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Uric acid to creatinine ratio predicts metabolic syndrome in women
In Japanese women, baseline serum uric acid to creatinine ratio was a strong and independent predictor of incident metabolic syndrome over 3 years; however, this trend was not observed in men, according to findings published in Metabolic Syndrome and Related Disorders.
Renal clearance of serum uric acid is often impaired during kidney injury, making renal function a confounder in any studies assessing an association between serum uric acid levels and chronic kidney disease progression, Ryuichi Kawamoto, MD, PhD, of the department of internal medicine at Seiyo Municipal Nomura Hospital, Japan, and colleagues wrote in the study background. The researchers in turn attempted to determine whether renal function-normalized uric acid — via serum uric acid to creatinine ratio — is superior to serum uric acid as the predictor of incident metabolic syndrome.
“To the best of our knowledge, there are few studies showing an association between baseline [serum uric acid to creatinine ratio] and incident [metabolic syndrome], and it remains controversial,” the researchers wrote.
In a prospective study, Kawamoto and colleagues analyzed data from 1,072 Japanese adults who received a community-based annual health checkup at the Nomura Health and Welfare Center in rural areas of Ehime prefecture (625 women; mean age, 69 years). Researchers examined metabolic syndrome parameters, demographic characteristics and risk factors, including smoking status and drinking habits, by health exams conducted at baseline and 3 years. Metabolic syndrome was defined according to modified criteria from the National Cholesterol Education Program-Adult Treatment Panel III. Researchers stratified adults by serum uric acid to creatinine ratio tertiles for men (0.79-7.13, 7.14-8.22 and 8.23-13.94) and for women (1.23-7.39, 7.4-8.64 and 8.65-16.06).
At baseline, 155 men (34.7%) and 310 women (49.6%) had metabolic syndrome. At the 3-year follow-up, 149 men (33.3%) and 286 women (45.8%) had metabolic syndrome.
Researchers found that, in women only, baseline serum to creatinine ratio was independently associated with the number of metabolic syndrome components at follow-up. Compared with women in the first tertile of uric acid to creatinine ratio, the adjusted OR for women in the second tertile was 1.62 (95% CI, 0.97-2.69), whereas the OR for women in the third tertile was 2.07 (95% CI, 1.2-3.56).
In further analyses stratified by age, estimated glomerular filtration rate and baseline metabolic syndrome status, baseline uric acid to creatinine ratio was an independent determinant for incident metabolic syndrome in women aged at least 60 years, an eGFR of at least 70 mL/min/1.73 m² and metabolic syndrome at baseline.
Baseline number of metabolic syndrome components and age were also associated with development of the condition in women over 3 years, according to researchers.
“The underlying mechanism behind this relationship remains still relatively unclear but seems to be independent of traditional confounding factors such as age, smoking status, drinking habits, prevalence of CVD and eGFR,” the researchers wrote, adding that more population-based studies are needed to explore mechanisms underlying any association and whether interventions can decrease risk for developing metabolic syndrome. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.