Uric Acid Levels in Turkish Adults: A Determinant of Metabolic Syndrome and a Marker of CoronaryDisease, Especially in Women

Blood uric acid was first measured in the Turkish Adult Risk Factor survey in year 2003 among 422 males and 447 female participants having a mean age of 52 years and residing in the Marmara and Central Anatolian regions. Associatons with coronary heart disease (CHD), metabolic syndrome (MS), diabetes (DM), glucose intolerance (GI) and other risk factors were analyzed. MS was diagnosed based on the criteria of the ATP-III and CHD on the presence of angina and Minnesota coding of the resting ECGs. MS, CHD, and DM were observed in 37.2%, 10.5% and 10.9%, respectively, in our study group. Mean uric acid values were significantly different in men and women (5.84 vs 4.64 mg/dl; p<0.01). Concentrations correlated significantly and positively with age in women alone. They correlated significantly with total cholesterol (TC), triglycerides, phospholipids, TC/HDL-C ratio, fasting insulin, gamma glutamyl transferase (GGT), complement C3c (C3c), waist circumference, body mass index, apo B, systolic blood pressure (SBP), MS and, inversely, with physical activity in both genders; however, most of the parameters showed stronger associations in women. Significant association of uric acid levels with family income was observed only in males, whereas those with LDL-cholesterol and individual global risk score were noted only in females. Serum tri-glycerides, total cholesterol, glucose, waist circumference in both genders, SBP in women, and alcohol in men were independent determinants of uric acid values in a multivariate linear regression model which explained 36% of the uric acid variance in the model. In a logistic regression analysis, uric acid concentrations were associated with an odds ratio of 1.34 for MS likelihood. Uric acid levels above a cutoff point (7.5 mg/dl in men and 6.0 mg/dl in women), compared to those below, had an odds ratio for CHD likelihood 2.2 times (95% CI: 1.01; 4.69) in women, and 1.83 times in both genders combined. It was concluded that most MS components are independent determinants of uric acid which was associated with an excess of 50% in the likelihood of the metabolic syndrome. Uric acid levels above a cutpoint is associated with an almost 2-fold age-adjusted coronary heart disease likelihood, being a better risk marker in women. (Türk Kardiyol Dern Arş 2004; 32: 71-81)