A Study On The Association Between Dynamic Changes In Uric Acid And Metabolic Syndrome

OBJECTIVE: Although many studies have analyzed the relationship between uric acid(UA)and metabolic syndrome(MetS),however,most studies are cross-sectional studies and few cohort studies.And whether UA is a risk component for MetS has not yet been clearly defined.Therefore,this study based on the health checkup data explores the impact of UA baseline level and longitudinal dynamic changes on the risk of MetS,and accurately reveals the relationship between UA and MetS.Methods: The health checkup data during March 2010 to April 2016 was collected from the physical examination center of a third grade hospital in Dalian,Liaoning Province.The number of per individual physical examinations was ?2 times.The basic description of the data was performed by SPSS 17.0.For the count data,the chi-square test was used for comparison.For the measurement data that does not satisfy the normal distribution,two sets of large sample data were compared by two independent samples Z test and two sets of small sample data that did not satisfy the normal distribution were compared by the rank test of two independent samples.The multi-level model,the general Cox model,and the joint modeling of longitudinal and survival data(JMLS)were established by R 3.2.3 software to analyze the association between UA baseline level and dynamic changes and MetS occurrence.Results: 1.A total of 2317 subjects were followed up in this study,including 577(24.90%)males and 1740 females(75.10%).The baseline age ranged from 19 to 89 years,with a median baseline age of 36 years.The median follow-up period was 3.90(2.06,4.95)years.During the follow-up period,a total of 295 people developed MetS,including 119 males and 176 females.The incidence of MetS was 12.73%(the incidence density was 1.79 per 100 person-years)and was 20.62%(3.47 per 100 person-years)in males and 10.11%(1.35 per 100 person-years)in females.From baseline to follow-up,the average levels and the abnormal rates of UA in MetS group were higher than that in non-MetS group,regardless of males or females.The annual average rates of change in UA were no difference between MetS group and non-MetS group in males but that in MetS group was higher than in non-MetS group in female(P=0.001).2.In the multi-level model,the results of the whole population showed that the average level of UA logarithm(LNUA)in non-MetS group in females was 5.4663?mol/L at baseline,while that of males was 0.3331?mol/L higher than that of females;The average level ofLNUA in MetS group was higher than in non-MetS.The follow-up time was increased by 1year,the LNUA level for non-MetS group was increased 0.0106?mol/L.The annual increased rate of LNUA in MetS group was 0.0138?mol/L higher than in non-MetS group.The results of males showed that the average level of LNUA was 5.7966?mol/L at baseline and there was no difference in LNUA levels between MetS group and non-MetS group in males;The follow-up time was increased by 1 year,the LNUA level was increased 0.0121?mol/L.There is no difference in the annual increased rate of LNUA levels between non-MetS group and non-MetS group.The results of the females showed that the average level of LNUA was5.4667?mol/L with non-MetS group at baseline and the MetS group was 0.0370?mol/L higher than non-MetS group;The follow-up time was increased by 1 year,t he LNUA level was increased 0.0103?mol/L in non-MetS group.The annual increased rate of LNUA level in MetS group was 0.0168?mol/L higher than non-MetS group.3.In the general Cox model,the results of the whole population showed that the risk of developing MetS in males was 1.5968-fold(95% CI: 1.1713,2.1770)than females;A unit increased in LNUA represents a 3.5922-fold(95% CI: 1.8668,6.9130)increase in the relative risk of MetS.There was no association between baseline LNUA and developing MetS in males.A unit increased in LNUA at baseline represents a 3.6734-fold(95% CI: 1.6623,8.1180)increase in the relative risk of MetS.4.In JMLS,the results of whole population showed that the risk of developing MetS in males was 1.4405-fold(95% CI: 1.008,2.0736)than females.There was a correlation between the longitudinal changes of LNUA and the occurrence of MetS.A unit increased in longitudinal changes of LNUA represents a 7.0020-fold(95% CI:1.3409,36.5620)increase in the relative risk of MetS.There was no association between longitudinal changes of LNUA and the occurrence of MetS in males.However,the females had this association.A unit increased in LNUA represents a 9.2535-fold(95%CI: 1.3948,61.3962)increase in the relative risk of MetS in females.Conclusion: The longitudinal increased of UA level in female individuals with time changing added the relative risk of MetS.Even if the UA value changeswithin the normal range,it will also increase the relative risk of MetS.However,the longitudinal increased of UA value in male individuals had not been found to be a risk factor for MetS.Therefore,the dynamic changes of individual UA levels for many years should be monitored and early intervention should be carried out to maintain the stability of UA levels and to effectively prevent the occurrence of MetS.