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Serum uric acid level and the incidence of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study.

Lee JK, Ryoo JH, Choi JM, Park SK - J Prev Med Public Health (2014)

Bottom Line: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010.Cox proportional hazards models were performed.These associations were also significant in the clinically relevant subgroup analyses.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT

Objectives: Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS.

Methods: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.

Results: During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses.

Conclusions: Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.

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Related in: MedlinePlus

Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the incidence of metabolic syndrome by the serum uric acid level quartiles according to clinically relevant subgroups. HDL, high-density lipoprotein; ptrend, p for trend. 1Adjusted for total cholesterol, log(high-sensitivity C-reactive protein), homeostasis model assessment of insulin resistance, estimated using the glomerular filtration rate, number of baseline metabolic syndrome component, current smoking status, regular exercise, alcohol intake, hypertension, and diabetes mellitus.
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f1-jpmph-47-6-317: Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the incidence of metabolic syndrome by the serum uric acid level quartiles according to clinically relevant subgroups. HDL, high-density lipoprotein; ptrend, p for trend. 1Adjusted for total cholesterol, log(high-sensitivity C-reactive protein), homeostasis model assessment of insulin resistance, estimated using the glomerular filtration rate, number of baseline metabolic syndrome component, current smoking status, regular exercise, alcohol intake, hypertension, and diabetes mellitus.

Mentions: UA is the end-product of purine metabolism in humans that is generated during the metabolism of nucleotides and adenosine triphosphate by the action of xanthine oxidase [17]. Parallel to the findings of previous studies that claimed hyperuricemia might be a new component of MetS, the adjusted HRs (95% CI) for participants with only one component and two components of MetS compared to those with none at baseline were 3.43 (2.79-4.02) and 8.05 (6.57-9.87), respectively. These associations were apparent in the clinically relevant subgroup analysis of our study participants, with BP <130/85 mmHg, fasting serum glucose <100 mg/dL, triglyceride <150 mg/dL, HDL-cholesterol >40 mg/dL and waist circumference <90 cm (Figure 1). A recent review describes the possible mechanism that UA influences the development of CVD by inducing oxidative stress, endothelial dysfunction, inflammation, and vasoconstriction; they also suggest that UA may have a causal role in the development of MetS [18]. UA is a potent antioxidant in extracellular fluid but it also exerts prooxidative effects in the intracellular environment, and it has been demonstrated that serum UA is a circulating marker of oxidant damage in some metabolic disturbances [19]. Increased serum UA levels have been previously reported to be closely associated with hypertension [20-23], DM [23,24], dyslipidemia [25], and abdominal obesity [20], but the HRs of each component of MetS were comparable in the present study.


Serum uric acid level and the incidence of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study.

Lee JK, Ryoo JH, Choi JM, Park SK - J Prev Med Public Health (2014)

Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the incidence of metabolic syndrome by the serum uric acid level quartiles according to clinically relevant subgroups. HDL, high-density lipoprotein; ptrend, p for trend. 1Adjusted for total cholesterol, log(high-sensitivity C-reactive protein), homeostasis model assessment of insulin resistance, estimated using the glomerular filtration rate, number of baseline metabolic syndrome component, current smoking status, regular exercise, alcohol intake, hypertension, and diabetes mellitus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263007&req=5

f1-jpmph-47-6-317: Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the incidence of metabolic syndrome by the serum uric acid level quartiles according to clinically relevant subgroups. HDL, high-density lipoprotein; ptrend, p for trend. 1Adjusted for total cholesterol, log(high-sensitivity C-reactive protein), homeostasis model assessment of insulin resistance, estimated using the glomerular filtration rate, number of baseline metabolic syndrome component, current smoking status, regular exercise, alcohol intake, hypertension, and diabetes mellitus.
Mentions: UA is the end-product of purine metabolism in humans that is generated during the metabolism of nucleotides and adenosine triphosphate by the action of xanthine oxidase [17]. Parallel to the findings of previous studies that claimed hyperuricemia might be a new component of MetS, the adjusted HRs (95% CI) for participants with only one component and two components of MetS compared to those with none at baseline were 3.43 (2.79-4.02) and 8.05 (6.57-9.87), respectively. These associations were apparent in the clinically relevant subgroup analysis of our study participants, with BP <130/85 mmHg, fasting serum glucose <100 mg/dL, triglyceride <150 mg/dL, HDL-cholesterol >40 mg/dL and waist circumference <90 cm (Figure 1). A recent review describes the possible mechanism that UA influences the development of CVD by inducing oxidative stress, endothelial dysfunction, inflammation, and vasoconstriction; they also suggest that UA may have a causal role in the development of MetS [18]. UA is a potent antioxidant in extracellular fluid but it also exerts prooxidative effects in the intracellular environment, and it has been demonstrated that serum UA is a circulating marker of oxidant damage in some metabolic disturbances [19]. Increased serum UA levels have been previously reported to be closely associated with hypertension [20-23], DM [23,24], dyslipidemia [25], and abdominal obesity [20], but the HRs of each component of MetS were comparable in the present study.

Bottom Line: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010.Cox proportional hazards models were performed.These associations were also significant in the clinically relevant subgroup analyses.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT

Objectives: Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS.

Methods: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.

Results: During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses.

Conclusions: Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.

Show MeSH
Related in: MedlinePlus