Association Between Serum Uric Acid and Vitamin C Levels in Adults With Metabolic Syndrome

Saher Naeem1, Raja Yasser Shahbaz1, Aqsa Khan2, Hafiz Muhammad Muavia Akbar3, Izza Rana4
1Department of Internal Medicine, Hameed Latif Hospital, Lahore 54000, Pakistan
2Saleem Memorial Hospital, Lahore 54000, Pakistan
3Hameed Latif Hospital, Lahore 54000, Pakistan
4Clinical Hematology, INMOL Hospital, Lahore 54000, Pakistan
DOI: https://doi.org/10.70517/revcc2624158
Published: 15/10/2026
: Saher Naeem, Raja Yasser Shahbaz, Aqsa Khan, Hafiz Muhammad Muavia Akbar, Izza Rana. Association Between Serum Uric Acid and Vitamin C Levels in Adults With Metabolic Syndrome. Revista Cultura Científica, 2026 Issue 24. pg. 1888-1897.

Abstract

Metabolic syndrome (MetS) comprises several interrelated cardiometabolic abnormalities, including central obesity, elevated blood pressure, dyslipidemia, and impaired glucose metabolism. Serum uric acid (SUA) concentrations are frequently elevated in individuals with MetS, while vitamin C is a water-soluble antioxidant that may be associated with urate metabolism. Limited evidence is available concerning the relationship between circulating vitamin C and SUA among Pakistani adults with MetS. This cross-sectional study investigated the correlation between serum vitamin C and SUA and evaluated the association after adjustment for selected cardiometabolic factors. The study was conducted in the Department of Medicine at Hameed Latif Hospital, Lahore, between April and July 2026. A total of 120 adults aged 18–80 years were recruited using consecutive sampling. Demographic, anthropometric, clinical, and biochemical information was obtained. Fasting venous blood samples were collected to measure SUA and serum vitamin C, and dietary vitamin C intake was estimated with a food-frequency questionnaire. Pearson correlation coefficients and multivariable linear regression were used for analysis. The mean age was 49.6 ± 11.2 years, and the mean BMI was 31.4 ± 4.7 kg/m2. Mean SUA and serum vitamin C concentrations were 6.41 ± 1.38 mg/dL and 0.42 ± 0.18 mg/dL, respectively. Hyperuricemia was identified in 41.7% of participants, while vitamin C deficiency and insufficiency were observed in 28.3% and 46.7%, respectively. Serum vitamin C and SUA were inversely correlated in the total sample (r = -0.34, p < 0.001), among men (r = -0.37, p = 0.003), and among women (r = -0.29, p = 0.027). Following adjustment for age, sex, BMI, blood pressure, triglycerides, HDL cholesterol, and fasting glucose, every 0.1 mg/dL higher serum vitamin C concentration was associated with an estimated 0.19 mg/dL lower SUA (reported coefficient = -0.19; 95% CI: -0.28 to -0.10; p < 0.001). These findings identify a significant inverse association between serum vitamin C and SUA in the selected study population. Because the design was cross-sectional and no treatment was assigned, the findings do not establish a urate-lowering effect of vitamin C. Larger prospective and interventional investigations are needed to clarify the clinical implications.

Keywords: Metabolic Syndrome; Serum uric acid; Vitamin C; Ascorbic acid; Hyperuricemia; Oxidative stress; Metabolic risk factors

Abstract

Metabolic syndrome (MetS) comprises several interrelated cardiometabolic abnormalities, including central obesity, elevated blood pressure, dyslipidemia, and impaired glucose metabolism. Serum uric acid (SUA) concentrations are frequently elevated in individuals with MetS, while vitamin C is a water-soluble antioxidant that may be associated with urate metabolism. Limited evidence is available concerning the relationship between circulating vitamin C and SUA among Pakistani adults with MetS. This cross-sectional study investigated the correlation between serum vitamin C and SUA and evaluated the association after adjustment for selected cardiometabolic factors. The study was conducted in the Department of Medicine at Hameed Latif Hospital, Lahore, between April and July 2026. A total of 120 adults aged 18–80 years were recruited using consecutive sampling. Demographic, anthropometric, clinical, and biochemical information was obtained. Fasting venous blood samples were collected to measure SUA and serum vitamin C, and dietary vitamin C intake was estimated with a food-frequency questionnaire. Pearson correlation coefficients and multivariable linear regression were used for analysis. The mean age was 49.6 ± 11.2 years, and the mean BMI was 31.4 ± 4.7 kg/m2. Mean SUA and serum vitamin C concentrations were 6.41 ± 1.38 mg/dL and 0.42 ± 0.18 mg/dL, respectively. Hyperuricemia was identified in 41.7% of participants, while vitamin C deficiency and insufficiency were observed in 28.3% and 46.7%, respectively. Serum vitamin C and SUA were inversely correlated in the total sample (r = -0.34, p < 0.001), among men (r = -0.37, p = 0.003), and among women (r = -0.29, p = 0.027). Following adjustment for age, sex, BMI, blood pressure, triglycerides, HDL cholesterol, and fasting glucose, every 0.1 mg/dL higher serum vitamin C concentration was associated with an estimated 0.19 mg/dL lower SUA (reported coefficient = -0.19; 95% CI: -0.28 to -0.10; p < 0.001). These findings identify a significant inverse association between serum vitamin C and SUA in the selected study population. Because the design was cross-sectional and no treatment was assigned, the findings do not establish a urate-lowering effect of vitamin C. Larger prospective and interventional investigations are needed to clarify the clinical implications.

Keywords: Metabolic Syndrome; Serum uric acid; Vitamin C; Ascorbic acid; Hyperuricemia; Oxidative stress; Metabolic risk factors

References

  1. Metelskaya, Victoria A., et al. “Prevalence, Components, and Correlates of Metabolic Syndrome (MetS) among Elderly Muscovites.” Archives of Gerontology and Geriatrics, vol. 55, no. 2, 2012, pp. 231–237. https://doi.org/10.1016/j.archger.2011.09.005

  2. Noubiap, Jean Jacques, et al. “Geographic Distribution of Metabolic Syndrome and Its Components in the General Adult Population: A Meta-Analysis of Global Data from 28 Million Individuals.” Diabetes Research and Clinical Practice, vol. 188, 2022, article 109924. https://doi.org/10.1016/j.diabres.2022.109924

  3. Aryal, Nirmal, and Sharada Prasad Wasti. “The Prevalence of Metabolic Syndrome in South Asia: A Systematic Review.” International Journal of Diabetes in Developing Countries, vol. 36, no. 3, 2016, pp. 255–262. https://doi.org/10.1007/s13410-015-0365-5

  4. Maloberti, Alessandro, et al. “The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and Its Role in Metabolic Dysregulation.” High Blood Pressure & Cardiovascular Prevention, vol. 30, no. 5, 2023, pp. 411–425. https://doi.org/10.1007/s40292-023-00602-4

  5. Azzeh, Firas S., et al. “Vitamin C Supplementation and Serum Uric Acid: A Reaction to Hyperuricemia and Gout Disease.” PharmaNutrition, vol. 5, no. 2, 2017, pp. 47–51. https://doi.org/10.1016/j.phanu.2017.02.002

  6. Tetradze, L., et al. “Relation of Serum Uric Acid Levels with Basic Metabolic Parameters in Patients with Metabolic Syndrome during Insulin-Sensitizing Therapy.” Georgian Medical News, no. 151, 2007, pp. 44–47. https://pubmed.ncbi.nlm.nih.gov/18071212/

  7. Falsetti, Paolo, and Caterina Acciai. “Oral Vitamin C Supplementation and Serum Uric Acid: Comment on the Article by Juraschek et al.” Arthritis Care & Research, vol. 64, no. 6, 2012, p. 941. https://doi.org/10.1002/acr.21614

  8. Yang, Yanting, et al. “Associations between Vitamin C Intake and Serum Uric Acid in US Adults: Findings from National Health and Nutrition Examination Survey 2011–2016.” PLOS ONE, vol. 18, no. 10, 2023, article e0287352. https://doi.org/10.1371/journal.pone.0287352

  9. Zou, Yadan, et al. “Association between Dietary Vitamin C Intake and Gout among American Adults.” Frontiers in Immunology, vol. 15, 2024, article 1431323. https://doi.org/10.3389/fimmu.2024.1431323

  10. Enderle, Janna, et al. “Effect of Vitamin C and Hesperidin on Serum Uric Acid Concentrations in Healthy Adults with High Uric Acid Levels: The Randomized Controlled ‘HesperidrinC Trial’.” European Journal of Nutrition, vol. 65, no. 2, 2026, article 67. https://doi.org/10.1007/s00394-026-03905-z

  11. Kim, Ji Young, et al. “Predictive Cut-Off Values for the Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio to Predict Metabolic Syndrome in the Middle-Aged Korean Population.” Nutrition, Metabolism and Cardiovascular Diseases, vol. 34, no. 4, 2024, pp. 882–892. https://doi.org/10.1016/j.numecd.2024.01.023

  12. Raja, Sooraj, et al. “Frequency of Hyperuricemia and Its Risk Factors in the Adult Population.” Cureus, vol. 11, no. 3, 2019, article e4198. https://doi.org/10.7759/cureus.4198

  13. Ahad, Abdul, et al. “Prevalence and Correlates of Hyperuricemia in Patients with Hypertension: A Cross-Sectional Study from a Tertiary Care Hospital in Pakistan.” Pakistan Journal of Health Sciences, vol. 6, no. 2, 2025, pp. 15–20. https://doi.org/10.54393/pjhs.v6i2.2116

  14. Shaikh, Altaf Ahmed, et al. “Prevalence of Hyperuricemia in Sukkur; Pakistan: A Cross Sectional Survey.” The Professional Medical Journal, vol. 26, no. 9, 2019, pp. 1567–1569. https://doi.org/10.29309/TPMJ/2019.26.09.4027

  15. Santosh, Holenarasipur Nagesh, and Chaya David. “A Food Frequency Questionnaire to Determine the Intake of Vitamin C: A Pilot Validation Study.” Romanian Journal of Diabetes Nutrition and Metabolic Diseases, vol. 24, no. 2, 2017, pp. 95–99. https://doi.org/10.1515/rjdnmd-2017-0013

  16. Valenti, Luca, et al. “Consensus Statement on the Definition and Classification of Metabolic Hyperferritinaemia.” Nature Reviews Endocrinology, vol. 19, no. 5, 2023, pp. 299–310. https://doi.org/10.1038/s41574-023-00807-6

  17. Copur, Sidar, et al. “Uric Acid in Metabolic Syndrome: Does Uric Acid Have a Definitive Role?” European Journal of Internal Medicine, vol. 103, 2022, pp. 4–12. https://doi.org/10.1016/j.ejim.2022.04.022

  18. Guo, Hongbin, et al. “Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies.” Frontiers in Nutrition, vol. 8, 2021, article 728880. https://doi.org/10.3389/fnut.2021.728880

  19. Park, Sunmin, et al. “A Healthy Diet Rich in Calcium and Vitamin C Is Inversely Associated with Metabolic Syndrome Risk in Korean Adults from the KNHANES 2013–2017.” Nutrients, vol. 13, no. 4, 2021, article 1312. https://doi.org/10.3390/nu13041312

  20. Liu, Xin-Xin, et al. “Association between Oral Vitamin C Supplementation and Serum Uric Acid: A Meta-Analysis of Randomized Controlled Trials.” Complementary Therapies in Medicine, vol. 60, 2021, article 102761. https://doi.org/10.1016/j.ctim.2021.102761

Saher Naeem
Department of Internal Medicine, Hameed Latif Hospital, Lahore 54000, Pakistan
Raja Yasser Shahbaz
Department of Internal Medicine, Hameed Latif Hospital, Lahore 54000, Pakistan
Aqsa Khan
Saleem Memorial Hospital, Lahore 54000, Pakistan
Hafiz Muhammad Muavia Akbar
Hameed Latif Hospital, Lahore 54000, Pakistan
Izza Rana
Clinical Hematology, INMOL Hospital, Lahore 54000, Pakistan

How to cite:

Saher Naeem, Raja Yasser Shahbaz, Aqsa Khan, Hafiz Muhammad Muavia Akbar, Izza Rana. Association Between Serum Uric Acid and Vitamin C Levels in Adults With Metabolic Syndrome. Revista Cultura Científica, 2026 Issue 24. pg. 1888-1897.

Publication History

Copyright © 2026, Saher Naeem, Raja Yasser Shahbaz, Aqsa Khan, Hafiz Muhammad Muavia Akbar, Izza Rana. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

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