Uric acid and metabolic syndrome: Importance of hyperuricemia cut-off.
Level 4 - case-series / case-control
Cross-sectional observational study assessing biomarker associations
PubMed 39244097 · doi:10.1016/j.ijcard.2024.132527
What was done
Researchers evaluated the correlation between serum uric acid (UA), hyperuricemia (HU), insulin resistance (assessed by TG/HDL ratio), and metabolic syndrome (MS, diagnosed by NCEP-ATP-III criteria) in 473 hypertensive patients at a hypertension unit in Monza, Italy. Two hyperuricemia definitions were assessed: the classic cut-off (≥6 mg/dL for women, ≥7 mg/dL for men) and the URRAH cut-off (≥5.6 mg/dL for both sexes).
What was found
MS was present in 33.6% of patients, while HU affected 14.8% by traditional cut-offs and 35.9% by URRAH criteria. Serum UA was higher in patients with MS than without (5.7 vs 4.9 mg/dL, p < 0.0001). HU prevalence was higher in the MS group under both the classic definition (29.0% vs 7.6%, p < 0.0001) and URRAH definition (51.6% vs 28.0%, p < 0.0001). In multivariable logistic regression, each 1 mg/dL increase in UA was associated with MS (OR = 1.608, p < 0.0001), and HU was associated with MS using both the classic cut-off (OR = 5.532, p < 0.0001) and the URRAH cut-off (OR = 3.379, p < 0.0001).
Why it matters
This study provides evidence on how different hyperuricemia cut-offs relate to metabolic syndrome risk in hypertensive patients, showing that higher cut-offs yield stronger odds ratios while lower thresholds identify more individuals with both conditions.
Limits
The study is cross-sectional and single-center, precluding causal inference. The cohort was restricted to hypertensive patients, insulin resistance was estimated via TG/HDL ratio rather than gold-standard clamp measurements, and long-term cardiovascular outcomes were not evaluated.
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.