SERUM URIC ACID LEVELS ARE ASSOCIATED WITH ASYMPTOMATIC PERIPHERAL ARTERY DISEASE

Abstract

Objective: Higher serum uric acid (SUA) levels have been implicated in the development and progression of atherosclerotic cardiovascular disease. However, it is not clear whether SUA levels are related to subclinical measures of cardiovascular disease, including peripheral arterial disease (PAD). The aim of our study was to test the association between increasing SUA levels and PAD in the Brisighella Heart Study Cohort. Design and method: A cross-sectional study was conducted among 974 participants to the 2012 Brisighella Heart Study aged more than 40 years, without clinical history of cardiovascular disease, type 2 diabetes or gout, and not treated with SUA lowering drugs. Main outcome-of-interest was PAD defined as ankle-brachial index less than 0.9 (n = 57). We used three models: the age (years), sex-adjusted model, multivariable model 1 additionally adjusted for smoking (never, former, current), alcohol intake (number of drinks/day), waist circumference (cm), hypertension (absent, present), and the multivariable model 2 further adjusted for LDL-C (mg/dL) and eGFR (EPI-CKD equation; ml/min) Results: Considering the whole cohort, a statistically significant inverse relation between uric acid level and ABI in the multivariable-adjusted model (beta [standard error] = −0.04 [0.009], p less than 0.001). This association was present in separate analyses among men and women. Higher SUA levels were positively associated with PAD, independent of smoking, body mass index (BMI), hypertension, serum LDL cholesterol, eGFR, and other confounders. Multivariable odds ratio (OR) [95 percent confidence intervals (CI)] comparing SUA levels higher than the 75th percentile (equal or more than 6 mg/dL) to uric acid levels less than the 50th percentile (less than 5.2 mg/dL) was 1.62 (1.08–2.44), p-trend = 0.015. This association persisted in separate analysis among men and women. Further, the results were consistent in subgroup analyses by categories of age, current smoking, BMI, and eGFR. Conclusions: Higher SUA levels are associated with PAD in non diabetic subjects in primary prevention for cardiovascular disease and gout.