Uric acid: an additional component of metabolic syndrome?

The significance of metabolic syndrome in association with cardiovascular diseases has triggered extensive debate, and the number of medical reports in this area is increasing exponentially. One of several controversial points is whether the 5 components (elevated glucose, higher triglyceride, lowered highdensity lipoprotein [HDL] cholesterol, central obesity, and hypertension) of metabolic syndrome, as proposed by the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program (NCEP), are equally important. This debate has even been challenged by a new definition from the International Diabetes Federation (IDF), which singled out central obesity as the central core of metabolic syndrome. Another interesting point is whether these 5 components adequately cover the whole spectrum of this syndrome. For example, vascular inflammation markers such as highly sensitive C-reactive protein (CRP) have been proposed as additional components of metabolic syndrome. Metabolic syndrome is a group of risk factors that predispose to cardiovascular disease. Many studies have confirmed a positive association between hyperuricemia and cardiovascular disease. As a matter of fact, hyperuricemia was reported as one independent predictor of future cardiovascular events in an 11-year follow-up study from Taiwan. The link between insulin resistance, the major abnormality of metabolic syndrome, and hyperuricemia was elucidated by Facchini et al, who reported that urinary uric acid clearance decreased in proportion to increases in insulin resistance in normal volunteers. They attributed that to compensatory hyperinsulinemia in subjects with Uric Acid: An Additional Component of Metabolic Syndrome?