Uric acid is the end-product of purine breakdown by xanthine oxidoreductase and is cleared mostly by the kidneys. It sits at the crossroads of energy turnover, redox balance, and renal handling. In blood it can act as an antioxidant, while within tissues it can drive oxidative stress and inflammation. Because of this dual role, uric acid integrates signals from metabolism, kidney function, vascular tone, and cellular turnover.Low values usually reflect reduced purine production or increased renal loss. This can happen with low cell turnover, severe liver disease, certain genetic renal transport defects, or uricosuric medications. Most people are asymptomatic, but very low levels may indicate diminished circulating antioxidant capacity and, in rare renal tubular disorders, a tendency to exercise-induced kidney stress. Levels are naturally lower in children, women, and early pregnancy.Being in range suggests balanced purine metabolism, effective kidney excretion, and stable redox signaling that supports vascular and metabolic homeostasis. For cardiometabolic risk, epidemiologic data generally link the lower half of the reference range to favorable outcomes, recognizing sex differences (women tend to run lower premenopause).High values usually reflect increased production (high cell turnover, hypoxia/ATP depletion) and/or reduced renal excretion (impaired filtration, insulin resistance, diuretics). System effects include crystal formation (gout, kidney stones), endothelial dysfunction, oxidative stress, and activation of pathways that raise blood pressure and worsen glucose–lipid handling. Men typically have higher levels; values often rise after menopause and with aging. In late pregnancy, a rise can accompany hypertensive disorders.Notes: Uric acid varies with fasting status, recent exercise, dehydration, and acute illness. Many drugs shift levels. During an acute gout flare, serum uric acid can be transiently normal. Pregnancy lowers levels early and increases them later. Lab reference intervals differ by sex and age.
