Association of the Serum Uric Acid to Creatinine Ratio with Metabolic Syndrome: Meta-analysis

Abstract

Background This meta-analysis was conducted to evaluate the association between the serum uric acid to creatinine ratio (SUA/Cr) and metabolic syndrome (MetS). The study was designed to highlight relationships and assess the consistency of findings across different studies. Methods A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, to select studies examining the association between SUA/Cr and MetS. Meta-analysis was conducted using both random and fixed effects models, pooling odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the overall effect. Leave-one-out sensitivity analyses evaluated the influence of individual studies, while publication bias was assessed using Egger’s test and funnel plot. Meta-regression analyses were conducted to explore potential moderators. Results This meta-analysis included ten studies which investigated the association between SUA/Cr and MetS. The findings found a significant positive association between SUA/Cr and MetS, with elevated SUA/Cr leading to 52% higher odds of MetS (random effects OR = 1.52, 95% CI: 1.31–1.77, p < 0.0001). The fixed effect model produced a comparable estimate (OR = 1.25), and leave-one-out sensitivity analyses found that no individual study had a dominated impact on the overall results. Publication bias was assessed using Egger’s test and visualized via a funnel plot, which suggested no notable bias, although the small number of studies limits the test’s power. Meta-regression analyses found that study design and participant age significantly influenced the strength of the association, with retrospective cohort studies and older populations exhibiting stronger effects. Conclusion This meta-analysis confirmed a significant positive association between SUA/Cr and MetS, with the magnitude of the association influenced by study design and participant age. However, the current evidence should be interpreted with caution due to notable heterogeneity among studies, highlighting the need for further research to clarify the underlying mechanisms and clinical relevance.