scholarly journals Elevated Serum Uric Acid and Self-Reported Heart Failure in US Adults: 2007–2016 National Health and Nutrition Examination Survey

2019 ◽  
Vol 9 (6) ◽  
pp. 344-353 ◽  
Author(s):  
Michelle L. Stone ◽  
Michael R. Richardson ◽  
Larry Guevara ◽  
Bethany G. Rand ◽  
James R. Churilla
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
National Health ◽  
Representative Sample ◽  
Elevated Serum ◽  
Activity Level ◽  
Nutrition Examination Survey ◽  
Men And Women ◽  
Health And Nutrition

Introduction: There is limited evidence examining the relationship between elevated serum uric acid (sUA) concentration and heart failure (HF) in United States (US) adults. The aim of the present study was to examine the association(s) between elevated sUA and HF using a nationally representative sample of US adults. Methods: The final sample with complete data for this analysis (n = 17,349) included men and women aged ≥40 years who participated in the 2007–2016 National Health and Nutrition Examination Survey. Self-reported diagnosis of HF was assessed via interview. Elevated sUA was defined as values >6.0 mg/dL for women and >7.2 mg/dL for men. Multivariable gender-stratified logistic regression was utilized to examine the odds of self-reported HF. Results: The estimated prevalence of HF was 3.9 and 3.4% among men and women, respectively. Age-adjusted analysis revealed significantly increased odds of HF in men (OR 2.79; 95% CI 2.15–3.84, p < 0.01) and women (OR 3.24; 95% CI 2.37–4.44, p < 0.01) with elevated sUA. This relationship remained statistically significant following adjustment for age, race, education, income, alcohol consumption, smoking status, blood pressure, diabetes, physical activity level, cholesterol, creatinine level, and body mass index in men (OR 1.70; 95% CI 1.13–2.57 p < 0.05) and women (OR 1.74; 95% CI 1.18–2.58, p < 0.05). Conclusions: In a representative sample of US adults, having an elevated sUA concentration was associated with significantly increased odds of HF when compared to adults with normal sUA.

scholarly journals Association between mortality and serum uric acid levels in non-diabetes-related chronic kidney disease: An analysis of the National Health and Nutrition Examination Survey, USA, 1999–2010

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chia-Lin Lee ◽  
Shang-Feng Tsai
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
National Health ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Study Results ◽  
All Cause Mortality ◽  
History Of

Abstract The relationship between serum uric acid (SUA) and cardiovascular (CV) mortality in patients with chronic kidney disease (CKD) has been described as either a J- or U-shaped function. However, its effect in non-diabetic CKD (and varying severities of CKD) remains unclear. We analyzed the database of the National Health and Nutrition Examination Survey, USA, from the years 1999 to 2010. We then grouped the subjects into 4 categories according to their SUA levels: (a) < 5 mg/dl, (b) 5–7 mg/dl, (c) 7–9 mg/dl and (d) ≥ 9 mg/dl. For mortality comparison purposes (CV related, cancer related and all-cause mortality), we set the SUA group of 5–7 mg/dl as the reference. We also separated this population into moderate (stage 3) and severe (stages 4 and 5) CKD. A total of 1860 participants were included in this study. Results showed that the group with the lowest SUA levels (< 5 mg/dl), were the least male gender (19.25%), had the lowest body mass index (26.41(95% CI = 25.66–27.16) kg/m2), highest systolic blood pressure (139.02 (95% CI 135.72–142.32) mmHg), highest high-density cholesterol (59.55 (95% CI 57.37–61.74) mg/dl), lowest blood glucose (95.46 (95% CI 93.16–97.76) mg/dl), highest total cholesterol (210.31 (95% CI 203.36–217.25) mg/dl), lowest serum albumin (4.09 (95% CI 4.04–4.14) g/dl), highest estimated glomerular filtration rate (eGFR) (47.91 (95% CI 45.45–50.49) ml/min/1.732m2), least history of hypertension (54.4%), and least total energy intake (1643.7 (95% CI 1536.13–1751.27) kcal/day). In the group with SUA ≥ 9 mg/dl, patients had higher all-cause mortality (HR = 2.15) whatever their baseline CVD status. In non-DM CKD patients with a CVD history, the group with SUA ≥ 9 mg/dl had the highest all-cause mortality (HR = 5.39), CVD mortality (HR = 8.18) and CVD or cancer (HR = 8.25) related mortality. In non-DM patients with severe CKD (eGFR < 30 ml/min/1.732m2), the group with SUA < 5 had a significantly increased all-cause mortality. On the contrary, in non-DM patients with moderate CKD (eGFR = 30–60 ml/min/1.832m2), the group with SUA ≥ 9 had a significantly increased all-cause mortality. In moderate non-DM CKD, SUA ≥ 9 mg/dl is associated with higher all-cause mortality. However, once progressing to severe non-DM CKD, SUA < 5 mg/dl is associated with higher all-cause mortality (even though it has the least risk factors for metabolic syndrome).

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