Abstract
AimThe role of uric acid as a risk factor for cardio-cerebrovascular diseases is controversial. In this study, we aimed to investigate the relationship between serum uric acid level and the risk of cardio-cerebrovascular events in middle-aged and non-obese Chinese men.MethodsWe included 3152 participants from the health examination center of Tongji Hospital from June 2007 to June 2010. Clinical examination and medical records were collected at the annual health examination. The hazard ratios (HRs) of uric acid for cardio-cerebrovascular events were calculated by Cox proportional hazards models. Generalized additive model and threshold effect analysis were used to explore the non-linear relationship between serum uric acid level and the incidence of cardio-cerebrovascular event.ResultThe mean follow-up time was 52 months. When the participants were classified into four groups by the serum acid quarter (Q1-Q4), the HRs (95% CI) of Q2-Q4 for cardio-cerebrovascular events were 1.26 (0.83, 1.92), 1.97 (1.33, 2.91) and 2.05 (1.40, 3.01), respectively, compared with the reference (Q1). The actual incidence and conditional incidence of cardio-cerebrovascular events in the high serum acid group were higher than those in the low serum acid group, which were stratified by the turning point (sUA = 372 mol/L). We also showed a strong prognostic accuracy of the multiple variable-based score in 3 years and 5 years, with area under the receiver operating characteristic (ROC) curve of 0.790 (0.756-0.823) and 0.777 (0.749-0.804), respectively.ConclusionSerum uric acid level is a strong risk factor for cardio-cerebrovascular events.
Highlights
Cardiovascular and cerebrovascular diseases, including coronary artery disease, acute myocardial infarction, stroke, and so on, are well known to be the most common causes of morbidity and mortality worldwide [1, 2]
We investigated the association between serum uric acid level and cardiovascular and cerebrovascular events www.impactjournals.com/oncotarget (CCBVEs) in a large population-based longitudinal cohort in generally middle-aged and non-obese Chinese men who were cardio-cerebrovascular diseases (CCBVDs)-free at baseline
When adjusted for other confounding variables, we found that increment of serum uric acid (sUA) > 372 μmol/L do not increase the risk of CCBVEs, indicating that sUA no longer play www.impactjournals.com/oncotarget
Summary
Cardiovascular and cerebrovascular diseases, including coronary artery disease, acute myocardial infarction, stroke, and so on, are well known to be the most common causes of morbidity and mortality worldwide [1, 2]. Biological/life style factors, including aging, smoking, hyperlipidemia, hypertension, and obesity are well known risk factors for cardio-cerebrovascular diseases (CCBVDs) [3,4,5]. Levels were associated with risk of myocardial infarction and stroke during a mean follow-up of 8.4 years [9]. Odden et al recently included 10,956 participants from the National Health and Nutrition Examination Survey and demonstrated an association between uric acid level and cardiovascular mortality even after adjustment for potential confounders [10]. Some studies only found an association in women, and the associations disappeared after adjustment for confounders in others [11,12,13]
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