Download PDF
Horm Metab Res 2017; 49(05): 338-342
DOI: 10.1055/s-0042-117010
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

An Increase in Normal SUA Level Within the Normal Range Predicts Risk of Metabolic Syndrome, Especially in Women: A Cross-Sectional Study

Qian Li   *
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
,
Jing Lu   *
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
2   Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
,
Xi Cao
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
2   Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
,
Ting-Ting Shi
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
,
Jian-Ping Feng
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
,
Jin-Kui Yang
1   Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
2   Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
› Author Affiliations
Further Information

Publication History

received  21 January 2016

accepted 31 August 2016

Publication Date:
28 March 2017 (online)

Also available at
    Permissions and Reprints

Abstract

This study was aimed to evaluate the relationship between normal serum uric acid (SUA) level and metabolic syndrome (MetS) risk. This cross-sectional study involved 1914 subjects with MetS and 3 659 healthy controls aged 18–79 years. All participants filled out questionnaires and underwent physical examination and blood sample collection for biochemical examination. Demographic and clinical characteristics data were analyzed by t-test or chi-squared test. Normal SUA levels were divided into quartiles. Associations between quartiles of normal SUA level and the risk of MetS were explored using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Values of age, waist circumference, blood lipid, blood pressure, fasting plasma glucose, SUA, and body mass index were all higher in subjects with MetS than that of healthy controls significantly. The frequency of MetS increased with SUA level within the normal range. Compared with Q1, the risk of MetS was greater in the other quartiles of SUA level in men (OR, 1.495–2.288); this difference was significant for Q3 and Q4 (p<0.05), but not for Q2. Among women, the risk of MetS also increased with SUA level within the normal range, with all differences showing statistical significance (p<0.05). The area under the ROC curve of normal SUA level for MetS presence was larger for women than for men. In conclusion, the results provide support for the use of normal SUA level as a contributing clinical predictor of MetS, especially in women.

Key words

normal serum uric acid - metabolic syndrome - inflammation

* These authors contributed equally to this work.


 

  • References

  • 1 Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, Heine RJ. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study. Circulation 2005; 112: 666-673
    CrossrefPubMedGoogle Scholar
  • 2 Zhuo Q, Yang W, Chen J, Wang Y. Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol 2012; 8: 729-737
    CrossrefPubMedGoogle Scholar
  • 3 Manco M. Metabolic syndrome in childhood from impaired carbohydrate metabolism to nonalcoholic fatty liver disease. J Am Coll Nutr 2011; 30: 295-303
    CrossrefPubMedGoogle Scholar
  • 4 Blond E, Goudable J, Laville M. Nonalcoholic Fatty Liver Disease and Hyperuricemia: A Close Relation with Hepatic Insulin Resistance after Nicotinic Acid Treatment?. Horm Metab Res 2015; 47: 546-547
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Ruderman NB, Carling D, Prentki M, Cacicedo JM. AMPK, insulin resistance, and the metabolic syndrome. J Clin Invest 2013; 123: 2764-2772
    CrossrefPubMedGoogle Scholar
  • 6 Samson SL, Garber AJ. Metabolic Syndrome. Endocrinology and metabolism clinics of North America 2014; 43: 1-23
    CrossrefPubMedGoogle Scholar
  • 7 Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008; 28: 629-636
    CrossrefPubMedGoogle Scholar
  • 8 Nestel P, Lyu R, Low LP, Sheu WH, Nitiyanant W, Saito I, Tan CE. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr 2007; 16: 362-367
    PubMedGoogle Scholar
  • 9 Mankovsky B, Kurashvili R, Sadikot S. Is serum uric acid a risk factor for atherosclerotic cardiovascular disease? A review of the clinical evidence. Part 1. Diabetes Metab Syndr Clin Res Rev 2010; 4: 176-184
    CrossrefPubMedGoogle Scholar
  • 10 Durante W, Johnson FK, Johnson RA. Arginase: a critical regulator of nitric oxide synthesis and vascular function. Clin Exp Pharmacol Physiol 2007; 34: 906-911
    CrossrefPubMedGoogle Scholar
  • 11 Ninomiya JK, L’Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 2004; 109: 42-46
    CrossrefPubMedGoogle Scholar
  • 12 Zoccali C, Maio R, Mallamaci F, Sesti G, Perticone F. Uric acid and endothelial dysfunction in essential hypertension. J Am Soc Nephrol 2006; 17: 1466-1471
    CrossrefPubMedGoogle Scholar
  • 13 Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R. Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol 2008; 19: 2407-2413
    CrossrefPubMedGoogle Scholar
  • 14 Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS. Uric acid and incident kidney disease in the community. J Am Soc Nephrol 2008; 19: 1204-1211
    CrossrefPubMedGoogle Scholar
  • 15 Lu W, Xu Y, Shao X, Gao F, Li Y, Hu J, Zuo Z, Shao X, Zhou L, Zhao Y, Cen X. Uric acid produces an inflammatory response through activation of NF-κB in the hypothalamus: implications for the pathogenesis of metabolic disorders. Sci Rep 2015; 5: 12144
    CrossrefPubMedGoogle Scholar
  • 16 Ryu S, Song J, Choi BY, Lee SJ, Kim WS, Chang Y, Kim DI, Suh BS, Sung KC. Incidence and risk factors for metabolic syndrome in Korean male workers, ages 30 to 39. Ann Epidemiol 2007; 17: 245e52
    PubMedGoogle Scholar
  • 17 Yang T, Chu CH, Bai CH, You SL, Chou YC, Chou WY, Chien KL, Hwang LC, Su TC, Tseng CH, Sun CA. Uric acid level as a risk marker for metabolic syndrome: a Chinese cohort study. Atherosclerosis 2012; 220: 525e31
    PubMedGoogle Scholar
  • 18 Gonçalves JP, Oliveira A, Severo M, Santos AC, Lopes C. Crosssectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine 2012; 41: 450e7
    PubMedGoogle Scholar
  • 19 Oda E. Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population. Heart Vessels 2014; 4: 496e503
    PubMedGoogle Scholar
  • 20 Babio N, Martínez-González MA, Estruch R, Wärnberg J, Recondo J, Ortega-Calvo M, Serra-Majem L, Corella D, Fitó M, Ros E, Becerra-Tomás N, Basora J, Salas-Salvadó J. Associations between serum uric acid concentrations and metabolic syndrome and its components in the PREDIMED study. Nutr Metab Cardiovasc Dis 2015; 25: 173e80
    PubMedGoogle Scholar
  • 21 Yadav D, Lee ES, Kim HM, Choi E, Lee EY, Lim JS, Ahn SV, Koh SB, Chung CH. Prospective study of serum uric acid levels and incident metabolic syndrome in a Korean rural cohort. Atherosclerosis 2015; 241: 271e7
    PubMedGoogle Scholar
  • 22 Liu M, He Y, Jiang B, Wu L, Yang S, Wang Y, Li X. Association between serum uricacid level and metabolic syndrome and its sex difference in a Chinese communityelderly population. Int J of Endocrinol 2014; 2014: 754678
    PubMedGoogle Scholar
  • 23 Engelgau MM, Thompson TJ, Herman WH, Boyle JP, Aubert RE, Kenny SJ, Badran A, Sous ES, Ali MA. Comparison of fasting and 2-hour glucose and HbA1c levels for diagnosing diabetes. Diagnostic criteria and performance revisited. Diabetes Care 1997; 20: 785-791
    CrossrefPubMedGoogle Scholar
  • 24 So A, Thorens B. Uric acid transport and disease. J ClinInvest 2010; 20: 1791-1799
    PubMedGoogle Scholar
  • 25 Glynn RJ, Campion EW, Silbert JE. Trends in serum uric acid levels, 1961–1980. Arthritis Rheum 1983; 26: 87-93
    CrossrefPubMedGoogle Scholar
  • 26 Bardin T. Hyperuricemia starts at 360 micromoles (6 mg/dL). Joint Bone Spine 2015; 82: 141-143
    CrossrefPubMedGoogle Scholar
  • 27 Vargas-Santos AB, Castelar-Pinheiro Gda R, Coutinho ES, Schumacher Jr HR, Singh JA, Schlesinger N. Adherence to the 2012 American College of Rheumatology (ACR) Guidelines for Management of Gout: A Survey of Brazilian Rheumatologists. PLoS One 2015; 10: e0135805
    CrossrefPubMedGoogle Scholar
  • 28 Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr. SC, Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-2752
    CrossrefPubMedGoogle Scholar
  • 29 Zhang L, Ma X, Jiang Z, Zhang K, Zhang M, Li Y, Zhao X, Xiong H. Liver enzymes and metabolic syndrome: a large-scale casecontrol study. Oncotarget 2015; 6: 26782-26788
    CrossrefPubMedGoogle Scholar
  • 30 Liu PJ, Ma F, Lou HP, Zhu YN, Chen Y. Relationship between serum uric acid levelsand metabolic syndrome in Chinese postmenopausal women. Climacteric 2014; 17: 148-154
    CrossrefPubMedGoogle Scholar
  • 31 Steckhan N, Hohmann CD, Kessler C, Dobos G, Michalsen A, Cramer H. Effects of different dietary approaches on inflammatory markers in patients with metabolic syndrome: A systematic review and meta-analysis. Nutrition 2016; 32: 338-348
    CrossrefPubMedGoogle Scholar
  • 32 di Giovine FS, Malawista SE, Thornton E, Duff GW. Urate crystals stimulate production of tumor necrosis factor alpha from human blood monocytes and synovial cells. Cytokine mRNA and protein kinetics, and cellular distribution. J Clin Invest 1991; 87: 1375-1381
    CrossrefPubMedGoogle Scholar
  • 33 Kang DH, Park SK, Lee IK, Johnson RJ. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005; 16: 3553-3562
    CrossrefPubMedGoogle Scholar
  • 34 Anker SD, Doehner W, Rauchhaus M, Sharma R, Francis D, Knosalla C, Davos CH, Cicoira M, Shamim W, Kemp M, Segal R, Osterziel KJ, Leyva F, Hetzer R, Ponikowski P, Coats AJ. Uric acid and survival in chronic heart failure: validation and application in metabolic, functional, and hemodynamic staging. Circulation 2003; 107: 1991-1997
    CrossrefPubMedGoogle Scholar
  • 35 Mene P, Punzo G. Uric acid: bystander or culprit in hypertension and progressive renal disease?. J Hypertens 2008; 26: 2085-2092
    CrossrefPubMedGoogle Scholar
  • 36 Guijarro C, Egido J. Transcription factor-kappa B (NF-kappa B) and renal disease. Kidney Int 2001; 59: 415-424
    CrossrefPubMedGoogle Scholar
  • 37 Yang Z, Xiaohua W, Lei J, Ruoyun T, Mingxia X, Weichun H, Li F, Ping W, Junwei Y. Uric acid increases fibronectin synthesis through upregulation of lysyl oxidase expression in rat renal tubular epithelial cells. Am J Physiol Renal Physiol 2010; 299: F336-F346
    CrossrefPubMedGoogle Scholar
  • 38 Zhang X, Yan SM, Zheng HL, Hu DH, Zhang YT, Guan QH, Ding QL. A mechanism underlying hypertensive occurrence in the metabolic syndrome: cooperative effect of oxidative stress and calcium accumulation in vascular smooth muscle cells. Horm Metab Res 2014; 46: 126-132
    Article in Thieme ConnectPubMedGoogle Scholar
  • 39 Giovannoni SJ, DeLong EF, Oslen GJ, Pace NR. Phylogenetic group-specific oligodeoxynucleotide probes for identification of single microbial cells. J Bacteriol 1988; 170: 2418
    PubMedGoogle Scholar