Sex-specific association of serum uric acid dynamics with the incidence of metabolic syndrome in a health check-up Chinese population: a prospective cohort study

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p>Many studies have demonstrated that elevated serum uric acid (SUA) level is linked with metabolic syndrome (MetS). However, whether there is a sex difference in the association between SUA and MetS has not been determined. This study aimed to accurately explore the impact of SUA longitudinal changes on MetS by sex.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A prospective cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>The Health Check-up Centre of the Second Hospital affiliated with Dalian Medical University from 2010 to 2016.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>A health check-up cohort of 577 men and 1698 women aged 20–60 years who did not exhibit MetS or hyperuricaemia at baseline and underwent at least two physical examinations from 2010 to 2016.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Weight, height, blood pressure and blood biochemistry parameters, including SUA, were measured. MetS was defined according to the Joint Interim Statement criteria.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Based on longitudinal data, a linear mixed-effects model was constructed to explore the characteristics of SUA dynamic changes in males and females, and joint modelling of longitudinal and survival data was done to analyse the association between SUA dynamic changes and MetS occurrence.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The natural logarithm of SUA (LNSUA) in females exhibited a gradually increasing trend, and its annual growth rate in females who developed MetS was greater than that of the non-MetS females. The longitudinal growth of SUA in females was a risk factor for the onset of MetS, and the estimated HR was 13.2580 (95% CI 1.9106 to 91.9957) for each 1-unit rise in LNSUA longitudinally. An association between the longitudinal growth of LNSUA and MetS was not found in males.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The longitudinal increase in SUA in females could increase the risk of MetS, even if the SUA changes within the normal range. The longitudinal increase in SUA in males was not a predictor for MetS.</jats:p></jats:sec>

Interaction of sex and diabetes on the association between hemoglobin glycation index, hemoglobin A1c and serum uric acid

“…indicated SUA was associated with incident prediabetes among normoglycemia women but not among normoglycemia men, and increased SUA was also associated with incident pre-diabetes among normoglycemia individuals, but not with incident T2DM among individuals with prediabetes [ 29 ]. Similarly, these sex-specific characteristics of SUA were also reported in arteriosclerotic cardiovascular risk [ 30 ], metabolic syndrome [ 31 ], and β-cell function [ 32 ]. The SUA concentration and the prevalence of hyperuricemia in men are also generally higher than in women [ 33 ].…”

Prevalence of Hyperuricemia and Its Association with Cardiovascular Risk Factors and Subclinical Target Organ Damage

“…Our results, obtained from a cross-sectional analysis of the entry visit of the patients of the IBERICAN study, do not enable us to establish the causal link of these CVRF and HU. Nevertheless, these results reinforce the association with obesity [32], HTN [12,33], DM [34,35], MetS [36], and even a more atherogenic lipid profile [37]. After a slow reading of these results, it is not clear if the HU is a consequence of obesity and after favours the development of HTN, hypercholesterolemia, and DM [38].…”

Association between Glycosylated Hemoglobin and Serum Uric Acid: A US NHANES 2011–2020

“…Several studies have confrmed that the association between SUA and HbA1c was inconsistent between men and women and between diferent blood glucose control levels [12][13][14][15]. Of course, the index of SUA often refects gender specifcity, which is more common in metabolic syndrome and acts on islet β cells [16,17]. In the same level of hyperuricemia, the prevalence of hyperuricemia in men was generally higher than that in women [18].…”