Association of Serum Uric Acid with Cardiovascular Disease Risk Scores in Koreans.

Seung Yun Lee,Joo-Hyun Lee,Seong-Ryul Kwon,Young Bin Joo,Mie Jin Lim,Kyong-Hee Jung,Young Ju Suh,Won Park,Youn-Kyung Oh

doi:10.3390/ijerph16234632

Abstract

As the prevalence of gout and hyperuricemia increases, the comorbidities of gout and hyperuricemia have become a public health burden. In particular, risks of cardiovascular disease (CVD)-related complications are increasing. However, a few guidelines exist for the management of hyperuricemia. This cross-sectional study aimed to investigate the association of serum uric acid with CVD risk in the general population of Korean adults. We examined cross-sectional data from the first and second years of the seventh Korea National Health and Nutrition Examination Survey 2016–2017. Among 16,277 participants, 8781 were analyzed. We estimated the CVD risk using a 10-year CVD risk score prediction formula. There was a significant association of serum uric acid with 10-year CVD risk scores after adjusting for physical activity, body mass index, serum creatinine, and alcohol consumption in both sexes (p < 0.001). In the fitted fractional polynomial model, an approximate U-shaped association between serum uric acid levels and 10-year CVD risk scores was found in men. At the serum uric acid level of 6.9 mg/dL, the CVD risk was lowest. An approximate J-shaped association between serum uric acid levels and 10-year CVD risk scores was found in women. Our study showed that hyperuricemia was associated with an increased CVD risk. Hypouricemia was also associated with an increased CVD risk in men. We, therefore, recommend proper management of uric acid levels in the general population to reduce CVD risks.

Highlights

Gout is common inflammatory arthritis affecting >1% of the population in most developed countries [1]
Education, alcohol consumption, diabetes status, systolic blood pressure, body mass index (BMI), and levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C), and serum creatinine were significantly different depending on the serum uric acid level
Consumption) in men (A) and women (B). In this nationwide survey of the general population, we found associations of serum uric acid with cardiovascular disease (CVD) risk

Summary

Introduction

Gout is common inflammatory arthritis affecting >1% of the population in most developed countries [1]. There is a tendency to increase substantially in the prevalence of gout and hyperuricemia [3]. Prevalence of gout and hyperuricemia in the United States in 2007−2008 were 3.9% and 21.4%, indicating increases of 1.2% and 3.2%, respectively, compared to in 1988−1994. The prevalence of comorbidities, including cardiovascular disease (CVD), hypertension, diabetes, and metabolic syndrome, was reported to be. 2–3 times higher among patients with gout than among those without gout [4,5,6]. A high prevalence of comorbidities was found among patients with hyperuricemia. As the prevalence of gout and hyperuricemia increase in parallel, the comorbidities of gout and hyperuricemia created a public health burden, especially increasing CVD-related overall mortality [1]

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