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Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population

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Abstract

Serum levels of uric acid (UA) are associated with metabolic syndrome (MetS). However, no study has been aimed to investigate whether baseline UA is a predictor of MetS in a Japanese population. The multivariable adjusted hazard ratios (HRs) of MetS through 3 years were calculated for each 1 SD increase in baseline UA, for the higher quartiles of baseline UA 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 UA, 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 UA 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 UA and incident MetS. Baseline UA is an independent predictor of MetS in a Japanese health screening population.

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References

  1. Davis N (1897) The cardiovascular and renal relations and manifestations of gout. JAMA 29:261–262

    Article  Google Scholar 

  2. Gertler MM, Garn SM, Levine SA (1951) Serum uric acid in relation to age and physique in health and in coronary heart disease. Ann Intern Med 34:1421–1431

    Article  CAS  PubMed  Google Scholar 

  3. Cannon PJ, Stason WB, Demartini FE, Sommers SC, Laragh JH (1966) Hyperuricemia in primary and renal hypertension. N Engl J Med 275:457–464

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  CAS  PubMed  Google Scholar 

  5. 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

    Article  CAS  PubMed  Google Scholar 

  6. Feig DI, Johnson RJ (2003) Hyperuricemia in childhood primary hypertension. Hypertension 42:247–252

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. 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

    Article  CAS  PubMed  Google Scholar 

  8. 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

    Article  CAS  PubMed  Google Scholar 

  9. 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

    Article  CAS  PubMed  Google Scholar 

  10. 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

    Article  CAS  PubMed  Google Scholar 

  11. Culleton BF, Larson MG, Kannel WB, Levy D (1999) Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 131:7–13

    Article  CAS  PubMed  Google Scholar 

  12. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ, National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2572

    Article  CAS  PubMed  Google Scholar 

  13. Pearson TA, Blair SN, Daniels SR, Eckel RH, Fair JM, Fortmann SP, Franklin BA, Goldstein LB, Greenland P, Grundy SM, Hong Y, Miller NH, Lauer RM, Ockene IS, Sacco RL, Sallis JF Jr, Smith SC Jr, Stone NJ, Taubert KA (2002) AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update: consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. Circulation 106:388–391

    Article  PubMed  Google Scholar 

  14. Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, Salonen JT (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

    Article  CAS  PubMed  Google Scholar 

  15. Fang J, Alderman MH (2000) Serum uric acid and cardiovascular mortality: the NHANES I epidemiologic follow-up study, 1971–1992. JAMA 283:2404–2410

    Article  CAS  PubMed  Google Scholar 

  16. Alderman MH, Cohen H, Madhavan S, Kivlighn S (1999) Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension 34:144–150

    Article  CAS  PubMed  Google Scholar 

  17. Niskanen L, Laaksonen DE, Lindström J, Eriksson JG, Keinänen-Kiukaanniemi S, Ilanne-Parikka P, Aunola S, Hämäläinen H, Tuomilehto J, Uusitupa M (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

    Article  PubMed  Google Scholar 

  18. Iseki K, Ikemiya Y, Inoue T, Iseki C, Kinjo K, Takishita S (2004) Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort. Am J Kidney Dis 44:642–650

    Article  PubMed  Google Scholar 

  19. Iseki K, Oshiro S, Tozawa M, Iseki C, Ikemiya Y, Takishita S (2001) Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res 24:691–697

    Article  CAS  PubMed  Google Scholar 

  20. Tomita M, Mizuno S, Yamanaka H, Hosoda Y, Sakuma K, Matuoka Y, Odaka M, Yamaguchi M, Yosida H, Morisawa H, Murayama T (2000) Does hyperuricemia affect mortality? A prospective cohort study of Japanese male workers. J Epidemiol 10:403–409

    Article  CAS  PubMed  Google Scholar 

  21. Alper AB Jr, Chen W, Yau L, Srinivasan SR, Berenson GS, Hamm LL (2005) Childhood uric acid predicts adult blood pressure: the Bogalusa Heart Study. Hypertension 45:34–38

    Article  CAS  PubMed  Google Scholar 

  22. Forman JP, Choi H, Curhan GC (2007) Plasma uric acid level and risk for incident hypertension among men. J Am Soc Nephrol 18:287–292

    Article  CAS  PubMed  Google Scholar 

  23. Krishnan E, Kwoh CK, Schumacher HR, Kuller L (2007) Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension 49:298–303

    Article  CAS  PubMed  Google Scholar 

  24. Masuo K, Kawaguchi H, Mikami H, Ogihara T, Tuck ML (2003) Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Hypertension 42:474–480

    Article  CAS  PubMed  Google Scholar 

  25. Mellen PB, Bleyer AJ, Erlinger TP, Evans GW, Nieto FJ, Wagenknecht LE, Wofford MR, Herrington DM (2006) Serum uric acid predicts incident hypertension in a biethnic cohort: the Atherosclerosis Risk in Communities study. Hypertension 48:1037–1042

    Article  CAS  PubMed  Google Scholar 

  26. Nagahama K, Inoue T, Iseki K, Touma T, Kinjo K, Ohya Y, Takishita S (2004) Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertens Res 27:835–841

    Article  PubMed  Google Scholar 

  27. Nakanishi N, Okamoto M, Yoshida H, Matsuo Y, Suzuki K, Tatara K (2003) Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. Eur J Epidemiol 18:523–530

    Article  CAS  PubMed  Google Scholar 

  28. Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, Weiss ST, Litonjua AA (2006) Uric acid and the development of hypertension: the Normative Aging Study. Hypertension 48:1031–1036

    Article  CAS  PubMed  Google Scholar 

  29. Sundström J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS (2005) Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 45:28–33

    Article  PubMed  Google Scholar 

  30. Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K (2001) Serum uric acid and the risk for hypertension and Type 2 diabetes in Japanese men: the Osaka Health Survey. J Hypertens 19:1209–1215

    Article  CAS  PubMed  Google Scholar 

  31. Dehghan A, van Hoek M, Sijbrands EJ, Hofman A, Witteman JC (2008) High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 31:361–362

    Article  CAS  PubMed  Google Scholar 

  32. Quiñones Galvan A, Natali A, Baldi S, Frascerra S, Sanna G, Ciociaro D, Ferrannini E (1995) Effect of insulin on uric acid excretion in humans. Am J Physiol 268:E1–E5

    PubMed  Google Scholar 

  33. Carnethon MR, Fortmann SP, Palaniappan L, Duncan BB, Schmidt MI, Chambless LE (2003) Risk factors for progression to incident hyperinsulinemia: the Atherosclerosis Risk in Communities Study, 1987–1998. Am J Epidemiol 158:1058–1067

    Article  PubMed  Google Scholar 

  34. Chien KL, Chen MF, Hsu HC, Chang WT, Su TC, Lee YT, Hu FB (2008) Plasma uric acid and the risk of type 2 diabetes in a Chinese community. Clin Chem 54:310–316

    Article  CAS  PubMed  Google Scholar 

  35. Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, Ouyang X, Feig DI, Block ER, Herrera-Acosta J, Patel JM, Johnson RJ (2006) A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 290:F625–F631

    Article  CAS  PubMed  Google Scholar 

  36. Sánchez-Lozada LG, Tapia E, Bautista-García P, Soto V, Avila-Casado C, Vega-Campos IP, Nakagawa T, Zhao L, Franco M, Johnson RJ (2008) Effects of febuxostat on metabolic and renal alterations in rats with fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 294:F710–F718

    Article  PubMed  Google Scholar 

  37. Reungjui S, Roncal CA, Mu W, Srinivas TR, Sirivongs D, Johnson RJ, Nakagawa T (2007) Thiazide diuretics exacerbate fructose-induced metabolic syndrome. J Am Soc Nephrol 18:2724–2731

    Article  CAS  PubMed  Google Scholar 

  38. Onat A, Uyarel H, Hergenç G, Karabulut A, Albayrak S, Sari I, Yazici M, Keleş I (2006) Serum uric acid is a determinant of metabolic syndrome in a population-based study. Am J Hypertens 19:1055–1062

    Article  CAS  PubMed  Google Scholar 

  39. 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

    Article  CAS  PubMed  Google Scholar 

  40. Choi HK, Ford ES (2007) Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 120:442–447

    Article  PubMed  Google Scholar 

  41. Liu PW, Chang TY, Chen JD (2010) Serum uric acid and metabolic syndrome in Taiwanese adults. Metabolism 59:802–807

    Article  CAS  PubMed  Google Scholar 

  42. Ryu S, Song J, Choi BY, Lee SJ, Kim WS, Chang Y, Kim DI, Suh BS, Sung KC (2007) Incidence and risk factors for metabolic syndrome in Korean male workers, ages 30–39. Ann Epidemiol 17:245–252

    Article  PubMed  Google Scholar 

  43. 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

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  44. 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

    Article  PubMed  Google Scholar 

  45. Yang T, Chu CH, Bai CH, You SL, Chou YC, Chou WY, Chien KL, Hwang LC, Su TC, Tseng CH, Sun CA (2012) Uric acid level as a risk marker for metabolic syndrome: a Chinese cohort study. Atherosclerosis 220:525–531

    Article  CAS  PubMed  Google Scholar 

  46. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: a statement for health care professionals: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752

    Article  PubMed  Google Scholar 

  47. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr, International Diabetes Federation Task Force on Epidemiology and Prevention, National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, International Association for the Study of Obesity (2009) Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645

    Article  CAS  PubMed  Google Scholar 

  48. Alberti KGMM, Zimmet P, Shaw J (2006) Metabolic syndrome—a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 223:469–480

    Article  Google Scholar 

  49. Oda E (2012) Metabolic syndrome: its history, mechanisms, and limitations. Acta Diabetol 49:89–95

    Article  CAS  PubMed  Google Scholar 

  50. Choi HK, Ford ES (2007) Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 120:442–447

    Article  PubMed  Google Scholar 

  51. Saito T, Mochizuki T, Uchida K, Tsuchiya K, Nitta K (2012) Metabolic syndrome and risk of progression of chronic kidney disease: a single-center cohort study in Japan. Heart Vessels. doi:10.1007/s00380-012-0254-5

    Google Scholar 

  52. Nishino M, Mori N, Yoshimura T, Nakamura D, Lee Y, Taniike M, Makino N, Kato H, Egami Y, Shutta R, Tanouchi J, Yamada Y (2013) Higher serum uric acid and lipoprotein(a) are correlated with coronary spasm. Heart Vessels. doi:10.1007/s00380-013-0346-x

    Google Scholar 

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Acknowledgments

The author thanks all subjects who participated in the study, the paramedical staff at our center who assisted with the study, and Honorary Prof. Yoshifusa Aizawa at Tachikawa Medical Center for his instructive comments. The author received no financial support for this study and has no conflict of interest to disclose.

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  1. Medical Check-up Center, Tachikawa Medical Center, Nagachou 2-2-16, Nagaoka, Niigata, 940-0053, Japan

    Eiji Oda

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Oda, E. Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population. Heart Vessels 29, 496–503 (2014). https://doi.org/10.1007/s00380-013-0386-2

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