Association between Risk Factors of Metabolic Syndrome, Serum Uric Acid, and Urine pH in University Students

Background:Gout is the most prevalent inflammatory arthritis globally. Despite treatment advances, the prevalence of gout has continued to increase over the last several decades. There has also been increasing evidence that gout has a strong association with the metabolic syndrome. This indicates that gout is likely both an inflammatory and a metabolic disease that has a significant effect on quality of life and healthcare costs. Although current recommendations support aggressive medical therapy for gout treatment, dietary counseling is less emphasized. We hypothesize that emphasis on this nonpharmacological therapy will likely improve management and the metabolic syndrome in gout patients.Objectives:To analyze the effectiveness of dietary counseling on gout management and risk factors for metabolic syndrome in gout patients at the Veteran’s Affairs Medical Center in Long Beach, CA (VALB).Methods:A retrospective cohort study was created from 2009-2016 involving Long Beach Veterans Affairs Hospital gout patients (n= 119) based on International Classification of Disease version 9 or 10. Patients were then stratified into two cohorts: received diet counseling (n=90) and no diet counseling (n=29). Data was reviewed for 24 months following initial gout diagnosis or intervention. Management was evaluated based on frequency of flares and related ED visits, change in creatinine clearance, serum uric acid levels (sUA), and changes to risk factors for metabolic syndrome including blood pressure, body mass index (BMI), cholesterol panel and hemoglobin A1c levels at six-month intervals.Results:Although patients in both cohorts were noted to have decreased number of gout attacks, patients who received diet counseling had a significant decrease in number of gout attacks by month 12 (0=0.004). In addition, after 6 months, patients who received diet counseling were more likely to have sUA at goal (sUA<6 for nontophaeous gout and sUA<5 for tophaceous gout) (p=0.003). These patients were also noted to have improved creatinine clearance (p=0.08) and increased HDL (p =0.08). In addition, patients with improved HDL and LDL values more likely to have improved sUA levels and decreased ED visits (R2=0.4, slope 0.14 and R2=0.4, slope 0.05, respectively) by month 6. Patients with improved hemoglobin A1c levels were also noted to have a significant outcome in lowering serum uric acid level at month 18 (R2=0.9, slope 2.6).Conclusion:Gout patients who receive diet counseling had lower rate of future attacks and better control of sUA. In addition, these gout patients were also noted to have improvement in some risk factors associated with the metabolic syndrome. Notably, patients who had better control of their hemoglobin A1c levels were able to have lower serum uric acid levels. This may imply that controlling diabetes in patients may also help improve gout management. Given the serious complications and increased cardiovascular risks that can be associated with metabolic syndrome, optimization of gout through a nonpharmacologic intervention such as diet counseling can enhance clinical outcomes and optimize healthcare resources.References:[1]Rai SK et al. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;357:j1794.[2]Álvarez-lario B, et al. Hyperuricemia and gout; the role of diet. Nutr Hosp. 2014;29(4):760-70.Disclosure of Interests:None declared

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Serum uric acid is no more a by-stander for risk of cardiovascular diseases in metabolic syndrome: a prospective study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212100 ◽

2021 ◽

Vol 8 (6) ◽

pp. 788

Author(s):

Anirudh Kumar Allam ◽

Chandrakant Chavan ◽

Rahul Mandole ◽

Jagdish Hiremath ◽

Vikrant Khese

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Uric Acid ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Serum Uric Acid ◽

Serum Uric Acid Level ◽

Worldwide Population ◽

Study Population ◽

A Prospective Study

Background: Cardiovascular diseases have become the fastest growing health issue in India and worldwide. Population with metabolic syndrome is known to be pre-disposed to several chronic disorders along with higher risk of experiencing cardiovascular events. The role of uric acid as a cardiovascular risk factor in metabolic syndrome was not well studied in the literature, which made us to undertake the present study.Methods: All the patients aged between 18 to 75 years (both gender) who approached Madhavbaug cardiac care clinics located in Maharashtra, India for assessing risk of heart disease from January 2015 to January 2017 were screened. Risk factors for metabolic syndrome have been evaluated among the study population and categorised into metabolic syndrome positive (³3 risk factors) and negative groups (<3 risk factors). Statistical analysis was done using SPSS software version: 21.0.Results: Our study includes 2294 subjects who met the inclusion and exclusion criteria. Males outnumbered the females and sex ratio was 2.89:1. Females had lower serum uric acid levels compared to males irrespective of metabolic component. Gender and serum uric acid levels (high and low) were used stratification of the subjects. Serum uric acid is an independent predictor of cardiovascular diseases with an Odds ratio of 1.13 (95% confidence interval).Conclusions: Serum uric acid level is one of the important predictor for cardiovascular risk in metabolic syndrome. Raised uric acid is not an innocent by-stander and one of the major contributors in development of cardiovascular diseases.

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Uric Acid: An Overlooked, Inexpensive Biomarker of Metabolic Syndrome (P10-068-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-068-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Maribel Barragan ◽

Viridiana Luna ◽

Juan Manuel Vargas-Morales ◽

Celia Aradillas-Garcia ◽

Margarita Teran-Garcia

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Uric Acid ◽

Serum Uric Acid ◽

San Luis ◽

San Luis Potosi ◽

Mexican Adults ◽

Males And Females ◽

San Luis Potosí

Abstract Objectives Elevated serum uric acid (HUA) levels have been shown to have a positive correlation with metabolic syndrome (MetS) risk factors. In countries where rates of MetS continue to increase, such as Mexico, it is important to identify reliable and inexpensive markers that will aid in predicting the development of MetS. Our aim was to evaluate the association between serum uric acid (UA) and MetS risk factors in young Mexican adults. Risk factors include glucose (GLU), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), triglycerides (TG), high-density lipoprotein (HDL), and body mass index (BMI). Methods Mexican college applicants involved in the Universities of San Luis Potosí and Illinois: Multidisciplinary Investigation on Obesity, Genetics and Socio-environment (UP AMIGOS) cohort (ages 18–25, n = 747, 56% female) underwent a health screening following an overnight fast. Fasting blood samples, anthropometric measurements, and blood pressure were collected. According to the literature, HUA levels are defined as ≥7 and ≥6 mg/dL for males and females, respectively. T-tests were conducted to compare mean differences of MetS risk components between individuals with and without HUA levels. Analyses were conducted separately by sex. Results The mean ± SD of UA was 5.73 ± 1.32 mg/dL and 4.39 ± 1.19 mg/dL for males and females, respectively. Males and females with HUA had significantly higher TG, and WC, and lower HDL (all P < 0.001). HUA was positively correlated with WC (R2 = 0.331, SBP (R2 = 0.151), DBP (R2 = 0.176), GLU (R2 = 0.863), TG (R2 = 0.424) and BMI (R2 = 0.363). In contrast, HDL was negatively correlated with HUA (R2 = -0.277), as hypothesized. All Pearson correlations were adjusted for age and sex and statistically significant (P < 0.05). Conclusions Serum UA has a strong correlation with MetS risk factors in young Mexican adults. Routine monitoring of serum UA could be utilized as an inexpensive early predictor of MetS, which would allow for early interventions to aid in preventing cardiovascular disease and type 2 diabetes. Funding Sources This study was funded by the University of Illinois at Urbana-Champaign and the USDA National Institute of Food and Agriculture, Hath Projects to M.T.-G. Funding was also provided by the Univerdidad Autonoma de San Luis Potosí to support C.A.-G.

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Association of Serum Uric Acid with cardio-metabolic risk factors and metabolic syndrome in seafarers working on tankers

BMC Public Health ◽

10.1186/s12889-020-08466-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Fereshteh Baygi ◽

Kimmo Herttua ◽

Ali Sheidaei ◽

Alireza Ahmadvand ◽

Olaf Chresten Jensen

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Uric Acid ◽

Serum Uric Acid ◽

Metabolic Risk Factors ◽

Metabolic Risk

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The role of correction of hypogonadism in the treatment and prophylaxis of urolithiasis in the men presenting with metabolic syndrome

Problems of Endocrinology ◽

10.14341/probl201561212-20 ◽

2015 ◽

Vol 61 (2) ◽

pp. 12-20

Author(s):

D A Gusakova ◽

S Yu Kalinchenko ◽

A A Kamalov ◽

Yu A Tishova

Keyword(s):

Metabolic Syndrome ◽

Uric Acid ◽

Serum Uric Acid ◽

The Body ◽

Magnesium Concentration ◽

Urine Ph ◽

Testosterone Therapy ◽

Serum Uric Acid Concentration ◽

Group 1

Abdominal obesity is a major component of metabolic syndrome (MS) considered to be the key factor contributing to the development of testosterone deficiency (hypogonadism) in men. Bearing in mind the etiopathogenetic relationship between MS and urolithiasis (UL), the present study was undertaken for the purpose of elucidating the role of the main biochemical risk factors of metabolic syndrome in men, evaluating the influence of correction of hypogonadism on these factors, and optimization of the treatment and prevention of MS in these patients. The study included 90 men presenting with hypogonadism in whom the serum levels and renal excretion of the main lithogenic substances (uric acid, calcium, phosphates, magnesium) and urine pH were measured. At the first stage of the study, the patients were allocated to two groups. Group 1 was comprised of 52 patients with UL, group 2 consisted of 38 patients without UL. The patients of group 1 were found to suffer hyperuricemia (the serum uric acid levels 430 mcmol/l and higher). The patients of both groups exhibited hyperuricosuria (daily uric acid excretion over 4.13 mmol/24 hr) with the urine pH value of 5.5 and lower. The serum uric acid concentration was shown to positively correlate with the insulin and C-peptide levels. At the second stage of the study, 65 randomly selected patients were divided into two groups in one of which (n=40) they were given testosterone therapy. Compensation of hypogonadism in these patients was associated with a significant reduction of the serum uric acid levels and its daily excretion, an increase and normalization of urine pH, and a rise in the serum magnesium concentration, Similar significant changes of the same parameters were absent in the control subjects (n=25). Moreover, testosterone therapy improved characteristics of lipid and carbohydrate metabolism, caused reduction in the body weight, BMI, and the severity of insulin resistance.

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Abstract 3488: Hyperuricemia and the Risk of Isolated Hypertension among Young People without Cardiovascular and Metabolic Risk Factors: The CARDIA Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_790 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Eswar Krishnan ◽

Hyon K Choi ◽

Lewis H Kuller ◽

Kiang Liu

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Uric Acid ◽

Cardiovascular Risk ◽

Young People ◽

Cardiovascular Risk Factors ◽

Serum Uric Acid ◽

The Metabolic Syndrome

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far. METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up. RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49). CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.

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Is the increase of uric acid associated with the components of the metabolic syndrome?

Seminars in Cardiovascular Medicine ◽

10.2478/semcard-2020-0002 ◽

2020 ◽

Vol 26 (1) ◽

pp. 7-13

Author(s):

Vaida Sudmantaitė ◽

Jurgita Mikolaitytė ◽

Jolita Badarienė ◽

Alma Čypienė ◽

Agnė Jucevičienė ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Uric Acid ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Serum Uric Acid ◽

Serum Uric Acid Level ◽

Density Lipoprotein ◽

Cross Sectional ◽

The Metabolic Syndrome

Summary Objectives: There is increasing evidence that metabolic syndrome (MetS) may be associated with increased uric acid levels. Previous studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disorders. We sought to determine the association of serum uric acid (SUA) with MetS components and other cardiovascular risk factors among middle aged Lithuanians with MetS. Design and methods: A cross-sectional study was conducted in 2018. A total of 705 subjects aged 40 to 65 years with MetS diagnosed using NCEP ATP III criteria were included. None of the participants had previously diagnosed cardiovascular, cerebrovascular, peripheral artery or end-stage oncological disease. Blood tests and all anthropometric measurements were obtained using standard methods. Subjects were divided into 2 groups: with hyperuricaemia and without hyperuricaemia. Results: Hyperuricaemia was found in 33.3% of subjects. Mean serum uric acid level increased as the number of metabolic factors increased. Participants with hyperuricaemia had abnormal waist circumference (p < 0.001), higher systolic (p = 0.001) and diastolic blood pressure (p = 0.003), higher levels of triglycerides and, lower levels of high-density lipoprotein cholesterol (p < 0.001). Subjects in hyperuricaemia group were more likely to be alcohol users (p = 0.034), to have diabetes (p = 0.02) and higher body mass index (p < 0.001). Their creatinine levels were statistically significantly higher (p < 0.001). Conclusions: Our analysis showed that serum uric acid is associated with MetS and other cardiovascular risk factors. The study found a statistically significant association with the four out of five components of the MetS (excluding plasma glucose) as well as with alcohol consumption, and renal function indicators (creatinine, eGFR).

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Serum uric acid. Its relationship to coronary heart disease risk factors and cardiovascular disease, Evans County, Georgia

Archives of Internal Medicine ◽

10.1001/archinte.132.3.401 ◽

1973 ◽

Vol 132 (3) ◽

pp. 401-410 ◽

Cited By ~ 25

Author(s):

R. Klein

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Uric Acid ◽

Heart Disease ◽

Serum Uric Acid ◽

Coronary Heart Disease Risk ◽

Disease Risk ◽

Heart Disease Risk Factors ◽

Heart Disease Risk

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Review of the Literature Examining the Association of Serum Uric Acid with Osteoporosis and Mechanistic Insights into Its Effect on Bone Metabolism

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530318666181102115106 ◽

2019 ◽

Vol 19 (3) ◽

pp. 259-273 ◽

Cited By ~ 3

Author(s):

Neelam Kaushal ◽

Divya Vohora ◽

Rajinder K Jalali ◽

Sujeet Jha

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Uric Acid ◽

Bone Metabolism ◽

Serum Uric Acid ◽

Bone Mineral ◽

Molecular Mechanisms ◽

Association Studies ◽

Mineral Density ◽

Age Related

Background And Objective:Osteoporosis is a common bone disorder that increases susceptibility to fragility bone fractures. The clinical and public health repercussions of osteoporosis are huge due to the morbidity, mortality, and cost of medical care linked with fragility fractures. Clinical assessment of osteoporotic risk factors can help to identify candidates at an early stage that will benefit from medical intervention and potentially lowering the morbidity and mortality seen with fractures and complications. Given this, research is ongoing to evaluate the association of osteoporosis with some novel or less well-studied risk factors/bio-markers such as uric acid (UA).Discussion:Uric acid’s antioxidant activity has been proposed to be one of the factors responsible for increasing longevity and lowering rates of age-related cancers during primate evolution, the level of which increased markedly due to loss of uricase enzyme activity (mutational silencing). Accumulated evidence shows that oxidative stress is the fundamental mechanism of age-related bone loss and acts via enhancing osteoclastic activity and increasing bone resorption. Antioxidant substances such as ascorbic acid scavenge free radicals are positively related to bone health. Thus, it is hypothesized that uric acid holds bone-protective potential owing to its potent antioxidative property. Several correlation studies have been conducted globally to investigate the relationship between serum uric acid with bone mineral density and osteoporosis. Few pre-clinical studies have tried to investigate the interaction between uric acid and bone mineral density and reported important role played via Runt-related transcription factor 2 (RUNX2)/core-binding factor subunit alpha-1 (CBF-alpha-1), Wingless-related integration site (Wnt)-3a/β-catenin signaling pathway and 11β Hydroxysteroid Dehydrogenase type 1.Conclusion:In this review, the authors provided a comprehensive summary of the literature related to association studies reported in humans as well work done until date to understand the potential cellular and molecular mechanisms that interplay between uric acid and bone metabolism.

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