Relationship Between Serum Uric Acid Concentration and Insulin Resistance and Metabolic Syndrome

Abstract

etabolic syndrome is a cluster of metabolic abnormalities related to an increased risk of cardiovascular disease, 1 and recent research has demonstrated that adipocytokines, especially adiponectin, are associated with metabolic syndrome. 2 In terms of the evaluation and management of hypercholesterolemia (a risk factor of cardiovascular disease and a causative factor of death in more than 40% of heart-related deaths) according to the recommendations of the 2001 Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Guidelines, the risk factors for the development of metabolic syndrome are visceral obesity, hypertension, hypertriglyceridemia, a low level of high-density lipoprotein cholesterolemia, and an impaired glucose tolerance. 3 Hyperuricemia is also considered by some investigators to be a component of metabolic syndrome that reflects insulin resistance. 4,5 In several epidemiological studies, a close relationship between hyperuricemia and hypertension, heart failure and other cardiovascular diseases has been reported, [6][7][8][9] and correlations between hyperuricemia and obesity, dyslipidemia, and diabetes have also been recently reported. [10][11][12] However, studies of Asians, who differ physically from Caucasians, are relatively rare. In Korea, knowledge of the general adult population without type 2 diabetes, hypertension and other diseases is inadequate, and no study has been performed on the association between the newly defined metabolic syndrome and hyperuricemia in the Korean population. Hence, this study investigated Korean adults who had undergone health screening to assess the correlation between increased serum uric acid concentration and hypertension, insulin resistance, and other risk factors of metabolic syndrome. Methods Study PopulationThe study group comprised 53,477 individuals (34,169 males, 19,308 females), who underwent health screening at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea between January 1, 2002, and December 31, 2002. Subjects who were taking diuretics, antihypertensive or antidiabetic agents, lipid-lowering agents, hyper-or hypouricemic agents, and those with any clinical suspicion of malignancy, acute infectious disease, acute inflammatory disease or renal disease were excluded. Physical Examination and Blood Pressure (BP)Height, weight, waist -hip circumference and systolic and diastolic BP were measured. According to the Hypertension Detection and Follow-up Program protocol, 13 BP was measured using a sphygmomanometer after the subjects had rested for more than 5 min. For those with a systolic BP >140 mmHg and a diastolic BP >90 mmHg (defined as hypertension by the 2003 JNC-7 14 ) BP was measured on a further 2 occasions after resting, and average Seung Ho Ryu, MD*; Dong Geuk Keum, MD** Background Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined ...

Uric acid transport and disease

“…In a second study, the prevalence of gout in the U.K. adult population was estimated to be 1.4%, with a peak of more than 7% in men aged over 75 years old (5). This trend has also been observed in studies in developing countries in Asia (6,7). Although the studies focused on gout, it is inferred that hyperuricemia incidence has also increased over the same period.…”

Associations between serum uric acid levels and the incidence of hypertension and metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa, Japan

“…MetS is characterized by the presence of multiple common cardiovascular risk factors, such as central obesity, atherogenic dyslipidemia (hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C)) levels, hyperglycemia and elevated blood pressure (BP). Elevated SUA levels are prevalent in patients with hypertension 1,2 and MetS, [3][4][5][6][7] and these levels can be a significant predictor of the development of hypertension 3,[8][9][10] and MetS. [11][12][13][14] Although evidence has suggested that elevated SUA levels might have a role in hypertension, 15 a causal relationship has not been established.…”

Interaction between serum uric acid and triglycerides in relation to blood pressure

“…In clinical and epidemiological studies, SUA has been found to be positively related not only to the risk of hypertension [1][2][3] but also to the risk of atherosclerosis, 4 cardiovascular diseases (CVDs) 5 and metabolic syndrome. 6 To prevent the incidence of hypertension effectively, it has become increasingly important to assign weightage to the influence of individual risk factors.…”