Hyperuricemia and insulin resistance.

Vuorinen-Markkola, Helena; Yki‐Järvinen, Hannele

doi:10.1210/jcem.78.1.8288709

Cited by 153 publications

(113 citation statements)

References 39 publications

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“…This has been observed by others, 47 and recently Haffner and coworkers 12 confirmed this association in a prospective study: subjects with hyperinsulinemia had the highest risk of developing hypertriglyceridemia and low HDL cholesterol levels after 8 years of follow-up and also after adjustment for overweight and body fat distribution. Several mechanisms for this observation have been suggested, 68 such as an increased very-low-density lipoprotein (VLDL) production by increased availability of free fatty acids, a reduced VLDL clearance, or reduced adipose tissue lipoprotein lipase activity.…”

Section: Discussionsupporting

confidence: 70%

Hyperinsulinemia, risk factors, and coronary heart disease. The Zutphen Elderly Study.

Feskens

Kromhout

1994

Arterioscler Thromb

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We investigated the association between fasting insulin concentration -an indicator of insulin resistance in nondiabetic individuals-cardiovascular risk factors, and coronary heart disease in a study of 390 men in the town of Zutphen. In 1990, an extensive examination was carried out on the participating men (aged 70 to 89 years). Fasting insulin levels were determined and a number of other risk factors measured. Known and newly diagnosed diabetics were excluded from the data analyses. Fasting insulin concentration was significantly associated with levels of glucose, triglycerides, uric acid, serum albumin, creatinine, and fibrinogen as well as resting heart rate. Inverse associations with high-density lipoprotein cholesterol and factor VII activity were observed. These results were independent of confounding factors such as age, body mass index, ratio of subscapular to triceps skinfold thicknesses, cigarette smoking, physical activity, and alcohol consumption. Men with a fasting insulin level higher than 80 I t has been appreciated for a long time that a number a cardiovascular risk factors tend to cluster in the same individuals.1 " 7 Recently, an etiologic framework for this observation was provided by Reaven, 8 who referred to this clustering as "syndrome X." The basic components of this syndrome are insulin resistance, hyperinsulinemia, hyperglycemia, dyslipidemia (notably high levels of triglycerides and low levels of high-density lipoprotein [HDL] cholesterol), and hypertension, predisposing to coronary heart disease and non-insulin-dependent diabetes mellitus (type 2). In this view, insulin resistance, hyperinsulinemia, or both are the main underlying metabolic deteriorations, and this cluster is now more frequently referred to as the insulin-resistance syndrome or multiple metabolic syndrome. 8 ' 12 However, some elements of this hypothesis remain controversial. Several epidemiological studies failed to show an association between insulin and hypertension.1316 Only a few studies showed an association between insulin and the risk of coronary heart disease, 1719 and results varied according to the subgroup studied or the insulin measurement used. © 1994 American Heart Association, Inc.pmol/L (highest quartile of the distribution) had a significantly higher prevalence of coronary heart disease and especially of myocardial infarction. This result was independent of potential confounding variables as well as of possible intermediates (total and high-density lipoprotein cholesterol, hypertension, serum triglycerides, fasting glucose, and other risk factors related to fasting insulin) (odds ratio, 2.2; 95% confidence interval, 1.2-4.0). No association between fasting insulin level and hypertension or blood pressure was observed. These results show that fasting insulin is an important indicator of coronary heart disease in elderly men. Clotting factors, resting heart rate, uric acid, serum albumin, and creatinine may also play a role in this metabolic syndrome. {Arterioscter Thromb. 1994;14:1641...

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Section: Discussionsupporting

confidence: 70%

Hyperinsulinemia, risk factors, and coronary heart disease. The Zutphen Elderly Study.

Feskens

Kromhout

1994

Arterioscler Thromb

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“…SUA levels have been positively correlated with insulin resistance. 28,29 We observed that WC increased with increasing SUA levels ( Table 1). WC is a marker of visceral obesity, and a larger WC was correlated with a higher degree of insulin resistance.…”

Section: Discussionmentioning

confidence: 73%

Associations between serum uric acid levels and the incidence of hypertension and metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa, Japan

et al. 2014

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The purpose of this study was to examine the associations between serum uric acid (SUA) levels and the incidences of hypertension and metabolic syndrome (MetS) in a large screened cohort of Japanese men and women. We evaluated 4812 subjects (males, 2528; females, 2284; mean age, 47.5 years) who underwent health checkups between 2006 and 2010 and were free of hypertension and MetS in 2006. After 4 years, 618 (13%), 764 (16%) and 158 (3%) subjects developed hypertension, MetS and hypertension with MetS, respectively. Increased SUA levels were significantly and positively associated with the incidences of hypertension, MetS and hypertension with MetS. Compared with the first quartile of SUA levels, the odds ratios (95% confidence intervals) for the third and fourth quartiles, respectively, were as follows: 1.5 (1.1-2.1; P = 0.0128) and 1.8 (1.2-2.5; P = 0.0022) for hypertension, 1.3 (0.9-1.9; P = 0.1910) and 1.8 (1.2-2.7; P = 0.0039) for MetS and 2.7 (1.1-6.6; P = 0.0276) and 3.2 (1.3-8.0; P = 0.0115) for hypertension with MetS. In conclusion, increased SUA levels were significantly and independently associated with the incidences of hypertension and MetS in subjects without hypertension or MetS at baseline. Increased SUA levels might also be correlated with the incidence of hypertension with MetS.

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“…In this regard, our data are consistent with reports relating insulin resistance not only with diabetes, dyslipidemia, hypertension, central obesity and microalbuminuria, but also hyperuricemia, hyperleptinemia, endothelial dysfunction, inflammatory status, thrombophilia, oxidative stress and liver steatosis. [42][43][44][45][46][47][48] In conclusion, the coexistence of multiple metabolic disorders in the single individual, also called Metabolic Syndrome, occurs very frequently in the general population. The syndrome is associated with several nonmetabolic abnormalities documenting thrombophilia, increased oxidative stress, inflammation, endothelial dysfunction, liver steatosis and leptin resistance.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome: epidemiology and more extensive phenotypic description. Cross-sectional data from the Bruneck Study

et al. 2003

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OBJECTIVES:The present study aimed at evaluating the prevalence of the Metabolic Syndrome and at identifying its additional clinical features. RESEARCH DESIGN AND METHODS: Within a prospective population-based survey examining 888 subjects aged 40-79 y, subjects were identified fulfilling the WHO and the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria for diagnosing the Metabolic Syndrome. In these subjects and in the rest of the sample (controls), several metabolic and nonmetabolic biochemical parameters were compared. RESULTS: The prevalence of the Metabolic Syndrome by WHO criteria was 34.1% (95% CI 31.0-37.2) and by NCEP-ATPIII criteria 17.8% (15.5-20.3). The prevalence was significantly higher in older subjects and in those less physically active. Subjects with the Metabolic Syndrome either by WHO or by NCEP-ATPIII criteria showed higher levels of oxidized low-density lipoprotein, apolipoprotein B, urate, leptin, fibrinogen, leukocytes, erythrocyte sedimentation rate, GOT, gamma-GT and soluble endothelial adhesion molecules (E-selectin, vascular adhesion molecule-1 and intercellular adhesion molecule-1) and lower apolipoprotein A concentrations. Insulin resistance, as assessed by the Homeostasis Model Assessment, increased with the increase in the number of traits composing the syndrome found within the single individual. Subjects with insulin resistance had more pronounced abnormalities in several parameters, including the additional features of the syndrome (eg fibrinogen and soluble adhesion molecules). CONCLUSIONS: The Metabolic Syndrome occurs very frequently in the general population aged 40-79 y, and is associated with several additional metabolic and nonmetabolic abnormalities that likely contribute to an increased cardiovascular risk. Insulin resistance seems to play a major role in classic and additional abnormalities featuring the Metabolic Syndrome.

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Hyperuricemia and insulin resistance.

Cited by 153 publications

References 39 publications

Hyperinsulinemia, risk factors, and coronary heart disease. The Zutphen Elderly Study.

Hyperinsulinemia, risk factors, and coronary heart disease. The Zutphen Elderly Study.

Associations between serum uric acid levels and the incidence of hypertension and metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa, Japan

Metabolic Syndrome: epidemiology and more extensive phenotypic description. Cross-sectional data from the Bruneck Study

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