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Uric acid, gender, and insulin


Clinical bottom line

Hyperinsulinaemia is more common with high levels of serum uric acid in nondiabetic subjects


P Chou et al. Gender differences in the relationships of serum uric acid with fasting serum insulin and plasma glucose in patients without diabetes. J Rheumatol 2001 28: 571-576.


This study was done in 7,500 men and women from 45,000 on the Kinmen islands off southern China. During 1991 to 1995 all residents over 30 years were surveyed for a number of demographic variables. The subjects were responders who were not diabetics and who had blood tests that included serum uric acid and fasting glucose and insulin.


The mean age was about 50 years. Hyperuricaemia occurred in 987/3218 men (31% over 7 mg/dL or 410 µmol/L) and 892/4283 women (21% over 6 mg/dL or 350 µmol/L). hperinsulinaemia, defined as a fasting serum insulin level greater than the 90th percentile of the general population in Kinmen (>20.5 µU/mL) was higher in men and women with high serum uric acid (Figure 1).

Figure 1: Hyperinsulinaemia in men and women according to serum uric acid

For women and men fasting plasma insulin levels rose with increasing serum uric acid in a highly significant manner.


This study exposes a relationship between serum uric acid and insulin resistance, which may in turn be related to higher risks of cardiovascular disease. Both may be related to body weight and obesity. High serum uric acid levels are not just about gout.