The Optimal Range of Serum Uric Acid for Cardiometabolic Diseases: A 5-Year Japanese Cohort Study

The optimal range of serum uric acid (urate) associated with the lowest risk for developing cardiometabolic diseases is unknown in a generally healthy population. This 5-year cohort study is designed to identify the optimal range of serum urate. The data were collected from 13,070 Japanese between ages 30 and 85 at the baseline (2004) from the Center for Preventive Medicine, St. Luke’s International Hospital, Tokyo. We evaluated the number of subjects (and prevalence) of those free of the following conditions: hypertension, diabetes, dyslipidemia, and chronic kidney disease (CKD) over 5 years for each 1 mg/dL of serum urate stratified by sex. Furthermore, the odds ratios (ORs) for remaining free of these conditions were calculated with multiple adjustments. Except for truly hypouricemic subjects, having lower serum urate was an independent factor for predicting the absence of hypertension, dyslipidemia, and CKD, but not diabetes. The OR of each 1 mg/dL serum urate decrease as a protective factor for hypertension, dyslipidemia, and CKD was 1.153 (95% confidence interval, 1.068–1.245), 1.164 (1.077–1.258), and 1.226 (1.152–1.306) in men; 1.306 (1.169–1.459), 1.121 (1.022–1.230), and 1.424 (1.311–1.547) in women, respectively. Moreover, comparing serum urate of 3–5 mg/dL in men and 2–4 mg/dL in women, hypouricemia could be a higher risk for developing hypertension (OR: 4.532; 0.943–21.78) and CKD (OR: 4.052; 1.181–13.90) in women, but not in men. The optimal serum urate range associated with the lowest development of cardiometabolic diseases was less than 5 mg/dL for men and 2–4 mg/dL for women, respectively.

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P1683Optimal serum uric acid levels for hypertension: 5-year cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0439 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Kuwabara ◽

K Niwa ◽

I Hisatome

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Serum Uric Acid ◽

Cumulative Incidence ◽

Healthy Population ◽

Drinking Habits ◽

Logistic Analysis ◽

Baseline Systolic Blood Pressure ◽

History Of ◽

Acid Range

Abstract Background Although hyperuricemia is known as a risk factor for hypertension, the optimal range of serum uric acid (SUA) for preventing hypertension has not been established, especially in a healthy population. Methods This is a 5-year cohort study to clarify the optimal SUA for hypertension. Subjects consisted of Japanese adults between 30 and 85 years of age were enrolled in the study at our Center for Preventive Medicine, and available at enrollment (2004) and at 5-year follow-up (2009). We excluded the study subjects who were hypertensive, diabetic, dyslipidemic, had a history of gout or hyperuricemia on medications, or if they had chronic kidney disease as estimated glomerular filtration rate <60 ml/min/1.73m2. Linear and logistic regression analyses were used to examine the relationship between each 1 mg/dL of serum uric acid range and development of hypertension with multiple adjustments for age, smoking, drinking habits, body mass index and baseline systolic blood pressure. Results Of 13,070 subjects enrolled at this step, we included 6,476 subjects (46.9±10.1 years old, 34.6% men) without comorbidities. The cumulative incidences of hypertension over 5 years were 5.9% in women and 12.1% in men. The lowest cumulative incidences of hypertension were 2.6% in 2.0–3.0 mg/dL of serum uric acid in women and 6.9% in 4.0–5.0 mg/dL in men. In contrast, the highest uric acid range showed highest cumulative incidence of hypertension both in women (28.6% in 8.0–9.0 mg/dL) and men (21.0% in ≥9.0 mg/dL). Hypouricemic (<2.0 mg/dL) subjects had higher cumulative incidences of hypertension than subjects with 2.0–3.0 mg/dL of serum uric acid levels, we excluded these subjects in multivariable logistic analysis. The odds ratio of 1 mg/dL increase of serum uric acid for developing hypertension was 1.395 (95% CI, 1.182–1.648) in women and 1.139 (95% CI, 1003–1.294) in men after multiple adjustments. Conclusion The optimal serum uric acid range for preventing hypertension was 2.0–3.0 mg/dL in women and 4.0–5.0 mg/dL in men. Higher uric acid levels increase cumulative incidence of hypertension. Acknowledgement/Funding None

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P4556Obesity and serum uric acid as a risk factor for hypertension and diabetes mellitus: 5-year Japanese cohort study

European Heart Journal ◽

10.1093/eurheartj/ehx504.p4556 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

M. Kuwabara ◽

K. Niwa ◽

I. Hisatome ◽

C. Roncal-Jimenez ◽

A. Andres-Hernando ◽

...

Keyword(s):

Diabetes Mellitus ◽

Uric Acid ◽

Risk Factor ◽

Cohort Study ◽

Serum Uric Acid ◽

Japanese Cohort

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Serum uric acid control for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-220439 ◽

2021 ◽

pp. annrheumdis-2021-220439

Author(s):

Ruriko Koto ◽

Akihiro Nakajima ◽

Hideki Horiuchi ◽

Hisashi Yamanaka

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Health Insurance ◽

Serum Uric Acid ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Disease Status ◽

Insurance Claims ◽

Health Insurance Claims ◽

Gout Flare

ObjectivesIn patients with gout, treating to target serum uric acid levels (sUA) of ≤6.0 mg/dL is universally recommended to prevent gout flare. However, there is no consensus on asymptomatic hyperuricaemia. Using Japanese health insurance claims data, we explored potential benefits of sUA control for preventing gout flare in subjects with asymptomatic hyperuricaemia.MethodsThis retrospective cohort study analysed the JMDC Claims Database from April 2012 through June 2019. Subjects with sUA ≥8.0 mg/dL were identified, and disease status (prescriptions for urate-lowering therapy (ULT), occurrence of gout flare, sUA) was investigated for 1 year. Time to first onset and incidence rate of gout flare were determined by disease status subgroups for 2 years or more. The relationship between gout flare and sUA control was assessed using multivariable analysis.ResultsThe analysis population was 19 261 subjects who met eligibility criteria. We found fewer occurrences of gout flare, for both gout and asymptomatic hyperuricaemia, in patients who achieved sUA ≤6.0 mg/dL with ULT than in patients whose sUA remained >6.0 mg/dL or who were not receiving ULT. In particular, analysis by a Cox proportional-hazard model for time to first gout flare indicated that the HR was lowest, at 0.45 (95% CI 0.27 to 0.76), in subjects with asymptomatic hyperuricaemia on ULT (5.0<sUA ≤ 6.0 mg/dL), compared with untreated subjects (sUA ≥8.0 mg/dL).ConclusionsOccurrences of gout flare were reduced by controlling sUA at ≤6.0 mg/dL in subjects with asymptomatic hyperuricaemia as well as in those with gout.Trial registration numberUMIN000039985.

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Abstract P146: Uric Acid is an Independent Risk Factor for Developing Hypertension From Prehypertension: A 5-year Japanese Cohort Study

Hypertension ◽

10.1161/hyp.70.suppl_1.p146 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Masanari Kuwabara ◽

Shigeko Hara ◽

Koichiro Niwa ◽

Minoru Ohno ◽

Ichiro Hisatome

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

Uric Acid ◽

Risk Factor ◽

Cohort Study ◽

Serum Uric Acid ◽

Independent Risk Factor ◽

Drinking Habits

Objectives: Prehypertension frequently progresses to hypertension and is associated with cardiovascular diseases, stroke, excess morbidity and mortality. However, the identical risk factors for developing hypertension from prehypertension are not clarified. This study is conducted to clarify the risks. Methods: We conducted a retrospective 5-year cohort study using the data from 3,584 prehypertensive Japanese adults (52.1±11.0 years, 2,081 men) in 2004 and reevaluated it 5 years later. We calculated the cumulative incidences of hypertension over 5 years, then, we detected the risk factors and calculated odds ratios (ORs) for developing hypertension by crude analysis and after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid. We also evaluated whether serum uric acid (hyperuricemia) provided an independent risk for developing hypertension. Results: The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%, but there were no significant differences between women and men (24.4% vs 26.0%, p=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2,858) (30.7% vs 24.0%, p<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR per 1 year increased: 1.023; 95% CI, 1.015-1.032), women (OR versus men: 1.595; 95% CI, 1.269-2.005), higher body mass index (OR per 1 kg/m 2 increased: 1.051; 95% CI 1.021-1.081), higher baseline systolic blood pressure (OR per 1 mmHg increased: 1.072; 95% CI, 1.055-1.089) and diastolic blood pressure (OR per 1 mmHg increased: 1.085; 95% CI, 1.065-1.106), and higher serum uric acid (OR pre 1 mg/dL increased: 1.149; 95% CI, 1.066-1.238), but not smoking and drinking habits, diabetes mellitus, dyslipidemia, and chronic kidney diseases. Conclusions: Increased serum uric acid is an independent risk factor for developing hypertension from prehypertension. Intervention studies are needed to clarify whether the treatments for hyperuricemia in prehypertensive subjects are useful.

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Changes in serum uric acid levels after allogeneic hematologic stem cell transplantation: A retrospective cohort study

Blood Research ◽

10.5045/br.2016.51.3.200 ◽

2016 ◽

Vol 51 (3) ◽

pp. 200 ◽

Cited By ~ 1

Author(s):

Sang Hyun Joo ◽

Jin Kyun Park ◽

Eunyoung Emily Lee ◽

Yeong Wook Song ◽

Sung-Soo Yoon

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Serum Uric Acid ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Hyperuricaemia in congenital heart disease patients

Cardiology in the Young ◽

10.1017/s1047951113001443 ◽

2013 ◽

Vol 25 (1) ◽

pp. 29-34 ◽

Cited By ~ 3

Author(s):

Efrén Martínez-Quintana ◽

Fayna Rodríguez-González

Keyword(s):

Body Mass Index ◽

Congenital Heart Disease ◽

Uric Acid ◽

Heart Disease ◽

Serum Uric Acid ◽

Congenital Heart ◽

C Reactive Protein ◽

Lower Serum ◽

Reactive Protein ◽

Low Serum

AbstractIntroductioHyperuricaemia is associated with traditional cardiovascular risk factors such as type 2 diabetes or dyslipidaemia and a higher mortality.MethodsOut of 528 congenital heart disease patients, 329 patients, including 190 male and 139 female patients, in whom uric acid determination was performed, were studied and followed up to determine survival.ResultsMale congenital heart disease patients with high serum uric acid concentrations (>7 mg/dl) showed significantly (p < 0.05) higher body mass index, serum creatinine, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and C-reactive protein concentrations than those male congenital heart disease patients with lower serum uric acid levels (≤7 mg/dl). Meanwhile, female congenital heart disease patients with higher serum uric acid concentrations (>5.7 mg/dl) were significantly (p < 0.05) younger, more hypoxaemic, more obese, and with higher C-reactive protein and N-terminal-pro-B-type natriuretic peptide levels than those female congenital heart disease patients with lower serum uric acid concentrations (≤5.7 mg/dl). During a median follow-up of 90 months, 16 out of 528 congenital heart disease patients died – 14 patients of cardiac origin and two patients of non-cardiac origin – of whom 10 were hypoxaemic. Kaplan–Meier analysis showed no significant differences in mortality between male and female congenital heart disease patients with high and low serum uric acid level concentrations.ConclusionsHypoxaemia, body mass index, and C-reactive protein concentrations are higher in hyperuricaemic congenital heart disease patients, although no significant differences were seen in mortality between congenital heart disease patients with high and low serum uric acid concentrations.

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Serum Uric Acid Levels and Their Changes and Risk of Stroke: A 7-Year Prospective Cohort Study in Northwest China

Cerebrovascular Diseases ◽

10.1159/000519142 ◽

2021 ◽

pp. 1-10

Author(s):

Shan Zheng ◽

Yan Luo ◽

Qian Miao ◽

Zhiyuan Cheng ◽

Yanli Liu ◽

...

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Serum Uric Acid ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Reference Group ◽

Northwest China ◽

Stroke Incidence ◽

Increased Risk ◽

Over Time

Introduction: It is not clear whether serum uric acid (SUA) levels and their changes over time are associated with the risk of stroke. A 7-year prospective cohort study in northwest China was conducted to analyze effects of SUA and their changes on the risk of stroke. Methods: A total of 23,262 individuals without cardiovascular disease in the Jinchang cohort were followed up for an average of 5.26 years. The Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence interval (95% CI) of stroke incidence to SUA and relative changes in SUA. Sensitivity analysis was performed after controlling the effect of renal insufficiency. Results: Baseline SUA and relative changes in SUA were positively correlated with the incidence of stroke in both males and females (p for overall association <0.0001). Stroke risk increased by 4.6% per 10% increase in the relative change of SUA (HR = 1.046, 95% CI, 1.007–1.086). The fully adjusted regression analysis demonstrated that only the large gain (>30%) in SUA was associated with an increased risk of stroke by 36.5% (95% CI, 1.8–83.0%), compared with the reference group (participants within ±10% changes in SUA). The same trend was observed in people with normal baseline SUA. In the unadjusted model, the risk of stroke associated with elevated SUA was significantly higher in the hyperuricemia group than in the normal SUA group. Conclusion: High initial SUA concentration and an increase in SUA concentration over time would increase the risk of stroke, and this means that there is no safe increase in SUA.

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