The association between serum uric acid levels, metabolic syndrome and cardiovascular disease in middle aged and elderly Chinese: results from the DYSlipidemia International Study

Clinical characteristics according to serum uric acid levels

The clinical characteristics of the 15,401 eligible participants are summarized according
to sex-specific categories of the SUA levels. (Table 1 and Table 2). Participants were older in the highest category of SUA level (hyperuricemia) in
women but not in men. Higher SUA levels were significantly adversely associated with
weight, body mass index (BMI), WC, SBP, TG, and nonHDL-C, but inversely associated
with HDL-C and FPG in both genders (all p values for trend 0.05). Subjects with the
highest SUA category exhibited a higher prevalence of hypertension, central obesity,
CHD, HF and diuretic agents in both men and women (all p values for trend 0.001).
In addition, there existed a higher prevalence of PAD in women with the highest SUA
category but not in men. However, there was no significant association between SUA
levels and alcohol consumption, family history of premature CVD, TC, LDL-C, and cerebrovascular
disease.

Table 1. Baseline clinical features of the participants according to serum uric acid level
in men

Table 2. Baseline clinical features of the participants according to serum uric acid level
in women

The association between serum uric acid categories and MetS

As presented in Table 3 and Table 4, compared with the lowest category of SUA level, the highest category was presented
a higher OR for MetS in both genders. Even after multiple adjustments for age, smoking,
alcohol consumption, sedentary lifestyle, family history of premature CVD, DM, hypertension,
CHD, cerebrovascular disease, HF, PAD, BMI, TC, LDL-C, and diuretic agent use, this
association was attenuated but still statistically significant [OR 1.51, 95 % confidence
interval (I) (1.30, 1.74) according to NCEP-ATPIII criteria, and OR 1.40 95 % CI (1.20,1.63)
according to IDF criteria in men, OR 2.35 95 % CI (2.00, 2.75) according to NCEP-ATPIII
criteria, and OR 1.65 95 % CI (1.41, 1.94) according to IDF criteria in women, respectively].
In addition, even in the normal range of, the ORs for MetS were higher with elevated
SUA categories only in women. When comparing with the lowest category, according to
NCEP ATP III criteria, SUA concentration between 270?~?310 ?mol/L [OR 1.31, 95 % CI
(1.12, 1.54)] and 310?~?360 ?mol/L [OR 1.62, 95 % CI (1.38, 1.90)] showed a higher
risk of prevalence of MetS. Furthermore, we explored the association between SUA level
and the components of MetS. When compared with SUV in the lowest category, the highest
category of SUA level was significantly associated with central obesity [OR1.29, 95
% CI (1.11, 1.51) in men] and hypertension [OR1.56, 95 % CI (1.34, 1.83) in men, OR
1.66 95 % CI (1.39, 1.98) in women, respectively] after multiple adjustments. In addition,
the ORs of hypertension across categories of SUA levels in subjects with normouricemia
were 1, 1.07, 1.29, 1.40 (p value for trend??0.0001) among men, and 1, 1.06, 1.27,
1.50 (p value for trend??0.0001), respectively.

Table 3. The association between SUA and MetS, hypertension, central obesity, and CVD in men

Table 4. The association between SUA and MetS, hypertension, central obesity, and CVD in women

The relationship between serum uric acid categories and CVD

The relationship between SUA levels and CVD are also shown in Table 3 and Table 4. In the present study, elevated SUA levels (the highest category) were suggested
to be significantly associated with HF and CHD even after multiple adjustments for
age, sedentary lifestyle, current smoking habits, alcohol consumption, Family history
of premature CVD, T2DM, hypertension WC, TC, TG, HDL-C, LDL-C, diuretic agent use
[OR 1.26 95 % CI (1.09,1.45) for CHD, and OR 1.61 95 % CI (1.15,2.24) for HF in men,
OR 1.27 95 % CI (1.07,1.50) for CHD, and OR 1.91 95 % CI (1.29,2.82) for HF in women,
respectively], when compared to the lowest category SUA level. In addition, no association
between SUA level and PAD was found in both men and women after multiple adjustments.