title: Prospective study of serum uric acid levels and incident metabolic syndrome in a Korean rural cohort.
abstract: OBJECTIVE
  Recent studies have demonstrated an association between serum uric acid (SUA) levels and metabolic syndrome (MetS). However, paucity of available data regarding the cause and effect relationship between SUA and MetS in healthy adults is still a big challenge which remains to be studied. Therefore, we investigated whether SUA predicts new onset of MetS in a population-based cohort study.
  
  
  METHODS
  The study included 1590 adults (661 men and 929 women) aged 40-70 years without MetS at baseline (2005-2008) and subjects were prospectively followed for 2.6 years. To evaluate the relationship between SUA and MetS, we divided the aforementioned subjects into quintiles (SUA-I to SUA-V) from the lowest to the highest values of SUA. SUA was measured by the enzymatic colorimetric method. We used category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) to characterize the performance of predicted model.
  
  
  RESULTS
  During a mean of 2.6 years of follow-up, 261(16.4%) adults developed MetS. MetS variables were significantly related to the baseline SUA level. Waist circumference (WC), blood pressure (BP), and serum triglyceride (TG) were significantly higher in the highest quintile of SUA compared to the lowest SUA quintile in men and women. After adjustment for age, total cholesterol and low-density lipoprotein cholesterol (LDL-C) in men and women, subjects in the fifth quintiles of SUA showed significantly higher ORs for incident MetS. The association between hyperuricemia and new onset of MetS were consistently stronger in women than men. Additionally, among women, we found an improvement in the area under the ROC curve in the models that added SUA to core components of MetS.
  
  
  CONCLUSIONS
  Our study suggests that SUA is significantly correlated with future risk of WC, BP, TG and may predicted as a risk factor for developing MetS. SUA may have a clinical role in predicting new-onset metabolic syndrome among women. Large prospective study is needed to reveal the clinical significance of SUA in metabolic disease.
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Yadav
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Hong Min
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Song Vogue
authors.initials: SV
authors.lastname: Ahn
authors.affiliation: Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Sang Baek
authors.initials: SB
authors.lastname: Koh
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Electronic address: cchung@yonsei.ac.kr.
authors.forename: Choon Hee
authors.initials: CH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012423:Rural Health; D012737:Sex Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D008055:Lipids; D014527:Uric Acid
keywords: Hyperuricemia; Korean adults; Metabolic syndrome; Serum uric acid