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(Circulation. 2007;115:2526-2532.)
© 2007 American Heart Association, Inc.

Pediatric Cardiology

Serum Concentrations of Uric Acid and the Metabolic Syndrome Among US Children and Adolescents

Earl S. Ford, MD, MPH; Chaoyang Li, MD, PhD; Stephen Cook, MD; Hyon K. Choi, MD, DrPh

From the Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga (E.S.F, C.L.); Strong Children’s Research Center, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY (S.C.); and Rheumatology Division, Arthritis Research Centre of Canada, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada, and Channing Laboratory, Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (H.K.C.).

Correspondence to Earl S. Ford, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS K66, Atlanta, GA 30341. E-mail eford{at}cdc.gov

Received October 4, 2006; accepted March 19, 2007.

Background— The association between concentrations of uric acid and the metabolic syndrome in children and adolescents remains incompletely understood. The objective of this study was to examine how these 2 were associated in a nationally representative sample of US children and adolescents.

Methods and Results— We performed a cross-sectional analysis of 1370 males and females aged 12 to 17 years using data from the National Health and Nutrition Examination Survey 1999–2002. The prevalence of the metabolic syndrome was <1% among participants in the lowest quartile of serum concentration of uric acid, 3.7% in the second quartile, 10.3% in the third quartile, and 21.1% in the highest quartile. Compared with the lowest 2 quartiles of uric acid together (291.5 µmol/L), the odds ratios were 5.80 (95% confidence interval, 3.22 to 10.46) for those in the third quartile (>291.5 to 339 µmol/L or >4.9 to 5.7 mg/dL) and 14.79 (95% confidence interval, 7.78 to 28.11) for those in the top quartile (>339 µmol/L) after adjustment for age, sex, race or ethnicity, and concentrations of C-reactive protein. Starting with the lowest quartile of concentration of uric acid, mean concentrations of serum insulin were 66.2, 66.7, 79.9, and 90.9 pmol/L for ascending quartiles, respectively (P for trend <0.001).

Conclusions— Among US children and adolescents, serum concentrations of uric acid are strongly associated with the prevalence of the metabolic syndrome and several of its components.

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