Serum Uric Acid to Creatinine Ratio and Risk of Metabolic Syndrome in Patients with Overweight/Obesity

Figures & data

Table 1 Baseline Characteristics of the Study Population Based on Sex and Presence of Metabolic Syndrome (MetS)

	Men			Women			Total
	MetS [n (%)]			MetS [n (%)]			MetS [n (%)]
	No	Yes	p-value	No	Yes	p-value	No	Yes	p-value
	1126 (34.16)	2170 (65.84)		1246 (88.81)	157 (11.12)		2372 (50.48)	2327 (49.52)
Age (years)	46.30±13.31	45.94±12.52	0.443	57.96±5.34	74.26±2.42	<0.001	52.42±11.53	47.85±14.03	<0.001
SBP (mmHg)	136.34±2.96	153.13±10.78	<0.001	134.60±2.34	151.17±9.89	<0.001	135.43±2.79	153.00±10.73	<0.001
DBP (mmHg)	81.50±2.12	88.64±2.84	<0.001	80.25±1.69	88.12±2.78	<0.001	80.84±2.00	88.61±2.84	<0.001
BMI (kg/m^2)	24.67±0.34	26.12±0.70	<0.001	24.50±0.33	25.99±0.66	<0.001	24.58±0.34	26.12±0.70	<0.001
TG (mg/dl)	158.13±17.12	251.07±56.00	<0.001	147.71±12.80	240.57±52.48	<0.001	152.66±15.88	250.36±55.82	<0.001
TC (mg/dl)	186.02±5.71	209.98±11.26	<0.001	182.62±4.47	207.81±10.94	<0.001	184.23±5.37	209.83±11.25	<0.001
HDL-c (mg/dl)	56.02±2.59	67.09±5.31	<0.001	54.48±2.01	66.08±5.15	<0.001	55.21±2.43	67.03±5.30	<0.001
LDL-c (mg/dl)	108.29±4.75	127.83±9.54	<0.001	105.47±3.77	125.99±9.21	<0.001	106.81±4.49	127.70±9.53	<0.001
ALT (IU/L)	30.10±4.56	33.89±24.36	<0.001	27.37±3.54	35.05±22.06	<0.001	28.67±4.28	33.97±24.21	<0.001
AST (IU/L)	22.58±1.20	28.85±3.83	<0.001	21.86±0.93	28.13±3.60	<0.001	22.20±1.13	28.80±3.82	<0.001
FBG (mg/dl)	92.58±1.84	105.57±10.41	<0.001	91.47±1.39	103.76±9.38	<0.001	92.00±1.71	105.45±10.36	<0.001
SUA (mg/dl)	6.18±0.26	7.22±0.51	<0.001	6.03±0.21	7.13±0.48	<0.001	6.10±0.25	7.22±0.50	<0.001
Cr (mg/dl)	0.99±0.031	1.10±0.048	<0.001	0.97±0.025	1.09±0.046	<0.001	0.98±0.029	1.09±0.048	<0.001
BUN (mg/dl)	15.25±0.62	17.88±1.24	<0.001	14.88±0.48	17.64±1.19	<0.001	15.06±0.58	17.86±1.24	<0.001
eGFR (mL/min/1.73²)	94.28±14.45	117.41±19.64	<0.001	67.57±1.26	68.25±3.55	<0.001	80.25±16.67	114.10±22.65	<0.001
SUA/Cr	6.24±0.13	6.59±0.21	<0.001	6.19±0.08	6.56±0.19	<0.001	6.22±0.11	6.59±0.20	<0.001

Note: Data are presented as mean ± standard deviation.

Abbreviations: MetS, metabolic syndrome; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ALT, alanine transaminase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; FBG, fasting blood glucose; SUA, serum uric acid; Cr, creatinine; eGFR, estimated glomerular filtration rate; SUA/Cr, serum uric acid to creatinine ratio.

Table 2 Correlation Between Serum Uric Acid to Creatinine Ratio (SUA/Cr) and Clinical Parameters in Overweight and Obese Population

Variables	SUA/Cr	Age	SBP	DBP	BMI	TG	TC	HDL-c	LDL-c	FBG	eGFR
SUA/Cr	1
Age	−0.069**	1
SBP	0.863**	−0.161**	1
DBP	0.863**	−0.161**	0.952**	1
BMI	0.933**	−0.154**	0.961**	0.973**	1
TG	0.868**	−0.166**	0.994**	0.966**	0.971**	1
TC	0.873**	−0.167**	0.975**	0.992**	0.981**	0.988**	1
HDL-c	0.873**	−0.168**	0.976**	0.991**	0.980**	0.989**	1.000**	1
LDL-c	0.873**	−0.166**	0.978**	0.991**	0.980**	0.990**	1.000**	1.000**	1
FBG	0.840**	−0.155**	0.987**	0.907**	0.932**	0.982**	0.942**	0.945**	0.947**	1
eGFR	0.614**	−0.765**	0.715**	0.739**	0.725**	0.727**	0.742**	0.741**	0.740**	0.685**	1

Note: **p < 0.01.

Abbreviations: MetS, metabolic syndrome; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ALT, alanine transaminase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; FBG, fasting blood glucose; SUA, serum uric acid; Cr, creatinine; eGFR, estimated glomerular filtration rate; SUA/Cr, serum uric acid to creatinine ratio.

Table 3 Univariate Logistic Regression Analysis for Clinical Variables Associated with Risk of Metabolic Syndrome (MetS)

	Odds Ratio (95% Confidence Interval)
	OR (95% CI) - Total	p-value	OR (95% CI) - Men	P-value	OR (95% CI) - Women	p-value
AGE (years)	0.973 (0.968, 0.977)	<0.001	0.998 (0.992, 1.003)	0.443	9.47 (4.29, 20.91)	<0.001
Sex
Men	1
Women	0.065 (0.055, 0.078)	<0.001
ALT (IU/L)	1.018 (1.014, 1.021)	<0.001	1.009 (1.006, 1.013)	<0.001	1.086 (1.066, 1.107)	<0.001
SBP (mmHg)	12.044 (8.745, 16.587)	<0.001	12.194 (8.618, 17.254)	<0.001	11.529 (4.756, 27.949)	<0.001
DBP (mmHg)	28.047 (19.626, 40.083)	<0.001	27.785 (18.858, 40.939)	<0.001	31.164 (11.203, 86.687)	<0.001
FBG (mg/dl)	142.950 (70.125, 291.403)	<0.001	160.834 (73.938, 349.852)	<0.001	72.163 (12.159, 428.245)	<0.001
TG (mg/dl)	1.677 (1.56,1.802)	<0.001	1.698 (1.569, 1.837)	<0.001	1.563 (1.306, 1.870)	<0.001
TC (mg/dl)	5.834 (4.533, 7.509)	<0.001	6.086 (4.618, 8.021)	<0.001	4.632 (2.463, 8.712)	<0.001
HDL-C (mg/dl)	33.289 (20.387, 54.359)	<0.001	35.759 (20.957, 61.015)	<0.001	21.624 (6.434, 72.671)	<0.001
LDL-C (mg/dl)	8.723 (6.492, 11.720)	<0.001	9.182 (6.644, 12.689)	<0.001	6.603 (3.175, 13.731)	<0.001
eGFR (mL/min/1.73²)	1.078 (1.074, 1.082)	<0.001	1.081 (1.074, 1.088)	<0.001	1.231 (1.127, 1.344)	<0.001

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ALT, alanine transaminase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; FBG, fasting blood glucose; SUA, serum uric acid; Cr, creatinine; eGFR, estimated glomerular filtration rate; SUA/Cr, serum uric acid to creatinine ratio.

Table 4 Multivariate Logistic Regression Analysis for Serum Uric Acid to Creatinine Ratio (SUA/Cr) Associated with Risk of Metabolic Syndrome (MetS)

SUA/Cr	OR (95% CI)	p-value
Crude	1.29 (1.27, 1.32)	<0.001
Model 1	1.33 (1.29, 1.36)	<0.001
Model 2	2.15 (1.82, 2.56)	<0.001

Note: Model 1 was adjusted for age, gender Model 2 was adjusted for age, gender, ALT, AST.

Table 5 Multivariate Logistic Regression Analysis for Serum Uric Acid to Creatinine Ratio (SUA/Cr) Associated with Risk of Metabolic Syndrome (MetS) Components

Variables	OR (95% CI)	p-value
Hypertension
Crude	1.145 (1.136, 1.150)	<0.001
Model 1	1.124 (1.115, 1.133)	<0.001
Hyperglycemia
Crude	1.107 (1.100, 1.115)	<0.001
Model 1	1.108 (1.100, 1.116)	<0.001
Dyslipidemia
Crude	1.193 (1179, 1.207)	<0.001
Model 1	1.185 (1.170, 1.200)	<0.001

Note: Model 1 was adjusted for age, gender.

Figure 1 Associations between serum uric acid to creatinine ratio (SUA/Cr) and the number of metabolic syndrome (MetS) components. Values are adjusted for age and gender.

Figure 2 Comparison of the prevalence of MetS and its components between SUA/Cr tertiles. (A) Comparison of the prevalence of MetS between SUA/Cr tertiles after controlling for age and sex. (B) Comparison of the prevalence of hyperglycemia between SUA/Cr tertiles after controlling for age and sex. (C) Comparison of the prevalence of HBP between SUA/Cr tertiles after controlling for age and sex. (D) Comparison of the prevalence of dyslipidemia between SUA/Cr tertiles after controlling for age and sex.

Data Sharing Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.