title: Evaluation of Association of Hyperuricaemia with Metabolic Syndrome and Insulin Resistance.
abstract: BACKGROUND
  The prevalence of Metabolic Syndrome (MetS) ranges from <10% to as much as 84% depending on region and composition of the population studied. The MetS is a growing public health problem in the world.
  
  
  OBJECTIVE
  To evaluate association of hyperuricaemia with components of MetS and insulin resistance.
  
  
  METHODS
  Sixty patients with MetS were conveniently recruited. MetS was defined as per Adult Treatment Panel III (ATP III) guidelines. For the purpose of analysis study participants were grouped into, group-I (controls - normal serum uric acid levels) and group-II (cases - hyperuricaemia). Hyperuricaemia was defined with cut-off >6.8mg/dl in both men and women. Associated work up for MetS and insulin resistance like fasting blood sugar, fasting lipid profile, fasting insulin, serum uric acid was done. Blood pressure and anthropometric measurements including weight, height and waist circumferences were measured and BMI was calculated. HOMA IR method was used to measure the degree of insulin resistance. Logistic regression analysis was used to evaluate association of hyperuricaemia with MetS and insulin resistance. Receiver Operating Curve (ROC) was plotted to find out optimum cut-off value for insulin resistance.
  
  
  RESULTS
  A significant increase in systolic blood pressure (p < 0.001) and triglyceride levels (p=0.027) were observed in hyperuricaemia subjects when compared to controls. After adjusting for potential confounders, Insulin resistance (HOMA IR >3.4) was independently associated with hyperuricaemia (OR=5.79, 95% CI=1.6- 20.69, p=0.007).
  
  
  CONCLUSIONS
  Insulin resistance beyond a threshold is independently associated with hyperuricaemia in subjects with MetS.
authors.affiliation: Post Graduate, Department of Internal Medicine, Kasturba Medical College , Mangalore, Karnataka, India .
authors.forename: Naveen Reddy
authors.initials: NR
authors.lastname: Avula
authors.affiliation: Professor and Head, Department of Internal Medicine, Kasturba Medical College , Mangalore, Karnataka, India .
authors.forename: Damodar
authors.initials: D
authors.lastname: Shenoy
keywords: Homeostasis model assessment of insulin resistance; Public health problem; Serum uric acid