Association between baseline and changes in serum uric acid and incident metabolic syndrome: a nation-wide cohort study and updated meta-analysis
Tóm tắt
To prospectively examine the associations of baseline serum uric acid (SUA) and SUA changes with incident metabolic syndrome (MetS) and update the evidence through a meta-analysis. Our analyses were based on the China Health and Retirement Longitudinal Study from 2011–2012 to 2015–2016. The exposures were baseline SUA and SUA changes, and the outcome was incident MetS assessed in 2015–2016. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A meta-analysis was conducted to synthesize evidence from all cohort studies on the same topic. Of 3779 participants (47.2% men; mean age: 59.5 years) without MetS, 452 participants developed MetS after a follow-up of 4 years. Compared to the lowest quartiles, the adjusted ORs (95% CIs) for MetS were 1.08 (0.77–1.50), 1.32 (0.95–1.82), and 1.55 (1.12–2.16) for three higher quartiles of baseline SUA, and 1.23 (0.89–1.71), 1.39 (1.00–1.93), and 1.89 (1.38–2.58) for three higher quartiles of SUA changes. Each increment of 1 mg/dL of baseline SUA level was associated with 19% higher odds of MetS (adjusted OR 1.19; 95% CI 1.07–1.33). In the meta-analysis of 24 cohort studies among 140,913 participants, the pooled relative risk (95% CI) was 1.32 (1.25–1.40) for the highest versus lowest SUA category, and 1.15 (1.09–1.21) for each 1 mg/dL increase in the SUA level. Both baseline SUA and longitudinal SUA changes were positively associated with risk of MetS among middle-aged and elderly Chinese, which was supported by findings from a comprehensive meta-analysis across multiple populations. SUA levels might need to be monitored closely for subsequent risk of MetS in clinical practice.
Tài liệu tham khảo
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC. Harmonizing the metabolic syndrome. Circulation. 2009;120:1640–5.
Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018;20:12.
Ford ES. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care. 2005;28:1769–78.
Lima WG, Martins-Santos ME, Chaves VE. Uric acid as a modulator of glucose and lipid metabolism. Biochimie. 2015;116:17–23.
Kanbay M, Jensen T, Solak Y, Le M, Roncal-Jimenez C, Rivard C, Lanaspa MA, Nakagawa T, Johnson RJ. Uric acid in metabolic syndrome: from an innocent bystander to a central player. Eur J Intern Med. 2016;29:3–8.
Yuan H, Yu C, Li X, Sun L, Zhu X, Zhao C, Zhang Z, Yang Z. Serum uric acid levels and risk of metabolic syndrome: a dose-response meta-analysis of prospective Studies. J Clin Endocrinol Metab. 2015;100:4198–207.
Chen DN, Zhang HY, Gao Y, Lu Z, Yao ZT, Jiang YH, Lin XG, Wu CL, Yang XB, Tan AH, et al. Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome: results from Fangchenggang Area Male Health and Examination Survey in China. Clin Chim Acta. 2015;446:226–30.
Kawamoto R, Ninomiya D, Kasai Y, Senzaki K, Kusunoki T, Ohtsuka N, Kumagi T. Baseline and changes in serum uric acid independently predict 11-year incidence of metabolic syndrome among community-dwelling women. J Endocrinol Invest. 2018;41:959–68.
Yu TY, Jin SM, Jee JH, Bae JC, Lee MK, Kim JH. The protective effects of increasing serum uric acid level on development of metabolic syndrome. Diabetes Metab J. 2019;43:504–20.
Lu JL, Wang LM, Li M, Xu Y, Jiang Y, Wang WQ, Li JH, Mi SQ, Zhang M, Li YC, et al. Metabolic syndrome among adults in China: the 2010 China noncommunicable disease surveillance. J Clin Endocrinol Metab. 2017;102:507–15.
Zhao Y, Hu Y, Smith JP, Strauss J, Yang G. Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol. 2014;43:61–8.
Association AD. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44:S15–33.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.
Liu H, Zhang X-M, Wang Y-L, Liu B-C. Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol. 2014;27:653–8.
Joint committee issued Chinese guideline for the management of dyslipidemia in adults. 2016 Chinese guideline for the management of dyslipidemia in adults (in Chinese). Zhonghua Xin Xue Guan Bing Za Zhi. 2016; 44:833–53.
Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol. 2021;9:373–92.
Stang A. Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.
Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998;280:1690–1.
Babio N, Martinez-Gonzalez MA, Estruch R, Waernberg J, Recondo J, Ortega-Calvo M, Serra-Majem L, Corella D, Fito M, Ros E, et al. Associations between serum uric acid concentrations and metabolic syndrome and its components in the PREDIMED study. Nutr Metab Cardiovasc Dis. 2015;25:173–80.
Bombelli M, Quarti-Trevano F, Tadic M, Facchetti R, Cuspidi C, Mancia G, Grassi G. Uric acid and risk of new-onset metabolic syndrome, impaired fasting glucose and diabetes mellitus in a general Italian population: data from the Pressioni Arteriose Monitorate E Loro Associazioni study. J Hypertens. 2018;36:1492–8.
Chang JB, Chen YL, Hung YJ, Hsieh CH, Lee CH, Pei D, Lin JD, Wu CZ, Liang YJ, Lin CM. The role of uric acid for predicting future metabolic syndrome and type 2 diabetes in older people. J Nutr Health Aging. 2016;21:329–35.
Chen Y, Kao T, Yang H, Chou C, Wu C, Lai C, Sun Y, Wang C, Chen W. The association of uric acid with the risk of metabolic syndrome, arterial hypertension or diabetes in young subjects—an observational study. Clin Chim Acta. 2018;478:68–73.
Goncalves JP, Oliveira A, Severo M, Santos AC, Lopes C. Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine. 2012;41:450–7.
Lan Q, Wu H, Zhou XH, Zheng L, Lin F, Meng QS, Xi XL, Yue AX, Buys N, Sun J, et al. Predictive value of uric acid regarding cardiometabolic disease in a community-dwelling older population in Shanghai: a cohort study. Front Med. 2020;7:24.
Lee JK, Ryoo JH, Choi JM, Park SK. Serum uric acid level and the incidence of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study. J Prev Med Public Health. 2014;47:317–26.
Nagahama K, Inoue T, Kohagura K, Ishihara A, Kinjo K, Ohya Y. Hyperuricemia predicts future metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa. Jpn Hypertens Res. 2014;37:232–8.
Norvik JV, Storhaug HM, Ytrehus K, Jenssen TG, Zykova SN, Eriksen BO, Solbu MD. Overweight modifies the longitudinal association between uric acid and some components of the metabolic syndrome: the Tromso Study. BMC Cardiovasc Disord. 2016;16:85.
Oda E. Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population. Heart Vessels. 2014;29:496–503.
Ren P, Gao MN. Association between metabolic syndrome and the serum uric acid: a cohort Study. Clin Lab. 2018;64:719–26.
Ryu S, Song J, Choi BY, Lee SJ, Kim WS, Chang Y, Kim DI, Suh BS, Sung KC. Incidence and risk factors for metabolic syndrome in Korean male workers, ages 30 to 39. Ann Epidemiol. 2007;17:245–52.
Sui X, Church TS, Meriwether RA, Lobelo F, Blair SN. Uric acid and the development of metabolic syndrome in women and men. Metab Clin Exp. 2008;57:845–52.
Sumiyoshi H, Ohyama Y, Imai K, Kurabayashi M, Saito Y, Nakamura T. Association of uric acid with incident metabolic syndrome in a Japanese general population. Int Heart J. 2019;60:830–5.
Yadav D, Lee ES, Kim HM, Choi E, Lee EY, Lim JS, Ahn SV, Koh SB, Chung CH. Prospective study of serum uric acid levels and incident metabolic syndrome in a Korean rural cohort. Atherosclerosis. 2015;241:271–7.
Yang T, Chu CH, Bai CH, You SL, Chou YC, Chou WY, Chien KL, Hwang LC, Su TC, Tseng CH, et al. Uric acid level as a risk marker for metabolic syndrome: a Chinese cohort study. Atherosclerosis. 2012;220:525–31.
Yu TY, Jee JH, Bae JC, Jin SM, Baek JH, Lee MK, Kim JH. Serum uric acid: a strong and independent predictor of metabolic syndrome after adjusting for body composition. Metab Clin Exp. 2016;65:432–40.
Zhang M, Gao Y, Wang X, Chang H, Huang G. Serum uric acid and appropriate cutoff value for prediction of metabolic syndrome among Chinese adults. J Clin Biochem Nutr. 2013;52:38–42.
Zhang Q, Zhang C, Song X, Lin H, Zhang D, Meng W, Zhang Y, Zhu Z, Tang F, Liu L, et al. A longitudinal cohort based association study between uric acid level and metabolic syndrome in Chinese Han urban male population. BMC Public Health. 2012;12:419.
Zurlo A, Veronese N, Giantin V, Maselli M, Zambon S, Maggi S, Musacchio E, Toffanello ED, Sartori L, Perissinotto E, et al. High serum uric acid levels increase the risk of metabolic syndrome in elderly women: the PRO.V.A study. Nutr Metab Cardiovasc Dis. 2016;26:27–35.
Ferrara LA, Wang H, Umans JG, Franceschini N, Jolly S, Lee ET, Yeh J, Devereux RB, Howard BV, de Simone G. Serum uric acid does not predict incident metabolic syndrome in a population with high prevalence of obesity. Nutr Metab Cardiovasc Dis. 2014;24:1360–4.
Borghi C, Francesco A, Cicero G. Serum uric acid and cardiometabolic disease: another brick in the wall? Hypertension. 2017;69:1011–3.
Spatola L, Ferraro PM, Gambaro G, Badalamenti S, Dauriz M. Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus. Metabol Clin Exp. 2018;83:225–33.
King C, Lanaspa MA, Jensen T, Tolan DR, Sanchez-Lozada LG, Johnson RJ. Uric acid as a cause of the metabolic syndrome. Uric Acid Chronic Kidney Dis. 2018;192:88–102.
Tsouli SG, Liberopoulos EN, Mikhailidis DP, Athyros VG, Elisaf MS. Elevated serum uric acid levels in metabolic syndrome: an active component or an innocent bystander? Metab Clin Exp. 2006;55:1293–301.
Liu Z, Que S, Zhou L, Zheng S. Dose-response relationship of serum uric acid with metabolic syndrome and non-alcoholic fatty liver disease incidence: a meta-analysis of prospective studies. Sci Rep. 2015;5:14325.
Choi SS, Diehl AM. Hepatic triglyceride synthesis and nonalcoholic fatty liver disease. Curr Opin Lipidol. 2008;19:295–300.
Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008;26:269–75.