Serum uric acid and the incidence of new-onset metabolic syndrome among military young adults in Taiwan: the CHIEF cohort study

Backgrounds: Serum uric acid (SUA), a purine metabolite, can reflect the status of low-grade inflammation in the body, which may contribute to metabolic syndrome (MetS). However, the association has been found to be weak in men, especially in elderly individuals. Whether this association is present in young men remains unclear. This study aimed to investigate the association between SUA concentrations and the incident MetS among military personnel, most of whom were young men. Materials and methods: This cohort study included 2,890 Taiwanese military personnel (90% male), aged 18-39 years, who were free of MetS at baseline following new-onset MetS from 2014 (baseline) through the end of 2020. SUA concentrations were measured at baseline. Incident MetS was diagnosed using the modified NCEP ATP III criteria and was identified during the annual military health examinations. A multivariable Cox regression analysis model adjusted for baseline age, sex, substance use, physical activity level, body mass index, blood urea nitrogen level, serum creatinine level, total white blood cell count and hemoglobin level was used to determine the association. Subgroup analyses were performed for each component of MetS. Results: During a mean follow-up of 6.0 years, 673 incident MetS events (23.3%) were reported. Higher SUA concentrations (every 1 mg/dL increase) were associated with a greater risk of MetS hazard ratio: 1.22 (95% confidence interval: 1.15-1.30). There were no significant differences within each MetS component, i.e., central obesity, hypertension, hyperglycemia or dyslipidemia, according to the subgroup analyses. Conclusion: This study suggests that higher SUA concentrations are associated with a greater risk of new-onset MetS among Taiwanese military personnel, most of whom were young men, and the association was consistent across the MetS subgroups. Since this prospective cohort study is observational, the cause-and- effect association requires further investigation.