Supplementary Material

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Abstract

Background: The incidence of metabolic syndrome (MetS) dramatically increases among middle-aged and elderly populations in China, which increases the risk of cardiovascular disease events and mortality.

Methods: This surveywas based on the China Health and Retirement Longitudinal Study baseline data in 2011 and follow-up data in 2015. 4,602 participants without MetS at baseline were included in the final analysis. The diagnosis of MetS was based on the Chinese guidelines. A multivariable logistic regression model was used to examine the association of serum uric acid quartiles, or continuous serum uric acid with the risk of incident MetS. Restricted cubic spline regression models were used to explore the dose–response relationship between serum uric acid levels and MetS incidence.

Results: Serum uric acid quartileswere associated with an increased risk of MetS incidence (p for trend = 0.03), and the adjusted RRs (95% CI) were 1.17 (0.77, 1.75), 1.51 (1.01, 2.24) and 1.54 (1.01, 2.33) in quartiles 2-4, respectively. In particular, the association was more evident among women. The multivariable-adjusted RR for 1 mg/dL in serum uric acid level was 1.17 (95% CI: 1.03, 1.34) for MetS incidence. In addition, the restricted cubic splines showed that higher serum uric acid levels were dose–response associated with increased MetS incidence risk (p for linear trend < 0.001).

Conclusions: Our results suggested that higher serum uric acid levels were independently associated with a dose-response increased risk of MetS incidence.