Korean J Health Promot.  2018 Sep;18(3):113-118. 10.15384/kjhp.2018.18.3.113.

Relationship between Metabolic Syndrome and Uric Acid to Creatinine Ratio in Korean Adults: Korea National Health and Nutrition Examination Survey 2016

• Shin SR
• Han AL

• KMID: 2421869
• DOI: http://doi.org/10.15384/kjhp.2018.18.3.113

Abstract

BACKGROUND
While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016).
METHODS
The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components.
RESULTS
The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051-1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054-1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070-1.271; P < 0.001), triglyceride level 1.340 (95% CI, 1.259-1.427; P < 0.001), high density lipoprotein level 1.163 (95% CI, 1.100-1.230; P < 0.001), waist circumference 1.342 (95% CI, 1.239-1.455; P < 0.001), and the presence of MS 1.041 (95% CI, 1.034-1.049; P≤0.001).
CONCLUSIONS
The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.

Keyword

Metabolic syndrome; Uric acid; Creatinine

MeSH Terms

Adult*
Blood Glucose
Blood Pressure
Confounding Factors (Epidemiology)
Creatinine*
Fasting
Humans
Korea*
Lipoproteins
Logistic Models
Nutrition Surveys*
Triglycerides
Uric Acid*
Waist Circumference
Blood Glucose
Creatinine
Lipoproteins
Uric Acid

Reference

References

1. Park E, Kim J. Gender- and age-specific prevalence of metabolic syndrome among Korean adults: analysis of the fifth Korean National Health and Nutrition Examination Survey. J Cardiovasc Nurs. 2015; 30(3):256–66.

2. Quiñones Galvan A, Natali A, Baldi S, Frascerra S, Sanna G, Ciociaro D, et al. Effect of insulin on uric acid excretion in humans. Am J Physiol. 1995; 268(1 Pt 1):E1–5.

3. Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol. 2006; 290(3):F625–31.

4. Gagliardi AC, Miname MH, Santos RD. Uric acid: a marker of increased cardiovascular risk. Atherosclerosis. 2009; 202(1):11–7.

5. Fu CC, Wu DA, Wang JH, Yang WC, Tseng CH. Association of C-reactive protein and hyperuricemia with diabetic nephropathy in Chinese type 2 diabetic patients. Acta Diabetol. 2009; 46(2):127–34.

6. Guo L, Cheng Y, Wang X, Pan Q, Li H, Zhang L, et al. Association between microalbuminuria and cardiovascular disease in type 2 diabetes mellitus of the Beijing Han nationality. Acta Diabetol. 2012; 49(Suppl 1):S65–71.

7. Ruggiero C, Cherubini A, Ble A, Bos AJ, Maggio M, Dixit VD, et al. Uric acid and inflammatory markers. Eur Heart J. 2006; 27(10):1174–81.

8. Chen N, Wang W, Huang Y, Shen P, Pei D, Yu H, et al. Community-based study on CKD subjects and the associated risk factors. Nephrol Dial Transplant. 2009; 24(7):2117–23.

9. Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, et al. Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey (1988–1994). Arch Intern Med. 2001; 161(9):1207–16.

10. Muntner P, He J, Hamm L, Loria C, Whelton PK. Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States. J Am Soc Nephrol. 2002; 13(3):745–53.

11. Gu L, Huang L, Wu H, Lou Q, Bian R. Serum uric acid to creatinine ratio: a predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function. Diab Vasc Dis Res. 2017; 14(3):221–5.

12. Durmus Kocak N, Sasak G, Aka Akturk U, Akgun M, Boga S, Sengul A, et al. Serum uric acid levels and uric acid/creatinine ratios in stable chronic obstructive pulmonary disease (COPD) patients: are these parameters efficient predictors of patients at risk for exacerbation and/or severity of disease? Med Sci Monit. 2016; 22:4169–76.

13. Al-Daghri NM, Al-Attas OS, Wani K, Sabico S, Alokail MS. Serum uric acid to creatinine ratio and risk of metabolic syndrome in Saudi type 2 diabetic patients. Sci Rep. 2017; 7(1):12104.

14. Li M, Gu L, Yang J, Lou Q. Serum uric acid to creatinine ratio correlates with β-cell function in type 2 diabetes. Diabetes Metab Res Rev. 2018; 34(5):e3001.

15. Santos RD. Elevated uric acid, the metabolic syndrome and cardiovascular disease: cause, consequence, or just a not so innocent bystander? Endocrine. 2012; 41(3):350–2.

16. Johnson RJ, Titte S, Cade JR, Rideout BA, Oliver WJ. Uric acid, evolution and primitive cultures. Semin Nephrol. 2005; 25(1):3–8.

17. Reaven G. Why a cluster is truly a cluster: insulin resistance and cardiovascular disease. Clin Chem. 2008; 54(5):785–7.

18. Wang HJ, Shi LZ, Liu CF, Liu SM, Shi ST. Association between uric acid and metabolic syndrome in elderly women. Open Med (Wars). 2018; 13:172–7.

19. Chang IH, Han JH, Myung SC, Kwak KW, Kim TH, Park SW, et al. Association between metabolic syndrome and chronic kidney disease in the Korean population. Nephrology (Carlton). 2009; 14(3):321–6.

20. Alizadeh S, Ahmadi M, Ghorbani Nejad B, Djazayeri A, Shab-Bidar S. Metabolic syndrome and its components are associated with increased chronic kidney disease risk: evidence from a metaanalysis on 11 109 003 participants from 66 studies. Int J Clin Pract. 2018 May 23. [Epub ahead of print].

21. Thomas G, Sehgal AR, Kashyap SR, Srinivas TR, Kirwan JP, Navaneethan SD. Metabolic syndrome and kidney disease: a systematic review and metaanalysis. Clin J Am Soc Nephrol. 2011; 6(10):2364–73.

22. Tanner RM, Brown TM, Muntner P. Epidemiology of obesity, the metabolic syndrome, and chronic kidney disease. Curr Hypertens Rep. 2012; 14(2):152–9.

23. Wahba IM, Mak RH. Obesity and obesity-initiated metabolic syndrome: mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol. 2007; 2(3):550–62.