title: Serum uric acid does not predict incident metabolic syndrome in a population with high prevalence of obesity.
abstract: OBJECTIVE
  To evaluate whether uric acid (UA) predicts 4-yr incidence of metabolic syndrome (MetS) in non-diabetic participants of the Strong Heart Study (SHS) cohort.
  
  
  RESULTS
  In this population-based prospective study we analyzed 1499 American Indians (890 women), without diabetes or MetS, controlled during the 4th SHS exam and re-examined 4 years later during the 5th SHS exam. Participants were divided into sex-specific tertiles of UA and the first two tertiles (group N) were compared with the third tertile (group H). Body mass index (BMI = 28.3 ± 7 vs. 31.1 ± 7 kg/m(2)), fat-free mass (FFM = 52.0 ± 14 vs. 54.9 ± 11 kg), waist-to-hip ratio, HOMA-IR (3.66 vs. 4.26), BP and indices of inflammation were significantly higher in group H than in group N (all p < 0.001). Incident MetS at the time of the 5th exam was more frequent in group H than group N (35 vs. 28%, OR 1.44 (95% CI = 1.10-1.91; p < 0.01). This association was still significant (OR = 1.13, p = 0.04) independently of family relatedness, sex, history of hypertension, HOMA-IR, central adiposity and renal function, but disappeared when fat-free mass was included in the model.
  
  
  CONCLUSIONS
  In the SHS, UA levels are associated to parameters of insulin resistance and to indices of inflammation. UA levels, however, do not predict incident MetS independently of the initial obesity-related increased FFM.
authors: Department of Clinical Medicine and Surgery, Federico II University, Via S. Pansini 5, 80131 Naples, Italy. Electronic address: ferrara@unina.it.
authors: L A
authors: LA
authors: Ferrara
authors: MedStar Health Research Institute, Washington, D.C., USA.
authors: H
authors: H
authors: Wang
authors: MedStar Health Research Institute, Washington, D.C., USA; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, D.C., USA.
authors: J G
authors: JG
authors: Umans
authors: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors: N
authors: N
authors: Franceschini
authors: General Internal Medicine, Cleveland Clinic Medicine Institute, USA.
authors: S
authors: S
authors: Jolly
authors: Center for American Indian Health Research, University of Oklahoma, Oklahoma City, OK, USA.
authors: E T
authors: ET
authors: Lee
authors: Center for American Indian Health Research, University of Oklahoma, Oklahoma City, OK, USA.
authors: J
authors: J
authors: Yeh
authors: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors: R B
authors: RB
authors: Devereux
authors: MedStar Health Research Institute, Washington, D.C., USA; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, D.C., USA.
authors: B V
authors: BV
authors: Howard
authors: Department of Medicine, Weill Cornell Medical College, New York, NY, USA; Department of Translational Medical Sciences, Federico II University, Naples, Italy.
authors: G
authors: G
authors: de Simone
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007198:Indians, North American; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood*; D049629:Waist-Hip Ratio
chemical_list: D014527:Uric Acid
keywords: Fat-free mass; Metabolic syndrome; Obesity; Strong heart study; Uric acid