Prevalence of the Metabolic Syndrome in Individuals with Hyperuricemia

doi:10.1016/j.amjmed.2006.06.040

The American Journal of Medicine

Volume 120, Issue 5, May 2007, Pages 442-447

https://doi.org/10.1016/j.amjmed.2006.06.040 Get rights and content

Abstract

Purpose

The link between hyperuricemia and insulin resistance has been noted, but the prevalence of the metabolic syndrome by recent definitions among individuals with hyperuricemia remains unclear. Our objective was to determine the prevalence of the metabolic syndrome according to serum uric acid levels in a nationally representative sample of US adults.

Methods

By using data from 8669 participants aged 20 years and more in The Third National Health and Nutrition Examination Survey (1988-1994), we determined the prevalence of the metabolic syndrome at different serum uric acid levels. We used both the revised and original National Cholesterol Education Program Adult Treatment Panel (NCEP/ATP) III criteria to define the metabolic syndrome.

Results

The prevalences of the metabolic syndrome according to the revised NCEP/ATP III criteria were 18.9% (95% confidence interval [CI], 16.8-21.0) for uric acid levels less than 6 mg/dL, 36.0% (95% CI, 32.5-39.6) for uric acid levels from 6 to 6.9 mg/dL, 40.8% (95% CI, 35.3-46.4) for uric acid levels from 7 to 7.9 mg/dL, 59.7% (95% CI, 53.0-66.4) for uric acid levels from 8 to 8.9 mg/dL, 62.0% (95% CI, 53.0-66.4) for uric acid levels from 9 to 9.9 mg/dL, and 70.7% for uric acid levels of 10 mg/dL or greater. The increasing trends persisted in subgroups stratified by sex, age group, alcohol intake, body mass index, hypertension, and diabetes. For example, among individuals with normal body mass index (<25 kg/m²), the prevalence increased from 5.9% (95% CI, 4.8-7.0), for a uric acid level of less than 6 mg/dL, to 59.0%, (95% CI, 20.1-97.9) for a uric acid level of 10 mg/dL or greater. With the original NCEP/ATP criteria, the corresponding prevalences were slightly lower.

Conclusions

These findings from a nationally representative sample of US adults indicate that the prevalence of the metabolic syndrome increases substantially with increasing levels of serum uric acid. Physicians should recognize the metabolic syndrome as a frequent comorbidity of hyperuricemia and treat it to prevent serious complications.

Section snippets

Study Population

Conducted between 1988 and 1994, the NHANES III included a representative sample of the non-institutionalized US civilian population, which was selected using a multistage, stratified sampling design. Persons 60 years and older and African American and Mexican American persons were oversampled. In the current study, we analyzed data for 8669 men and nonpregnant women aged at least 20 years who attended the medical examination, had fasted at least 8 hours before the blood collection, and had

Results

The mean age of the study sample was 44 years, 50% were male, 76% were white, and the mean BMI was 26.5 kg/m². The mean uric acid level was 5.42 mg/dL (95% CI, 5.37-5.46 mg/dL). There was a graded increase in the prevalence of the metabolic syndrome according to the revised NCEP/ATP III criteria among individuals with increasing levels of serum uric acid, up to 70% (95% CI, 51.4-89.9) among individuals with serum uric acid level of 10 mg/dL or greater (Table 1). Similarly, the increasing trend

Discussion

In this nationally representative sample of men and women, we found that there was a graded increase in the prevalence of the metabolic syndrome among individuals with increasing levels of hyperuricemia, up to 70% among individuals with the highest serum uric acid levels (≥10 mg/dL). This prevalence was approximately 4 times that among adults with the lowest serum uric acid levels (<6 mg/dL). The increasing prevalence of individual metabolic abnormalities with increasing levels of hyperuricemia

Conclusion

These findings from a nationally representative sample of US adults indicate that the prevalence of the metabolic syndrome increases substantially with increasing serum uric acid levels. These prevalence estimates should be reflected in an index of clinical suspicion for the concomitant presence of the metabolic syndrome. Physicians should recognize the metabolic syndrome as a frequent comorbidity of hyperuricemia and treat it to prevent serious complications.

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Clinical research studyPrevalence of the Metabolic Syndrome in Individuals with Hyperuricemia

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Study Population

Results

Discussion

Conclusion

Am J Med

Ann Epidemiol

Lancet

Lancet

Metabolism

Am J Hypertens

Metabolism

Atherosclerosis

Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement

Circulation

Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus

Circulation

Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults

Circulation

The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men

JAMA

Syndrome X and mortality: a population-based study

Am J Epidemiol

Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey

JAMA

Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence

Diabetes Care

Uric acid and coronary heart disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndromeThe Normative Aging Study

Am J Epidemiol

Hyperlipidaemia in hyperuricaemia and gout

Ann Rheum Dis

Gout, diet, and the insulin resistance syndrome

J Rheumatol

Pathogenesis of gout

Ann Intern Med

Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration

JAMA

Clinical research study
Prevalence of the Metabolic Syndrome in Individuals with Hyperuricemia