Serum uric acid is a predictive biomarker of incident metabolic syndrome at the Brazilian longitudinal study of adult Health (ELSA - Brasil)

Diabetes Res Clin Pract. 2022 Sep;191:110046. doi: 10.1016/j.diabres.2022.110046. Epub 2022 Aug 24.


Aim: To investigate whether serum uric acid (SUA) levels and hyperuricemia can be predictive biomarkers of incident metabolic syndrome(MS) among different body mass index(BMI) categories, and to investigate SUA cutoffs that best discriminate individuals with incident MS.

Methods: We analyzed 7,789 participants without MS at baseline of ELSA-Brasil study. Logistic regression models were performed to evaluate associations between incident MS and SUA levels/hyperuricemia, expressed by odds ratios(ORs) and confidence intervals(95 % CI).

Results: We found 1,646 incident MS cases after a median follow-up of 3.8[3.5-4.1] years. Incident MS was present among 8.3 % (n = 290) of participants with normal weight, 28.3 % (n = 850) with overweight, 39.8 % (n = 506) with obesity. Among incident MS participants of total sample, 33.0 % had hyperuricemia [SUA > 6.0 mg/dL (356.9 μmol/L)]. After all adjustments, SUA was independently prognostic of incident MS: for each 1 mg/dL increase in SUA the odds of incident MS were 45 % higher (OR1.45[CI95 %1.34-1.55 p <.01]). Associations were found for those presenting normal weight, overweight and obesity (OR1.43[CI95 %1.31-1.57 p <.01; OR1.22[CI95 %1.13-1.32 p <.01]; and OR1.16[CI95 %1.04-1.29 p <.05]) respectively. Hyperuricemia was independently associated with incident MS (OR1.88[CI95 %1.49-0.2.36 p <.01]). The SUA cut point level maximizing sensitivity and specificity in the discrimination of incident MS was 5.0 mg/dL.

Conclusions: SUA level is an independent predictive biomarker of incident MS at all BMI categories.

Keywords: Biomarker; Cohort; Hyperuricemia; Incidence study; Metabolic syndrome; Uric acid.

MeSH terms

  • Adult
  • Biomarkers
  • Brazil / epidemiology
  • Humans
  • Hyperuricemia* / diagnosis
  • Hyperuricemia* / epidemiology
  • Longitudinal Studies
  • Metabolic Syndrome* / diagnosis
  • Metabolic Syndrome* / epidemiology
  • Obesity
  • Overweight / epidemiology
  • Risk Factors
  • Uric Acid


  • Biomarkers
  • Uric Acid