kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2018.18.3.113 kjhp-18-113 Original Article Relationship between Metabolic Syndrome and Uric Acid to Creatinine Ratio in Korean Adults: Korea National Health and Nutrition Examination Survey 2016 ShinSae-Ron HanA Lum Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea ￭ Corresponding author: A Lum Han, MD, PhD Department of Family Medicine, Wonkwang University Hospital, 501 Iksan-daero, Iksan 54536, Korea Tel: +82-63-859-1300, Fax: +82-63-859-1306 E-mail: qibosarang@naver.com 01 2018 10 01 2018 18 3 113 118 02082018 25092018 Copyright © 2018 The Korean Society of Health Promotion and Disease Prevention 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016).

 Methods

The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components.

 Results

The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051–1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054–1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070–1.271; P<0.001), triglyceride level 1.340 (95% CI, 1.259–1.427; P<0.001), high density lipoprotein level 1.163 (95% CI, 1.100–1.230; P<0.001), waist circumference 1.342 (95% CI, 1.239–1.455; P<0.001), and the presence of MS 1.041 (95% CI, 1.034–1.049; P≤0.001).

 Conclusions

The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.

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Comparison of non-metabolic syndrome group and metabolic syndrome group in study participants

  Non-MetS group n=2,840 (81.2) MetS group n=672 (18.8) Pa
Age, y 39.14±0.32 46.03±0.66 <0.001
Sex      
   Male 10,292,158.23/1,151 (47.8) 3,478,776.98/409 (69.6) <0.001
   Female 11,239,099.82/1,689 (52.2) 15,204,153.37/263 (30.4)  
Smoking status      
   No 16,469,069.35/2,275 (77.4) 3,103,038.44/452 (63.5) <0.001
   Yes 4,812,785.44/534 (22.6) 1,783,042.32/207 (36.5)  
Alcohol drinking frequency      
   No 2,155,041.26/345 (10.8) 711,948.84/100 (15.7)  
   <1/month 3,854,068.97/538 (19.3) 648,940.35/99 (14.3)  
   =1/month 2,714,161.67/328 (13.6) 361,983.11/52 (8.0) <0.001
   2–4/month 6,471,337.08/777 (32.4) 1,202,023.85/151 (26.5)  
   2–3/week 3,504,747.82/448 (17.5) 1,086,540.20/129 (24.0)  
   >4/week 1,290,625.48/165 (6.5) 524,116.48/70 (11.6)  
Systolic blood pressure (mmHg) 112.54±0.32 126.45±0.63 <0.001
Diastolic blood pressure (mmHg) 74.02±0.22 84.41±0.42 <0.001
Fasting blood glucose (mg/dL) 92.60±0.41 108.61±1.09 <0.001
HbA1c (%) 5.37±0.01 5.78±0.03 <0.001
Total cholesterol (mg/dL) 192.75±0.80 210.98±1.82 <0.001
HDL cholesterol (mg/dL) 54.69±0.28 41.65±0.41 <0.001
Triglyceride (mg/dL) 109.03±1.87 260.00±12.89 <0.001
LDL cholesterol (mg/dL) 123.09±2.83 123.15±2.10 0.986
Waist circumference (cm) 78.98±0.21 91.10±0.37 <0.001
BMI (kg/m2) 22.87±0.07 26.77±0.16 <0.001
hsCRP 0.087±0.02 1.48±0.07 <0.001
Serum UA (mg/dL) 4.96±0.02 5.85±0.06 <0.001
Serum Cr (mg/dL) 0.82±0.00 0.88±0.00 <0.001
Serum UA/Cr 6.15±0.03 6.71±0.07 <0.001

Abbreviations: MetS, metabolic syndrome; HbA1c, hemoglobin A1c; HDL, high density lipoprotein; LDL, low density lipoprotein; BMI, body mass index; hsCRP, highly sensitive C-reactive protein; UA, uric acid; Cr, creatinine.

Values are presented as mean±standard error or unweighted number/weighted number (weighted %). Percentages were weighted using the Korean National Health and Nutrtion Examination Survey 2016 sampling weights.

P-value was taken by complex sample Rao-Scott adjusted chi-square test or complex sample generalized linear model t-test.

Crude odds ratios for MetS and components by serum uric acid to creatinine ratio

Variable Serum UA/Cr
Odds ratio Pa 95% confidence interval
Systolic blood pressure (mmHg)      
  <130 Reference    
  ≥130 1.083 0.027 1.009–1.162
Diastolic blood pressure (mmHg)      
  <85 Reference    
  ≥85 1.117 0.002 1.041–1.198
Fasting blood glucose (mg/dL)      
  <100 Reference    
  ≥100 1.109 0.004 1.034–1.189
Serum triglyceride (mg/dL)      
  <150 Reference    
  ≥150 1.293 <0.001 1.223–1.367
HDL Cholesterol (mg/dL)      
  Man ≥50, woman ≥45 Reference    
  Man <50, woman <45 1.128 <0.001 1.071–1.189
Waist circumference (cm)      
  Man <90, woman <85 Reference    
  Man ≥90, woman ≥85 1.311 <0.001 1.216–1.414
Metabolic syndrome      
  No Reference    
  Yes 1.284 <0.001 1.177–1.400

Abbreviations: MetS, metabolic syndrome; UA, uric acid; Cr, creatinine; HDL, high density lipoprotein.

P-value was taken by complex samples logistic regression test.

Adjusted odds ratios for MetS and components by serum uric acid to creatinine ratio

Variable Serum UA/Cr
Odds ratio Pa 95% confidence interval
Systolic blood pressure (mmHg)      
   <130 Reference    
   ≥130 1.143 0.002 1.051–1.243
Diastolic blood pressure (mmHg)      
   <85 Reference    
   ≥85 1.144 0.001 1.054–1.241
Fasting blood glucose (mg/dL)      
   <100 Reference    
   ≥100 1.166 <0.001 1.070–1.271
Serum triglyceride (mg/dL)      
   <150 Reference    
   ≥150 1.340 <0.001 1.259–1.427
Low HDL cholesterol (mg/dL)      
   Man ≥50, woman ≥45 Reference    
   Man <50, woman <45 1.163 <0.001 1.100–1.230
Waist circumference (cm)      
   Man <90, woman <85 Reference    
   Man ≥90, woman ≥85 1.342 <0.001 1.239–1.455
Metabolic syndrome      
   No Reference    
   Yes 1.041 <0.001 1.034–1.049

Abbreviations: MetS, metabolic syndrome; UA, uric acid; Cr, creatinine; HDL, high density lipoprotein. Adjust for age, sex and smoking status, alcohol drinking frequency, exercise frequency.

P-value was taken by complex samples logistic regression test.