Objective:This study aims to explore the relationship between serum uric acid(UA)level as a marker of metabolic syndromes(MS)in physical examination adults. Methods:A total of 58 207(41 707 males and 16 500 females)aged 20~70 years were included who received physical examination in Nanjing from 2012-2016. MS were defined according to the criteria of the Adult Treatment Panel Ⅲ. Multivariate logistic regression analysis was used to estimate the odds ratios(OR)of MS,and multiple linear regression analysis was performed to explore the association between UA and characteristic variables. Results:LDL-C,waist,BMI,blood pressure,fasting glucose,triglycerides and cholesterol were increased with quantile UA(P for trend<0.01). UA increased with the rise of MS components from 0 through 4 or 5(298.00 μmol/L,312.90 μmol/L,328.70 μmol/L,345.20 μmol/L and 360.20 μmol/L respectively,P < 0.01 for linear trend). Compared with the first UA quartile(Q1),the multiple logistic regression analysis demonstrated that the risk of MS in those with the third and fourth UA quartiles(Q3,Q4)were 1.18(95%CI:1.06~1.31,P < 0.01)and 1.31(95%CI:1.19~1.44,P < 0.01),respectively. After adjusting for age,sex,waist,systolic blood pressure,diastolic blood pressure,glucose and triglycerides. UA was positively related to waist circumference,body mass index,triglycerides,LDL-C with multiple linear regression analysis. The optimal cutoff point of UA by using receiver operating characteristic(ROC) curve to diagnose MS was 346.5 μmol/L. The sensitivity and specificity were 59.7% and 62.6%,respectively. Conclusion:The component number of MS in health examination population has a certain correlation with the level of UA. Higher UA level is associated with higher incidence of MS.