“…The exact mechanism for this association is not fully understood, but it is postulated that metabolic syndrome is associated with changes in the urine, including lowering of pH, decreased excretion of citrate and increased excretion of calcium and uric acid, leading to increased risk of uric acid and calcium stone formation. 23 By contrast with observational findings, there is no strong evidence for causal associations between uric acid and ischaemic heart disease or blood pressure. 24 However, evidence supports a causal effect between body mass index and uric acid level and hyperuricaemia.…”