HYPERURICEMIA AND INSULIN-RESISTANCE

The associates of gout-obesity, hypertriglyceridemia, glucose intolera nce, and hypertension, strikingly resemble those of insulin resistance . In the present study we determined whether hyperuricemia is associat ed with insulin resistance and, if so, whether this association can be explained by other components of the syndrome. For this purpose we qu antitated insulin sensitivity (euglycemic clamp) in 37 nondiabetic sub jects (aged 30-68 yr) exhibiting varying degrees of the metabolic synd rome (body mass index, 21.5-35.7 kg/m(2); serum triglycerides, 0.4-22. 0 mmol/L; high density lipoprotein cholesterol 0.38-1.86 mmol/L; blood pressure, 190-100/116-60 mm Hg). In simple linear regression analysis , the serum uric acid concentration (range, 182-568 mu mol/L) was inve rsely correlated with insulin sensitivity (rate of glucose utilization ; r = -0.61; P < 0.001) and positively with serum triglycerides (r = 0 .68; P < 0.001), but not with body mass index, age, or the plasma gluc ose concentration. In multiple linear regression analysis, both insuli n sensitivity (P < 0.05) and serum triglycerides (P < 0.005) were inde pendently associated with the serum uric acid concentration, and toget her explained 50% of its variation. Addition of body mass index or age to the model did not improve the degree of explanation. Acute elevati on of serum triglycerides about 8-fold, of plasma FFA about g-fold, or of serum insulin about 28-fold had no effect on the serum uric acid c oncentration in healthy volunteers. The data indicate that hyperuricem ia is indeed an inherent component of the metabolic syndrome and could also be used as a simple marker of insulin resistance.