Gender Differences in the Associations Between Serum Urate and Cardiometabolic Risk Factors in Age-Matched Middle-Aged Japanese.

Background: The purpose of this study was to determine whether gender affects associations between serum urate and cardiometabolic risk factors in age-matched men and women. Methods: The subjects were 4612 men and 4612 age-matched women (35-60 years old) who had undergone health-checkup examinations. The relationships between high urate (defined as the highest quartile for serum urate) and cardiovascular risk factors were compared between men and women using logistic regression analysis and receiver operating characteristic analysis. Results: The odds ratio (OR) of subjects with high urate versus subjects without high urate for metabolic syndrome was significantly higher in women than in men (women: 3.82 [95% confidence interval: 2.93-4.97] vs. men: 1.99 [1.63-2.42], p < 0.01), and the ORs for each of the cardiometabolic risk factors (high body mass index [BMI], hypertension, hypertriglyceridemia, low HDL cholesterolemia, and diabetes mellitus) were also significantly higher in women than in men. The ORs of the interaction term consisting of gender (women vs. men) and high urate for each of the cardiometabolic risk factors (high BMI, hypertriglyceridemia, low HDL cholesterolemia, and diabetes mellitus) and metabolic syndrome were significantly higher than the reference level. In receiver operating characteristic analysis, area under the curve of the relationship between serum urate and each of high BMI, hypertension, hypertriglyceridemia, low HDL cholesterolemia, high LDL cholesterolemia, diabetes, and metabolic syndrome was significantly larger in women than in men. The cutoffs of serum urate for metabolic syndrome were 6.25 and 4.65 mg/dL in men and women, respectively, which are lower than those currently used. Conclusions: The associations between hyperuricemia and cardiometabolic risk factors were age-independently stronger in women than in men. The results suggested that the cutoff values for hyperuricemia that are currently used should be redefined from the viewpoint of prevention of cardiovascular disease.