Uric acid and Metabolic Syndrome: What is the Relationship?
Uric acid and Metabolic Syndrome: What is the Relationship?
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DOI：
10.2174/157339711795305004
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发表时间：
2011-01-01
影响因子：
1.5
通讯作者：
Johnson, Richard J.
中科院分区：
文献类型：
--
作者：
Lanaspa, Miguel A.;Sautin, Yuri Y.;Johnson, Richard J.
尿酸升高在胰岛素抵抗和肥胖症患者中很常见，实际上是代谢综合征复合体的一部分。在这篇文章中，我们回顾了尿酸在代谢综合征中的潜在因果作用的证据。虽然一些研究表明，尿酸可能只是代谢综合征受试者存在氧化应激或高胰岛素血症的结果，但越来越多的证据表明，尿酸可能起到促进作用。首先，血尿酸升高往往是肥胖和代谢综合征发展的先兆。第二，实验和临床研究提供了越来越多的证据表明，过量摄入果糖，主要是以添加糖的形式，可能在代谢综合征的发展中起关键作用。果糖可以增加尿酸水平，降低果糖喂养大鼠的尿酸水平可以改善胰岛素抵抗和代谢综合征的特征。其机制可能是通过改善内皮功能和尿酸对脂肪细胞的直接作用。然而，摄入高剂量果糖的受试者尿酸的降低与血压的改善有关，但与代谢综合征的其他特征无关。显然，需要更多的研究来更好地了解尿酸在代谢综合征中的作用，但似乎尿酸可能既是代谢综合征的标志物，也是潜在的修饰物。
An elevated uric acid is common in subjects with insulin resistance and obesity, and is in effect part of the metabolic syndrome complex. In this paper we review evidence for a potential causal role of uric acid in the metabolic syndrome. While some studies suggest that uric acid may simply be a consequence of the presence of oxidative stress or hyperinsulinemia present in subjects with metabolic syndrome, there is increasing evidence that uric acid could have a contributory causal role. First, an elevated serum uric acid often precedes the development of obesity and metabolic syndrome. Second, experimental and clinical studies provide increasing evidence that excessive intake of fructose, primarily in the form of added sugars, may have a key role in the development of metabolic syndrome. Fructose increases uric acid levels, and lowering uric acid in fructose fed rats can improve insulin resistance and features of metabolic syndrome. The mechanism may be via the improvement in endothelial function and due to direct actions of uric acid on adipocytes. However, the lowering of uric acid in human subjects ingesting high doses of fructose was associated with improvement in blood pressure but not in other features of metabolic syndrome. Clearly more studies are needed to better understand the role of uric acid in metabolic syndrome, but it seems likely that uric acid may have a role as both a marker and potential modifier of the metabolic syndrome.