Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru

What is the relationship between serum uric acid level and insulin resistance?: A case-control study

Diabetes, arises from either an absolute or relative insufficiency of insulin or insulin resistance of peripheral tissues. For assessing long-term blood glucose concentration and insulin resistance, the utilization of glycosylated hemoglobin (HbA1c) and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is widespread. Insulin resistance can lead to hyperuricemia by reducing the kidney ability to excrete urate, thus increasing sodium reabsorption. The aim of this study was to investigate the possible relationship between serum uric acid levels and insulin resistance. This was a retrospective case-control study. A total of 2530 applications in 2-year time were included in the study. Patient, known hypertension status, fasting plasma glucose, insulin, uric acid, HDL, low-density lipoprotein (LDL), triglyceride/Tg, HbA1c laboratory values and Tg/HDL ratio were examined. A statistically significant difference existed in the median uric acid values between the insulin-resistant and insulin-sensitive groups (P < .001). Additionally, a weak positive statistical correlation was identified between uric acid and HOMA-IR values (R = 0.299; P < .001) and uric acid and Tg/HDL values (R = 0.357; P < .001). This study concludes that there is a positive correlation between serum uric acid levels and insulin resistance.

An analysis of the associations of high-sensitivity C-reactive protein and uric acid with metabolic syndrome components in Korean adults by sex: a cross-sectional study using the Korea national health and nutrition examination survey 2016-2018

BACKGROUND

Low-grade inflammation plays a role in the pathogenesis of metabolic syndrome (MetS), and measuring levels of inflammatory molecules, such as high-sensitivity C-reactive protein (hs-CRP), may indicate Mets progression. Serum uric acid (SUA) has also been identified as an independent risk factor for MetS. This study aimed to investigate the association between MetS components and levels of serum hs-CRP and SUA using representative and reliable data for the Korean population.

METHODS

This study used the data of the Korea National Health and Nutrition Examination Survey 2016-2018, a cross-sectional and nationally representative survey performed by the Korean Centers for Disease Control and Prevention.

RESULTS

We analysed the data of 13,454 individuals. High hs-CRP levels were observed in 1,164 (8.7%) subjects while 3,296 (24.5%) subjects had high SUA levels. Moreover, hs-CRP was negatively correlated with serum high-density lipoprotein (HDL) (OR, 1.703; 95% CI, 1.431-2.027). When stratified by sex, this trend remained, but the correlation was stronger in women than in men. Furthermore, high SUA levels were significantly associated with hypertension (HTN) (OR, 1.399; 95% CI, 1.210-1.616), hypertriglyceridemia (OR, 1.735; 95% CI, 1.486-2.026), and low HDL (OR, 1.257; 95% CI, 1.106-1.429), but not with diabetes mellitus (DM) (OR, 0.478; 95% CI, 0.382-0.597). When grouped by sex, this trend remained, however, all MetS components were found to be more prevalent in women with high SUA.

CONCLUSIONS

Our findings showed that low HDL was more prevalent in subjects with high hs-CRP, and high SUA levels were observed in subjects with HTN, hypertriglyceridemia, and low HDL. However, the prevalence of high SUA was lower in diabetic subjects.

Association between the Triglyceride Glucose Index and Hyperuricemia in Patients with Primary Hypertension: A Cross-Sectional Study

Objective

The aim of this study was to investigate the association between the triglyceride glucose (TyG) index and hyperuricemia (HUA) in patients with grades 1-3 hypertension. Study Design. This is a cross-sectional study. A total of 1,707 patients from the cardiovascular department of Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine were studied. In this study, 899 patients with grades 1-2 hypertension were included, of which 151 had HUA; additionally, 808 patients with grade 3 hypertension were included, of which 162 patients had HUA. This study obtained all patient data from the electronic medical record system of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine. The TyG index was calculated as Ln (triglycerides × fasting glucose/2). Hyperuricemia was defined as uric acid ≥420 μmol/L (7 mg/dL). Multivariate logistic regression, penalized spline regression, and generalized additive models were used to evaluate the association between the TyG index and HUA. Stratified analyses were performed to assess the association in populations with different grades of hypertension.

Results

The average TyG index was 8.71 ± 0.58. After adjusting for correlated variables, the logistic regression analysis revealed a positive correlation between the TyG index and HUA (OR = 1.83; 95% CI: 1.40-2.39). Smooth curve fitting showed that this correlation was linear in the whole range of the TyG index. In the subgroup analysis, the TyG index more strongly associated with HUA in the grades 1-2 hypertension group (OR = 2.22; 95% CI: 1.44-3.42) compared to that in the grade 3 hypertension group (OR = 1.58; 95% CI: 1.11-2.24; P for interaction = 0.03). In addition, this association was consistent in all models.

Conclusion

The TyG index was positively associated with HUA in patients with hypertension, and the association was more strongly confirmed in those with grades 1-2 hypertension rather than in those with grade 3 hypertension.

Uric acid and metabolic syndrome: Findings from national health and nutrition examination survey

Introduction

Hyperuricemia commonly associated with Gout has been proposed as an independent risk factor for Metabolic Syndrome (MetS).

Objective

The purpose of the study was to determine if there is a relationship between hyperuricemia and MetS.

Methods

An analysis of cross-sectional data was conducted using the 2013-2018 National Health and Nutrition Examination Survey (NHANES) datasets. Sample weights were assigned by NHANES researchers to each participant allowing researchers to generalize results to all non-institutionalized United States (US) civilians. The analysis included 6,432 individuals, which were representative of 94,729,059 US citizens.

Results

Pearson's correlations, chi-square tests, and logistic regression equations were calculated to determine the association between hyperuricemia and MetS. In an unadjusted regression analysis, individuals with hyperuricemia (above 7.0 mg/dL in males and 6.0 mg/dL in females) were 3.19 times more likely to have MetS compared to those with normal uric acid (UA) levels. When controlling for various confounding variables those with hyperuricemia were 1.89 and 1.34 times more likely to have MetS than those with normal UA levels in two additional logistic regression models.

Conclusion

In this large cross-sectional study, hyperuricemia was found to be associated with MetS. Additional analyses that controlled for various risk factors previously identified as predictive of MetS still demonstrated hyperuricemia independently associated with MetS. The results of this study suggest a need to understand the metabolic pathways of UA more clearly to further explain the contribution to MetS. Additional research should include prospective clinical trials assessing the effects of UA and the control of UA on MetS and concomitant medical outcomes.

Detection and Quantification of the Relationship between the Ratio of Triglycerides over High-Density Lipoprotein Cholesterol and the Level of Serum Uric Acid: One Cross-Sectional Study

Background

Hyperuricemia acts as an independently known risk factor for diabetes, cardiovascular disease, and gout. It was previously reported that the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) is not only an important marker of cardiovascular disease, stroke, atherosclerosis, and insulin resistance but is also associated with an elevated level of serum uric acid. However, it is still poorly understood what the association is between TG/HDL-C and serum uric acid levels. Hence, the aim of this research was to determine this association.

Methods

A total of 5,402 participants who underwent physical examinations in 2021 were analyzed during our cross-sectional research. In order to verify this correlation between TG/HDL-C and uric acid, we performed both a generalized additive model (GAM) and a smoothing curve fit. We also performed receiver operating characteristic (ROC) curves for evaluation of differences in clinical risk factor models in identifying hyperuricemia risk before and after the introduction of TG/HDL-C.

Results

Upon adjustment for confounders, we found that there was a nonlinear positive correlation between TG/HDL-C and the level of uric acid, and the inflection point was 1.41. When TG/HDL-C was less than 1.41, the effect size was 40.56 (19.08-62.04, P = 0.0002), whereas when TG/HDL-C was more than 1.41 the effect size was 17.18 (3.70-30.65, P=0.0125). As shown by the ROC curve, a significant increase in the area under the curve (AUC) was observed upon the introduction of TG/HDL-C into the established risk factor model which elevated from 0.7206(0.7053-0.7359, P < 0.05) to 0.8291 (0.8175-0.8407, P < 0.05).

Conclusion

Therefore, TG/HDL-C is positively and nonlinearly correlated to the level of uric acid, and the inflection point is 1.41. Furthermore, TG/HDL-C leads to an improvement in hyperuricemia risk stratification.

What Drives Abdominal Obesity in Peru? A Multilevel Analysis Approach Using a Nationally Representative Survey

Abdominal obesity (AO) is a serious public health threat due to its increasing prevalence and effect on the development of various non-communicable diseases. A multilevel analysis of the 2019 Demographic and Family Health Survey (ENDES in Spanish) using the Latin American Diabetes Association (ALAD in Spanish) cut-off points was carried out to evaluate the individual and contextual factors associated with AO in Peru. A total of 30,585 individuals 18 years and older were included in the analysis. The prevalence of AO among Peruvians in 2019 was 56.5%. Individuals of older age (aOR 4.64; 95% CI: 3.95-5.45), women (aOR 2.74; 95% CI: 2.33-3.23), individuals with a higher wealth index (aOR 2.81; 95% CI: 2.40-3.30) and having only secondary education (aOR 1.45; 95% CI: 1.21-1.75) showed increased odds of presenting AO compared to their peers. At a contextual level, only the Human Development Index (aOR 1.59; 95% CI: 1.17-2.16) was associated with the development of AO. A high Human Development Index is the contextual factor most associated with AO. It is necessary to formulate and implement new public health policies focused on these associated factors in order to reduce the prevalence of OA and prevent the excessive burden of associated noncommunicable diseases.

Association between hyperuricemia and metabolic syndrome: A cross-sectional study in Tibetan adults on the Tibetan plateau

PURPOSE

This study aimed to assess the relationship of serum uric acid with metabolic syndrome and its components in Tibetan adults on the Tibetan plateau.

METHODS

A total of 307 participants were enrolled in this study and biochemical parameters including serum uric acid, fasting plasma glucose, white blood cell, lymphocyte count, mononuclear cells, alanine aminotransferase, aspartate aminotransferase, creatinine, and lipid profile were analyzed using standard methods. The IDF criteria were applied to define metabolic syndrome. The association of serum uric acid with metabolic syndrome and its components was evaluated by multivariable logistic regression models.

RESULTS

The overall prevalence of metabolic syndrome was 17.3% (53/307) with 19.6% (31/158) in females and 14.8% (22/149) in male participants. The prevalence of hyperuricemia was 40.7% (125/307) with significant differences between the male (53.7%,80/149) and female (28.5%,45/158) groups. In regression analysis, we observed that the risk of MetS was higher in participants in the hyperuricemia group (adjusted OR, 4.01; 95% CI, 2.02~7.99) compared with those in the normouricemia group. After adjusting for all confounding factors, a 9% higher risk of MetS could be shown in participants with SUA increased per 10umol/L (adjusted OR, 1.09; 95% CI, 1.04~1.14). These relationships were not affected by sex or age (p >0.05). After adjusting for the confounding factors, hyperuricemia is positively associated with abdominal obesity (adjusted OR, 2.53; 95% CI, 1.41~4.53), elevated blood pressure (adjusted OR, 2.61; 95% CI, 1.37~4.97), and elevated triglycerides(adjusted OR, 2.47; 95% CI, 1.09~5.57).

CONCLUSIONS

In our study, hyperuricemia is significantly associated with the prevalence of metabolic syndrome and part of its components, and these relationships are not affected by sex or age. Given the high prevalence of MetS and hyperuricemia among Tibetan adults, more studies are required to explore the role of SUA in the pathogenesis of MetS.