Elevated uric acid, the metabolic syndrome and cardiovascular disease: cause, consequence, or just a not so innocent bystander?

For more than 200 years initially seen as a cause of gout, speaking in a politically correct 21st century term, a disease of the rich and very well nourished people, many experimental and epidemiological studies have associated increased levels of serum uric acid (UA) with the classical components of the metabolic syndrome (MS), type 2 diabetes, and cardiovascular disease [1]. This association with components of the MS is seen even in children and adolescents [2]. The topic of increased UA concentrations, its consequences or associations is getting more important nowadays due to the increments in the prevalence of obesity and the MS in both developed and developing countries.