Urolithiasis, Independent of Uric Acid, Increased Risk of Coronary Artery and Carotid Atherosclerosis: A Meta-Analysis of Observational Studies

Background and Aims. Recent epidemiological evidence indicates an association between urolithiasis and atherosclerosis; however, results are incongruous. Our aim is to summarize the association between urolithiasis and arteriosclerosis risk through a detailed meta-analysis. Methods. Relevant studies published before April 2019 were identified by searching OVID, EMBASE, PubMed, Web of Science database, and Cochrane Library. The relationship between urolithiasis and the risk of atherosclerosis was assessed by using odds ratio (OR) values and the corresponding 95% confidence intervals (CIs), and the selection of fixed- or random-effects model based on heterogeneity. Results. The meta-analysis includes 8 observational studies that contained 70,716 samples. Pooled results showed that urolithiasis was associated with an increased adjusted and unadjusted risk estimated for atherosclerosis (P=0.017 and P=0.014, respectively), especially in coronary artery and carotid atherosclerosis, which was associated with the outcome of CV disease. Interestingly, when we merged the data from the vast majority of these samples (n = 65,751/70,716) with serum uric acid levels less than 6.0 mg/dl, it still showed that urolithiasis was associated with a higher risk of atherosclerosis (P<0.001) and with no evidence of heterogeneity (I2 = 0.0%, P=0.697). Furthermore, we also found that renal calculi would increase the risk of moderate or severe atherosclerosis (P<0.001) and recurrent renal calculi were associated with the incidence of atherosclerosis (P=0.007). Conclusions. Urolithiasis is associated with an increased risk for atherosclerosis, especially in coronary artery and carotid atherosclerosis. Urolithiasis may be another potential risk factor of atherosclerosis, which is independent of serum uric acid levels.

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Serum Uric Acid and Mortality in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Blood Purification ◽

10.1159/000513944 ◽

2021 ◽

pp. 1-9

Author(s):

Jialing Zhang ◽

Xiangxue Lu ◽

Han Li ◽

Shixiang Wang

Keyword(s):

Uric Acid ◽

Serum Uric Acid ◽

Cardiovascular Mortality ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Hazard Ratios ◽

Increased Risk ◽

All Cause Mortality ◽

The Cochrane Library

Background: Existing studies suggested conflicting relationships between serum uric acid (SUA) and mortality in CKD patients. The present meta-analysis aimed to determine whether SUA can be a predictor for mortality in CKD cohorts. Method: A systematical search was conducted on PubMed, EMBASE, and The Cochrane Library to identify studies reporting the relationship between SUA level and all-cause and cardiovascular mortality in CKD populations. In addition, random-effects models were adopted to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: On the whole, 29 studies were involved. In the present meta-analysis, patients exhibiting the maximum SUA level showed an association with a significantly higher risk for all-cause mortality (HR, 1.30; 95% CI, 1.06–1.59) compared with patients exhibiting the minimum SUA level. As revealed from the meta-analysis of 8 studies, low level of SUA was another predictor for all-cause mortality in patients with CKD (HR, 1.36; 95% CI, 1.20–1.54). No significant relationship was identified between SUA and cardiovascular mortality. Conclusions: Higher and lower SUA levels are both associated with significantly increased risk of all-cause mortality in patients with CKD. A appreciate dose of treatment of lowering SUA agents should be confirmed.

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Serum uric acid levels and risk of prehypertension: a meta-analysis

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2016-0339 ◽

2017 ◽

Vol 55 (3) ◽

Cited By ~ 8

Author(s):

Menglin Jiang ◽

Dandan Gong ◽

Yu Fan

Keyword(s):

Uric Acid ◽

Serum Uric Acid ◽

Meta Analysis ◽

Elevated Serum ◽

China National Knowledge Infrastructure ◽

Cross Sectional ◽

Knowledge Infrastructure ◽

Increased Risk ◽

Cross Sectional Studies ◽

The Relationship

AbstractElevated serum uric acid (SUA) levels may increase the risk of prehypertension. However, the findings from these studies remain conflicting. The objective of this study was to determine the relationship between SUA levels and risk of prehypertension by conducting a meta-analysis. We conducted a comprehensive literature search of PubMed, Embase, China National Knowledge Infrastructure, VIP, and the Wangfang database without language restrictions through May 2015. Observational studies assessing the relationship between SUA levels and prevalence of prehypertension were included. Pooled adjust odds ratio (OR) and corresponding 95% confidence intervals (CI) of prehypertension were calculated for the highest vs. lowest SUA levels. Prehypertension was defined as systolic blood pressure (BP) ranging from 120 to 139 mmHg or diastolic BP ranging from 80 to 89 mmHg. Eight cross-sectional studies with a total of 21,832 prehypertensive individuals were included. Meta-analysis showed that elevated SUA levels were associated with increased risk of prehypertension (OR: 1.84; 95% CI: 1.42–2.38) comparing the highest vs. lowest level of SUA levels. Subgroup analyses showed that elevated SUA levels significantly increased the risk of prehypertension among men (OR: 1.60; 95% CI: 1.12–2.21) and women (OR: 1.59; 95% CI: 1.17–2.16). Elevated SUA levels are positively associated with the risk of prehypertension in the general population. However, more well-designed longitudinal studies are needed before a definitive conclusion can be drawn due to the cross-sectional studies included are susceptible to bias.

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Role of high sensitive c-reactive protein and serum uric acid in coronary artery diseases: a case control study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213091 ◽

2021 ◽

Vol 9 (8) ◽

pp. 2414

Author(s):

Nandini Takkalaki ◽

Raja Shekhar Muchchandi ◽

Krishnamurthy N.

Keyword(s):

Uric Acid ◽

Coronary Artery ◽

Serum Uric Acid ◽

Coronary Artery Diseases ◽

Mortality And Morbidity ◽

Treatment And Prevention ◽

Increased Risk ◽

The Mean ◽

Hs Crp ◽

Artery Disease

Background: Coronary artery diseases (CAD) are considered to be the major public health concerns throughout the world, including India. Despite significant improvement in the diagnosis, treatment and prevention, CAD remains the most common, acute, and chronic illness, which is the leading cause of mortality and morbidity in the world.Methods: To estimate the serum uric acid and hs-CRP levels in coronary artery disease cases with diabetes mellitus and hypertension and compare with the healthy individuals.Results: The mean serum uric acid levels were raised in cases (6.1±1.54 mg/dl) compared to the controls (5.16±1.007 mg/dl) which was significant statistically (p<0.008). The mean hs-CRP levels were raised in cases (7.1±8.122 mg/dl) compared to the controls (0.185±0.254 mg/dl) which was highly significant statistically.Conclusions: Measurement of the levels of hs-CRP and serum uric acid in CAD might help in identifying the patient at increased risk of mortality.

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Abstract P598: Increased Risk of Acute Stroke in Patients With Severe Course of Covid-19: A Multicenter Study and Meta-Analysis

Stroke ◽

10.1161/str.52.suppl_1.p598 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Timo Siepmann ◽

Annahita Sedghi ◽

Erik Simon ◽

Simon Winzer ◽

Jessica Barlinn ◽

...

Keyword(s):

Acute Stroke ◽

Multicenter Study ◽

Observational Studies ◽

Meta Analysis ◽

Clinical Severity ◽

Cochrane Library ◽

Stroke Rate ◽

Multicenter Cohort Study ◽

Increased Risk ◽

Study Heterogeneity

Introduction: Recent studies linked coronavirus disease 2019 (COVID-19) to thromboembolic complications likely mediated by increased blood coagulability and inflammatory endothelial impairment. Objective: We aimed to assess the risk of acute stroke in patients with COVID-19 related to clinical severity of the disease. Methods: We conducted an observational multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we performed a systematic review using PubMed/MEDLINE, EMBASE, Cochrane Library and bibliographies of identified articles following PRISMA guidelines including data from observational studies of acute stroke in COVID-19 patients. Data was extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RR) and 95% confidence intervals (95%CIs) for acute stroke related to COVID-19 severity using random effects model. Between-study heterogeneity was assessed using Cochran’s Q and I 2 -statistics. PROSPERO identifier : CRD42020187194. Results: Of 165 patients hospitalized for COVID-19 (49.1% males, median age 67 [57-79], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95%CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were eligible for meta-analysis. Among 741 pooled COVID-19 patients overall stroke rate was 2.9% (95%CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR 4.12, 95%CI 1.7-10.25; p=0.002) with no evidence of heterogeneity (I 2 =0%, p=0.82). Conclusions: Synthesized analysis of data from our multicenter study and previously published cohorts demonstrate that severity of COVID-19 is associated with an increased risk of acute stroke, underscoring the necessity of neurological monitoring in patients infected with SARS-CoV-2.

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Hyperuricemia and Hypertension, Coronary Artery Disease, Kidney Disease: From Concept to Practice

International Journal of Molecular Sciences ◽

10.3390/ijms21114066 ◽

2020 ◽

Vol 21 (11) ◽

pp. 4066 ◽

Cited By ~ 1

Author(s):

Mélanie Gaubert ◽

Thomas Bardin ◽

Alain Cohen-Solal ◽

François Diévart ◽

Jean-Pierre Fauvel ◽

...

Keyword(s):

Coronary Artery Disease ◽

Renal Function ◽

Uric Acid ◽

Coronary Artery ◽

Kidney Disease ◽

Serum Uric Acid ◽

Elevated Serum ◽

Renal Diseases ◽

Increased Risk ◽

Artery Disease

Since the publication of the Framingham Heart Study, which suggested that uric acid should no longer be associated with coronary heart disease after additional adjustment for cardiovascular disease risk factors, the number of publications challenging this statement has dramatically increased. The aim of this paper was to review and discuss the most recent studies addressing the possible relation between sustained elevated serum uric acid levels and the onset or worsening of cardiovascular and renal diseases. Original studies involving American teenagers clearly showed that serum uric acid levels were directly correlated with systolic and diastolic pressures, which has been confirmed in adult cohorts revealing a 2.21-fold increased risk of hypertension. Several studies involving patients with coronary artery disease support a role for serum uric acid level as a marker and/or predictor for future cardiovascular mortality and long-term adverse events in patients with coronary artery disease. Retrospective analyses have shown an inverse relationship between serum uric acid levels and renal function, and even a mild hyperuricemia has been shown to be associated with chronic kidney disease in patients with type 2 diabetes. Interventional studies, although of small size, showed that uric acid (UA)-lowering therapies induced a reduction of blood pressure in teenagers and a protective effect on renal function. Taken together, these studies support a role for high serum uric acid levels (>6 mg/dL or 60 mg/L) in hypertension-associated morbidities and should bring awareness to physicians with regards to patients with chronic hyperuricemia.

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Serum uric acid and risk of incident chronic kidney disease: a national cohort study and updated meta-analysis

Nutrition & Metabolism ◽

10.1186/s12986-021-00618-4 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Nianwei Wu ◽

Jing Xia ◽

Sen Chen ◽

Chuan Yu ◽

Ying Xu ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Kidney Disease ◽

Cohort Studies ◽

Serum Uric Acid ◽

Meta Analysis ◽

Positive Association ◽

Effect Estimate ◽

Logistic Regression Models ◽

Increased Risk

Abstract Background We prospectively examined the association between serum uric acid (SUA) levels and chronic kidney disease (CKD) in China and updated the evidence through a comprehensive meta-analysis of prospective studies worldwide. Methods Our original analyses were based on data from the China Health and Retirement Longitudinal Study. The primary exposure of interest was SUA at baseline, and the main outcome was incident CKD. Logistic regression models were used to examine the association between SUA levels and incident CKD. A meta-analysis was performed to pool our effect estimate and those from other cohort studies. Results During a 4-year follow-up, 180 participants developed incident CKD. Participants in the highest SUA quartile were 2.73 times as likely to develop incident CKD compared to those in the lowest quartile (multivariable-adjusted OR, 2.73; 95% CI, 1.65–4.50). Each 1 mg/dL increment in the SUA levels was associated with a 49% increased risk of incident CKD (multivariable-adjusted OR, 1.49; 95% CI, 1.28–1.74). In the meta-analysis of 30 cohort studies (including the current study), pooled relative risks (95% CIs) of incident CKD were 1.15 (1.10–1.21) for SUA each 1 mg/dL increment, 1.22 (1.14–1.30) for the highest versus lowest SUA group, and 1.17 (1.12–1.23) for hyperuricemia versus no hyperuricemia. Conclusions Baseline SUA levels were associated with higher risk of incident CKD in middle-aged and elderly Chinese adults, and this positive association was confirmed in the meta-analysis of multiple cohort studies. Our findings may imply that SUA levels need to be routinely monitored for future CKD risk.

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Correlation between Serum Uric Acid Level and Severity of Coronary Artery Stenosis in Patients with Acute Coronary Syndrome

Majalah Kedokteran Bandung ◽

10.15395/mkb.v53n1.2221 ◽

2021 ◽

Vol 53 (1) ◽

Author(s):

Diding Heri Prasetyo ◽

◽

Sally Aman Nasution ◽

Idrus Alwi ◽

Murdani Abdullah

Keyword(s):

Uric Acid ◽

Coronary Artery ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Acid Level ◽

Coronary Artery Stenosis ◽

Serum Uric Acid Level ◽

Meta Analysis ◽

Artery Stenosis ◽

Coronary Syndrome

Acute coronary syndrome (ACS) is a life-threatening disease which remains one of the causes of high morbidity and mortality despite the current advances in treatment. The relationship between the serum uric acid (SUA) level and ischemic heart disease continues to be controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between the two factors has not yet fully understood. Prior epidemiological evidence of the causal relationship between the too is still argumentative. Various studies have been done using the same methods; yet, the outcomes were different. This study aimeds to conduct a meta-analysis to synthesize the results of recent studies in order to obtain accurate quantitative data. This systematic study followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline and studies published in the period of January 2010 to May 2020 were screened using the Cochrane Library, Ebsco, Medline/PubMed, ProQuest and Science Direct as the sources. Meta-analysis was conducted to synthesize the association between the SUA level and severity of coronary artery stenosis using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2 and the meta-analysis was performed using Comprehensive Meta Analysis Version 3 (CMA3) software. Five studies (n = 601 subjects) identified a correlation between serum uric acid level and Gensini score (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis, whereas publication bias was not found. Thus, the severity of coronary artery stenosis in patients with ACS is positively correlated with serum uric acid level.

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PROGNOSTIC VALUE OF SERUM URIC ACID IN PATIENTS WITH ACUTE HEART FAILURE:A META-ANALYSIS

10.36106/gjra/0601830 ◽

2021 ◽

pp. 44-45

Author(s):

Mohit Desai ◽

Brajendra kumar

Keyword(s):

Uric Acid ◽

Observational Studies ◽

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Adverse Outcomes ◽

Improve Risk Stratification ◽

Increased Risk ◽

All Cause Mortality ◽

Comprehensive Search

Our meta-analysis aimed to determine the prognostic significance of SUA level in patients with AHF.We made a comprehensive search in databases from inception to April 6, 2018. All available observational studies that evaluated the prognostic value of SUA level in patients with AHF were eligible. Outcome of interests were all-cause mortality and the combined endpoint of death or readmission. Prognostic values of SUA level were summarized as higher vs lower SUA category or per 1 mg/ml SUA rise.Eleven studies involving 12,854 AHF patients were identified and analyzed. AHF patients with the highest SUA level had an increased risk of all-cause mortality (risk ratio [RR] 1.43; 95% confidence intervals [CI] 1.31–1.56) and combined endpoint of death or readmission (RR 1.68; 95% CI 1.33–2.13) after adjusting potential variables. In addition, per 1 mg/ml SUA rise significantly increased by 11% and 12% higher risk all-cause mortality and combined endpoint of death or readmission, respectively..This meta-analysis indicates that elevated SUA level independently predicts all-cause mortality and the combined endpoint of death or readmission in AHF patients. Measurement of SUA level may improve risk stratification of adverse outcomes in these patients

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Associations between LPL gene polymorphisms and coronary artery disease: evidence based on an updated and cumulative meta-analysis

Bioscience Reports ◽

10.1042/bsr20171642 ◽

2018 ◽

Vol 38 (2) ◽

Cited By ~ 3

Author(s):

Wen-Qi Ma ◽

Ying Wang ◽

Xi-Qiong Han ◽

Yi Zhu ◽

Nai-Feng Liu

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Gene Polymorphisms ◽

Genetic Model ◽

Meta Analysis ◽

Cochrane Library ◽

Increased Risk ◽

Lpl Gene ◽

Artery Disease ◽

Cad Risk

Lipoprotein lipase (LPL) is widely linked to lipid and lipoprotein metabolism, but its effects on coronary artery disease (CAD) are not clearly elucidated. The aim of the present study was to clarify the association between LPL gene polymorphisms and CAD susceptibility. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the relationship between LPL gene polymorphisms and CAD risk. Comprehensive electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library, were systematically searched. A total of 45 records containing 80 eligible studies were analyzed. The results indicated an increased risk between the LPL D9N polymorphism and susceptibility to CAD in the dominant genetic model (AA + GA vs. GG: OR = 1.46, 95% CI = 1.14–1.87), whereas the LPL HindIII polymorphism showed a protective effect against CAD under all tested models (GG + GT vs. TT: OR = 0.85, 95% CI = 0.75–0.97; GG vs. TT + TG: OR = 0.62, 95% CI = 0.47–0.83; G vs. T: OR = 0.81, 95% CI = 0.71–0.92). No significant association was identified for the LPL N291S and PvuII polymorphisms. Stratification analysis by ethnicity suggested a significant correlation between the LPL S447X polymorphism and CAD susceptibility in Caucasians under the dominant and allele genetic models. In summary, our meta-analysis indicated that the LPL D9N polymorphism was associated with an increased risk of CAD, whereas the S447X and HindIII polymorphisms showed protective effects. There was no association observed between the N291S and PvuII polymorphisms and CAD risk.

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