Association Of Serum Uric Acid Research Articles

Serum uric acid to high-density lipoprotein ratio as a novel indicator of inflammation is correlated with the presence and severity of metabolic syndrome: A large-scale study.

We investigated the association of serum uric acid to high-density lipoprotein ratio (UHR) with the presence and severity of metabolic syndrome (MetS) among MASHAD cohort participants. In this cross-sectional study, according to International Diabetes Federation criteria, the cohort participants were divided into MetS (+) and MetS (-) groups. MetS (+) were classified into Group 1 (those with 3 MetS criteria), Group 2 (those with 4 MetS criteria) and Group 3 (those with 5 MetS criteria). UHR was compared among the groups. Data related to 9637 subjects including 3824 MetS (+) and 5813 MetS (-) were analysed. The mean UHR was significantly higher (p < .001) in the MetS (+) group compared with the MetS (-) group. UHR increased as the MetS severity increased (p < .001). ROC analysis revealed that UHR greater than 9.5% has 89.07% sensitivity and 77.03% specificity in differentiating MetS (-) from MetS (+) subjects. Among MASHAD cohort study participants, a significant association between UHR and MetS was found. Furthermore, there is an increase in UHR as the severity of MetS increases. Registration number of MASHAD cohort study: 85134.

P02-012-23 Association of Serum Uric Acid With Metabolic Syndrome and Its Components in a Rural Hypertensive Population in China

P02-012-23 Association of Serum Uric Acid With Metabolic Syndrome and Its Components in a Rural Hypertensive Population in China

Association of serum uric acid with hepatic steatosis detected by controlled attenuation parameter in the United States population

BackgroundThe relationship between serum uric acid (SUA) and nonalcoholic fatty liver disease (NAFLD) has been previously reported. Controlled attenuation parameter (CAP) has better diagnostic performance than ultrasonography for assessing hepatic steatosis. The association of SUA with hepatic steatosis detected by CAP is worth further study.MethodsThe US population aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) was assessed. Hepatic steatosis was evaluated by the controlled attenuation parameter (CAP). NAFLD status was defined as CAP values of 268 dB/m without hepatitis B or C virus infection or considerable alcohol consumption. Multiple imputations were performed to fill in the missing covariate values. Linear regression, logistic regression, and smooth curve fitting were used to examine the association.ResultsIn total, 3919 individuals participated in this study. There was a positive association between SUA (µmol/L) and CAP (β = 0.14, 95% CI: 0.12-0.17, P < 0.01). After stratification by sex, a significant relationship between SUA and CAP existed in both males (β = 0.12, 95% CI: 0.09-0.16, P < 0.01) and females (β = 0.17, 95% CI: 0.14-0.20, P < 0.01) after multiple imputation. The inflection points of the threshold effect of SUA on CAP were 487.7 µmol/L in males and 386.6 µmol/L in females. There was a positive association between SUA (mg/dL) and NAFLD (OR = 1.30, 95% CI: 1.23-1.37, P < 0.01). After stratification by race, positive relationships were also observed. Meanwhile, a positive relationship existed between hyperuricemia and NAFLD (OR = 1.94, 95% CI: 1.64-2.30, P < 0.01). The positive relationship was more significant in females than in males (P for interaction < 0.01).ConclusionsThere was a positive association between SUA and CAP, as well as between SUA and NAFLD. Subgroup studies stratified by sex and ethnicity demonstrated that the effects were consistent.

Association of serum uric acid with anemia in U.S. adults: a cross-sectional study using secondary data

BackgroundHigh serum uric acid (SUA) is a risk factor of cardiovascular disease (CVD). Abnormal SUA have been correlated with a significant increase in mortality. Anemia is an independent predictor of mortality and CVD. To date, no study has investigated the relationship between SUA and anemia. Here, we explored the correlation between SUA and anemia in the American population.MethodsThe cross-sectional study involved 9205 US adults from NHANES (2011–2014). The relationship between SUA and anemia was explored using multivariate linear regression models. Two-piecewise linear regression model, generalized additive models (GAM) and smooth curve fitting were performed to explore the non-linear relationships between SUA and anemia.ResultsWe found a U-shaped non-linear relationship between SUA and anemia. The inflection point of the SUA concentration curve was 6.2 mg/dL. The ORs (95% CIs) for anemia on the left and right of the inflection point were 0.86 (0.78–0.95) and 1.33 (1.16–1.52), respectively. The 95% CI of inflection point was 5.9-6.5 mg/dL. The findings showed that both genders presented a U-shaped correlation. Safe ranges of SUA in men and women were 6-6.5 and 4.3–4.6 mg/dL, respectively.ConclusionsBoth high and low SUA levels were correlated with increased risk of anemia, and a U-shaped relationship was observed between SUA and anemia.

Association of serum uric acid with risk of stroke in US adults: A cross-sectional study from NHANES 1999–2020

Background and aimsThe validity of high uric acid levels as an independent cause of stroke remains controversial, and the association between its low concentration and stroke is unclear. This study determines how different serum uric acid (SUA) levels are associated with stroke risk. MethodsThis cross-sectional study used continuous National Health and Nutrition Examination Survey data in the United States during 1999–2020. The SUA levels of 6.0, 6.8, and 9.0 mg/dL were all considered as cut-off points. Restricted cubic spline interpolation and logistic regression models were used to evaluate the different associations. Subgroup analyses and sensitivity analyses were conducted to evaluate the influence of multiple factors on the outcomes. ResultsThe study included 23,413 participants aged ≥ 20 years. A J-shaped curve existed between SUA and stroke risk, and the risk of stroke was positively correlated with SUA levels in the overall population. Subgroup analysis of all adults in the SUA 6.8–9.0 mg/dL group showed that stroke risk for non-Hispanic white, obese, ex-smoker, and heavy drinking groups was increased, but for the other Hispanic group was reduced. In the SUA < 6.0 mg/dL group, stroke risk for ex-smoker, heavy drinkers, and no chronic kidney disease groups was increased. ConclusionOur findings indicate a J-shaped relationship between SUA levels and stroke risk. Low and high SUA levels increased stroke risk for different populations, except in the other Hispanic population. Early SUA management is highly significant for stroke prevention in high-risk populations.

U-shaped association of serum uric acid with all-cause mortality in patients with hyperlipidemia in the United States: a cohort study.

Serum uric acid (SUA) interferes with lipid metabolism and is considered an independent risk factor for atherosclerosis, a major complication in patients with hyperlipidemia. However, the effects of uric acid levels on mortality in hyperlipidemic patients has yet to be sufficiently determined. In this study, we aimed to assess the association between all-cause mortality and SUA in a hyperlipidemic population. To determine mortality rates, we obtained data for 20,038 hyperlipidemia patients from the U.S. National Health and Nutrition Examination Surveys (NHANES) 2001-2018 and National Death Index. To examine the all-cause mortality effect of SUA, multivariable Cox regression models, restricted cubic spline models, and two pairwise Cox regression models were used. Over a median follow-up of 9.4 years, a total of 2079 deaths occurred. Mortality was examined according to SUA level quintiles: <4.2, 4.3-4.9, 5.0-5.7, 5.8-6.5, and >6.6 mg/dl. In multivariable analysis using 5.8-6.5 mg/dl SUA as a reference, the hazard ratios (95% confidence interval) of all-cause mortality across the five groups were 1.24 (1.06-1.45), 1.19 (1.03-1.38), 1.07 (0.94-1.23), 1.00 (reference), and 1.29 (1.13-1.48), respectively. According to a restricted cubic spline, we noted a U-shaped relationship between SUA and all-cause mortality. The inflection point was approximately 6.30 mg/dl, with hazard ratios of 0.91 (0.85-0.97) and 1.22 (1.10-1.35) to the left and right of the inflection point, respectively. In both sexes, SUA was characterized by a U-shaped association, with inflection points at 6.5 and 6.0 mg/dl for males and females, respectively. Using nationally representative NHANES data, we identified a U-shaped association between SUA and all-cause mortality in participants with hyperlipidemia.

The association of serum uric acid with all-cause and cardiovascular mortality among adults with rheumatoid arthritis: a cohort study.

Serum uric acid (SUA) is associated with poor outcomes in patients with numerous types of disease. However, the association between SUA and the outcomes of patients with rheumatoid arthritis (RA) remains to be fully elucidated. Thus, the present study aimed to determine the associations between SUA and all-cause or cardiovascular disease (CVD)-associated mortality in adults with RA. The data of patients with RA were collected from the National Health and Nutrition Examination Survey from 2001 to 2018. All-cause and CVD-associated mortality were identified using national death records through 31 December 2019. Weighted survival curves, Cox proportional hazards regression models, restricted cubic splines (RCS) and stratified analyses were used to assess the association between SUA levels and mortality. Among 2,312 patients with RA, a total of 597 all-cause deaths and 198 CVD-associated deaths were recorded during 19,133 person-years of follow-up. The results of the Kaplan-Meier curves for long-term all-cause and CVD-associated mortality demonstrated that increased levels of SUA were associated with a higher incidence of mortality. In the fully adjusted models, the highest SUA quartile exhibited hazard ratios [(HRs); 95% confidence intervals (CIs)] of 1.53 (1.10, 2.14) for all-cause mortality and 1.93 (1.14, 3.27) for CVD-associated mortality, compared with the lowest SUA quartile. The results of the RCS analysis confirmed a strong linear association between SUA levels and the HR of all-cause mortality, while a U-shaped association was observed between SUA and CVD-associated mortality. The results of the present study demonstrated that high SUA levels were significantly associated with increased risks of all-cause and CVD-associated mortality in patients with RA. Further studies are required to elucidate the potential impact of treatments on reducing SUA levels.

ASSOCIATION OF URIC ACID WITH COMPONENTS OF METABOLIC SYNDROME AT A TERTIARY CARE CENTRE IN BENGALURU

Background: Metabolic syndrome (MetS) is also known as syndrome X, insulin resistance syndrome is dened as a group of disease developed due to accumulation of multiple risk factors that includes resistance to insulin, dyslipidemia, abdominal obesity and hypertension. Metabolic syndrome, is associated not only with type 2 diabetes mellitus and cardiovascular disease, but also with many other systemic disorders such as cerebrovascular accident, chronic lung disease and fatty liver disease. Hyperuricemia (above 7.0 mg/dL in men and 6.0 mg/dL in women) has been reported to be closely related to diabetes, hypertension, obesity, renal function decline, and cardiovascular disease, most of which are principal contributors in the development and progression of MetS. The study aimed to assess the associations of serum uric acid with the components of MetS. Methods: This cross-sectional study was conducted in the hospitals attached to Bangalore medical college and research Institute. 110 patients with metabolic syndrome who satised the inclusion criteria were included. Data was collected in the form of history, clinical examination, and relevant investigations. Statistical analysis was performed using SPSS software, p value of &lt;0.5 being signicant Results: The mean age of the study participants was found to be 51.55+7.760 years of age. 62.7% of the study participants were males The mean serum uric acid level of the study participants was found to be 6.325+2.7910. 41.82% of the study participants who had metabolic syndrome had hyperuricemia. The association was found to be statistically signicant between hyperuricemia and hypertension, central obesity, low HDL, high FBS among the study participants. Conclusions: Serum uric acid is closely associated with metabolic syndrome and its components. Serum uric acid can also be considered as a mandatory investigation in patients who has any of the ve components of metabolic syndrome

Higher serum uric acid is associated with body fat, retinol-binding protein 4, and antioxidative status in Brazilian children

ObjectiveThe aim of this study was to evaluate the association of serum uric acid (SUA) with adiposity, adipokines, and anti- and oxidative markers in Brazilian children. MethodsThis was a cross-sectional investigation with 378 children ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. Information on sociodemographic and lifestyle characteristics was obtained via questionnaires, and body fat was determined by dual energy x-ray absorptiometry. We compared the distributions of adiposity (total and central), adipokines (adiponectin, chemerin, leptin, and retinol-binding protein 4 [RBP4]), anti- and oxidative markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by SUA categories using linear regression. ResultsSUA was positively associated with total and central fat. Every standard deviation (SD) of SUA was related, respectively, to a 3.4 (95% confidence interval [CI], 2.4–4.4), 4 (95% CI, 2.8–5.1), 4.2 (95% CI, 2.9–5.5), and 3.5 (95% CI, 2.4–4.6) units higher of total, truncal, android, and gynoid fat. We found a positive association of SUA with RBP4 and FRAP, and a negative association with MDA. Every SD of SUA was related, respectively, to 0.1 (95% CI, 0.01–0.1) and 7.8 (95% CI, 5.5–10.1) units higher of RBP4 and FRAP; and to –0.3 (95% CI, –0.5 to –0.1) units lower of MDA. ConclusionsSUA was positively associated with adiposity, RBP4, and antioxidative status in Brazilian children.

Association of serum uric acid and fasting plasma glucose with cognitive function: a cross-sectional study

BackgroundThe combined effect of serum uric acid (SUA) and blood glucose on cognition has not been explored. This study aimed to examine the separate and combined association of SUA and fasting plasma glucose (FPG) or diabetes mellitus (DM) with cognition in a sample of Chinese middle-aged and elderly population.MethodsA total of 6,509 participants aged 45 years or older who participated in the China Health and Retirement Longitudinal Study (CHARLS, 2011) were included. The three cognitive domains assessed were episodic memory, mental status, and global cognition (the sum of the first two terms). Higher scores indicated better cognition. SUA and FPG were measured. The participants were grouped based on SUA and FPG quartiles to evaluate their combined associations of cognition with SUA Q1–Q3 only (Low SUA), with FPG Q4 only (High FPG), without low SUA and high FPG levels (Non), and with low SUA and high FPG levels (Both), multivariate linear regression models were used to analyze their association.ResultsLower SUA quartiles were associated with poorer performance in global cognition and episodic memory compared with the highest quartile. Although no association was found between FPG or DM and cognition, high FPG or DM combined with low SUA levels in women (βFPG = -0.983, 95% CI: -1.563–-0.402; βDM = -0.800, 95% CI: -1.369–-0.232) had poorer cognition than those with low SUA level only (βFPG = -0.469, 95% CI: -0.926–-0.013; βDM = -0.667, 95% CI: -1.060–-0.275).ConclusionMaintaining an appropriate level of SUA may be important to prevent cognitive impairment in women with high FPG.

An Observational Analytical Study on Correlation of Serum Uric Acid and HbA1C in Prediabetic and Diabetic Patients

Aims: Diabetes mellitus is a metabolic disorder characterised by hyperglycaemia caused by either deficiency in insulin production or insulin action, or both. HbA1c is a commonly accessible test indicated by most doctors to assess the long term glycaemic control in diabetes patients over the duration of past 3 months. Oxidative stress can be predicted in both diabetic and non-diabetic patients through the serum uric acid levels. Therefore, this study aimed at finding out the association between serum uric acid and glycaemic control (HbA1c).&#x0D; Study Design: Analytical Observational Cross Sectional Study.&#x0D; Place and Duration of Study: Department of General Medicine, KLES Dr. Prabhakar Kore Hospital, Belagavi; conducted between 1st January 2020 to 31st December 2020.&#x0D; Methodology: A one year analytical observation type of study was conducted on 108 patients between the ages of 30 and 70 years diagnosed with Type 2 Diabetes Mellitus and Prediabetes were included in this research. Patients diagnosed with myeloproliferative or lymphoproliferative illnesses, psoriasis, pregnancy, gout and those on medications for gout, and chronic alcoholics were excluded. Enzymatic approach was used to measure serum uric acid (UA) using an automated device and HPLC technique was used to measure whole blood HbA1c.&#x0D; Results: 108 patients were included in the research out of which, 67 were diabetics and 41 were pre-diabetics. A majority of the participants were males, with a mean age of 59.12±14.06 years. The serum uric acid was substantially greater amongst the patients with diabetes mellitus (6.76±3.1mg/dL) compared to participants with pre-diabetes (5.5±1.9mg/dL). The serum HbA1c and the serum uric acid have a mild positive significant association in diabetics.&#x0D; Conclusion: There is a weak association of serum uric acid with HbA1c among diabetic patients. Diabetes mellitus patients have greater serum uric acid levels than those with prediabetes mellitus.

Association between serum uric acid and measures of adiposity in Chinese adults: a cross-sectional study

ObjectiveThe purposes of the study were to investigate the detailed association of serum uric acid (SUA) with visceral fat area (VFA) and body fat percentage (BFP) as calculated by bioelectrical...

Sex differences in the association between urate metabolism and kidney outcomes in patients with chronic kidney disease.

The association between serum uric acid (SUA) concentration and kidney outcomes in patients with chronic kidney disease (CKD) is controversial. Furthermore, there are no reports regarding the association of clearance of uric acid (CUA) with kidney outcomes. We aimed to determine whether SUA or CUA was associated with kidney outcomes in patients with CKD stratified by sex. The present prospective study was conducted in 815 patients (523 men and 292 women) with CKD. The participants were divided into quartiles (Q1-Q4) of SUA or CUA for each sex. Endpoints were defined as a composite of doubling of serum creatinine (SCr), end-stage kidney disease (ESKD), or death (outcome 1) and a composite of doubling of SCr or ESKD (outcome 2). During a median follow-up of 2.5years, outcomes 1 and 2 occurred in 363 and 321 patients, respectively. Multivariable-adjusted Cox analyses showed that in men, the hazard ratios (95% confidence intervals) for outcome 1 of Q1, Q2, and Q3 of CUA were 2.08 (1.18-3.70), 2.03 (1.22-3.39), and 1.85 (1.17-2.95), respectively, compared with Q4. Additionally, there were similar associations between lower CUA quartiles and outcome 2 in men. However, no associations between SUA and either outcome were observed in men. Conversely, in women, neither SUA nor CUA was associated with an outcome. In CKD, lower CUA was independently associated with poor kidney outcomes only in men, and in both sexes, there was no association of SUA with kidney outcomes.

Association of serum uric acid with body mass index in the United Arab Emirates UAE healthy future pilot study

Association of serum uric acid with body mass index in the United Arab Emirates UAE healthy future pilot study

Associations of serum uric acid levels with liver disease-related morbidity and mortality: A prospective cohort study of the UK Biobank.

The association of serum uric acid (SUA) levels with liver-related morbidity and mortality remains undetermined. Therefore, we aimed to explore the association of SUA levels with liver-related morbidity and mortality. The present cohort study included 459,619 adults from the UK Biobank. Multivariable Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of SUA levels with morbidity and mortality of overall liver disease. Mendelian randomization (MR) analyses were conducted to explore the underlying causality. A polygenic risk score was generated to assess whether there was a gene-exposure interaction. During a median follow-up of 12.6 years, 14,302 nonfatal and 609 fatal cases of overall liver disease were identified. Compared to individuals in the lowest quartile, the HRs (95% CI) of incident overall liver disease were 1.08 (1.02-1.14), 1.13 (1.07-1.20), and 1.44 (1.36-1.53) for individuals with SUA levels in quartiles 2, 3, and 4, respectively. Similarly, the HRs (95% CI) of liver disease-associated mortality were 1.09 (0.78-1.52), 1.55 (1.14-2.13), and 1.96 (1.42-2.69) for individuals with SUA levels in quartiles 2, 3, and 4, respectively. The MR results did not support the causal association of SUA levels with liver disease. In addition, there was a significant modification effect of the polygenic risk score on the association of SUA levels with incident overall liver disease (Pinteraction = 0.003). Higher SUA levels were significantly associated with an increased risk of overall liver disease morbidity and mortality.

U-shaped association of serum uric acid with cardiovascular disease risk scores and the modifying role of sex among Chinese adults

Background and aimsSerum uric acid (SUA) is involved in the development of cardiovascular disease (CVD). However, information on the dose-response relationship between SUA and CVD is limited in the Chinese population. This study aimed to investigate the potential nonlinear dose-response association of SUA with CVD risk in a Chinese population and to explore the effect of sex on these associations. Methods and resultsCross-sectional data, from 6252 Chinese adults aged 30–74 years who participated in the China Health and Nutrition Survey 2009, were stratified by SUA deciles. The 10-year risk of CVD was determined using the Framingham risk score. A restricted cubic spline (RCS) was incorporated into the logistic models to assess the nonlinear relationship between SUA and CVD. Among the participants, 65%, 20%, and 15% had low, moderate, and high 10-year CVD risks, respectively. Compared with the reference SUA strata of 225 to <249 μmol/L, CVD risk was significantly increased at SUA ≥294 μmol/L, with adjusted ORs ranging from 2.39 (1.33–4.33) to 4.25 (2.37–7.65). An increasingly higher nonsignificant CVD risk was found at SUA <225 μmol/L and showed a nonlinear U-shaped association. In the fitted RCS model, an approximate U-shaped association between SUA and CVD risk scores was found in women, but this significant nonlinear relationship was not found in men. ConclusionThis study showed that both lower and higher SUA levels were associated with a higher 10-year CVD risk among Chinese adults, forming a U-shaped relationship, and this pattern was particularly pronounced for women.

Association between serum uric acid levels and long-term mortality of metabolic dysfunction-associated fatty liver disease: a nationwide cohort study

BackgroundThe association between hyperuricemia and metabolic dysfunction-associated fatty liver disease (MAFLD) remains undetermined. This study aimed to examine the association of serum uric acid (SUA) levels with prevalence and long-term mortality of MAFLD in a nationally representative sample of US adults.MethodsThis analysis included 11,177 participants from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) with matched mortality data until 2019. We used logistic regression models to estimate the adjusted odd ratios (ORs) for factors associated with risk of MAFLD, and applied restricted cubic spline (RCS) regression to assess the non-linear associations of SUA levels with all-cause and cause-specific mortality of MAFLD. We also used Cox proportional hazards regression analysis to estimate hazard ratios (HRs) for the mortality.ResultsA higher SUA level contributed to a significant increased risk of MAFLD. every 1 mg/dL increment of SUA level was related to 17% (95% CI 9–24%) increased risk of MAFLD. Furthermore, a U-shaped association for males and a J-shaped association for females was discovered between SUA levels and all-cause mortality in participants with MAFLD. Specifically, among males, when SUA > 6.7 mg/dL, the higher SUA showed increased risk of cardio-cerebrovascular disease (CVD) mortality [HR (95% CI): 1.29 (1.05–1.58)]. As for females, only when SUA > 5.5 mg/dL, it showed a significantly positive association with risk of CVD and cancer mortality [HR (95% CI) 1.62 (1.24–2.13) and 1.95 (1.41–2.68)].ConclusionsElevated SUA level is significantly associated with an increased risk of MAFLD. Besides, SUA level is also a predictor of long-term mortality of MAFLD.

Serum uric acid variation and the risk of cardiovascular disease: A prospective cohort study

BackgroundThe association of serum uric acid (SUA) with cardiovascular disease (CVD) is inconsistent and limited by a single measurement of SUA. This study aimed to investigate the association of SUA variation, considering its magnitude and direction, with the risk of CVD. MethodsThis study included 41,578 participants with four biennial measurements of SUA during 2006–2012 from the Kailuan study. SUA variation was measured using the coefficient of variation (primary index), standard deviation, average real variability, and variability independent of mean, and the direction of variation was also assessed. Multivariate-adjusted Cox regressions were used to assess the associations, and Bayesian network was utilized to find the most important pathway from SUA variation to CVD. ResultsDuring a median follow-up of 6.74 (interquartile range: 6.45–7.03) years, we identified 1,852 (4.45%) cases of incident CVD. A large SUA variation (top vs. bottom tertiles) was associated with a higher risk of CVD (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.11–1.40), especially in older adults than that in young adults (Pint=0.0137). The higher risk of CVD was observed with both large rises (HR, 1.24; 95% CI, 1.10–1.39) and falls (HR, 1.19; 95% CI, 1.03–1.38) in SUA variation. The hazardous effect of SUA variation on CVD was mainly induced by excessive inflammation and elevated blood pressure. Similar results were observed for CVD subtypes. ConclusionsElevated SUA variation was associated with a higher risk of CVD, irrespective of the direction of SUA variation, and inflammation played an important role in the pathway.

Association of serum uric acid with benefits of intensive blood pressure control

Introduction and objectivesIntensive systolic blood pressure (SBP) control improved outcomes in the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Whether the serum uric acid concentration at baseline alters the benefits of intensive SBP control is unknown. MethodsThe STEP trial was a randomized controlled trial that compared the effects of intensive (SBP target of 110 to<130mmHg) and standard (SBP target of 130 to <150mmHg) SBP control in Chinese patients aged 60 to 80 years with hypertension. The primary outcome was a composite of cardiovascular disease events. This post hoc analysis was performed to examine whether the effects of intensive SBP intervention differed by the baseline uric acid concentration using 2 models: restricted cubic spline curves and subgroup analyses, both based on the Fine-Gray subdistribution hazard model in the analysis of the primary outcome and secondary outcomes (excluding all-cause death). In the analysis of all-cause death, the Cox regression model was used. We also examined the change in the follow-up uric acid concentrations. ResultsOverall, the risk of the primary outcome rose as the cumulative uric acid concentration increased in both the intensive and standard treatment groups. Patients with intensive treatment had a lower multivariable-adjusted subdistribution hazard ratio for the primary outcome, but with a wide overlap of 95%CI. Next, we stratified patients according to their baseline uric acid concentration (tertile 1 [T1], <303.0μmol/L; tertile 2 [T2], 303.0 to <375.8μmol/L; and tertile 3 [T3], ≥375.8μmol/L). Subgroup analyses using tertiles provided HRs and 95%CI in T1 (HR, 0.55; 95%CI, 0.36–0.86; P=.008), T2 (HR, 0.80; 95%CI, 0.56–1.14; P=.22) and T3 (HR, 0.86; 95%CI, 0.60–1.21; P=.39), with an interaction P value of .29. The results for most of the secondary outcomes followed the same trends. ConclusionsThere was no evidence that the benefit of the intensive SBP control differed by baseline uric acid concentrations. This trial was registered at ClinicalTrial.gov (Identifier: NCT03015311).

Association of serum uric acid to lymphocyte ratio, a novel inflammatory biomarker, with risk of stroke: A prospective cohort study.

Inflammation plays an important role in the pathological progress associated with stroke. Serum uric acid (SUA) to lymphocyte ratio (ULR), a novel inflammatory biomarker, has been considered as a better risk stratification tool of adverse outcomes than SUA or lymphocyte alone. This study aimed to investigate whether ULR produced more predictive value for stroke and explore the potential mediators of the associations. This study enrolled 93,023 Chinese participants without stroke and myocardial infarction at baseline. Cox proportional hazard models were used to analyze the associations of ULR with stroke and subtypes. Mediation analyses were conducted to explore potential mediators of the associations. During a median follow-up of 13.00 years, 6081 cases of incident stroke occurred, including 5048 cases of ischemic stroke (IS) and 900 cases of hemorrhagic stroke (HS). After adjustment for confounders, the Q4 group was associated with a higher risk of HS (HR, 1.25; 95% CI, 1.03-1.50), but not with total stroke (HR, 1.07; 95% CI, 1.03-1.13) or IS (HR, 1.04; 95% CI, 0.97-1.12). No significant associations were found between SUA or lymphocyte and any stroke. ULR outperformed SUA or lymphocytes alone in predicting stroke. Additionally, the significant association between ULR and HS was partially mediated by systolic blood pressure (20.32%), diastolic blood pressure (11.18%) and estimated glomerular filtration rate (9.19%). ULR was significantly associated with the risk of HS, but not with IS. Systolic blood pressure, diastolic blood pressure and estimated glomerular filtration rate were potential mediators for the association.