scholarly journals Low Serum Uric Acid Predicts Risk of a Composite Disease Endpoint

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 361
Author(s):  
Fatma Özpamuk-Karadeniz ◽  
Yusuf Karadeniz ◽  
Adnan Kaya ◽  
Servet Altay ◽  
Günay Can ◽  
...  

Background and objectives: Mortality may increase in hypouricemia as well as inhyperuricemia. We assessed the predictive value of low serum uric acid (SUA) levels on the risk of overall mortality or a composite endpoint of death and nonfatal events. Materials and Methods: In 1013 community-based middle-aged adults, free of uncontrolled diabetes and coronary heart disease at baseline, the association of sex-specific SUA tertiles with defined outcomes was evaluated prospectively by logistic regression, stratified to gender and presence of type-2 diabetes, using recent criteria. Results: Totally, 43 deaths and additional incident nonfatal events in 157 cases were recorded at a median 3.4 years’ follow-up. Multivariable linear regression disclosed SUA to be significantly associated among non-diabetic individuals positively with creatinine, triglycerides, and body mass index in women further with fasted glucose. In multivariable-adjusted logistic regression analysis, sex-specifically dichotomized baseline uric acid (<5.1 and <4.1 mg/dL vs. higher values) significantly predicted the non-fatal events in the whole sample (relative risk (RR) 1.51 [95% confidence interval (CI) 1.02; 2.26]), as well as in men, while composite endpoint in the whole sample tended to rise (RR 1.38). Compared with the intermediate one, the top and bottom SUA tertiles combined tended to confer mortality risk (RR 2.40 [95% CI 0.89; 6.51]). Adverse outcomes in diabetic women were predicted by tertiles 2 and 3. Conclusions: Inverse association of SUA with adverse outcomes, especially in men, is consistent with the involvement of uric acid mass in autoimmune activation. The positive association of uric acid with adverse outcomes in diabetic women is likely mediated by concomitant high-density lipoprotein dysfunction.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fuyin Kou ◽  
Shanshan Yang ◽  
Shengshu Wang ◽  
Miao Liu ◽  
Yao He

Abstract Background This study aims to analyze the distribution of serum uric acid (SUA) level based on more than 1000 centenarians and to explore the association with three common diseases including hypertension, diabetes and dyslipidemia. Methods All the 1002 centenarians from the CHCCS were included. Household survey was conducted. Results The mean SUA level of centenarians was 329.04 ± 97.75 μmol/L and the prevalence of hyperuricemia in centenarians was 26.5%. There was no statistical difference in the distribution of SUA levels among centenarians with or without hypertension/diabetes. For dyslipidemia, there was an independent positive association. The risk of dyslipidemia among those with hyperuricemia was 1.646 (95%CI: 1.078–2.298) compared with those who didn’t have hyperuricemia. By comparing different subtypes of dyslipidemia, hyperuricemia was positively associated with hypertriglyceridemia and low-density lipoprotein cholesterolemia, with the corresponding ORs of 2.553 (95%CI: 1.282–5.083) and 1.927 (95%CI: 1.273–2.917) respectively, while there was no statistically significant association with hypercholesterolemia 0.998 (95%CI: 0.574–1.732). Conclusions There was no relation between SUA with hypertension or diabetes, while there was independently and positively association with hypertriglyceridemia and low-density lipoprotein cholesterolemia. The health benefits of controlling SUA in centenarians still require evidence based on prospective studies.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041919
Author(s):  
Jie Zeng ◽  
Wayne R Lawrence ◽  
Jun Yang ◽  
Junzhang Tian ◽  
Cheng Li ◽  
...  

ObjectivesHyperuricaemia has been reported to be significantly associated with risk of obesity. However, previous studies on the association between serum uric acid (SUA) and body mass index (BMI) yielded conflicting results. The present study examined the relationship between SUA and obesity among Chinese adults.MethodsData were collected at Guangdong Second Provincial General Hospital in Guangzhou City, China, between January 2010 and December 2018. Participants with ≥2 medical check-up times were included in our analyses. Physical examinations and laboratory measurement variables were obtained from the medical check-up system. The high SUA level group was classified as participants with hyperuricaemia, and obesity was defined as BMI ≥28 kg/m2. Logistic regression model was performed for data at baseline. For all participants, generalised estimation equation (GEE) model was used to assess the association between SUA and obesity, where the data were repeatedly measured over the 9-year study period. Subgroup analyses were performed by gender and age group. We calculated the cut-off values for SUA of obesity using the receiver operating characteristic curves (ROC) technique.ResultsA total of 15 959 participants (10 023 men and 5936 women) were included in this study, with an average age of 37.38 years (SD: 13.27) and average SUA of 367.05 μmol/L (SD: 97.97) at baseline, respectively. Finally, 1078 participants developed obesity over the 9-year period. The prevalence of obesity was approximately 14.2% for high SUA level. In logistic regression analysis at baseline, we observed a positive association between SUA and risk of obesity: OR=1.84 (95% CI: 1.77 to 1.90) for per-SD increase in SUA. Considering repeated measures over 9 year for all participants in the GEE model, the per-SD OR was 1.85 (95% CI: 1.77 to 1.91) for SUA and the increased risk of obesity were greater for men (OR=1.45) and elderly participants (OR=1.01). In subgroup analyses by gender and age, we observed significant associations between SUA and obesity with higher risk in women (OR=2.35) and young participants (OR=1.87) when compared with men (OR=1.70) and elderly participants (OR=1.48). The SUA cut-off points for risk of obesity using ROC curves were approximately consistent with the international standard.ConclusionsOur study observed higher SUA level was associated with increased risk of obesity. More high-quality research is needed to further support these findings.


2020 ◽  
Author(s):  
Yuntian Chu ◽  
Qianqian Zhao ◽  
Mei Zhang ◽  
Bo Ban ◽  
Hongbing Tao

Abstract Background: Elevated triglyceride (TG) levels are a biomarker of CVD risk. The relationship between serum uric acid (SUA) and TG in adults and obese children is well established. However, studies on children with short stature with SUA and TG are limited. Aim: The aim of this study was to examine the relationship between SUA and TG in Chinese children and adolescents with short stature.Methods: This study is a cross-sectional analysis of a cohort study. A total of 1095 children and adolescents with short stature (720 males and 375 females) were included. The related clinical characteristics, including body mass index (BMI), serum uric acid (SUA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), were determined.Results: The univariate analysis results showed a significant positive association between SUA and TG (P < 0.001). Furthermore, a smooth curve fitting after adjusting for potential confounders was performed, and a nonlinear relationship between SUA and TG was observed. A multivariate piecewise linear regression model revealed a significant positive association between SUA and TG when the SUA level was greater than 7 mg/dL (β 0.13, 95% CI 0.05, 0.22; P = 0.002). However, we did not observe a significant relationship between SUA and TG when the SUA level was lower than 7 mg/dL (β 0.01, 95% CI -0.01, 0.04; P=0.799).Conclusion: This study described a nonlinear relationship between UA and TG in children and adolescents with short stature. When SUA rises to a certain level, there is a strong positive association between UA and TG. This finding suggests that elevated UA levels may be another risk indicator of cardiovascular disease in children and adolescents with short stature.


2019 ◽  
Vol 15 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Quan-Bo Zhang ◽  
Dan Zhu ◽  
Zhong Wen ◽  
Ting Yi ◽  
Qing Li ◽  
...  

Objective: To investigate the changes of serum Uric Acid (sUA), lipids and Cystatin C (CysC) in primary gout patients, and to explore the clinical significance in gout patients. Methods: : sUA, CysC, high-sensitivity C-reactive Protein (hsCRP) and other biochemical parameters were measured in 326 gout patient and 210 healthy control subjects, blood cell counts were also detected. Clinical data were collected from gout patients. Results: sUA, CysC, hsCRP, Body Mass Index (BMI), White Blood Cell (WBC) counts, neutrophil Granulocyte (GR), Monocyte (Mo), Triglycerides (TG), plasma Total Cholesterol (TC), Very Low Density Lipoprotein (VLDL), apolipoprotein B100 (apoB100), Blood Glucose (GLU), serum Creatinine (sCr) and Urea Nitrogen (BUN) were significantly increased in gout patients compared with HC subjects (P<0.01, respectively), while lymphocyte counts and High Density Lipoprotein- Cholesterol (HDL-C) were significantly decreased in gout patients compared with HC subjects (P<0.01, respectively). Positive correlations were observed between concentration of sUA and age, TG, VLDL, sCr and CysC (P<0.05, respectively). While negative correlations were observed between the concentration of sUA and HDL-C(P<0.01). Besides, Positive correlations were observed between concentration of CysC and WBC, GR, Mo, apoA1, GLU, sCr, BUN, sUA, hsCRP (P<0.05, respectively). While negative correlations were observed between the concentration of CysC and TC, LDL-C(P<0.01, respectively). Conclusions: Blood lipid profile changes in gout patients. Gout patients who suffer from lipid metabolism disorder and vascular diseases might be associated with hyperuricemia, which leads to endothelial cell damage and vascular smooth muscle cell proliferation. CysC might be a marker for renal function damage and inflammation. Hyperuricemia is the risk factor of renal disorder in gout patients.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Selvaraj ◽  
B.L Claggett ◽  
D.V Veldhuisen ◽  
I.S Anand ◽  
B Pieske ◽  
...  

Abstract Background Serum uric acid (SUA) is a biomarker of several pathobiologies relevant to the pathogenesis of heart failure with preserved ejection fraction (HFpEF), though by itself may also worsen outcomes. In HF with reduced EF, SUA is independently associated with adverse outcomes and sacubitril/valsartan reduces SUA compared to enalapril. These effects in HFpEF have not been delineated. Purpose To determine the prognostic value of SUA, relationship of change in SUA to quality of life and outcomes, and influence of sacubitril/valsartan on SUA in HFpEF. Methods We analyzed 4,795 participants from the Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction (PARAGON-HF) trial. We related baseline hyperuricemia to the primary outcome (CV death and total HF hospitalization), its components, myocardial infarction or stroke, and a renal composite outcome. At the 4-month visit, the relationship between SUA change and Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OSS) and several biomarkers including N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also assessed. We simultaneously adjusted for baseline and time-updated SUA to determine whether lowering SUA was associated with clinical benefit. Results Average age was 73±8 years and 52% were women. After multivariable adjustment, hyperuricemia was associated with increased risk for most outcomes (primary outcome HR 1.61, 95% CI 1.37, 1.90, Fig 1A). The treatment effect of sacubitril/valsartan for the primary outcome was not modified by baseline SUA (interaction p=0.11). Sacubitril/valsartan reduced SUA −0.38 mg/dL (95% CI: −0.45, −0.31) compared with valsartan (Fig 1B), with greater effect in those with baseline hyperuricemia (−0.50 mg/dL) (interaction p=0.013). Change in SUA was independently and inversely associated with change in KCCQ-OSS (p=0.019) and eGFR (p&lt;0.001), but not NT-proBNP (p=0.52). Time-updated SUA was a stronger predictor of adverse outcomes over baseline SUA. Conclusions SUA independently predicts adverse outcomes in HFpEF. Sacubitril/valsartan significantly reduces SUA compared to valsartan, an effect that was stronger in those with higher baseline SUA, and reducing SUA was associated with improved outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ana Lucía Valencia ◽  
Armando Coca ◽  
Arturo Lorenzo ◽  
Veronica Fidalgo ◽  
Vicente Perez ◽  
...  

Abstract Background and Aims Kidney stone disease is widely prevalent in the general population and has been associated with multiple comorbidities including hypertension, diabetes, chronic kidney disease and cardiovascular disease. We aimed to describe the possible link between stone composition and cardiovascular disease and its differential effect among women and men. Method Retrospective review of patients with known stone composition seen in a nephrolithiasis unit in the last five years. Anthropometric and clinical data were gathered from the hospital records. Stone composition was defined as such if ≥50% of the stone was made from a single component. Cardiovascular disease included coronary artery disease, stroke and peripheral vascular disease. Unadjusted and adjusted logistic regression analysis were applied to describe the potential relationship between stone composition and cardiovascular disease. Results 337 patients were included in the study sample. Median age was 57 (IQR 47-67), 61.1% males. 58.2% suffered from recurrent stone disease and 28.5% from family history of stone formation. 32.9% of patients had hypertension, 22,4% diabetes and 13,1% chronic kidney disease. The most common kidney stone component was calcium oxalate (38.6%) followed by calcium phosphate (21.3%), uric acid (14.2%), struvite (8%) and brushite (0.9%). Only uric acid as main stone component was associated with cardiovascular disease among men but not women in our sample in univariate analysis. That relationship was lost in adjusted logistic regression analysis. Conclusion Calcium oxalate and phosphate were the most common components of kidney stones. No relationship was found between stone composition and cardiovascular disease in the study sample.


2021 ◽  
Author(s):  
Ranya A. Ghamri ◽  
Tala A. Qalai ◽  
Raghad A. Ismail ◽  
Joud M. Aljehani ◽  
Dina S. Alotaibi ◽  
...  

Abstract Background: Hyperuricemia is a metabolic defect caused by high purine consumption, overproduction of uric acid, or reduced uric acid excretion. Hyperuricemia is the second most common metabolic disease after diabetes mellitus and can mediate proinflammatory endocrine imbalance in adipose tissue, which contributed to dyslipidemia. Furthermore, several studies have associated uric acid with dyslipidemia. However, no previous studies have examined patients without chronic illness. Thus, we aimed to assess the relationship between serum uric acid concentration and lipid profile parameters and to estimate the prevalence of hyperuricemia in the city of Jeddah. Methods: A retrospective study was conducted among 1206 patients without chronic illness after applying the exclusion criteria. Patients had undergone laboratory blood testing over a 3-year period (2018–2020) at King Abdulaziz University Hospital, which was ethically approved. We used a predesigned checklist to collect data from electronic hospital records using Google Forms. Bivariate analysis, tables, and graphs were used to represent and identify the relationships between variables. A P-value of <0.05 was considered significant.Results: Our study revealed a prevalence of 12% for hyperuricemia in the study population. Males were more frequently affected than females (8.13% vs. 3.73%, respectively). There was no association between serum uric acid concentration and lipid profile parameters, including total cholesterol (P = 0.92), triglyceride (P = 0.42), high-density lipoprotein (P = 0.47), and low-density lipoprotein (P = 0.66). There was a strong association between serum uric acid concentration and high body mass index (P < 0.001), older age (P = 0.002), male sex (P < 0.001), and nationality (P < 0.001). Furthermore, there was an association between sex and mean erythrocyte sedimentation rate (P = 0.02) and mean triglyceride concentration (P = 0.02).Conclusion: We observed a low prevalence of hyperuricemia, and our results indicate no association between serum uric acid concentration and lipid profile parameters.


2020 ◽  
Author(s):  
Guanqun Chao ◽  
Yue Zhu ◽  
Lizheng Fang

Abstract Background: To clarify the risk factors associated with NAFLD and further clarify the correlation between uric acid level and NAFLD by analyzing the correlation between NAFLD and different metabolic factors.Methods: Datas were obtained from subjects who underwent health examination in the Health promotion centre of Sir Run Run Shaw hospital of Zhejiang University from January 2016 to December 2017.The diagnosis of NAFLD was according to the clinical diagnosis of the Guidelines.Statistical analyses were performed using R software.Results: 79492 subjects were analyzed. 56680(71.3%) participants did not have NAFLD, 22812(28.7%) participants had NAFLD. Male, age, BMI, high blood pressure, central obesity, high glycosylated hemoglobin, high serum uric acid, high triglyceride, high total cholesterol, high low density lipoprotein cholesterol (LDL-C), abnormal liver function were risk factors of NAFLD, however, low high-density lipoprotein cholesterol (HDL-C) level was another risk factor of NAFLD.OR value suggested serum uric acid was a robust risk factor for NAFLD in all subgroups.In male group, AUC was 0.656 (95%CI: 0.651-0.661), the optimal diagnostic threshold was 395.5 mol/L, the sensitivity was 61.9%, the specificity was 61.1%, and the yoden index was 0.23. In female group, AUC was 0.716 (95%CI: 0.708-0.724), the optimal diagnostic threshold was 294.5 mol/L, sensitivity was 67.7%, specificity was 64.5%, and the Jordan index was 0.32.Conclusions: Our study suggested that there was a close correlation between serum uric acid level and NAFLD.Uric acid levels was a key risk factor for NAFLD.The diagnosis of fatty liver in patients can be preliminarily determined by detecting uric acid level.Contributions to the literature:1. The purpose of this study was to clarify the risk factors associated with NAFLD and further clarify the correlation between uric acid level and NAFLD by analyzing the correlation between NAFLD and different metabolic factors in the physical examination population.2. There was a close correlation between serum uric acid level and NAFLD.Uric acid levels was a key risk factor for NAFLD.3. The diagnosis of fatty liver in patients can be preliminarily determined by detecting uric acid level.


2013 ◽  
Vol 25 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Efrén Martínez-Quintana ◽  
Fayna Rodríguez-González

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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