HYPERURICEMIA - RELATIONSHIPS TO BODY-FAT DISTRIBUTION AND OTHER COMPONENTS OF THE INSULIN-RESISTANCE SYNDROME IN 38-YEAR-OLD HEALTHY-MEN AND WOMEN

The aim of this work was to evaluate whether hyperuricaemia correlates with the cluster of metabolic and haemodynamic disorders closely asso ciated with insulin resistance syndrome (IRS) in young apparently heal thy individuals also, and, if so, whether hyperinsulinaemia itself or some other component of this syndrome, are independently associated wi th hyperuricaemia. The subjects were a random population sample of 181 (M = 94/F = 87) 38-year-old apparently healthy subjects, non-diabetic , without a history of gout. Obesity (overall and regional), serum lip id profile, uric acid, fasting glucose and insulin, 2 h insulin after glucose-load (only in men), blood pressure and main behavioural variab les were measured. As expected, most parameters were statistically dif ferent between men and women. In particular, serum uric acid levels we re significantly higher in the male group than in female group (348 +/ - 59 mu mol l(-1) vs 277 +/- 59 mu mol l(-1), P < 0.0001). After adjus tment for sex, in pooled individuals, serum uric acid concentration sh owed positive associations with BMI (r = 0.21; P < 0.001), waist/hip g irth (WHR; r = 0.45; P < 0.0001), waist/thigh girth (WTR; r = 0.35; P < 0.0001) and subscapula/triceps skinfold ratios (STR; r = 0.30; P < 0 .001). Furthermore, serum uric acid was also positively correlated wit h fasting insulin (r = 0.23; P < 0.001), serum triglycerides (r = 0.34 ; P < 0.0001), LDL cholesterol (r = 0.16; P = < 0.01), diastolic blood pressure (r = 0.26; P < 0.001), and negatively with HDL/total cholest erol ratio (r = 0.28; P < 0.001). When these correlations were calcula ted in the two separate populations, similar results were observed, bu t there were generally lower univariate correlations between uric acid and anthropometric parameters in male than in female population; furt hermore alcohol intake was related to urate levels only in men. In mul tivariate regression analysis, serum triglycerides and WHR in women an d triglycerides in men, were the only variables which, in turn, were d emonstrated to be independently related to uric acid concentration whe n all other potential confounding factors were taken into account. Thi s study shows that, in a population sample of 38-year-old predominantl y non-obese healthy men and women, hyperuricaemia is associated with s everal metabolic and haemodynamic abnormalities commonly present in th e IRS, thus confirming that increased levels of uric acid are yet anot her feature of insulin resistance. Moreover, this study suggests that, at least in our population sample, both abdominal fat distribution an d hypertriglyceridaemia, rather than fasting hyperinsulinaemia, play a major role in the relationship between hyperuricaemia and other compo nents of the insulin resistance syndrome.