scholarly journals Visit-to-visit variability of serum uric acid measurements and the risk of all-cause mortality in the general population

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Xue Tian ◽  
Anxin Wang ◽  
Yingting Zuo ◽  
Shuohua Chen ◽  
Licheng Zhang ◽  
...  
Keyword(s):  
Uric Acid ◽  
General Population ◽  
Serum Uric Acid ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Alternative Measures ◽  
Average Real Variability ◽  
Longitudinal Variability

Abstract Background Evidence on longitudinal variability of serum uric acid (SUA) and risk of all-cause mortality in the general population is limited, as many prior studies focused on a single measurement of SUA. Methods A total of 53,956 participants in the Kailuan study who underwent three health examinations during 2006 to 2010 were enrolled. Variability of SUA was measured using the coefficient of variation (primary index), standard deviation, average real variability, and variability independent of the mean. Cox proportional hazard regressions were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the association of variability of SUA with subsequent risk of all-cause mortality, considering its magnitude and the direction and across different baseline SUA categories. Results Over a median follow-up of 7.04 years, 2728 participants died. The highest variability of SUA was associated with an increased risk of all-cause mortality, the HR was 1.33 (95% CI, 1.20–1.49) compared with the lowest variability. In this group, both a large fall (HR, 1.28; 95% CI, 1.14–1.44) and rise (HR, 1.18; 95% 1.05–1.32) in SUA were related to risk of all-cause mortality. These associations were similar across different baseline SUA categories. Consistent results were observed in alternative measures of SUA variability. Moreover, individuals with higher variability in SUA were more related to common risk factors than those with stable SUA. Conclusions Higher variability in SUA was independently associated with the risk of all-cause mortality irrespective of baseline SUA and direction of variability in the general population.

scholarly journals The Significance of Follow-Up Serum Uric Acid Levels in Predicting All-Cause Mortality and Cardiovascular Mortality in Peritoneal Dialysis Patients

2021 ◽  
Author(s):  
Pingping Ren ◽  
Qilong Zhang ◽  
Yixuan Pan ◽  
Yi Liu ◽  
Chenglin Li ◽  
...  
Keyword(s):  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Serum Uric Acid ◽  
Cardiovascular Mortality ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Background: Studies on the correlation between serum uric acid (SUA) and all-cause mortality in peritoneal dialysis (PD) patients were mainly based on the results of baseline SUA. We aimed to analyze the change of SUA level post PD, and the correlation between follow-up SUA and prognosis in PD patients. Methods: All patients who received PD catheterization and maintaining PD in our center from March 2, 2001 to March 8, 2017 were screened. Kaplan-Meier and Cox proportional-hazards regression models were used to analyze the effect of SUA levels on the risks of death. We graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months post PD by mean of SUA plus or minus a standard deviation as cut-off values, and compared all-cause and cardiovascular mortality among patients with different SUA grades. Results: A total of 1402 patients were included, 763 males (54.42%) and 639 females (45.58%). Their average age at PD start was 49.50±14.20 years. The SUA levels were 7.97±1.79mg/dl at baseline, 7.12±1.48mg/dl at 6 months, 7.05±1.33mg/dl at 12 months, 7.01±1.30mg/dl at 18 months, and 6.93±1.26mg/dl at 24 months. During median follow-up time of 31 (18, 49) months, 173 (12.34%) all-cause deaths occurred, including 68 (4.85%) cardiovascular deaths. There were no significant differences on all-cause mortality among groups with graded SUA levels at baseline, 12 months, 18 months and 24 months during follow-up or on cardiovascular mortality among groups with graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months during follow-up. At 6 months post PD，Kaplan Meier analysis showed there was significant difference on all-cause mortality among graded SUA levels (c2=11.315, P=0.010), and the all-cause mortality was lowest in grade of 5.65mg/dl≤SUA<7.13mg/dl. Conclusion: SUA level decreased during follow up post PD. At 6 months post PD, a grade of 5.65mg/dl≤SUA<7.13mg/dl was appropriate for better patients’ survival.

scholarly journals Distinct Prognostic Role of Serum Uric Acid Levels for Predicting All-Cause Mortality Among Chinese Adults Aged 45~75 Years With and Without Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Bowen Zhu ◽  
Jian Zhang ◽  
Nana Song ◽  
Yiqin Shi ◽  
Yi Fang ◽  
...  
Keyword(s):  
Uric Acid ◽  
Risk Factor ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Prognostic Role ◽  
Chinese Adults ◽  
Baseline Serum ◽  
All Cause Mortality

IntroductionThe current study sought to explore the effect of baseline serum uric acid (SUA) on the risk of all-cause mortality among Chinese adults aged 45~75 years and to determine its interaction relationship with diabetes.MethodsThe study was designed as a community-based cohort of 4467 adults aged between 45~75 years included in a 6-years follow-up period from 2009 to 2015 years by the China Health and Nutrition Survey (CHNS). Baseline SUA levels were grouped into quartiles and its association on all-cause mortality was explored using multivariate Cox proportional hazards models. Stratified analyses were performed to explore the associations of SUA quartiles with all-cause mortality among diabetic and non-diabetic individuals.ResultsA total of 141 deaths (5.3 per 1000 person-years) were recorded During a follow-up of 26431 person-years. Out of the 141 deaths, 28 deaths (10.1 per 1000 person-years) were reported in the diabetic groups and 113 deaths (4.8 per 1000 person-years) were recorded in the non-diabetic group. An increased risk of all-cause mortality was observed for participants in the first and fourth quartiles compared with the second SUA quartile, (Q1 SUA: aHR=2.1, 95% CI 1.1~4.1; Q4 SUA: aHR=2.1, 95% CI 1.1~4.0). Stratification of participants by diabetes status showed a U-shaped association for non-diabetic individuals. Whereas, declined eGFR, rather than SUA, was an independent risk factor for all-cause mortality in diabetic individuals (aHR=0.7, 95% CI 0.6~1.0).ConclusionOur study proved that the prognostic role of SUA for predicting all-cause death might be regulated by diabetes. Both low and high SUA levels were associated with increased mortality, supporting a U-shaped association only in non-diabetic individuals. Whereas, renal dysfunction rather than SUA was an independent risk factor for all-cause mortality. Further studies should be conducted to determine the SUA levels at which intervention should be conducted and explore target follow-up strategies to prevent progression leading to poor prognosis.

scholarly journals The effect of baseline serum uric acid on chronic kidney disease in normotensive, normoglycemic, and non-obese individuals: A health checkup cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244106
Author(s):  
Young-Bin Son ◽  
Ji Hyun Yang ◽  
Myung-Gyu Kim ◽  
Sang Kyung Jo ◽  
Won Yong Cho ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Risk Factor ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Baseline Serum ◽  
Increased Risk ◽  
Egfr Decline

Introduction The independent role of serum uric acid (SUA) on kidney disease is controversial due to its association with metabolic syndrome. The objective of this study was to investigate the association of baseline SUA with development of chronic kidney disease and eGFR decline in normotensive, normoglycemic and non-obese individuals during follow up period. Materials and methods We included non-hypertensitive, non-diabetic, and non-obese 13,133 adults with estimated glomerular filtration rate (eGFR) ≥ 60ml/min/1.73m2 who had a voluntary health check-up during 2004–2017. Results SUA was positively related to adjusted means of systolic blood pressure (SBP), triglyceride, body mass index, and body fat percent. SUA was inversely associated with high density lipoprotein HDL (P for trend ≤0.001). SUA was an independent risk factor for the development of diabetes, hypertension, and obesity. During 45.0 [24.0–76.0] months of median follow up, the highest quartiles of SUA showed significant risks of 30% eGFR decline compared than the lowest quartile (RR:3.701; 95% CI: 1.504–9.108). The highest quartile had a 2.2 fold (95% CI: 1.182–4.177) increase in risk for incident chronic kidney disease (CKD). Conclusions SUA is an independent risk factor for the development of diabetes, hypertension, and obesity in the healthy population. High SUA is associated with increased risk of CKD development and eGFR decline in participants with intact renal function.

Abstract 12435: Coronary Artery Calcium Score of Zero Predicts Lower All-Cause Mortality Over a Long-Term Follow-Up

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Joseph T Knapper ◽  
Taylor Lebeis ◽  
Geoff Southmayd ◽  
Pratik Sandesara ◽  
Michael J Blaha ◽  
...  
Keyword(s):  
Coronary Artery ◽  
General Population ◽  
Coronary Artery Calcium ◽  
Statistical Significance ◽  
Hazard Modeling ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Chd Risk Factors

Background: Coronary artery calcium (CAC) scoring has been shown in numerous studies to correlate well with adverse cardiovascular outcomes. In particular, a CAC score of zero has been linked with excellent survival. However, the majority of studies report only short-term follow-up results, and there is little data available on the long-term significance of a zero CAC score. Methods: A total of 9,074 (53±10 years, 60% male) consecutive asymptomatic individuals, free of known coronary heart disease (CHD), underwent CAC Agatston scoring for cardiovascular risk assessment. CHD risk factors were prospectively obtained by patient interview. Unadjusted and risk-factor adjusted Cox proportional hazard modeling was used to estimate time to all-cause mortality (median follow-up=14.7 years) by CAC subsets and was compared to general population mortality estimates. Results: Of all patients enrolled, 4,537 (50.0%) had a CAC score of zero. Annual all-cause mortality, based on adjusted Cox hazard modeling, was significantly lower in both men and women with a CAC score of zero than would be predicted for the general population (see Figure ). The median reduction in projected annual mortality was 68.4% for men and 51.2% for women, with the degree of mortality reduction increasing with age. Compared to a CAC score of zero, even a low-risk CAC score of 1-10 was associated with an increased risk of all-cause mortality (HR = 4.19, 1.97, 2.44 * , 1.82 * , and 1.70 * at 1, 3, 5, 10, and 15 years of follow-up, respectively), though importantly this effect did not reach statistical significance until 5 years of follow-up. Conclusion: A CAC score of zero is associated with a markedly decreased risk of all-cause mortality compared to the general population, and its significance increases with both age and length of follow-up.

Relationship between serum uric acid level and all-cause and cardiovascular mortality in population with obesity

2020 ◽  
Vol 96 (1141) ◽  
pp. 660-665 ◽  
Author(s):  
Jie LI ◽  
Jia-Yi Huang ◽  
Lin Liu ◽  
Kenneth Lo ◽  
Shuo Sun ◽  
...  
Keyword(s):  
Uric Acid ◽  
Linear Regression ◽  
Serum Uric Acid ◽  
Cardiovascular Mortality ◽  
Serum Uric Acid Level ◽  
Piecewise Linear ◽  
Generalised Additive Model ◽  
Piecewise Linear Regression ◽  
All Cause Mortality

BackgroundWe aimed to investigate the association between serum uric acid (SUA) and all-cause or cardiovascular mortality among participants with obesity.MethodAll participants were included from the 1999 to 2014 National Health and Nutrition Examination Survey with follow-up mortality assessment through 31 December 2015. Cox proportional hazards models were built to estimate adjusted HRs and 95% CIs for mortality according to baseline uric acid in quartiles. Obesity was defined as body mass index ≥30 (kg/m2). Generalised additive model (GAM) and two-piecewise linear regression models were performed to explore any non-linearity in associations.ResultsThere were 12 637 adults with obesity eligible for analysis. There were 999 (7.91%) all-cause and 147 (1.16%) cardiovascular mortality occurred during the mean follow-up of 98.11 months. Comparing with the lowest quartile of SUA, the highest SUA group did not have significant association with all-cause (HR 1.08, 95% CI 0.76 to 1.52) and cardiovascular mortality (HR 1.63, 95% CI 0.58 to 4.53) after adjusting for various confounding factors. GAM and two-piecewise linear regression model demonstrated a non-linearly relationship between SUA and all-cause mortality, and the corresponding cut-off point was 6.5 mg/dL. However, there is no significant relationship between uric acid and cardiovascular death on both sides of the cut-off value of 6.1 mg/dL.ConclusionsSUA showed a J-shaped relationship with all-cause mortality, but no significant with cardiovascular mortality in adults with obesity.

scholarly journals Sex-Specific Association of Serum Uric Acid Level and Change in Hyperuricemia Status with Risk of Type 2 Diabetes Mellitus: A Large Cohort Study in China

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yanmei Lou ◽  
Pei Qin ◽  
Changyi Wang ◽  
Jianping Ma ◽  
Xiaolin Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Serum Uric Acid Level ◽  
Increased Risk ◽  
Specific Association

Background. Conflicting findings have been reported regarding the sex-specific association between serum uric acid (SUA) level and type 2 diabetes mellitus (T2DM) risk, and no study has explored the association between the change in hyperuricemia status and T2DM risk. The study was aimed at exploring the sex-specific association of baseline SUA and changes in hyperuricemia status with T2DM risk. Methods. We included 37,296 eligible adults without T2DM at the first examination who attended the baseline examination and at least one follow-up annual examination. Cox and logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs) with their 95% confidence intervals (CIs) for T2DM risk associated with baseline SUA and the change in hyperuricemia status, respectively. Results. During a median follow-up of 3.09 years, of 37,296 eligible adults, 2,263 developed T2DM. Compared with the first SUA quartile, higher quartiles were associated with an increased risk of T2DM in women (HR 1.78, 95% CI 1.17-2.71 for Q3 and 1.93, 1.27-2.93 for Q4; Ptrend<0.001) but not in men. Compared with women with a persistent normal SUA level at baseline and the last follow-up, T2DM risk increased significantly among those whose SUA status changed from normal at baseline to hyperuricemia at the last follow-up (OR 1.71, 95% CI 1.12-2.55) and those with persistent hyperuricemia at baseline and the last follow-up (OR 2.37, 95% CI 1.60-3.46). However, for men, a nonsignificant association was found between the change in hyperuricemia status and T2DM risk. Conclusions. Baseline SUA and the change in hyperuricemia status were associated with T2DM risk only among women. The findings suggest the importance of monitoring SUA levels and maintaining them within a normal range for preventing or reducing incident T2DM in Chinese women.

scholarly journals One-Hour Plasma Glucose as a Long-Term Predictor of Cardiovascular Events and All-Cause Mortality in a Chinese Older Male Population Without Diabetes: A 20-year Retrospective and Prospective Study

2020 ◽  
Author(s):  
Lingjun Rong ◽  
Xinyu Miao ◽  
Yanping Gong ◽  
Chunlin Li ◽  
Banruo Sun
Keyword(s):  
Plasma Glucose ◽  
Continuous Variable ◽  
Male Population ◽  
Cox Proportional Hazard ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Regression

Abstract BackgroundThe association between one-hour plasma glucose (1h-PG) and the incidence of type 2 diabetes has been investigated in previous studies. However, the predictive value of 1h-PG for the risk of cardiovascular disease (CVD) and all-cause mortality, especially in older Asians, has been investigated in only a few studies. Therefore, the influence of 1h-PG on the incidence of CVD and mortality was evaluated in the present study. MethodsThe participants were recruited from the Chinese People’s Liberation Army General Hospital, and were categorized into 1h-PG tertiles. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1h-PG.ResultsThe study included 862 male participants. Median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115-1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631-3.485; P < 0.001) after full adjustment.ConclusionHigher 1h-PG is associated with an increased risk of all-cause mortality and CVD. 1h-PG might be a better predictor of CVD than 2h-PG in older adults.

scholarly journals Extreme Nonfasting Remnant Cholesterol vs Extreme LDL Cholesterol as Contributors to Cardiovascular Disease and All-Cause Mortality in 90000 Individuals from the General Population

2015 ◽  
Vol 61 (3) ◽  
pp. 533-543 ◽  
Author(s):  
Anette Varbo ◽  
Jacob J Freiberg ◽  
Børge G Nordestgaard
Keyword(s):  
Myocardial Infarction ◽  
General Population ◽  
Mortality Risk ◽  
Ldl Cholesterol ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Remnant Cholesterol ◽  
Shaped Pattern

Abstract BACKGROUND Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD, myocardial infarction (MI), and all-cause mortality. METHODS We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. RESULTS Compared with participants with nonfasting remnant cholesterol &lt;0.5 mmol/L (19.3 mg/dL), hazard ratios for IHD ranged from 1.3 (95% CI 1.1–1.5) for remnant cholesterol of 0.5–0.99 mmol/L (19.3–38.2 mg/dL) to 2.4 (1.9–2.9) for remnant cholesterol of ≥1.5 mmol/L (58 mg/dL) (P for trend &lt;0.001). Compared with participants with LDL cholesterol &lt;3.0 mmol/L (115.8 mg/dL), hazard ratios for IHD ranged from 1.3 (1.1–1.5) for LDL cholesterol of 3–3.99 mmol/L (115.8–154 mg/dL) to 2.3 (1.9–2.8) for LDL cholesterol of ≥5 mmol/L (193 mg/dL) (P &lt; 0.001). Corresponding hazard ratios for MI ranged from 1.8 (1.4–2.3) to 3.4 (2.5–4.8) for remnant cholesterol (P &lt; 0.001), and from 1.7 (1.4–2.2) to 4.7 (3.5–6.3) for LDL cholesterol (P &lt; 0.001). Nonfasting remnant cholesterol concentrations were associated stepwise with all-cause mortality ranging from hazard ratio 1.0 (0.9–1.1) to 1.6 (1.4–1.9) (P &lt; 0.001), whereas LDL cholesterol concentrations were associated with decreased all-cause mortality risk in a U-shaped pattern, with hazard ratios from 0.8 (0.7–0.8) to 0.9 (0.8–1.0) (P = 0.002). After mutual adjustment, LDL cholesterol best predicted MI, and remnant cholesterol best predicted all-cause mortality. CONCLUSIONS Both lipoproteins were associated equally with risk of IHD and MI; however, only nonfasting remnant cholesterol concentrations were associated stepwise with increased all-cause mortality risk.

scholarly journals Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project

2021 ◽  
Vol 8 ◽  
Author(s):  
Elisa Russo ◽  
Francesca Viazzi ◽  
Roberto Pontremoli ◽  
Carlo M. Barbagallo ◽  
Michele Bombelli ◽  
...  
Keyword(s):  
Uric Acid ◽  
Risk Factor ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Total Mortality ◽  
Roc Curves ◽  
All Cause Mortality ◽  
Progression Of Kidney Disease ◽  
Definition Of

Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality.Methods: We retrospectively investigated 21,963 patients from the URRAH study database. Hyperuricemia was defined on the basis of outcome specific cut-offs separately identified by ROC curves according to eGFR strata. The primary endpoints were cardiovascular and all-cause mortality.Results: After a mean follow-up of 9.8 year, there were 1,582 (7.20%) cardiovascular events and 3,130 (14.25%) deaths for all causes. The incidence of cardiovascular and all-cause mortality increased in parallel with reduction of eGFR strata and with progressively higher uric acid quartiles. During 215,618 person-years of follow-up, the incidence rate for cardiovascular mortality, stratified based on eGFR (&gt;90, between 60 and 90 and &lt;60 ml/min) was significantly higher in patients with hyperuricemia and albuminuria (3.8, 22.1 and 19.1, respectively) as compared to those with only one risk factor or none (0.4, 2.8 and 3.1, respectively). Serum uric acid and eGFR significantly interact in determining cardiovascular and all-cause mortality. For each SUA increase of 1 mg/dl the risk for mortality increased by 10% even after adjustment for potential confounding factors included eGFR and the presence of albuminuria.Conclusions: hyperuricemia is a risk factor for cardiovascular and all-cause mortality additively to eGFR strata and albuminuria, in patients at cardiovascular risk.

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