Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Journal of the Chinese Medical Association (Impact Factor: 0.85). 11/2006; 69(11):512-6. DOI: 10.1016/S1726-4901(09)70320-X
Source: PubMed


Serum uric acid (UA) level has been suggested to be associated with factors that contribute to the metabolic syndrome. However, the association between metabolic syndrome and UA has not been elucidated. We sought to determine the association between serum UA level and the number of components that contribute to the metabolic syndrome, and which component was associated most with higher serum UA level.
A consecutive sample was taken of the health examinations of all hospital staff who were assessed between January 2004 and December 2004 in a medical center. A total of 3,065 subjects aged 18 to 81 years (635 males, 2,430 females) participated. Blood tests and all physical variables were examined using standard methods. Subjects were divided into 5 groups according to their possession of 0, 1, 2, 3 or > or = 4 components of the metabolic syndrome. The differences in all variables between groups were analyzed by ANOVA. The relationship between serum UA level and the number of metabolic components was determined by linear regression analysis. The contribution to elevated UA of possessing different risk factors was determined by a multivariate linear regression model.
Mean serum UA level increased as the number of metabolic factors increased. Serum UA level was higher in subjects with abnormal triglyceride (TG), waist circumference, high-density lipoprotein cholesterol (HDL-C) level and blood pressure (BP),with mean increases in UA level of 22.8, 21.4, 14.4 and 9.4 micromol/L, respectively (p < or = 0.001), compared to subjects with normal levels. After controlling for body mass index, abnormal TG, HDL-C and BP continued to account, in order of influence, for elevated UA.
Serum UA level was elevated significantly as the number of metabolic components increased. Abnormal TG had the most influence on serum UA. A prospective study is warranted to determine if the prevention or treatment of hyperuricemia affects the development of metabolic syndrome.

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    • "Some authors also suggest a relationship between elevated BMI, obesity and insulin resistance and high levels of serum uric acid (Fabbrini et al., 2014). Previous studies found significant positive correlations between uric acid levels and an increased AIP index (Lippi et al., 2010; Baliarsingh et al., 2012) and inverse relationships between uric acid and HDL-c levels (Chu et al., 2000; Lin et al., 2006; Onat et al., 2006a, 2006b). Previous studies showed increased uric acid levels in bipolar disorder (Albert et al., 2015) and lower uric acid in depression (Chaudhari et al., 2010; Wen et al., 2012). "
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    ABSTRACT: This study examines the effects of malondialdehyde (MDA) and uric acid on insulin resistance and atherogenicity in subjects with and without mood disorders, the metabolic syndrome (MetS) and tobacco use disorder (TUD). We included 314 subjects with depression and bipolar depression, with and without the MetS and TUD and computed insulin resistance using the updated homeostasis model assessment (HOMA2IR) and atherogenicity using the atherogenic index of plasma (AIP), that is log10 (triglycerides/high density lipoprotein (HDL) cholesterol. HOMA2IR is correlated with body mass index (BMI) and uric acid levels, but not with mood disorders and TUD, while the AIP is positively associated with BMI, mood disorders, TUD, uric acid, MDA and male sex. Uric acid is positively associated with insulin and triglycerides and negatively with HDL cholesterol. MDA is positively associated with triglyceride levels. Comorbid mood disorders and TUD further increase AIP but not insulin resistance. Glucose is positively associated with increasing age, male gender and BMI. The results show that mood disorders, TUD and BMI together with elevated levels of uric acid and MDA independently contribute to increased atherogenic potential, while BMI and uric acid are risk factors for insulin resistance. The findings show that mood disorders and TUD are closely related to an increased atherogenic potential but not to insulin resistance or the MetS. Increased uric acid is a highly significant risk factor for insulin resistance and increased atherogenic potential. MDA, a marker of lipid peroxidation, further contributes to different aspects of the atherogenic potential. Mood disorders and TUD increase triglyceride levels, lower HDL cholesterol and are strongly associated with the atherogenic, but not insulin resistance, component of the MetS. Copyright © 2015. Published by Elsevier B.V.
    Journal of Affective Disorders 04/2015; 179:148-155. DOI:10.1016/j.jad.2015.03.041 · 3.38 Impact Factor
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    • "The present and other recent studies [9] [11] [13] [18] [19] add to the debate over whether hyperuricemia like hypertension , insulin resistance, abdominal obesity, and dyslipidemia might be considered an additional independent component of MS and, more specifically, whether it would be useful to include increased SUA levels in the definition of MS. Interestingly, increased SUA levels have been related to metabolically unhealthy obesity not only in adults [18] but also in youth [19], a condition less likely to be influenced by atherosclerotic and/or age related variables and therefore more informative on the pathogenetic mechanisms underlying unfavorable phenotypes. "
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    ABSTRACT: Background and aims The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensive patients with a high prevalence of diabetes. Methods and results: A total of 2,429 patients (mean age 62±11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73m2 or as the presence of microalbuminuria (albumin-to-creatinine ratio ≥2.5 mg/mmol in men and ≥3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respectively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95%CI 1.03-1.18; p=0.0060; OR 1.28, 95%CI 1.15-1.42; p <0.0001). These associations were stronger in patients without diabetes and with normal renal function. Conclusions Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensive patients under specialist care. Intervention trials are needed to investigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 08/2014; 24(8). DOI:10.1016/j.numecd.2014.01.018 · 3.32 Impact Factor
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    • "Indeed, hyperuricemia is commonly part of the cluster of metabolic and hemodynamic abnormalities including abdominal obesity , glucose intolerance, insulin resistance, dyslipidemia, and hypertension all often subsumed under the term " metabolic syndrome " [3] [4]. Not only collectively, but also individually , hypertension, obesity, dyslipidemia, hyperglycemia, and insulin resistance are positively correlated with serum levels of uric acid [5] [6] [7] [8] [9] "
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    ABSTRACT: Hyperuricemia has long been established as the major etiologic factor in gout. In recent years, a large body of evidence has accumulated that suggests that hyperuricemia may play a role in the development and pathogenesis of a number of metabolic, hemodynamic, and systemic pathologic diseases, including metabolic syndrome, hypertension, stroke, and atherosclerosis. A number of epidemiologic studies have linked hyperuricemia with each of these disorders. In some studies, therapies that lower uric acid may prevent or improve certain components of the metabolic syndrome. There is an association between uric acid and the development of systemic lupus erythematosus; the connection between other rheumatic diseases such as rheumatoid arthritis and osteoarthritis is less clear. The mechanism for the role of uric acid in disorders other than gout is not well established but recent investigations point towards systemic inflammation induced by urate, as the major pathophysiological event common to systemic diseases, including atherosclerosis.
    02/2014; 2014(5-6):852954. DOI:10.1155/2014/852954
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