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Mini-report on the association between serum uric acid and incident metabolic syndrome

Eiji Oda

Medical Check-up Center, Tachikawa General Hospital, Asahioka 1-24, Nagaoka, Niigata, 940-8621 Japan

E-mail : aa

DOI: 10.15761/JIC.1000242

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Metabolic syndrome (MetS) is a constellation of interrelated metabolic risk factors that appear to directly promote the development of cardiovascular disease (CVD) and may be a systemic manifestation of adipose tissue dysfunction characterized by an increased aggregation of activated macrophages into adipose tissue induced by chronic energy overload, which is related to many other complex pathophysiological mechanisms including insulin resistance [1]. Many epidemiological studies have been reported regarding the association between serum uric acid (SUA) and CVD including MetS [2-8]. Some studies that have adjusted for multiple risk factors suggest that SUA is an independent risk factor of CVD [9-12] and increasing evidence suggests that SUA may contribute to the development of MetS. The increased SUA levels observed in MetS has been attributed to hyperinsulinemia because insulin reduces the renal excretion of SUA [13]. However, hyperuricemia often precedes the development of hyperinsulinemia [8,14]. Despite many epidemiological studies have demonstrated a cross-sectional association between SUA and MetS [15-18], longitudinal studies regarding baseline SUA as a predictor of incident MetS are limited [19-21]. The author reported that baseline SUA is an independent predictor of incident MetS in a Japanese health screening population [22].

The multivariable adjusted hazard ratios (HRs) of incident MetS through three years were calculated for each 1 SD increase in baseline SUA, for the higher quartiles of baseline SUA compared with the lowest quartile, and for baseline hyperuricemia defined as ≥ 7.0 mg/dL for men and ≥ 6.0 mg/dL for women in apparently healthy 1,606 men aged 51.7 ± 9.4 years and 953 women aged 51.6 ± 9.4 years who visited a medical check-up center in Japan.

The HRs (95% confidence interval; p value) were 1.282 (1.097-1.499; 0.002) in men and 1.354 (1.041-1.762; 0.024) in women for 1 SD increase in baseline SUA, 2.206 (1.344-3.620; 0.002) in men and 3.110 (1.121-8.627; 0.029) in women for the highest quartile of baseline SUA compared with the lowest quartile, and 1.900 (1.376-2.622; <0.001) in men and 2.088 (1.040-4.190; 0.038) in women for baseline hyperuricemia adjusting for the pre-existing components of MetS, age, smoking, drinking, physical activity, use of antihypertensive, antihyperlipidemic, and antidiabetic medications and histories of coronary heart disease and stroke. However, no significant association was found between longitudinal changes in SUA and incident MetS.

The above results suggested that baseline SUA is an independent predictor of incident MetS. Animal studies show that decreasing SUA levels can prevent or reverse features of MetS [23-25]. Management of hyperuricemia may be beneficial to prevent individuals from these CVD-related morbid conditions. However, there is not an enough evidence to support SUA lowering therapy for non-gout individuals with hyperuricemia [26].


  1. Oda E (2012) Metabolic syndrome: its history, mechanisms, and limitations. Acta Diabetol 49: 89-95. [Crossref]
  2. Lehto S, Niskanen L, Rönnemaa T, Laakso M (1998) Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke 29: 635-639. [Crossref]
  3. Tuttle KR, Short RA, Johnson RJ (2001) Sex differences in uric acid and risk factors for coronary artery disease. Am J Cardiol 87: 1411-1414. [Crossref]
  4. Feig DI, Johnson RJ (2003) Hyperuricemia in childhood primary hypertension. Hypertension 42: 247-252. [Crossref]
  5. Siu YP, Leung KT, Tong MK, Kwan TH (2006) Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis 47: 51-59. [Crossref]
  6. Talaat KM, el-Sheikh AR (2007) The effect of mild hyperuricemia on urinary transforming growth factor beta and the progression of chronic kidney disease. Am J Nephrol 27: 435-440. [Crossref]
  7. Ford ES, Li C, Cook S, Choi HK (2007) Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation 115: 2526-2532. [Crossref]
  8. Nakagawa T, Tuttle KR, Short RA, Johnson RJ (2005) Fructose-induced hyperuricemia as a casual mechanism for the epidemic of the metabolic syndrome. Nat Clin Pract Nephrol 1: 80-86. [Crossref]
  9. Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, et al. (2004) Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 164: 1546-1551. [Crossref]
  10. Fang J, Alderman MH (2000) Serum uric acid and cardiovascular mortality: the NHANES I epidemiologic follow-up study, 1971-1992. JAMA 283: 2404-2410. [Crossref]
  11. Alderman MH, Cohen H, Madhavan S, Kivlighn S (1999) Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension 34: 144-150. [Crossref]
  12. Niskanen L, Laaksonen DE, Lindström J, Eriksson JG, Keinänen-Kiukaanniemi S, et al. (2006) Serum uric acid as a harbinger of metabolic outcome in subjects with impaired glucose tolerance: the Finnish Diabetes Prevention Study. Diabetes Care 29: 709-711. [Crossref]
  13. Quiñones Galvan A, Natali A, Baldi S, Frascerra S, Sanna G, et al. (1995) Effect of insulin on uric acid excretion in humans. Am J Physiol 268: E1-E5. [Crossref]
  14. Carnethon MR, Fortmann SP, Palaniappan L, Duncan BB, Schmidt MI, et al. (2003) Risk factors for progression to incident hyperinsulinemia: the Atherosclerosis Risk in Communities Study, 1987–1998. Am J Epidemiol 158: 1058-1067. [Crossref]
  15. Onat A, Uyarel H, Hergenç G, Karabulut A, Albayrak S, et al. (2006) Serum uric acid is a determinant of metabolic syndrome in a population-based study. Am J Hypertens 19:1055-1062. [Crossref]
  16. Lohsoonthorn V, Dhanamun B, Williams MA (2006) Prevalence of hyperuricemia and its relationship with metabolic syndrome in Thai adults receiving annual health exams. Arch Med Res 37: 883-889. [Crossref]
  17. Choi HK, Ford ES (2007) Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 120: 442-447. [Crossref]
  18. Liu PW, Chang TY, Chen JD (2010) Serum uric acid and metabolic syndrome in Taiwanese adults. Metabolism 59: 802-807. [Crossref]
  19. Ryu S, Song J, Choi BY, Lee SJ, Kim WS, et al. (2007) Incidence and risk factors for metabolic syndrome in Korean male workers, ages 30 to 39. Ann Epidemiol 17: 245-252. [Crossref]
  20. Sui X, Church TS, Meriwether RA, Lobelo F, Blair SN (2008) Uric acid and the development of metabolic syndrome in women and men. Metabolism 57: 845-852. [Crossref]
  21. Gonçalves JP, Oliveira A, Severo M, Santos AC, Lopes C (2012) Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine 41: 450-457. [Crossref]
  22. Oda E (2014) Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population. Heart Vessels 29: 496-503. [Crossref]
  23. Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, et al. (2006) A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 290: F625-F631. [Crossref]
  24. Sánchez-Lozada LG, Tapia E, Bautista-García P, Soto V, Avila-Casado C, et al. (2008) Effects of febuxostat on metabolic and renal alterations in rats with fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 294: F710-F718. [Crossref]
  25. Reungjui S, Roncal CA, Mu W, Srinivas TR, Sirivongs D, et al. (2007) Thiazide diuretics exacerbate fructose-induced metabolic syndrome. J Am Soc Nephrol 18: 2724-2731. [Crossref]
  26. 2021 Copyright OAT. All rights reserv
  27. Oda E (2017) Uric acid lowering therapy for prevention of cardiovascular disease requires further evidence to be validated. J Lab Precis Med 2: 66.

Editorial Information


Massimo Fioranelli
Guglielmo Marconi University

Article Type

Mini Report

Publication history

Received date: March 15, 2018
Accepted date: March 25, 2018
Published date: March 30, 2018


©2018 Oda E. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Oda E (2018) Mini-report on the association between serum uric acid and incident metabolic syndrome. J Integr Cardiol 4: DOI: 10.15761/JIC.1000242

Corresponding author

Eiji Oda

Medical Check-up Center, Tachikawa General Hospital, Asahioka 1-24, Nagaoka, Niigata, 940-8621 Japan

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