Serum Uric Acid Level Has Stronger Correlations with Metabolic Syndrome-Related Markers in Women than in Men in a Japanese Health Check-Up Population

Background A serum uric acid (UA) level of 7.0 mg/dL has been used as the criterion for hyperuricemia in Japan regardless of gender, despite higher serum UA levels in men than in women. Serum UA has been identified as a predictive biomarker for metabolic syndrome (MetS); however, the gender differences in the association between UA levels and MetS-related conditions in a Japanese population have not been completely assessed. Objective To examine gender and age differences in the associations between serum UA levels and other biomarkers within a health-screened Japanese population and to evaluate the usefulness of serum UA as a predictor of MetS between the two genders. Methods A cross-sectional study of healthy individuals in Japan (16,391 men; 16,656 women) was conducted. Associations between UA and several biomarkers were analyzed for each gender type and for age- and serum UA level-stratified groups. Logistic regression was used to analyze the association of age and serum UA levels with MetS-related conditions. Receiver operating characteristic (ROC) curve analysis was performed to identify the UA cut-off value for predicting the risk of the MetS-related conditions. Results Serum UA levels in women had stronger correlations with MetS-related biomarkers than in men. After adjusting for age, the odds ratios for a 1-mg/dL serum UA increase for diabetes mellitus and dyslipidemia in women were 1.13 (95% confidence interval, 1.04 - 1.23) and 1.30 (1.25 - 1.34), respectively. In ROC analysis, women had significantly higher area under the curve (AUC) values for MetS prediction than men. Conclusion An elevated serum UA level has a higher predictive ability for the risk of MetS-related conditions in Japanese women than in men. The optimal serum UA cut-off value for MetS in women was suggested to be approximately 5 mg/dL, remarkably lower than that in men.