Abstract
Hyperuricemia is associated with all-cause and cardiovascular mortality. However, the threshold value of serum uric acid levels for increased risk of mortality has not been determined. This large-scale cohort study used a nationwide database of 500,511 Japanese subjects (40–74 years) who participated in the annual health checkup and were followed up for 7 years. The association of serum uric acid levels at baseline with cardiovascular and all-cause mortality was examined. The Cox proportional hazard model analysis with adjustment for possible confounders revealed that the all-cause and cardiovascular mortality showed a J-shaped association with serum uric acid levels at baseline in both men and women. A significant increase in the hazard ratio for all-cause mortality was noted with serum uric acid levels ≥ 7 mg/dL in men and ≥ 5 mg/dL in women. A similar trend was observed for cardiovascular mortality. This study disclosed that even a slight increase in serum uric acid levels was an independent risk factor for all-cause and cardiovascular mortality in both men and women in a community-based population. Moreover, the threshold values of uric acid for mortality might be different for men and women.
Highlights
Tsuneo Konta1*, Kazunobu Ichikawa2, Ryo Kawasaki3, Shouichi Fujimoto4, Kunitoshi Iseki4, Toshiki Moriyama4, KunihiroYamagata 4, Kazuhiko Tsuruya4, Ichiei Narita4, Masahide Kondo4, Yugo Shibagaki4, Masato Kasahara4, Koichi Asahi4 & Tsuyoshi Watanabe4
The results showed that all-cause and cardiovascular mortality were high in both men and women with high serum uric acid levels (Fig. 1)
The hazard ratio (HR) for each 1 mg/dL increase in serum uric acid level and all-cause and cardiovascular mortality increased in both men and women
Summary
Tsuneo Konta1*, Kazunobu Ichikawa, Ryo Kawasaki, Shouichi Fujimoto, Kunitoshi Iseki, Toshiki Moriyama, KunihiroYamagata 4, Kazuhiko Tsuruya, Ichiei Narita, Masahide Kondo, Yugo Shibagaki, Masato Kasahara, Koichi Asahi4 & Tsuyoshi Watanabe. This study disclosed that even a slight increase in serum uric acid levels was an independent risk factor for all-cause and cardiovascular mortality in both men and women in a community-based population. Some studies showed that the association between serum uric levels and mortality was not linear, but J-shaped, indicating that the conventional classification of uric acid levels, such as hyperuricemia (e.g., > 7 mg/dL) or per 1 mg/dL increase, might be inappropriate to evaluate the risk of increased serum uric acid levels on mortality Considering these conditions, a large-scale study with a sufficient number of events, various correction factors, and a sex-specific reference range of uric acid is necessary to address this issue. The association between uric acid levels and mortality remains unclear
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