Background: A great debate in literature exists nowadays on the role of uric acid as a marker
of cardiovascular and metabolic organ damage or a risk factor for cardiovascular and metabolic disease.
Methods: The study aimed to determine the relationship among serum uric acid and metabolic syndrome
and atherosclerosis, by means of carotid intima media-thickness, in a cohort of 811 otherwise
healthy overweight/obese subjects, without overt atherosclerosis not using any kind of drug.
Results: Uric acid levels were positively related to male gender, waist circumference, BMI, systolic
and diastolic pressure levels, fasting insulin, fasting glucose, HOMA-IR, triglycerides, total cholesterol,
LDL cholesterol, the presence of metabolic syndrome and the number of the components of
metabolic syndrome and negatively related to HDL cholesterol levels. No correlation was found between
uric acid and carotid intima media thickness. At the multiple regression analysis, only waist
circumference and triglycerides (positively) and HDL-cholesterol (negatively) maintained an independent
association with uric acid as dependent variable, while age, female gender and uric acid
showed a significant independent association with metabolic syndrome as dependent variable. Moreover,
the analysis of the odd ratios showed that the risk of developing metabolic syndrome was consistent
with uric acid levels ranging from 3 mg/dl to 8 mg/dl.
Conclusion: The presence of metabolic syndrome does not seem to provide hyperuricemia. By contrast,
higher serum uric acid level may predict the risk of metabolic syndrome. Moreover, our results
suggest that uric acid cannot be considered a risk factor for early atherosclerosis, at least when assessed
using carotid ultrasound.