| ObjectiveThe study aimed to find out the prevalence of hyperuricemia(HUA)and metabolic syndrome(MetS)among rural older adults,explore the influence of baseline serum uric acid and HUA on incident MetS and its components,as well as the effect of baseline MetS and its components on serum uric acid and HUA at follow-up,and then assess the bidirectional associations of HUA with MetS.The results may help to provide the theoretical basis for the prevention of HUA and MetS among older adults.MethodsThe study was conducted in the Weitang town among older adults aged 60 years or older in Suzhou located in Jiangsu province using the cluster sampling method.When incident MetS was treated as outcome,older adults with MetS at baseline or missing data to diagnose MetS at the follow-up were ruled out.Moreover,the analysis conducted among older adults with incident HUA excluded older adults with HUA at baseline and without the data about serum uric acid at follow-up.The baseline study began in 2014 and the follow-up study was conducted in 2018.Information on participants’ socio-demographic characteristics,lifestyle habits and disease history was collected using the pre-designed questionnaire at baseline.Meanwhile,anthropometric examinations and collection of blood sample were conducted both at baseline and follow-up.HUA was defined as 7 mg/dL or above for men and 6 mg/dL or greater for women.MetS was assessed based on the National Cholesterol Education Program-Adult Treatment Panel Ⅲ,and older adults with the presence of at least three of MetS components were considered as having MetS.Data were analyzed using SPSS version 21.0 and statistical significance was considered if a p-value was less than 0.05.ResultsThe sample at baseline consisted of 4579 older adults aged 60 years or older.The prevalence of MetS and HUA was 20.1%(95%confidence interval,95%CI=18.9,21.2)and 15.8%(95%CI=14.8,16.9).Among 4579 older adults at baseline,183(4.0%)deceased before the follow-up examination and 526(11.5%)refused to participate or were out of touch.Eventually,3870 participants enrolled in the follow-up examination with the mean age of 67.3±5.7.The cohort study consisted of 2023(52.3%)women and 1847(47.7%)men.The number of older adults concluded in the analysis of incident MetS was 3005.The trend of incidence rate of MetS was increased with elevated serum uric acid.Each unit increase in serum uric acid increased the risk of MetS by 30%(odds ratio,OR=1.30,95%CI=1.19,1.43).There was a linear trend between serum uric acid quartiles and incident MetS(P value for trend<0.05).Quartiles of changed serum uric acid also presented a linear trend with incident MetS(P value for trend<0.05).The risk of incident MetS in the elderly with HUA at baseline was 1.69 times higher than their counterparts without HUA(95%CI=1.25,2.27).HUA made effect on high body mass index(OR=2.08,95%CI=1.61,2.68)and low high-density lipoprotein cholesterol(OR=1.62,95%CI=1.10,2.40).The analysis included 3247 older adults when incident HUA was treated as outcome.MetS at baseline affect the serum uric acid at follow-up(β=0.19,95%CI=0.11,0.28)and incident HUA(OR=1.73,95%CI=1.30,2.30).Components of MetS,including high blood pressure,high body mass index,diabetes mellitus and high triglycerides,were significantly related to serum uric acid at follow-up and incident HUA.The association between high blood pressure and incident HUA is strongest among the five MetS components.Moreover,increasing number of MetS components at baseline was positively related to incident HUA.ConclusionsHUA at baseline could increase the risk of incident MetS,and made influence on incident high body mass index as well as low high-density lipoprotein cholesterol of MetS components.Meanwhile,older adults with MetS at higher risk of incident HUA,and high blood pressure may be the most important determinant.There was a bidirectional associations between HUA and MetS,suggesting that there were similarities in pathogenesis between HU A and MetS. |
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