Cardiovascular disease has been suggested to be asso-
ciated with increased serum uric acid (UA) level1–3
and an increased number of the components that
contribute to metabolic syndrome.4There is also an
established link between serum levels of UA and indi-
vidual risk factors such as hypertension5or dyslipi-
demia6,7that increase cardiovascular risk. However,
the association between an increasing number of meta-
bolic components and serum UA has not been well
studied except for 2 previous studies in the West.4,8
We sought to determine the association between serum
UA and the number of risk factors that contribute to
the metabolic syndrome, and which factor is associ-
ated most with higher serum UA level in a cohort of
hospital staff in a medical center in Taiwan.
This was a cross-sectional study of a consecutive sam-
ple of 3,065 staff who underwent health examination
between January 2004 and December 2004 at a med-
ical center in Taiwan. Blood tests and all physical vari-
ables were examined at nearly the same time. Blood
J Chin Med Assoc • November 2006 • Vol 69 • No 11
© 2006 Elsevier. All rights reserved.
Association Between Serum Uric Acid Level and
Components of the Metabolic Syndrome
Shi-Dou Lin, Dong-Hwa Tsai*, Shang-Ren Hsu
Division of Endocrinology and Metabolism, Department of Internal Medicine,
Changhua Christian Hospital, Changhua, Taiwan, R.O.C.
Background: Serum uric acid (UA) level has been suggested to be associated with factors that contribute to the meta-
bolic 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.
Methods: 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 ≥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.
Results: 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 9.4µmol/L, respectively (p≤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.
Conclusion: 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. [J Chin Med Assoc 2006;69(11):512–516]
Key Words: cardiovascular disease, metabolic syndrome, uric acid
*Correspondence to: Dr Dong-Hwa Tsai, Division of Endocrinology and Metabolism, Department of Internal
Medicine, Changhua Christian Hospital, 135, Nan-Shiao Street, Changhua 500, Taiwan, R.O.C.
● Received: February 10, 2006
● Accepted: September 22, 2006