Document Type : Original Research
Dept. of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Dept. of Biostatistics , Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Dept. of Research , Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Background and Objectives: The association between metabolic syndrome (MetS) and hyperuricemia has been formerly studied mostly in healthy people in western countries. We tried to examine the relationship betweenhyperuricemia and MetS in an Iranian population undergoing coronary angiography.
Materials and Methods: From March 2008 to September 2008, we studied 465 patients (260 men, 55.9%) undergoing elective coronary angiography due to symptoms related to coronary artery disease. The MetS was defined according to the adapted Adult Treatment Panel III (ATP-III A), and hyperuricemia was defined as serum uric acid concentrations ≥ 7.0 mg/dl in men and ≥ 6.0 mg/dl in women. For the statistical analysis, the statistical software SPSS version 13.0 and the statistical package SAS version 9.1 were applied
Results: The mean age of the study population was 59.66 ± 10.04, ranging from 31 to 85 years. Hyperuricemia was detected in 231 (49.7%) of total population, in 126 (54.5%) of men, and in 105 (45.5%) of women. In the multivariable adjusted model, subjects with MetS and subjects with 5 components of the MetS compared to those without any components of the MetS, had 1.56-fold and 4.19-fold increased odds of hyperuricemia, respectively. Hyperuricemia was significantly associated with elevated BP and low level of HDL-cholesterolbut not with other components of MetS.
Conclusions: Our study demonstrated that hyperuricemia was strongly associated with the prevalence of MetS according to adapted ATP III guidelines in an Iranian sample of patients undergoing coronary angiography.
- Denzer C, Muche R, Mayer H, Heinze E, Debatin KM, Wabitsch M. Serum uric acid levels in obese children and adolescents: linkage to testosterone levels and pre-metabolic syndrome. J Pediatr Endocrinol Metab 2003;16(9):1225-32.
- Nakanishi N, Tatara K, Nakamura K, Suzuki K. Risk factors for the incidence of hyperuricaemia: a 6-year longitudinal study of middle-aged Japanese men. Int J Epidemiol 1999;28(5):888-93.
- Boyko EJ, de Court, Zimmet PZ, Chitson P, Tuomilehto J, Alberti KG. Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: a prospective study in Mauritius. Diabetes Care 2000;23(9):1242-8.
- Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension 2003;42(3):247-52.
- Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiol Rev 2005;13(6):322-7.
- Saely CH, Koch L, Schmid F, Marte T, Aczel S, Langer P, et al. Adult Treatment Panel III 2001 but not International Diabetes Federation 2005 criteria of the metabolic syndrome predict clinical cardiovascular events in subjects who underwent coronary angiography. Diabetes Care 2006;29(4):901-7.
- Klausen KP, Parving HH, Scharling H, Jensen JS. The association between metabolic syndrome, microalbuminuria and impaired renal function in the general population: impact on cardiovascular disease and mortality. J Intern Med 2007;262(4):470-8.
- Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007;120(5):442-7.
- Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 2006;290(3):F625-F631.
- Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M. Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol 2005;25(5):1038-44.
- Chiou WK, Wang MH, Huang DH, Chiu HT, Lee YJ, Lin JD. The relationship between serum uric acid level and metabolic syndrome: differences by sex and age in Taiwanese. J Epidemiol 2010;20(3):219-24.
- Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18(6):499-502.
- Fam AG. Gout, diet, and the insulin resistance syndrome. J Rheumatol 2002;29(7):1350-5.
- Choi HK, Mount DB, Reginato AM. Pathogenesis of gout. Ann Intern Med 2005 Oct 4;143(7):499-516.
- Yoo TW, Sung KC, Shin HS, Kim BJ, Kim BS, Kang JH, et al. Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J 2005;69(8):928-33.
- Lin SD, Tsai DH, Hsu SR. Association between serum uric acid level and components of the metabolic syndrome. J Chin Med Assoc 2006;69(11):512-6.
- Nagahama K, Iseki K, Inoue T, Touma T, Ikemiya Y, Takishita S. Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan. Hypertens Res 2004;27(4):227-33.
- Al-Arfaj AS. Hyperuricemia in Saudi Arabia. Rheumatol Int 2001;20(2):61-4.
- Sumino H, Ichikawa S, Kanda T, Nakamura T, Sakamaki T. Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia. Lancet 1999 Aug 21;354(9179):650.
- Johnson RJ, Segal MS, Srinivas T, Ejaz A, Mu W, Roncal C, et al. Essential hypertension, progressive renal disease, and uric acid: a pathogenetic link? J Am Soc Nephrol 2005 Jul;16(7):1909-19.
- Krishnan E, Kwoh CK, Schumacher HR, Kuller L. Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension 2007;49(2):298-303.
- Chen LY, Zhu WH, Chen ZW, Dai HL, Ren JJ, Chen JH, et al. Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B 2007;8(8):593-8.
- Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, et al. Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 1998;47(8):929-33.
- Bonora E, Targher G, Zenere MB, Saggiani F, Cacciatori V, Tosi F, et al. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study. Int J Obes Relat Metab Disord 1996;20(11):975-80.
- Rathmann W, Haastert B, Icks A, Giani G, Roseman JM. Ten-year change in serum uric acid and its relation to changes in other metabolic risk factors in young black and white adults: the CARDIA study. Eur J Epidemiol 2007;22(7):439-45.
- Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F, et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 2004 Mar 25;4:9.:9.
- Becker MA, Jolly M. Hyperuricemia and associated diseases. Rheum Dis Clin North Am 2006 May;32(2):275-vi.
- Nakanishi N, Okamoto M, Yoshida H, Matsuo Y, Suzuki K, Tatara K. Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. Eur J Epidemiol 2003;18(6):523-30.
- Onat A, Uyarel H, Hergenc G, Karabulut A, Albayrak S, Sari I, et al. Serum uric acid is a determinant of metabolic syndrome in a population-based study. Am J Hypertens 2006;19(10):1055-62.