THE ASSOCIATION OF SERUM URIC ACID LEVELS WITH CARDIOVASCULAR MORBIDITY AND MORTALITY

Abstract

Objective: A number of epidemiological studies have demonstrated the association of hyperuricemia with cardiovascular morbidity and mortality. There are also data showing that hypouricemia can lead to endothelial dysfunction and oxidative stress, therefore, increasing the risk of hypertension, diabetes mellitus and kidney disease. The purpose was to evaluate the relationship between serum uric acid levels and fatal/non-fatal cardiovascular diseases in the Russian population-based sample during 8 years of follow-up Design and method: As a part of all-Russian epidemiology survey ESSE-RF a random sample of 4800 subjects was enrolled into the study. All subjects signed informed consent and underwent a questionnaire, anthropometry, blood pressure measurement, laboratory examination (biochemical blood tests, including uric acid). The observation period was 8 years with registration of cardiovascular end points: fatal and non-fatal myocardial infarction, stroke, transient ischemic attack. All patients were divided into 8 groups according to the reference level of serum uric acid based on South Korean population-based study categorization (Cho SK et al., 2018). Results: Data from 4168 subjects were collected. We demonstrated association between serum uric acid level and risk of CVD events, where age-adjusted hazard ratio (HR) for cardiovascular morbidity and mortality was significant only for the highest group of uric acid (Table 1). When the model was adjusted for body mass index (BMI), hypertension, glomerular filtration rate (GFR) and diabetes mellitus (DM), for DM only significant association remained (HR 4,6 (95% CI 1,91-11,0), p<0,001). Conclusions: In the Russian cohort only the highest uric acid level was predictive for increased cardiovascular morbidity and mortality. In the Russian population, the association between uric acid and cardiovascular events is explained primarily by the presence of diabetes. Agreement No 075-15-2022-301.