Influencing factors of serum uric acid and the critical concentration of serum uric acid to prevent and treat metabolic syndrome in female inhabitants from coastal area of Shandong province

Yangang WANG; Shihua ZHAO; Xinyan CHEN; Feng XU; Wei SONG; Changgui LI; Shengli YAN

ABSTRACT

BACKGROUND:

What are the influencing factors of serum uric acid of inhabitants from coastal area? What is the critical concentration of serum uric acid to prevent and treat metabolic syndrome?

OBJECTIVE:

To probe into the relationship between serum uric acid and metabolic syndrome in female inhabitants aged more than 20 years from coastal area of Shandong province.

DESIGN:

A clusting stratified random sampling survey.

SETTING:

Department of Endocrinology, Affiliated Hospital of Medical College of Qingdao University.

PARTICIPANTS:

The survey was carried out in the female inhabitants of five cities from coastal area of Shandong province (Qingdao, Rizhao, Yantai, Weihai and Dongying) between May and October 2004. The inhabitants, aged 20 to 80 years, lived there for 5 or more than 5 years, and they were natural crowd taking family as unit.

METHODS:

Investigations in the manner of entering every family and being on the spot were combined. Questionnaires were filled in on the first day, and fasting blood was taken to perform serum uric acid examination on the morning of the second day. For those with serum uric acid higher than normal, they were given rechecking on the third day, and education about prevention and treatment of gout and hyperuricemia was conducted at the same time.MAIN OUTCOME

MEASURES:

① Investigation on general conditionIncluding health status, diet, physical activity, labour intensity and economics. ② Investigation on nutrition Consists of food intake frequency and dietary. ③ Body height, body mass, waistline, hip circum, blood pressure and body mass index. ④ Levels of fasting blood glucose(FBG), serum uric acid, total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol(HDL-C), urea nitrogen (UN) and creatinine(Cr).

RESULTS:

① With the increase of concentration of serum uric acid, levels of systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP),body mass index(BMI) , waistline, waist-to-hip ratio(WHR), UN, Cr, TG,TC were all gradually increased. Each index was significantly higher in the serum uric acid 280-319 μmol/L group, serum uric acid 320-349 μmol/L group and serum uric acid ＞ 350 μmol/L group (hyperuricemia group)than that in serum uric acid ＜ 280 μmol/L (P ＜ 0.05-0.01 ), While the concentration of HDL-C was decreased with the increase of concentration of serum uric acid (all P ＜ 0.01). ② The incidence of hypertension, lipid metabolic disorder, overweight and obesity, glycometabolism disorder as well as metabolic syndrome was increased with the increase of uric acid;Compared with serum uric acid ＜ 280 μmol/L group, OR value of metabolic syndrome was 2.29(95%CI 1.81-2.89),4.15(95%CI3.10-5.55),4.96 (95%CI3.85-6.39) in the serum uric acid 280-319 μmol/L group,320-349 μmol/L group and hyperuricemia group , respectively. ③Noncondition Logistic multiple stepwise regression analysis showed that age,hypertension, shellfish intake volume, UN, Cr, TG and WHR and light physical activity were the independent risk factors for female patients with hyperuricemia and HDL-C was protective factor.

CONCLUSION:

The incidence of metabolic syndrome is increased with the increase of concentration of serum uric acid in female inhabitants from coastal area of Shandong province. 280 μmol/L should be as the critical concentration of serum uric acid to prevent and treat metabolic syndrome.Controlling metabolic syndrome and reducing intake of shellfish and other marine products which contain high level of purine is one of means to prevent hyperuricemia. Clinical physicians should paid more attention to the pathopoiesis of hyperuricemia.