Uric acid level as a risk marker for metabolic syndrome: A Chinese cohort study

Objective: Despite some epidemiologic research demonstrating a positive relationship between serum uric acid (SUA) levels and the prevalence of metabolic syndrome (MetS), prospective data on SUA as a predictor of MetS incidence are limited. Methods: The authors examined SUA as a risk marker for incident MetS in a prospective study of 3857 subjects who were free of MetS at baseline recruitment. Hyperuricemia was defined as SUA ≥7.7. mg/dL for men and ≥6.6. mg/dL for women. The MetS was defined according to a unified criteria set by several major organizations. Results: During a mean follow-up of 5.41 years, 476 participants developed MetS. A significantly stepwise increase in the incidence of MetS across tertiles of SUA was observed in the whole group (p for trend <0.001). Among women, this association was more robust than in men. After adjustment for age, variations of blood pressure, triglycerides, HDL-C, glucose, and waist circumference, females in the middle and upper tertiles of SUA had significantly higher risk of developing MetS when compared with subjects in the lowest tertile [adjusted-HR (95% CI) was 1.67 (1.12-2.49) and 3.18 (2.20-4.60), respectively; p for trend <0.001]. Overall, hyperuricemia was a significantly independent risk determinant for MetS in women, but it was a non-significant factor for MetS mediating waist circumference and serum triglycerides in men. Conclusion: SUA concentration is more closely associated with MetS in females than in males. Future investigations are needed to explore the underlying mechanisms involved in the sex-related association between SUA concentration and MetS risk.