Recent studies show that an elevated serum uric acid likely has a direct role to increase fat stores and induce features of metabolic syndrome. Lowering serum uric acid has been found to reduce fatty liver, serum triglycerides, blood pressure and improve insulin resistance in a variety of animal models.

Epidemiological studies show unequivocally that hyperuricemia is a consistent independent risk factor for obesity, fatty liver, insulin resistance and hypertension. Some genetic studies have linked polymorphisms in uric acid transport with hypertension, obesity and metabolic syndrome whereas others have not. Early clinical studies are also suggestive of a benefit of lowering serum uric acid on metabolic syndrome, although larger, randomized studies are needed before any definitive conclusions can be made.