Elevated circulating serum uric acid concentrations may be linked with an increased risk of coronary heart disease (CHD). We measured serum uric acid levels in 50 premenopausal and 88 postmenopausal non-obese white women who underwent an intravenous glucose tolerance test. The uric acid concentration was significantly higher in postmenopausal versus premenopausal women. Adjustment of the data to take into account a number of confounding variables, including the age and body mass index (BMI), revealed a highly significant independent difference between the groups. BMI was found to be a significant independent predictor of the uric acid concentration, but this was confined to premenopausal women. Postmenopausal women were found to be more insulin-resistant, and significant correlations were observed between components of the insulin resistance syndrome and uric acid in both groups. We conclude that increases in serum acid in postmenopausal women may result from changes in metabolism as a consequence of the menopause, and may be associated with the increased risk of CHD seen in these women.