In patients with diabetes mellitus, the serum uric acid (UA) to creatinine (Cr) ratio (UA/Cr) has been reported to be associated with a higher risk of metabolic syndrome (MetS). In healthy subjects, however, this relationship and a possible association with pathological conditions remain undetermined.
Methods:
In total, 9104 Japanese subjects who had undergone an annual health examination and who were not receiving medication were divided into four groups based on UA/Cr values, and various markers were compared.
Results:
Anthropometric measures, blood pressure, glycemic state, lipids [except high-density lipoprotein cholesterol (HDL-C)], renal function, transaminases, and numbers of MetS components increased, according to UA/Cr quartiles, as the UA/Cr increased. In contrast, HDL-C and Cr decreased as the UA/Cr increased. UA/Cr values increased as the number of MetS increased. When UA/Cr values within each alcohol consumption group were investigated, the overall metabolic profile was the worst in subjects who consumed ≥75 grams ethanol a day with a UA/Cr of ≥6.8, except for fasting immunoreactive insulin (FIRI), homeostasis model assessment of insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL-C), and HDL-C values. Subjects who did not consume alcohol with a UA/Cr of ≥6.8 showed the highest FIRI, HOMA-IR, and LDL-C values.
Conclusions:
The UA/Cr was associated with components of MetS, liver function, and alcohol intake in healthy Japanese subjects. The UA/Cr might be a useful marker to distinguish subjects with high IR and dyslipidemia who do not consume alcohol.
Get full access to this article
View all access options for this article.
References
1.
DaltonRN. Serum creatinine and glomerular filtration rate: Perception and reality. Clin Chem, 2010; 56:687–689.
2.
CulletonBF, LarsonMG, EvansJC, et al.Prevalence and correlates of elevated serum creatinine levels: The Framingham Heart Study. Arch Intern Med, 1999; 159:1785–1790.
3.
CoreshJ, WeiGL, McQuillanG, 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; 161:1207–1216.
4.
MuntnerP, HeJ, HammL, et al.Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States. J Am Soc Nephrol, 2002; 13:745–753.
5.
IshizakaN, IshizakaY, TodaE, et al.Higher serum uric acid is associated with increased arterial stiffness in Japanese individuals. Atherosclerosis, 2007; 192:131–137.
6.
ChenJH, ChuangSY, ChenHJ, et al.Serum uric acid level as an independent risk factor for all-cause, cardiovascular, and ischemic stroke mortality: A Chinese cohort study. Arthritis Rheum, 2009; 61:225–232.
7.
FormanJP, ChoiH, CurhanGC. Uric acid and insulin sensitivity and risk of incident hypertension. Arch Intern Med, 2009; 169:155–162.
8.
SuiX, ChurchTS, MeriwetherRA, et al.Uric acid and the development of metabolic syndrome in women and men. Metabolism, 2008; 57:845–852.
9.
MoriyamaK. HDL cholesterol subclasses are associated with serum uric acid in Japanese men. HEP, 2018; 45:563–568.
10.
GalassiFM, BorghiC. A brief history of uric acid: From gout to cardiovascular risk factor. Eur J Intern Med, 2015; 26:373.
11.
LiM, HuX, FanY, et al.Hyperuricemia and the risk for coronary heart disease morbidity and mortality: A systematic review and dose-response meta-analysis. Sci Rep, 2016; 6:19520.
12.
BragaF, PasqualettiS, FerraroS, et al.Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: A systematic review and meta-analysis. Clin Chem Lab Med, 2016; 54:7–15.
13.
Garcia-PachonE, Padilla-NavasI, ShumC. Serum uric acid to creatinine ratio in patients with chronic obstructive pulmonary disease. Lung, 2007; 185:21–24.
14.
Durmus KocakN, SasakG, Aka AkturkU, 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; 22:4169–4176.
15.
GuL, HuangL, WuH, et al.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; 14:221–225.
16.
Al-DaghriNM, Al-AttasOS, WaniK, et al.Serum uric acid to creatinine ratio and risk of metabolic syndrome in Saudi type 2 diabetic patients. Sci Rep, 2017; 7:12104.
17.
YamanakaH. The Guideline Revising Committee of Japanese Society of Gout and Nucleic Acid Metabolism. Essence of the Revised Guideline for the Management of Hyperuricemia and Gout. Japan Med Assoc J, 2012; 55:324–329.
18.
MatthewsDR, HoskerJP, RudenskiAS, et al.Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 1985; 28:412–419.
19.
FriedewaldWT, LevyRI, FredricksonDS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem, 1972; 18:499–502.
AlbertiKG, EckelRH, GrundySM, et al.International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 2009; 120:1640–1645.
22.
LolekhaP, WongwanP, KulkantrakornK. Association between serum uric acid and motor subtypes of Parkinson's disease. J Clin Neurosci, 2015; 22:1264–1267.
23.
StibůrkováB, PavlíkováM, SokolováJ, et al.Metabolic Syndrome, alcohol consumption and genetic factors are associated with serum uric acid concentration. PLoS One, 2014; 9:e97646.
24.
SchaeffnerES, KurthT, de JongPE, et al.Alcohol consumption and the risk of renal dysfunction in apparently healthy men. Arch Intern Med, 2005; 165:1048–1053.
25.
GazianoJM, GazianoTA, GlynnRJ, et al.Light-to-moderate alcohol consumption and mortality in the physicians' health study enrollment cohort. J Am Coll Cardiol, 2000; 35:96–105.
26.
RonksleyPE, BrienSE, TurnerBJ, et al.Association of alcohol consumption with selected cardiovascular disease outcomes: A systematic review and meta-analysis. BMJ, 2011; 22;342:d671.
27.
RaderDJ. Effect of insulin resistance, dyslipidemia, and intra-abdominal adiposity on the development of cardiovascular disease and diabetes mellitus. Am J Med, 2007; 120 (Suppl 1):S1–S8.
28.
GoodwinP, EnnisM, BahlM. High insulin levels in newly diagnosed breast cancer patients reflect underlying insulin resistance and are associated with components of the insulin resistance syndrome. Breast Cancer Res Treat, 2009; 114:517–525.
29.
SerioloB, FerroneC, CutoloM. Long-term anti-tumor necrosis factor α-treatment in patients with refractory rheumatoid arthritis: Relationship between insulin resistance and disease activity. J Rheumatol, 2008; 35:355–357.
30.
HanleyAJ, WilliamsK, SternMP, et al.Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: The San Antonio Heart Study. Diabetes Care, 2002; 25:1177–1184.
31.
GelonezeB, RepettoEM, GelonezeSR, et al.The threshold value for insulin resistance (HOMA-IR) in an admixture population. IR in the Brazilian Metabolic Syndrome Study. Diabetes Res Clin Pract, 2006; 72:219–220.
32.
BonoraE, KiechlS, WilleitJ, et al.Insulin resistance as estimated by Homeostasis Model Assessment predicts incident symptomatic cardiovascular disease in Caucasian subjects from the general population. The Bruneck Study. Diabetes Care, 2007; 30:318–324.
33.
LannD, LeRoithD. Insulin resistance as the underlying cause for the metabolic syndrome. Med Clin North Am, 2007; 91:1063–1077.
34.
RyderE, GómezME, FernándezV, et al.Presence of impaired insulin secretion and insulin resistance in normoglycemic male subjects with family history of type 2 diabetes. Diabetes Res Clin Pract, 2003; 60:95–103.
35.
ChenJ, WildmanRP, HammLL, et al.Third National Health and Nutrition Examination Survey. Association between inflammation and insulin resistance in U.S. nondiabetic adults: Results from the Third National Health and Nutrition Examination Survey. Diabetes Care, 2004; 27:2960–2965.
36.
BalkauB, MhamdiL, OppertJM, et al.; EGIR-RISC Study Group. Physical activity and insulin sensitivity. The RISC study. Diabetes, 2008; 57:2613–2618.
37.
RimmEB, WilliamsP, FosherK, et al.Moderate alcohol intake and lower risk of coronary heart disease: Meta-analysis of effects on lipids and hemostatic factors. BMJ, 1999; 319:1523–1528.
