Association of Serum Uric Acid with Metabolic Syndrome and Its Components: A Cross-Sectional Study in Chinese Coastal Population

Uncovering the Potential Mechanisms and Effects of Hyperuricemia and its Associated Diseases on Male Reproduction

Male fertility and metabolic disorders, including obesity and diabetes, are closely connected. Since hyperuricemia and metabolic syndrome are strongly related, male fertility and hyperuricemia may, to some degree, be associated. According to recent studies, hyperuricemia imposes various effects on sex hormones, semen quality, and male erectile dysfunction. Some researchers claim that uric acid worsens male semen and raises the risk of erectile dysfunction (ED), while others state that it safeguards both penile erection and male semen. Additionally, it has been shown that gout and metabolic syndrome also raise the risk of ED. To clarify this controversy, the influence and potential mechanisms of hyperuricemia on ED, semen quality, sex hormone levels, and the effects of hyperuricemia-related disorders on ED will be comprehensively summarized.

Individual and combined relationship of serum uric acid and alanine aminotransferase on metabolic syndrome in adults in Qingdao, China

BACKGROUND AND AIMS

Associations of alanine aminotransferase (ALT) and serum uric acid (SUA) with metabolic syndrome (MetS) remain controversial. We aimed to explore individual and combined effects of ALT and SUA on MetS in community residents.

METHODS AND RESULTS

A population-based cross-sectional survey involving randomly selected Chinese adults aged 35-74 years was conducted in 2009 in Qingdao, China, and 4642 participants were included in the current study. Based on a combination of SUA and ALT levels in the tertile, subjects were grouped into Group 1-9. The individual and combined relations of SUA and ALT to MetS were analyzed by logistic regression models. The prevalence of MetS was 28.50% in males and 22.30% in females. ALT and SUA were independently associated with MetS and ORs (95% CIs) were 1.55 (1.42-1.70) and 1.92 (1.72-2.14), respectively, after adjusting for potential confounders. With the elevation of ALT and SUA levels, the risk of developing MetS increased. Compared to Group 1, ORs (95% CIs) of combined ALT and SUA for MetS were 2.21 (1.70-2.88), 4.02 (3.10-5.21), 2.19 (1.62-2.97), 2.53 (1.91-3.34), 4.69 (3.60-6.12), 1.76 (1.17-2.64), 3.65 (2.63-5.06) and 7.15 (5.41-9.46) in Group 2-9, respectively.

CONCLUSIONS

ALT and SUA were both related to MetS independently. Combined elevation of ALT and SUA levels could increase the risk of MetS and its components than an elevation in SUA and ALT alone. Therefore, measures should be taken to lower SUA and ALT levels to reduce the risk of having MetS.

Effect of Two Different Dietary Weight Loss Strategies on Risk Factors for Urinary Stone Formation and Cardiometabolic Risk Profile in Overweight Women

Overweight has been suggested to increase the risk of kidney stone formation. Although weight reduction might affect risk factors for urolithiasis, findings on the impact of different dietary weight loss strategies are limited. This randomized, controlled study evaluated the effect of a conventional energy-restricted modified diet with (MR group) or without meal replacement (C group) on risk factors for stone formation in overweight women without a history of urolithiasis. Of 105 participants, 78 were included into the per-protocol analysis. Anthropometric, clinical, biochemical, and 24 h urinary parameters were collected at baseline and after 12 weeks. Although both dietary interventions resulted in a significant weight reduction, relative weight loss and rate of responders were higher in the MR group. Weight loss improved cardiometabolic risk profile in both groups. Unfortunately, the benefit of decreased GPT activity in the C group was offset by a significant increase in homocysteine and a decline in GFR. While the relative supersaturation of calcium oxalate decreased significantly in both groups, a significant decline in serum uric acid concentration and relative supersaturation of uric acid was observed only in the MR group. Finally, the energy-restricted modified diet with meal replacement showed significant advantages over the energy-restricted modified diet alone.

Association between metabolic syndrome and uric acid: a systematic review and meta-analysis

This systematic review and meta-analysis aim to provide the best evidence on the association between metabolic syndrome (MetS) and uric acid (UA) by determining the size of the effect of this biomarker on MetS. The review protocol is registered with PROSPERO (CRD42021231124). The search covered the PubMed and Scopus databases. Methodological quality was assessed with the STROBE tool, overall risk of bias with RevMan (Cochrane Collaboration) and quality of evidence with Grade Pro. Initially, 1582 articles were identified. Then, after excluding duplicates and reviewing titles and abstracts, 1529 articles were excluded from applying the eligibility criteria. We included 43 papers (56 groups) comparing UA concentrations between subjects 91,845 with MetS and 259,931 controls. Subjects with MetS had a higher mean UA of 0.57 mg/dl (95% CI 0.54-0.61) (p < 0.00001). Given the heterogeneity of the included studies, the researchers decided to perform subgroups analysis. Men with MetS have a higher UA concentration mg/dl 0.53 (95% CI 0.45-0.62, p < 0.00001) and women with MetS 0.57 (95% CI 0.48-0.66, p < 0.00001) compared to subjects without MetS. Assessment of UA concentration could provide a new avenue for early diagnosis of MetS, as a new biomarker and the possibility of new therapeutic targets.

Hyperuricemia is Associated with the Presence of Metabolically Obese Normal-Weight and Metabolically Healthy Obese Phenotypes

BACKGROUND

It is well-recognized that hyperuricemia is a common abnormality among individuals with metabolic syndrome.

AIMS

The objective of this study was to determine whether hyperuricemia is associated with the metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) phenotypes.

METHODS

Men and women equal or greater than 18 years of age were enrolled in a cross-sectional study. Normal-weight subjects were allocated into the MONW or healthy normal-weight (HNW) groups; while obese individuals were divided into the MHO and metabolically unhealthy obese (MUO) subgroups. MONW phenotype was defined by body mass index (BMI) <25.0 kg/m² accompanied by at least one cardiovascular risk factor (hyperglycemia, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol), and MHO phenotype was considered in obese subjects (BMI ≥30 kg/m²) without metabolic abnormalities.

RESULTS

A total of 567 individuals were enrolled; of them, normal-weight subjects were allocated into the MONW (n = 101) and control (n = 72) groups, whereas obese individuals into the MHO (n = 61) and MUO (n = 333) groups. The multiple logistic regression analysis adjusted by age, gender, and body mass index revealed that hyperuricemia is significantly associated with MONW (OR = 5.14; 95% CI: 1.37-19.29) and MHO (OR = 0.34; 95% CI: 0.14-0.82) phenotypes.

CONCLUSION

Results of our study showed that hyperuricemia is associated with both MONW and MHO phenotypes.

Correlation between serum C-peptide-releasing effects and the risk of elevated uric acid in type 2 diabetes mellitus

Our study aimed to investigate the C-peptide-releasing effect associated with the risk of elevated serum uric acid (SUA) levels in patients with type 2 diabetes mellitus (T2DM). In the cross-sectional study, 345 patients with T2DM hospitalized at the First Affiliated Hospital of Harbin Medical University were consecutively enrolled, and their baseline data were collected. The study design used two parameters for C-peptide releasing effects: the multiplication effect of 1 h postprandial C-peptide to fasting C-peptide ratio (1hCp/FCp) and 2hCp/FCp; the incremental effect of 1hCp minus FCp (1hΔCp) and 2hΔCp. The patients with T2DM in the upper quartiles of SUA had higher FCp, 1hCp, 1hΔCp, 2hCp, and 2hΔCp. Multiple linear regression analysis revealed that after adjusting all the confounding factors, the serum C-peptide including 1hCp (β = 5.14, p = 0.036), 1hΔCp (β = 7.80, p = 0.010), 2hCp (β = 4.27, p = 0.009) and 2hΔCp (β = 5.20, p = 0.005) were still positively correlated with SUA levels in patients with T2DM. In female patients, only the 2hCp (β = 4.78, p = 0.017) and 2hΔCp (β = 5.28, p = 0.019) were associated with SUA level; however, in male patients, no C-peptide parameter was associated with SUA levels in T2DM (all p > 0.05). Within a certain range, the elevated SUA levels might be associated with the better C-peptide incremental effect of islet β cell function in T2DM, especially in female patients.

Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review

Childhood cancer survivors (CCS) are at increased risk to develop metabolic syndrome (MetS), diabetes, and cardiovascular disease. Common criteria underestimate adiposity and possibly underdiagnose MetS, particularly after abdominal radiotherapy. A systematic literature review and meta-analysis on the diagnostic and predictive value of nine newer MetS related biomarkers (adiponectin, leptin, uric acid, hsCRP, TNF-alpha, IL-1, IL-6, apolipoprotein B (apoB), and lipoprotein(a) [lp(a)]) in survivors and adult non-cancer survivors was performed by searching PubMed and Embase. Evidence was summarized with GRADE after risk of bias evaluation (QUADAS-2/QUIPS). Eligible studies on promising biomarkers were pooled. We identified 175 general population and five CCS studies. In the general population, valuable predictive biomarkers are uric acid, adiponectin, hsCRP and apoB (high level of evidence), and leptin (moderate level of evidence). Valuable diagnostic biomarkers are hsCRP, adiponectin, uric acid, and leptin (low, low, moderate, and high level of evidence, respectively). Meta-analysis showed OR for hyperuricemia of 2.94 (age-/sex-adjusted), OR per unit uric acid increase of 1.086 (unadjusted), and AUC for hsCRP of 0.71 (unadjusted). Uric acid, adiponectin, hsCRP, leptin, and apoB can be alternative biomarkers in the screening setting for MetS in survivors, to enhance early identification of those at high risk of subsequent complications.

Association Between Uric Acid and Insulin-Like Growth Factor-1 in Type 2 Diabetes Mellitus

Objective

This research examined the relationship between uric acid (UA) and insulin-like growth factor-1 (IGF-1) in patients with type 2 diabetes mellitus (T2DM).

Methods

This study was a cross-sectional study that included 1230 Chinese patients with T2DM. We collected general information and laboratory indicators and calculated the standard deviation score of IGF-1 (IGF-1 SDS).

Results

The univariate analysis results demonstrated a significant positive relationship between UA levels and IGF-1 SDS (P<0.001). A nonlinear relationship was discovered between UA and IGF-1 SDS after adjusting for confounding factors. Multivariate piecewise linear regression showed that the levels of IGF-1 SDS increased when UA was <4.17 mg/dl (β 0.12,95% CI -0.04, 0.28; P=0.121) and decreased when UA was >4.17 mg/dl (β -0.38,95% CI -0.64, -0.12; P=0.004).

Conclusion

This study showed a nonlinear relationship between UA and IGF-1 in Chinese adults with T2DM. When the UA levels reached the inflection point, IGF-1 levels negatively correlated with the increase in UA. Further studies are needed to explore this relationship and mechanisms in the future.