Antihyperglycemic, antioxidant, and organ protective effects of Schumanniophyton magnificum stem bark aqueous extract in dexamethasone-induced insulin resistance rats

This study aimed to evaluate the effect of Schumanniophyton magnificum stem bark aqueous extract in dexamethasone-induced insulin-resistant male rats. Firstly, a phytochemical screening of the aqueous extract was carried out. Thereafter, using acute and subacute studies (11 days), the effect of the extract (200 mg/kg and 400 mg/kg) was evaluated on dexamethasone-induced hyperglycemic rats. Glycemia was measured before and after treatment in both studies. Histological examinations for isolated liver, kidneys, and pancreas were performed, body and the weight of some internal organs was determined. The biochemical assay in the blood samples was performed only for the subacute study. Phytochemical analysis revealed that the extract contains phenolic compounds, flavonoids, anthocyanins, saponins, gallic tannins, coumarins, and anthraquinones. In both studies, Schumanniophyton magnificum stem bark aqueous extract reduced the glucose blood Area under the Curve produced by dexamethasone injection. The extract, as well as glibenclamide significantly lowered the dexamethasone-induced increase in transaminases activities and uric acid concentration. Superoxide dismutase activity increased in all extract and glibenclamide groups compared to the dexamethasone group. The extract effect on the glutathione concentration was dose-dependent (p < 0.05 and p < 0.001 respectively). The histology of organs from rats treated with dexamethasone revealed hepatic cytolysis, leukocyte infiltration, and islet hypotrophy. The extract nd glibenclamide-treated groups had fewer or no anomalies observed with dexamethasone administration. Aqueous extract of S. magnificum stem bark protects against dexamethasone-induced pancreatic and hepatorenal abnormalities, probably due to the antioxidant properties of the chemical groups present in this extract.

Menopause and Hyperuricemia in Women in the Russian Population (Results of the ESSE-RF Study)

Aims. To evaluate the relationship of menopause and its features with hyperuricemia in Russian women. Methods. In this study, we used data from the cross-sectional phase of the epidemiological study Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation (ESSE-RF) conducted in 20132014, in 13 regions of Russia. The final random sample size was 12 781 women. According to the interviews, the fact of menopause and the features of climacteric were identified. Hyperuricemia was defined as a serum uric acid concentration greater than 360 mol/L. Age, behavioral risk factors and indicators of health status were assessed as covariates. Logistic regression analysis was used for multivariate assessment of associations. Apart from the assessment of the general sample, the analysis of the groups stratified by obesity, diabetes mellitus and the characteristics of climacteric was carried out. The results of logistic regression analysis are presented as odds ratios (OR) and 95% confidence intervals (CI). Results. In the general sample, after adjusting for covariates, menopause was directly associated with hyperuricemia (OR = 1.17; 95% CI 1.061.28), the association of hyperuricemia with age was not statistically significant. Menopause was more consistently associated with hyperuricemia in obese compared to non-obese women. In diabetic women, menopause is directly and significantly associated with hyperuricemia, whereas in non-diabetic women there was not the association between menopause and hyperuricemia. Taking into account the features of climacteric, menopause was directly associated with hyperuricemia only in the 410 years after the onset of menopause (OR = 1.13; 95% CI 1.021.26), in natural menopausal women (OR = 1.18; 95% CI 1.071.30) and who were taking hormone replacement therapy (OR = 1.23; 95% CI 1.061.43). Conclusions. The results of the study indicate the direct association of hyperuricemia with menopause, but not with the age of women. The stratified analysis has made it possible to identify some features of the association between hyperuricemia and menopause in women with metabolic disorders, as well as to assess the influence of the features of climacteric.

Hyperuricemia as a Risk Factor for Preterm Delivery in Women with Pre-Eclampsia

Objective: To determine hyperuricemia as a risk factor for preterm delivery in women with pre-eclampsia. Study Type: Case control study. Duration and Place of Study: Department of Gynaecology and Obstetrics, Sadiq Abbasi Hospital Bahawalpur from 1st July to 31st December 2019. Material and Methods: One hundred cases of pre-eclamptic and hyperuricemic women admitted for delivery through out-patient and emergency departments were divided in two groups, 50 cases in each group. Results: 70% women had hyperuricemia and pre-eclampsia deliver preterm and 34% women who had hyperuricemia and preeclampsia deliver at term. Conclusion: High serum uric acid concentration increased the chances of preterm delivery in pre-eclamptic women. Keywords: Hyperuricemia, Pre-eclampsia, Gestational hypertension, Uric acid, Pre-term delivery

Pharmacotherapy for gout

Background: Gout is a common disease that is mainly caused by hyperuricemia. Although it is relatively easy to treat, adherence to drug treatment and the rate at which treatment targets are met is low.Current Concepts: For the treatment of acute gout attack, colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids can be used alone or in combination depending on the severity of symptoms. To prevent gout attacks, patients are started on colchicine prior to or concurrent with treatment with uric acid–lowering drugs. The treatment is maintained until serum uric acid levels have returned to normal, and the patient has had no acute attacks for three to six months. Ultimately, the symptoms of gout are controlled in the long term by treating the patient’s hyperuricemia. For this purpose, allopurinol, febuxostat, and benzbromarone are used, and the side effects and contraindications for each drug should be checked. The goal for the treatment of chronic gout is to maintain a serum uric acid concentration below 6.0 mg/dL.Discussion and Conclusion: Patients visit the emergency departments of hospitals for sudden gout attacks. However, gout is a chronic disease that requires the lifelong use of uric acid–lowering agents. Therefore, it is necessary to educate patients on a serum urate-based treat-to-target approach.

Age and Gender-Specific Reference Intervals for Uric Acid Level in Children Aged 5–14 Years in Southeast Zhejiang Province of China: Hyperuricemia in Children May Need Redefinition

Context: Hyperuricemia is defined when the plasma uric acid concentration is above 416 μmol/L (7 mg/dl) in male adults, or 357 μmol/L (6 mg/dl) in female adults. However, there are no explicit criteria yet for children.Objective: It is necessary to set up reference intervals for the uric acid level in different age groups among children.Materials and Methods: A total of 5,439 individuals (3,258 males, 2,181 females) were included in the final statistical analysis. Reference values of all age groups were determined by statistical descriptions. Multiple linear regression analysis was applied to determine the relationship between uric acid level, BMI, and age.Results: The level of uric acid increased with age. Gender differences in uric acid level occurred after the onset of puberty. Additionally, linear regression revealed a positive correlation between the uric acid level and BMI.Discussion and Conclusion: The reference range of the uric acid level in children is inconsistent with the previous viewpoint. Body mass index plays an important role in uric acid metabolism.

Renal Hypouricemia 1: Rare Disorder as Common Disease in Eastern Slovakia Roma Population

Renal hypouricemia (RHUC) is caused by an inherited defect in the main reabsorption system of uric acid, SLC22A12 (URAT1) and SLC2A9 (GLUT9). RHUC is characterized by a decreased serum uric acid concentration and an increase in its excreted fraction. Patients suffer from hypouricemia, hyperuricosuria, urolithiasis, and even acute kidney injury. We report clinical, biochemical, and genetic findings in a cohort recruited from the Košice region of Slovakia consisting of 27 subjects with hypouricemia and relatives from 11 families, 10 of whom were of Roma ethnicity. We amplified, directly sequenced, and analyzed all coding regions and exon–intron boundaries of the SLC22A12 and SLC2A9 genes. Sequence analysis identified dysfunctional variants c.1245_1253del and c.1400C>T in the SLC22A12 gene, but no other causal allelic variants were found. One heterozygote and one homozygote for c.1245_1253del, nine heterozygotes and one homozygote for c.1400C>T, and two compound heterozygotes for c.1400C>T and c.1245_1253del were found in a total of 14 subjects. Our result confirms the prevalence of dysfunctional URAT1 variants in Roma subjects based on analyses in Slovak, Czech, and Spanish cohorts, and for the first time in a Macedonian Roma cohort. Although RHUC1 is a rare inherited disease, the frequency of URAT1-associated variants indicates that this disease is underdiagnosed. Our findings illustrate that there are common dysfunctional URAT1 allelic variants in the general Roma population that should be routinely considered in clinical practice as part of the diagnosis of Roma patients with hypouricemia and hyperuricosuria exhibiting clinical signs such as urolithiasis, nephrolithiasis, and acute kidney injury.

Sex Difference in the Association Between Eating Away From Home and the Risk of High Serum Uric Acid in South China

Background: The prevalence of high serum uric acid is increasingly rising in recent years, and diet behavior is perceived to be associated with it. This study aimed to explore the relationship between eating away from home (EAFH) and the risk of high serum uric acid in adults in South China.Methods: The data utilized in this study were from Guangdong Nutrition and Health Survey (NHS) 2015. Serum uric acid concentration was detected. EAFH in the past week was investigated. We defined EAFH as food consumption away from home. Dietary data were collected by 24-h recalls on 3 consecutive days. A generalized linear mixed-effects model was applied to compute the odds ratio (OR) and its corresponding 95% CI.Results: A total of 3,489 individuals were included in this study. A 1.27-fold OR (95% CI: 1.05–1.52, P = 0.012) of high serum uric acid was identified in adults with EAFH in comparison with those without EAFH. With respect to men, a 1.66-fold OR (95% CI: 1.3–2.1, P &lt; 0.001) of high serum uric acid was observed. We also observed that men with EAFH had higher intakes of red meat, poultry, vegetable, carbohydrate, protein, fat, and total energy, while a lower grain intake than those without EAFH. However, there was a lack of significant association between EAFH and the odds ratio of high serum uric acid in women. Women with EAFH did not have higher consumptions of red meat, vegetable, fish, fat, and water than those without EAFH.Conclusions: This study found that EAFH was associated with an increased odds ratio of high serum uric acid in men, but not in women.

Influence of Electronic Cigarettes on Antioxidant Capacity and Nucleotide Metabolites in Saliva

The balance between reactive oxygen species production and the activity of antioxidant systems present in saliva is an important element in maintaining oral environment homeostasis. E-cigarettes adversely affect the oral cavity and their cytotoxic effect is related to oxidative stress. The aim of this study was to assess the influence of using electronic cigarettes on antioxidant capacity of saliva. The study involved 110 subjects (35 e-cigarettes users, 33 traditional cigarettes smokers and 42 non-smokers). Laboratory analysis involved quantitation of uric acid, hypoxanthine, xanthine, TAOS (total antioxidant status) and TEAC (Trolox equivalent antioxidant capacity) in saliva. Lower values for TAOS and TEAC were observed among e-cigarettes users and traditional cigarettes smokers in comparison to non-smokers. Uric acid concentration tended to be higher among e-cigarettes users while no differences in hypoxanthine and xanthine saliva concentrations were observed. Electronic cigarettes usage affects antioxidant capacity of saliva to the same extent as traditional cigarettes, when comparing smokers to non-smokers. Further longitudinal studies on a larger study group are needed to assess the effect of changes in antioxidant status on oral health.

Influence of testosterone on purine metabolism and gout

Many different factors are involved in the regulation of purine metabolism. An important role is played by the level of sex hormones: high concentrations of androgens lead to a higher, and estrogen – to a lower level of uric acid. However, according to the results of numerous studies, it has been shown that the effect of sex hormones is not limited only to the uric acid concentration. Sex hormones affect inflammatory processes in the body by modulating the production of pro-inflammatory cytokines and regulating the corresponding signaling pathways. Androgen deficiency can lead to obesity and metabolic disorders, which can contribute to the development and course of gout. This review examines the effect of testosterone, as well as the effect of changes in its concentration on the dynamics of purine metabolism and gout.

Losartan and Eprosartan Induce a Similar Effect on the Acute Rise in Serum Uric Acid Concentration after an Oral Fructose Load in Patients with Metabolic Syndrome

Introduction. Excessive intake of fructose increases serum uric acid concentration. Hyperuricemia induces a negative effect on atherosclerosis and inflammation. Hyperuricemia is common in patients with arterial hypertension. Several antihypertensive drugs including diuretics increase serum uric acid concentration. In contrast, the angiotensin II receptor antagonist (ARB) losartan was found to lower serum uric acid though it may increase renal excretion while other ARBs showed mostly a neutral effect. In this study, effects of two AT1 receptor antagonists losartan and eprosartan on serum uric acid changes induced by oral fructose load were directly compared. Methods. The randomized, crossover, head-to-head comparative study comprised 16 ambulatory patients (mean age 64.5 ± 9.8 years). The patients fulfilled AHA/NHLBI 2005 criteria of metabolic syndrome. A daily single morning dose of each study drug (50 mg of losartan or 600 mg of eprosartan) was given during two 3-month periods in a random order separated by 2-week washout time. The oral fructose tolerance test (OFTT) was performed at baseline and after each two 3-onth treatment periods. Before and during OFTT, urine excretion of uric acid and creatinine was assessed in the first morning portion of urine. Blood samples for the measurement of serum uric acid and lipids were taken at baseline and 30, 60, and 120 minutes after oral intake of 75 g of fructose. Results. After 3-month treatment with eprosartan and losartan, both systolic and diastolic blood pressure decreased significantly and to a similar extent. After the treatment, serum uric acid and its baseline and postfructose urine excretion were unchanged. No significant changes of plasma lipids before and after OFTT were observed throughout the study. Conclusions. The study showed that in patients with hypertension and metabolic syndrome, both losartan and eprosartan have a neutral effect on fasting and postfructose load serum uric acid concentration and its urinary excretion. This trial is registered with NCT04954560.