The prevalence of metabolic syndrome in the elderly is high, according to the data of the World Health Organization, the prevalence of metabolic syndrome in the elderly ranged from 11–43% (median 21%), and NCEP is 23–55% (median 31%).[14–17] Our study revealed the relationship between uric acid and metabolic syndrome in elderly Chinese population. In addition, we analyzed the correlation between uric acid levels and blood lipids, sugar levels, and blood pressure and found the relationship among these.
Hyperuricemia is a risk factor for cardiovascular events. [18, 19]Similarly, metabolic syndrome is also an independent risk factor for cardiovascular events. In fact, there are different opinions about the correlation between uric acid and metabolic syndrome. Studies have shown that uric acid has nothing to do with metabolic syndrome and metabolic syndrome components  L. CIBIČKOVÁ et al. conducted an investigation and found that uric acid is related to metabolic syndrome, and the correlation is most obvious in the case of dyslipidemia.  Manfredi Rizzo et al. believe that the metabolic syndrome centered on insulin resistance can lead to hyperinsulinemia. Hyperinsulinemia in the body will increase the reabsorption of uric acid in the renal tubules, thereby forming hyperuricemia. 
Some studies even showed that uric acid is an independent risk factor for metabolic syndrome.[23–25]. Endy Adnan et al. investigated 102 outpatients and found that among subjects with MetS, serum uric acid levels were significantly higher than those of non-MetS subjects.  Our research found that various lipid components of metabolic syndrome are correlated with uric acid levels in elderly Chinese population. A study suggested that higher intracellular uric acid levels could induce mitochondrial translocation of the nicotinamide adenine dinucleotide phosphate oxidase subunit, the nicotinamide adenine dinucleotide phosphate oxidase 4, further leading to increased mitochondrial oxidative stress, mitochondrial dysfunction and citrate to release to the cytosol, ultimately promoting to the synthesis of lipid and TG. [27, 28] In addition, the enzyme activity that catalyzes the decomposition of TG is affected by high levels of uric acid, which inhibits the decomposition of serum TG, leading to the incidence of hypertriglyceridemia.. Hyperuricemia reduction in the Pound mouse or fructose-fed rats, as well as hyperuricemia induction by uricase inhibition in rodents and studies using cell culture have suggested that uric acid plays an important role in the development of metabolic syndrome. These studies have shown that high uric acid levels regulate the oxidative stress, inflammation and enzymes associated with glucose and lipid metabolism, suggesting a mechanism for the impairment of metabolic homeostasis. 
Metabolic syndrome is defined as insulin resistance syndrome (IR), which may lead to the occurrence of MetS.[31, 32] Studies have suggested that hyperuricemia and insulin resistance have a two-way relationship. [19, 33] Increasing serum uric acid can lead to insulin resistance, through the low-pressure bioavailability of nitric oxide (NO), and ultimately produce oxidative stress in the mitochondria.  IR can also cause hyperuricemia by increasing the sodium reabsorption mechanism and increase the absorption of uric acid. The increase in serum uric acid is negatively correlated with insulin sensitivity.  These data may indicate that hyperuricemia is probably an important factor of MetS.
At the end, several limitations should be mentioned. First, cross-sectional research cannot draw a causal relationship between the MetS and uric acid affected by the type of research. Second, we could not obtain some useful data, such as drug use. Therefore, we hope to conduct multi-center and prospective research in the future. In summary, we hope to bring new content to the management of metabolic syndrome for the elderly in China through our research. The common pathogenesis of hyperuricemia and metabolic syndrome is also worthy of further exploration.