Is lower uric acid level better? A combined cross-sectional and longitudinal study in the elderly
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ORIGINAL ARTICLE
Is lower uric acid level better? A combined cross-sectional and longitudinal study in the elderly Chang-Hsun Hsieh • Jiunn-Diann Lin • Chung-Ze Wu • Chun-Hsien Hsu • Dee Pei Yao-Jen Liang • Yen-Lin Chen
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Received: 20 November 2013 / Accepted: 31 January 2014 Ó Springer Science+Business Media New York 2014
Abstract The relationship between metabolic syndrome (MetS) and uric acid (UA) has been explored in many studies, but there is paucity of information on hypo-uricemia and MetS. The current study aimed to elucidate the relationship between the lower end of UA and MetS in elderly. Subjects aged C60 years who underwent routine health checkups were enrolled, and 10,579 were eligible for analysis. A cross-sectional study was first performed to determine the correlation between MetS and UA. The subjects were divided into two groups according to the lowest male MetS prevalence in each UA level (UA B5 and [5 mg/dl). A longitudinal study then excluded subjects with MetS at baseline to validate the UA level of those with the lowest incidence of MetS. In the prevalence of MetS in different UA levels, there was a J-shaped curve in males but a linear relationship in females. In males, waist circumference, systolic blood pressure, high-density lipoprotein, and triglyceride were correlated with UA in univariate analysis, but high-density lipoprotein became insignificant in multivariate analysis in UA [5 mg/dl (UA-high). Only fasting plasma C.-H. Hsieh Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan J.-D. Lin C.-Z. Wu Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei, Taiwan
glucose (FPG) was significantly related to UA B5 mg/dl (UA-low). The UA level of 4.5–5 mg/dl had the lowest risk of having MetS in odds ratio, log-rank test, and hazard ratio. A J-shaped phenomenon exists between UA and MetS in elderly men but not in elderly women and FPG seem to be the key factor in this. Lower UA does not provide benefits in elderly men. The new UA control strategy for the elderly warrants further investigation. Keywords J-shape
Uric acid Metabolic syndrome Elderly
Introduction Cardiovascular disease (CVD) is one of the leading causes of death worldwide. Recently, its incidence has been increasing, perhaps due to longer life span and aging. For the early detection of people at high risk of CVD, the concept of metabolic syndrome (MetS) has been elaborated. First described by Y.-J. Liang Department of Life-Science, Fu-Jen Catholic University, New Taipei, Taiwan Y.-L. Chen (&) Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, No. 362, Chung-Cheng Road, Xindian, New Taipei 23137, Taiwan e-mail: [email protected]
C.-H. Hsu Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan D. Pei Department of Internal Medicine, Car
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