J Rheum Dis.  2018 Jan;25(1):19-27. 10.4078/jrd.2018.25.1.19.

Interrelationship of Uric Acid, Gout, and Metabolic Syndrome: Focus on Hypertension, Cardiovascular Disease, and Insulin Resistance

• Kim SK

• KMID: 2405017
• DOI: http://doi.org/10.4078/jrd.2018.25.1.19

Abstract

The mean serum uric acid level and the prevalence of hyperuricemia have increased over the past few decades. Hyperuricemia is considered to be responsible for the increased risk of hypertension, insulin resistance, and cardiovascular disease. Metabolic syndrome also contributes to the development of type II diabetes mellitus and cardiovascular disease. Despite the close relationships between uric acid and the components of metabolic syndrome, the causal effect of uric acid on these clinical issues is unclear. Recent studies have revealed the possible development of metabolic syndrome mediated by fructose-induced hyperuricemia. This review summarizes the available clinical and experimental data supporting the causal effect of uric acid on the components of metabolic syndrome, including hypertension, cardiovascular disease, and insulin resistance.

Keyword

Uric acid; Hyperuricemia; Gout; Metabolic syndrome

MeSH Terms

Cardiovascular Diseases*
Diabetes Mellitus
Gout*
Hypertension*
Hyperuricemia
Insulin Resistance*
Insulin*
Prevalence
Uric Acid*
Insulin
Uric Acid

Figure

• 

  Figure 1. Uric acid contributes to different component features of metabolic syndrome. RAS: renin-angiotensin system, NO: nitric oxide, GLUT9: glucose transporter 9, MCP-1: monocyte chemoattractant protein-1, PDGFRβ: platelet-derived growth factor receptor beta, AMPK: adenosine monophosphate kinase.

• 

  Figure 2. Mechanisms of insulin resistance by fructose and uric acid. HFCS: high-fructose corn syrup, GLUT5: glucose transporter 5, ATP: adenosine triphosphate, NO: nitric oxide.

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