Serum uric acid predicts incident metabolic syndrome in the elderly in an analysis of the Brisighella Heart Study.
Level 3 - non-randomized controlled study
Prospective observational cohort follow-up study
PubMed 30068918 · doi:10.1038/s41598-018-29955-w
What was done
Researchers analyzed 923 older, healthy participants from the historical Brisighella Heart Study cohort evaluated during the 2008 and 2012 population surveys. They assessed associations between serum uric acid (SUA) concentrations and metabolic syndrome (MetS) prevalence and 4-year incidence, using receiver operating characteristic (ROC) analysis to determine predictive performance and sex-specific diagnostic cut-off values.
What was found
MetS prevalence was significantly higher with elevated SUA in both men (OR = 2.12, 95% CI: 1.55–2.90) and women (OR = 2.69, 95% CI: 1.91–3.78). For prevalent MetS, ROC AUC was 0.647 overall (95% CI: 0.609–0.686, P = 0.000001), 0.592 in men (95% CI: 0.529–0.654, P = 0.004, cut-off 5.5 mg/dL), and 0.758 in women (95% CI: 0.711–0.806, P < 0.000001, cut-off 4.2 mg/dL). Prospectively, baseline SUA predicted 4-year incident MetS in the total population (AUC = 0.604, 95% CI: 0.518–0.690, P = 0.029, cut-off 4.7 mg/dL) and in women (AUC = 0.641, 95% CI: 0.519–0.762, P = 0.039, cut-off 3.9 mg/dL), but did not reach statistical significance in men (P > 0.05).
Why it matters
This study identifies sex-specific cut-offs and indicates that elevated serum uric acid may serve as an early prospective marker for metabolic syndrome development specifically in older women.
Limits
The observational design cannot establish causality. Prospective predictive accuracy was modest (AUC ~0.60–0.64) and non-significant in men. The sample is restricted to a single regional Italian cohort, and the abstract does not report adjustment for potential confounders such as renal function, medication use, or dietary factors.
Cited by
- supports A serum uric acid level around 5.2 to 5.5 mg/dL is an inflection point above which the risk for diabetes, obesity, and kidney disease begins to rise significantly.