2B.07

Abstract

Objective: Serum uric acid (UA) has been associated with metabolic syndrome (MetS) and urine albumin/creatinine ratio (ACR). We questioned whether UA and ACR are associated in pre-metabolic individuals, and whether this association is modified by any component variable of the metabolic syndrome. Design and method: In a cross-sectional survey of a representative Czech population (n = 3612) aged 25–64 years, urinary albumin and creatinine excretion were determined in an early morning spot urine sample and ACR was calculated. Components of MetS were defined using the joint statement of IDF, NHBLI, AHA, WHF, IAS, and IASO. Individuals presenting with 1 or 2 components were defined as pre-metabolic. Individuals with urinary albumin excretion bellow the detection limit of 1 mg (n = 594), diabetes treated with glucose lowering medication (n = 122), current use of inhibitors of xanthine oxidase (n = 95) and incomplete data (n = 135) were excluded from this analysis. This resulted in 2666 individuals in total. Results: Six hundred and sixty-five (25%) individuals presented without any component of MetS, and 1248 (46.8%) individuals with 1 or 2 components. In individuals free of any component of MetS, there was no association between UA and ln-ACR. In pre-metabolic individuals, UA significantly correlated with ln-ACR in men (n = 639; standardized beta (SB) 0.091; p = 0.022) and in women (n = 609; SB 0.122; p = 0.003). After multivariate adjustment, UA was independently associated with ln-ACR (SB 0.058; p = 0.004), age (SB -0.247; p < 0.001), gender (SB -0.568; p < 0.001), waist-to-height ratio (SB 0.247; p < 0.001), ln-triglycerides (SB 0.087; p = 0.001), estimated glomerular filtration rate (SB -0.425; p < 0.001), and current use of diuretics (SB 0.054; p = 0.008). An independent interaction of ln-ACR with diastolic blood pressure (DBP), (p = 0.023) in relation to UA was present. In individuals with DBP over the median of 81 mmHg (n = 611), there was independent association between ln-ACR and UA (SB 0.094; p = 0.004), whereas no association between the two variables (SB 0.038; p = 0.176) was present in individuals with DBP bellow or equal to 81 mmHg (n = 637). Conclusions: Uric acid is independently associated with albumin/creatinine ratio in individuals with pre-metabolic syndrome. This association appears to be largely modified by diastolic blood pressure.