Abstract
Multiterritorial atherosclerosis has dramatically increased annual risk of adverse cardiovascular events than atherosclerotic disease with single‐artery affected. Serum uric acid (SUA) is an important predictor of stroke and atherosclerosis; however, which is supported by few direct evidence based on cohort studies. A prospective cohort study including 2644 North Chinese adults aged ≥40 years was performed in 2010‐2012 to investigate the association between SUA and multiterritorial vascular stenosis. Hyperuricaemia was defined as SUA levels >6 and >7 mg/dL for males and females, respectively. All participants underwent twice transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS) and peripheral arterial disease (PAD) was determined by ankle‐brachial index (ABI) on January 2010 and January 2012 based on regular health check‐ups. The cumulative incidence of vascular stenosis was significantly higher in subjects with hyperuricaemia than in those without hyperuricaemia (54.1% vs. 34.7%, P < 0.001). The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new on‐set vascular stenosis due to hyperuricaemia and a 1‐mg/dL change in SUA level were 1.75 (1.32‐2.31) and 1.29 (1.21‐1.38), respectively. Furthermore, in the gender‐stratified analysis, the association between SUA levels and ICAS was statistically significant in males (OR: 2.02; 95% CI: 1.18‐3.46), but not females (OR: 0.85, 95% CI: 0.41‐1.76, P for interaction: 0.026).
Highlights
We found that age, gender, education level, income level, physical activity, history of hypertension, his‐ tory of diabetes mellitus, history of hyperlipdaemia, C‐reactive protein (CRP), Serum uric acid (SUA) and estimated glomerular filtration rate (eGFR) were associated with the new vascular stenosis. (Table S1) In the unadjusted model, hyperuricaemic participants, as well as ones with higher SUA, had a higher risk for vascular stenosis (OR: 2.22; 95% confidence intervals (CIs): 1.72‐2.85 and odds ratios (ORs): 1.39; 95% CI: 1.31‐1.47, respectively), especially for extracranial artery stenosis (ECAS) (OR: 2.81; 95% CI: 2.17‐3.63, but not for intracranial artery stenosis (ICAS) OR: 1.28; 95% CI: 0.86‐1.90); in the fully
We focused on the longitudinal association between elevated SUA levels and asymptomatic polyvascular stenosis in a Chinese community cohort
Several studies have indicated that while not the case in young adults, in whom high SUA levels are frequently accompany higher body mass index (BMI), in mid‐ dle‐aged adults, SUA may play a major role in predicting subclinical atherosclerosis.[12,27]
Summary
The study subjects were participants in the APAC study, which aimed to investigate the epidemiology of asymptomatic polyvascu‐ lar abnormalities, including asymptomatic intracranial artery steno‐ sis (ICAS), extracranial artery stenosis (ECAS) and peripheral artery disease (PAD), in Chinese adults.[6]. A multivariable logistic regression analysis was used to deter‐ mine the association between elevated SUA levels (hyperuricaemia and per 1 mg/dL elevated) and new multiterritorial vascular stenosis by calculating the odd ratios (ORs) with 95% confidence intervals (CIs) after adjusting for age, sex, BMI, income, education level, smok‐ ing, alcohol consumption, physical activity, hypertension, diabetes mellitus, hyperlipidaemia, CRP, ALB, and eGFR. (Table S1) In the unadjusted model, hyperuricaemic participants, as well as ones with higher SUA (per 1 mg/dL increased), had a higher risk for vascular stenosis (OR: 2.22; 95% CI: 1.72‐2.85 and OR: 1.39; 95% CI: 1.31‐1.47, respectively), especially for ECAS (OR: 2.81; 95% CI: 2.17‐3.63, but not for ICAS OR: 1.28; 95% CI: 0.86‐1.90); in the fully. 0.45% (12/2644) female subjects suffer from hypouricaemia, and the result is consis‐ tent with our previous analysis
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