Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (8): 96-106.doi: 10.6040/j.issn.1671-7554.0.2026.0717

• Clinical Medicine • Previous Articles    

Association between serum uric acid and metabolic syndrome in children and adolescents: a cross-sectional study in Shandong and Hebei provinces, China

FENG Jian1, YANG Li2, WANG Yongjun3, LIU Changqing4, TIAN Meina4, ZHOU Han5, YU Lianlong5   

  1. 1. Department of Clinical Nutrition, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Infectious Disease Prevention and Control, Jinan Municipal Center for Disease Control and Prevention, Jinan 250021, Shandong, China;
    3. Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China;
    4. Institute of Nutrition and Food Safety, Hebei Center for Disease Control and Prevention, Shijiazhuang 050021, Hebei, China;
    5. Institute of Food and Nutrition, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China;
    6. Institute of Public Health Monitoring and Evaluation, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China
  • Published:2026-08-14

PDF (PC)

7

Abstract: Objective To investigate the association between serum uric acid(SUA)and metabolic syndrome(MetS)in children and adolescents aged 10-14 years, and to determine an optimal SUA cut-off for stratified screening, with the goal of providing epidemiological evidence for early detection, risk stratification, and precision prevention in this population. Methods Data were derived from the 2016-2017 Chinese National Nutrition and Health Survey(CNHS). A total of 3,098 participants aged 10-14 years were enrolled from Shandong and Hebei provinces. Demographic characteristics, lifestyle factors, anthropometric measurements, and laboratory parameters were collected. Multivariate logistic regression was used to examine the independent associations of SUA with MetS and its individual components. Restricted cubic spline(RCS)analysis was employed to evaluate the dose-response relationship, and receiver operating characteristic(ROC)curve analysis was performed to identify the optimal SUA cut-off for predicting MetS. Results The overall prevalence of MetS in the study population was 3.87%. After adjusting for multiple confounders, SUA was independently and positively correlated with MetS and each of its components, including abdominal obesity, hypertension, and dyslipidaemia(P<0.001). RCS analysis revealed a progressive increase in MetS risk with rising SUA levels. The optimal SUA cut-off value for predicting MetS was determined to be 334.5 μmol/L. Conclusion Our findings demonstrate an independent association between SUA and MetS among children and adolescents aged 10-14 years in Shandong and Hebei provinces. The identified cut-off of 334.5 μmol/L may serve as a reference threshold for stratified screening in this regional population, offering preliminary evidence to support health management and metabolic disease prevention efforts in this area.

Key words: Children and adolescents, Metabolic syndrome, Serum uric acid, Dose-response relationship, Cut-off value

CLC Number: 

  • R58
[1] 中华医学会健康管理学分会,《中华健康管理学杂志》编辑委员会,国家老年疾病临床医学研究中心(湘雅医院). 成人代谢综合征防控健康教育专家共识[J]. 中华健康管理学杂志,2024, 18(2): 81-92. Chinese Society of Health Management, Chinese Medical Association, Editorial Board of Chin J Health Manage, National Clinical Research Center for Geriatric Diseases(Xiangya Hospital). Expert consensus on health education for prevention and control of metabolic syndrome in adults[J]. Chin J Health Manage, 2024, 18(2): 81-92.
[2] 中华医学会儿科学分会内分泌遗传代谢学组,国家儿童健康与疾病临床医学研究中心,中国临床实践指南联盟. 儿童代谢综合征临床防治指南(2025)[J]. 中华儿科杂志,2025, 63(1): 6-14. Subspecialty Group of Endocrinology, Hereditary and Metabolic Diseases, Society of Pediatrics, Chinese Medical Association, National Clinical Research Center for Child Health and Disease, China Clinical Practice Guideline Alliance. Clinical prevention and treatment guidelines for pediatric metabolic syndrome(2025)[J]. Chin J Pediatr, 2025, 63(1): 6-14.
[3] Zhu Q, Zong X, Yu L, et al. Serum uric acid levels among children and adolescents in China: percentile refe-rence values and national prevalence estimates of hyperuricemia[J]. BMC Med, 2026, 24(1): 300. DOI: 10.1186/s12916-026-04814-y
[4] 中华医学会内分泌学分会,中华医学会儿科学分会,中国医师协会内分泌代谢科医师分会. 青少年高尿酸血症与痛风的管理: 2025年临床实践共识[J]. 中华内分泌代谢杂志, 2025, 41(10): 865-874. Chinese Society of Endocrinology, Chinese Medical Association, Chinese Society of Pediatrics, Chinese Medical Association, Endocrinology and Metabolism Branch, Chinese Medical Doctor Association. Clinical practice consensus statement 2025: management of hyperuricemia and gout in adolescents[J]. Chin J Endocrinol Metab, 2025, 41(10): 865-874.
[5] Foster C, Smith L, Alemzadeh R. Excess serum uric acid is associated with metabolic syndrome in obese adolescent patients[J]. J Diabetes Metab Disord, 2020, 19(1): 535-543.
[6] Di Y Z, Wang J P, Chen Y L, et al. Elevated interleukin 1β and interleukin 6 Levels in the serum of children with hyperuricemia[J]. J Clin Rheumatol, 2018, 24(2): 65-69.
[7] Barzin M, Asghari G, Hosseinpanah F, et al. The asso-ciation of anthropometric indices in adolescence with the occurrence of the metabolic syndrome in early adulthood: Tehran Lipid and Glucose Study(TLGS)[J]. Pediatr Obes, 2013, 8(3): 170-177.
[8] 朱博文,王同帅,王星云,等. 血尿酸水平对儿童青少年代谢综合征及其组分的影响[J]. 中国儿童保健杂志,2025, 33(5): 489-496. Zhu Bowen, Wang Tongshuai, Wang Xingyun, et al. Effect of serum uric acid levels on metabolic syndrome and its components in children and adolescents[J]. Chin J Child Health Care, 2025, 33(5): 489-496.
[9] 中华医学会儿科学分会内分泌遗传代谢学组,中华医学会儿科学分会心血管学组,中华医学会儿科学分会儿童保健学组. 中国儿童青少年代谢综合征定义和防治建议[J]. 中华儿科杂志,2012, 50(6): 420-422. Subspecialty Group of Endocrinology, Hereditary and Metabolic Diseases, Society of Pediatrics, Chinese Medical Association, Subspecialty Group of Cardiology, Society of Pediatrics, Chinese Medical Association, Subspecialty Group of Child Health Care, Society of Pediatrics, Chinese Medical Association. Definition and prevention recommendations of metabolic syndrome in Chinese children and adolescents[J]. Chin J Pediatr, 2012, 50(6): 420-422.
[10] Zimmet P, Alberti K G, Kaufman F, et al. The metabolic syndrome in children and adolescents-an IDF consensus report[J]. Pediatr Diabetes, 2007, 8(5): 299-306.
[11] 国家卫生健康委员会. 7岁~18岁儿童青少年高腰围筛查界值: WS/T 611-2018[S]. 北京: 中国标准出版社,2018. National Health Commission. High waist circumference screening threshold among children and adolescents aged 7-18 years: WS/T 611-2018[S]. Beijing: Standards Press of China, 2018.
[12] Li C, Li J, Diao Z Q, et al. Associations of dietary choline intake and kidney function with hyperuricemia in Chinese children and adolescents: a cross-sectional study[J]. eClinicalMedicine, 2025, 79: 103012. DOI: 10.1016/j.eclinm.2024.103012
[13] Lu J, Sun W Y, Cui L L, et al. A cross-sectional study on uric acid levels among Chinese adolescents[J]. Pediatr Nephrol, 2020, 35(3): 441-446.
[14] Noubiap J J, Nansseu J R, Lontchi-Yimagou E, et al. Global, regional, and country estimates of metabolic syndrome burden in children and adolescents in 2020: a systematic review and modelling analysis[J]. Lancet Child Adolesc Health, 2022, 6(3): 158-170.
[15] 高丽霞,张力之,朱文萱,等. 中国儿童青少年代谢综合征患病率的Meta分析[J]. 数理医药学杂志,2024, 37(12): 922-934. Gao Lixia, Zhang Lizhi, Zhu Wenxuan, et al. Meta-analysis of the prevalence of metabolic syndrome in Chinese children and adolescents[J]. J Math Med, 2024, 37(12): 922-934.
[16] Shi J, He L, Yu D M, et al. Prevalence and correlates of metabolicsyndrome and its components in Chinese children and adolescents aged 7-17: the China national nutrition and health survey of children and lactating mothers from 2016-2017[J]. Nutrients, 2022, 14(16): 3348. DOI: 10.3390/nu14163348
[17] Goli P, Riahi R, Daniali S S, et al. Association of serum uric acid concentration with components of pediatric metabolic syndrome: a systematic review and meta-analysis[J]. J Res Med Sci, 2020, 25(1): 43. DOI: 10.4103/jrms.JRMS_733_19
[18] Xiao Y, Wang H, Han L, et al. Effect of uric acid on lipid metabolism assessed via restricted cubic splines: a new insight[J]. Heliyon, 2024, 10(17): e37408. DOI: 10.1016/j.heliyon.2024.e37408
[19] Si S A, Chen M Q, Zhang G J. Association of serum uric acid with hypertriglyceridemia in children and adolescents: a cross-sectional study[J]. Lipids Health Dis, 2024, 23: 195. DOI: 10.1186/s12944-024-02182-1
[20] Park B, Lee H A, Lee S H, et al. Association between serum levels of uric acid and blood pressure tracking in childhood[J]. Am J Hypertens, 2017, 30(7): 713-718.
[21] Yuan H P, Yu C L, Li X H, et al. Serum uric acid levels and risk of metabolic syndrome: a dose-response meta-analysis of prospective studies[J]. J Clin Endocrinol Metab, 2015, 100(11): 4198-4207.
[22] Wang Y, Charchar F J. Establishment of sex difference in circulating uric acid is associated with higher testoste-rone and lower sex hormone-binding globulin in adolescent boys[J]. Sci Rep, 2021, 11: 17323. DOI: 10.1038/s41598-021-96959-4
[23] Kim S M, Lee S H, Kim Y G, et al. Hyperuricemia-induced NLRP3 activation of macrophages contributes to the progression of diabetic nephropathy[J]. Am J Physiol Renal Physiol, 2015, 308(9): F993-F1003.
[24] Wan X, Xu C, Lin Y, et al. Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism[J]. J Hepatol, 2016, 64(4): 925-932.
[25] Sautin Y Y, Nakagawa T, Zharikov S, et al. Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative/nitrosative stress[J]. Am J Physiol Cell Physiol, 2007, 293(2): C584-C596.
[26] Ford E S, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents[J]. Circulation, 2007, 116(19): 2526-2532.
[27] Feig D I, Soletsky B, Johnson R J. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial[J]. JAMA, 2008, 300(8): 924-932.
[1] KUANG Li, XU Heyan. From precision assessment to integrated intervention: innovations and future perspectives in the diagnostic and therapeutic paradigm for child and adolescent mental health disorders [J]. Journal of Shandong University (Health Sciences), 2026, 64(3): 10-16.
[2] LI Fanghua, LIU Na, LI Xiaoyu, XU Dianhua, WANG Qian. Research progress on medication adherence in children and adolescents with depressive disorder [J]. Journal of Shandong University (Health Sciences), 2026, 64(3): 24-34.
[3] WANG Qian, HU Xiaojing, WANG Aiqing, SUN Qiang, MENG Chunyan, LI Fanghua. Visual analysis of non-suicidal self-injury literature about children and adolescents with depressive disorder [J]. Journal of Shandong University (Health Sciences), 2026, 64(3): 93-107.
[4] HUANG Xin, WANG Mengxue, FU Shufan, ZHANG Qiyue, XU Li. Causal association of metabolic syndrome and its components with digestive system malignancies: a two-sample Mendelian randomized study [J]. Journal of Shandong University (Health Sciences), 2025, 63(5): 86-94.
[5] ZHAO Zhibo, MAN Zhentao, LI Wei. Role of cholesterol metabolism in osteoarthritis: a review of research progresses [J]. Journal of Shandong University (Health Sciences), 2024, 62(2): 1-9.
[6] ZHUANG Dayong, HE Qingqing, LI Xiaolei, ZHOU Peng, YUE Tao, XU Jing. Application of da Vinci robotic thyroidectomy for thyroid cancer in children and adolescents [J]. Journal of Shandong University (Health Sciences), 2021, 59(1): 45-48.
[7] HU Yanwen, WANG Zhiyuan, YU Wanjiang, ZHAO Huichen, HAN Heli, XU Zhipeng, MA Hong, ZHANG Yuchao, LIU Yuantao. Correlation of fat distribution with metabolic syndrome and glucose metabolism in 52 obese patients [J]. Journal of Shandong University (Health Sciences), 2020, 1(8): 101-106.
[8] MA Xiaotian, GU Jianhua, WANG Li, XUE Fuzhong, LIU Yanxun. Association between platelet count and metabolic syndrome based on a prospective cohort study [J]. Journal of Shandong University (Health Sciences), 2018, 56(12): 92-97.
[9] SUN Yuanying, YANG Yachao, QU Mingling, CHEN Yanmin, LI Min, WANG Shukang, XUE Fuzhong, LIU Yunxia. A prediction model for metabolic syndrome risk: a study based on the health management cohort [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 87-92.
[10] YU Zhenzhen, CHEN Hui, YANG Xiaoyun, LÜ Ming. Correlation between hyperuricemi, Helicobacter pylori infection and metabolic syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 76-80.
[11] XU Yibo, JI Xiaokang, LI Xiangyi, SHEN Zhenwei, XUE Fuzhong. Analysis on the relationship between urine pH and metabolic syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(12): 82-85.
[12] XIAO Juan, CHEN Qicai, ZHANG Pengpeng, CHEN Lili, CHEN Xiaoxiao, WANG Shumei. Association between serum alanine transaminase with metabolic syndrome and its components based on a longitudinal health check-up study in Dongying City, China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(1): 86-91.
[13] ZHANG Fenglei, ZHENG Man, ZHANG Qi, GU Lei, XU Xinsheng. Clinical study on the association between metabolic syndrome and P wave dispersion [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(2): 52-55.
[14] JIN Chengwei, LI Kui, ZHAO Jing, YUE Xin, SHANG Yuanyuan, HAN Lu, ZHANG Yun, ZHANG Wei, MA Xiao, ZHONG Ming. Relationship between the mRNA expression of adipose triglyceride lipase in peripheral blood mononuclear cells and metabolic syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(8): 39-42.
[15] LIU Congcong1, ZHU Yun2, SONG Cuiling3, LIU Ping4. Relationship between metabolic syndrome and serum bilirubin in asymptomatic population of Jinan, China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(3): 101-105.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd