scholarly journals Associations between serum uric acid levels and the incidence of hypertension and metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa, Japan

2014 ◽  
Vol 38 (3) ◽  
pp. 213-218 ◽  
Author(s):  
Kazufumi Nagahama ◽  
Taku Inoue ◽  
Kentaro Kohagura ◽  
Kozen Kinjo ◽  
Yusuke Ohya
2016 ◽  
Vol 123 (12) ◽  
pp. 1399-1402 ◽  
Author(s):  
Maria Teresa Pellecchia ◽  
Riccardo Savastano ◽  
Marcello Moccia ◽  
Marina Picillo ◽  
Pietro Siano ◽  
...  

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Bijoy K Menon ◽  
Eric E Smith ◽  
Shelagh B Coutts ◽  
Donald G Welsh ◽  
James E Faber ◽  
...  

Introduction: Leptomeningeal collaterals are native (pre-existing) anastomoses that cross-connect a small number of distal-most arterioles within the crowns of the cerebral artery trees. We seek to identify potentially modifiable determinants associated with variability in leptomeningeal collateral status in patients with acute ischemic stroke. Methods: Data is from the Keimyung Stroke Registry, a prospectively collected dataset of patients with acute ischemic stroke from Daegu, South Korea. Patients with M 1 segment middle cerebral artery (MCA) +/- intracranial internal carotid artery (ICA) occlusions on baseline CT-angio from May 2004 to July 2009 were included in the study.Baseline and follow-up imaging was analyzed at the imaging core lab of the Calgary Stroke Program. Two readers blinded to all clinical information assessed leptomeningeal collaterals on baseline CT-angio by consensus using the regional leptomeningeal score (rLMC). Results: Of 206 patients[mean age66.9±11.6 years, median baseline NIHSS 14 (IQR11-20), median stroke symptom onset to CT-angio time 166 minutes (IQR 96-262)], 133 patients (64.6%) had poor collateral status at baseline (rLMC score 11-20). On univariate analyses, patients with poor collateral status at baseline were older, hypertensive, had higher blood glucose values, higher white blood cell count at baseline, higher D-dimer and serum uric acid levels (measured next day morning) and were more likely to have metabolic syndrome as per ATP III criteria. Multivariable modeling identified metabolic syndrome (OR 3.22 95% CI 1.69-6.15, p<0.001), raised serum uric acid (per 1mg/dl OR 1.35 95% CI 1.12-1.62, p<0.01) and age (per year, OR 1.03 95% CI 1-1.05, p=0.03) as independent predictors of poor leptomeningeal collateral status at baseline. Conclusion: Metabolic syndrome and hyperuricemia are modifiable determinants associated with poor leptomeningeal collateral status in patients with acute ischemic stroke. This knowledge could potentially help in focusing research on appropriate therapeutic strategies for modulating function of leptomeningeal collaterals.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1763.1-1764
Author(s):  
M. Gamala ◽  
J. W. G. Jacobs ◽  
S. Linn-Rasker ◽  
M. Nix ◽  
B. Heggelman ◽  
...  

Background:Classification criteria are used for classifying groups of patients, especially for clinical trials, and diagnostic criteria for diagnosis in individual patients.Objectives:to establish the performance of the 2015 ACR/EULAR gout classification criteria for the diagnosis gout in patients with undifferentiated arthritis. Secondary, to explore the use and efficacy of uric acid lowering therapy (ULT) in daily clinical practice in new gout patients.Methods:1-year follow-up study was performed in subjects with unclassified arthritis, who had been classified as gout patients or not, according the gout classification criteria, including imaging with dual-energy CT, but without ultrasonography and joint X-rays.(1) The reference was the clinical diagnosis (gout yes/no) after 1-year follow-up.Results:71 patients were included; their demographic and clinical characteristics are summarized in Table 1. All 63/71 patients classified as having gout at baseline also had a clinical gout diagnosis after one year, and of the patients not classified, none had the clinical diagnosis of gout at one year.Table 1.Characteristics of the 71subjects included in analysesDiagnosis**gout (n=63)no gout (n=8)Age in years, mean (SD)62 (14)59 (14)Male gender, N (%)53 (84)5 (63)Symptom duration* at baseline in months, median (IQR)12 (1-48)8 (0.5-33)Joint involvement at baseline N patients (%):MTP,33 (52)1 (12)ankle/midfoot12 (19)1 (12)other joint18 (29)6 (76)SUA intercritical in umol/l, mean (SD)484 (63)337 (71)2015 ACR/EULAR criteria baseline score, mean (SD)***10.3 (2.5)2.6 (1.5)2015 ACR/EULAR criteria ≥8 points, N patients (%)***57 (90)0 (0)MSU crystal positive joint aspiration, N patients (%)44 (70)0 (0)DECT positive, N patients (%)49 (78)0 (0)* self-reported, intermittent symptoms; ** all patients classified with gout at baseline also had a clinical gout diagnosis after one yea; *** using a somewhat limited set, see methodsMTP, metatarsophalangeal joints; SUA, serum uric acid; DECT, dual-energy CT; MSU, monosodium urate;.Sensitivity, specificity, positive and negative predictive value, and accuracy values (95% CI) of the classification criteria set we used were 0.91 (0.80-0.96); 1 (0.63-1); 1; 0.57 (0.38-0.74) and 0.92 (0.83-0.97), respectively. The area under the receiver operating characteristics curve (95% CI) was 0.95 (0.91-0.99).ULT was started in 49/63 (78%) of gout patients; 45/49 (92%) of them had serum uric acid levels ≤ 360 μmol/l and no recurrent gout attack during one-year follow-up.Conclusion:The 2015 ACR-EULAR gout classification criteria performed well for the diagnosis gout in clinical practice. Most gout patients had been treated successfully, according to current guidelines.References:[1]Gamala M, Jacobs JWG, Linn-Rasker SF, Nix M, Heggelman BGF, Pasker-de Jong PCM, et al. The performance of dual-energy CT in the classification criteria of gout: a prospective study in subjects with unclassified arthritis. Rheumatology 2019 Sep (Epub ahead print).Disclosure of Interests:Mihaela Gamala: None declared, Johannes W. G. Jacobs Grant/research support from: Roche, Suzanne Linn-Rasker: None declared, Maarten Nix: None declared, Ben Heggelman: None declared, Pieternel Pasker: None declared, Jacob M. van Laar Grant/research support from: MSD, Genentech, Consultant of: MSD, Roche, Pfizer, Eli Lilly, BMS, Ruth Klaasen: None declared


2020 ◽  
Vol Volume 13 ◽  
pp. 945-953
Author(s):  
Kittrawee Kritmetapak ◽  
Suranut Charoensri ◽  
Rattrai Thaopanya ◽  
Chatlert Pongchaiyakul

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eswar Krishnan ◽  
Hyon K Choi ◽  
Lewis H Kuller ◽  
Kiang Liu

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far. METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up. RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49). CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.


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