Blood Uric Acid Levels Research Articles

Associations of early pregnancy serum uric acid levels with risk of gestational diabetes and birth outcomes: a retrospective cohort study

BackgroundPrevious evidence suggests that higher blood uric acid (UA) levels are associated with adverse cardiovascular outcomes during pregnancy and subsequent birth outcomes. However, it has been relatively unclear whether these associations persist in normotensive pregnant women.MethodsThe study was based on a retrospective analysis of 18,250 mother-infant pairs in a large obstetric center in China. Serum UA concentrations in early pregnancy (median: 17.6, IQR: 16.3, 18.6 gestational weeks) were assessed. Hyperuricemia was defined as ≥ one standard deviation (SD) of the reference value for the corresponding gestational age. Outcomes of gestational diabetes mellitus (GDM), preterm birth (PB), low birth weight (LBW), macrosomia, small for gestational age (SGA) and large for gestational age (LGA) were extracted from the medical records.ResultsThe mean maternal UA level was 0.22 ± 0.05 mmol/L, and 2,896 (15.9%) subjects had hyperuricemia. After adjustment for several covariates, UA was associated with several adverse outcomes. The ORs (95%CI) per one SD increase in serum UA concentration were 1.250 (1.136, 1.277) for GDM, 1.137 (1.060, 1.221) for PB, 1.134 (1.051, 1.223) for LBW, and 1.077 (1.020, 1.137) for SGA, respectively. Similar adverse associations were found between hyperuricemia and GDM, PB (ORs: 1.394 and 1.385, P < 0.001), but not for LBW, macrosomia, SGA, and LGA. Adverse associations tended to be more pronounced in subjects with higher BMI for outcomes including PB, LBW, and SGA (P interaction = 0.001–0.028).ConclusionHigher UA levels in early pregnancy were associated with higher risk of GDM, PB, LBW, and SGA in normotensive Chinese women.

Prevention of Pacemaker Malfunctions in Patients With Bradyarrhythmia: Results of a Single-Center Follow-up

Objective: To evaluate results of surgical treatment in patients with bradyarrhythmia and risk factors for pacemaker (PM) malfunctions using improved preventive measures.Materials and methods: Our study consisted of two stages. At stage I, we retrospectively analyzed histories and outpatient medical records of 948 patients with various forms of bradiarrhythmias who underwent surgery in the clinic between 2006 and 2021 to identify PM malfunctions that occurred both in the early and late postoperative periods. Based on the data on the most common types of PM malfunctions and possible risk factors for their development, preventive measures were improved in this cohort of patients and were further used at stage II (pilot) to select patients for surgery.During stage II (pilot), 188 patients were operated on between 2019 and 2021: risk factors for malfunctions were identified in 72 (38.3%) cases at the preoperative stage. All the patients underwent surgery with the proposed and improved preventive measures. Follow­up was during the hospital stay and in 6 and 12 months.Results: At stage I (retrospective analysis), 78 (8.23%) patients had signs of PM malfunction. The most common malfunctions were endocardial electrode displacement (30.8%), increased stimulation threshold (25.6%), a change in the endocardial electrode impedance (17.9%), and impaired sensitivity (10.3%). In addition, premature battery depletion and PM syndrome were present in 9% and 6.4% of the patients, respectively.The correlation analysis revealed that the most common findings associated with malfunctions were enlarged right chambers of the heart due to valvular defects and dilated cardiomyopathy, myocardial remodeling caused by chemotherapy and radiation therapy, postinfarction cardiosclerosis in the electrode implantation area, untimely and inadequate PM programming, as well as increased levels of blood uric acid, urea, and creatinine, and prolonged and uncontrolled use of steroid drugs and bronchodilators.At stage II, there were no PM malfunctions requiring changes in the pacing parameters during the hospitalization period. Six months postsurgery, 1 (1.4%) patient had an increase in impedance (to 2843 ohms) caused by the uncontrolled intake of high doses of corticosteroids due to decompensation of chronic obstructive pulmonary disease. After correction of the corticosteroids dose, the ventricular electrode impedance returned to the normal level. Twelve months postsurgery, 2 (2.8%) patients had a decrease in impedance to 215 and 143 ohms, respectively, caused by the ventricular electrode displacement. After correcting the electrode position, normal pacing parameters were restored. No cardiac complications due to malfunctions were observed. Morphofunctional parameters of the heart did not significantly differ when compared with preoperative ones.Conclusions: Surgical treatment of patients with bradyarrhythmia and risk factors for PM malfunctions who underwent surgery with the proposed preventive measures demonstrated high efficiency in reducing the number of malfunctions and cardiac complications associated with inadequate stimulation in the long­term follow­up.

Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies.

Studying the effects of uric acid levels on cognitive function and quantifying the dose-response relationship. Based on PubMed and Embase search terms, we identified prospective cohort studies that included blood uric acid as a risk factor and cognitive impairment as a result up to September 2022. We extracted pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs). Nine reports (including 488,915 participants and 5516 cognitive impairment cases) with median follow-up of 8.8-22 years were eligible for analyses. Compared with lowest category of blood uric acid concentration, the combined RR of cognitive impairment events in the highest classification was 0.81 (95% CI: 0.70-0.92, P < 0.001). Dose-response analysis of eight reports (including 484,297 participants and 5059 cognitive impairment cases) showed that there was no evidence of a curvilinear relationship between blood uric acid levels and cognitive impairment (P = 0.51 for nonlinear relationship). The summary RR of cognitive impairment for an increase of 1 mg/dL blood uric acid level was 0.98 (95% CI: 0.95-1.00; linear trend P = 0.07, I2 = 67.1%, heterogeneity P < 0.05). There was also a linear negative association between blood uric acid levels and cognitive impairment risk in the male subgroup analysis (RR = 0.97, 95% CI: 0.95-0.99, P < 0.05). Levels of blood uric acid are not related to risk of cognitive impairment. A subgroup analysis shows that the rise in blood uric acid levels in the male population is related to a decreased risk of cognitive impairment. These results need to be confirmed by further studies.

Clinical and laboratory features of rheumatoid arthritis in men depending on testosterone levels

It has been suggested that the presence of chronic immunoinflammatory rheumatic disease (CIRD) may be a factor that increases the likelihood of developing hypogonadism syndrome, and conversely, the presence of uncompensated testosterone deficiency may predispose to a greater risk of developing or more severe course of ICRD. To study the incidence of hypogonadism in men with rheumatoid arthritis (RA) and evaluate its impact on the course of RA and concomitant diseases. A one-time continuous study included 170 men with RA who were undergoing inpatient treatment at the Federal State Budgetary Institution NIIR named after.V.A.Nasonova.Patients were assessed for total testosterone levels and subsequently divided into subgroups with normal (&gt;12 nmol/l) and reduced levels.An intergroup comparison was carried out on the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of RA, as well as the state of purine and carbohydrate metabolism.A correlation analysis was performed between the level of total testosterone and some clinical and laboratory parameters. The frequency of detected testosterone deficiency in the study group was 24.1%. Significant correlations were noted between the level of total testosterone and body mass index (r=-0.29), the level of blood uric acid (r=-0.19) and C-reactive protein (r=-0.18). Patients with hypogonadism compared to the group with normal testosterone levels were characterized by higher body mass index (29.3±5.6 vs 26.3±4.0 kg/m2; p&lt;0.001), glucose levels (6.95±7 .85 mmol/l vs5.42±1.13 mmol/l; p=0.034) and uric acid (354.6±110.7 vs 317.5±84.8 µmol/l; p=0.03) blood. In addition, patients with hypogonadism were more likely to suffer from obesity (41.6% vs 15.7%; p=0.001) and diabetes mellitus (21.6% vs 10.2%; p=0.075) without a statistically significant difference, and also had higher ESR (46.5±42.2 vs 31.0±30.9 mm/h; p=0.012). A more frequent occurrence of anemia was noted in hypogonadism (32.4% vs 16.7%; p=0.041). Testosterone levels and the presence of hypogonadism were not associated with the stage and activity of RA, however, testosterone deficiency was accompanied by a more frequent development of overweight and obesity, and adeterioration in purine and carbohydrate metabolism.

Serum uric acid level in chronic liver disease and its correlation with Child-Pugh score in a tertiary care hospital from South India.

Chronic liver disease (CLD) is one of the important causes of morbidity and mortality in our country, and since the damage to the liver is irreversible, we have to look for many severity markers or predictors for the prognosis of the patient. In this study, we have tried to correlate the level of serum uric acid (UA) with the severity of CLD presented as a Child-Pugh score. A cross-sectional observational study was conducted at Vijayanagar Institute of Medical Science (VIMS), Ballari, Karnataka, from October 2015 to June 2017 in the Department of General Medicine. Fifty patients diagnosed with CLD, aged between 18 and 65 years, of either gender, were enrolled in the study. Serum UA levels were measured, and liver function and coagulation parameters were assessed. A statistical analysis was performed to evaluate the association between serum UA levels, liver function test, and coagulation parameters. In our study, the mean serum UA level was 6.52 mg/dl and was raised in patients with CLD in correlation to its severity. Alcoholic liver disease (ALD) was the most common etiology for CLD (80%) followed by hepatitis B (Hep B) virus infection (12%) and hepatitis C (Hep C) virus infection (6%). Serum UA levels increased as the Child-Turcotte-Pugh (CTP) score increased. The mean UA level in CTP class C was 8.29 mg/dl. Various parameters such as serum aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase, total bilirubin, international normalized ratio (INR), calcium, and albumin were significantly associated with serum UA levels in CLD patients. The correlation between rising blood UA levels and the Child-Pugh score shows that UA estimate may be a valid and affordable indicator for assessing the extent of liver cirrhosis in CLD.

An effect of statin on serum uric acid in patients with dyslipidemia at a tertiary care hospital

BackgroundHyperuricemia in dyslipidemic patients has been addressed as a potential risk factor for cardiovascular disease, because of its association with atherosclerosis and elevated oxidative stress. Hence, the main objective of the present study was to evaluate the effect of statins on blood uric acid level in patients being treated for dyslipidemia at a tertiary care hospital. MethodsThe study comprised 120 patients with dyslipidemia who were treated at UCMS-TH's outpatient medicine department over a six-month period from December 2022 to May 2023. Participants who met the inclusion criteria for this interventional longitudinal study had their serum uric acid and lipid parameters measured at the start of the study and again after 6 weeks of statin therapy. Using a dependent t-test, we compared the effects of statin on uric acid reduction in the serum. ResultsStatin significantly reduced serum uric acid levels from 6.36 ± 1.02 mg/dL baseline to 5.12 ± 0.43 mg/dL (P < 0.001) after 6 weeks of treatment. The lipid markers LDL-C, TG, TC, and VLDL were all lowered, whereas the HDL level was raised (P < 0.05) after 6 weeks of statin medication. ConclusionBecause of the association between elevated serum uric acid levels and an increased risk of cardiovascular disease, statins like atorvastatin may be prescribed to dyslipidemic individuals at high risk for cardiovascular mortality due to hyperuricemia.

Meta-analysis of the effect of losartan relative to other angiotensin receptor antagonists on serum uric acid level

Purpose: To systematically analyze the disparity in uric acid reduction between losartan and other angiotensin receptor antagonists.Methods: A computer-based search was conducted in databases including EMBASE, PubMed, Wanfang, CNKI, Ovid MEDLINE, and Web of Science to identify original literature comparing the impact of losartan with other angiotensin receptor antagonists on blood uric acid levels. Utilizing the Cochrane Collaboration bias risk tool, a quality assessment of the included randomized controlled studies was conducted.Results: A total of 12 publications were obtained, consisting of 6 randomized controlled studies and 6 cohort studies. Five of the twelve publications assessed the impact of losartan compared to valsartan on blood uric acid levels. The heterogeneity analysis yielded I2 = 98 % (p &lt; 0.01), indicating substantial variability among the studies. Findings indicated that losartan was more effective than valsartan in reducing blood uric acid levels (SMD = -3.26, 95 % CI (-5.01 to 1.51), p &lt; 0.05). Four publications investigated the impact of losartan versus telmisartan on blood uric acid levels. The results revealed that losartan had a greater effect in reducing blood uric acid levels compared to telmisartan (SMD = -1.77, 95 % CI (-3.411 to -0.13), p &lt; 0.05).Conclusion: Among the angiotensin receptor antagonists used as antihypertensive drugs, losartan stands out for its significant ability to reduce uric acid levels. This finding provides a strong evidencebase for making clinical medication decisions.

Clinical effectiveness of semaglutide on weight loss, body composition, and muscle strength in Chinese adults.

The aim of this study was to investigate the clinical effectiveness of semaglutide on weight loss, body composition and muscle strength in the Chinese population with obesity. Data were retrospectively analyzed for participants prescribed semaglutide in 2021 and 2022 from a Chinese weight management clinic. Changes in weight, body composition, biochemical indicators, calf circumference and handgrip strength were collected. Body fat and skeletal muscle were also measured using the bioelectrical impedance analysis. Paired t-test was used to compare the values after 6 months of treatment with the baseline values. A total of 53 obese patients received 24 weeks of lifestyle intervention plus semaglutide treatment. 10 patients who failed to adhere to the follow-up were excluded, and 43 patients were studied. The average baseline body mass index (BMI) was 33.0 kg/m2, and the average body weight was 90.0 kg. After 6 months of treatment, the patient's weight was significantly reduced by 9.9 ± 3.9 kg (p < 0.001), and the weight loss percentage was 11.2 ± 4.5% (p< 0.001). The proportion of patients with weight loss ≥ 5% and ≥ 10% was 93% and 54%, respectively. Fasting blood glucose, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, blood uric acid and blood lipid levels also decreased after treatment. Body composition analysis showed that the loss of skeletal muscle mass was 1.4 ± 1.3 kg (p < 0.001), which was significantly less than the loss of fat mass of 5.6 ± 3.7 kg (p < 0.001). By percentage, the fat mass loss was 15.6 ± 10.1%, and the muscle mass loss was 4.8 ± 4.4% (p < 0.001). The visceral fat area was significantly reduced by 24.4 ± 17.7 cm (p < 0.001). There was no significant change in skeletal muscle index (8.1 ± 1.0 kg/m2 at baseline and 7.9 ± 1.0 kg/m2 at 24 weeks). The calf circumference (42.6 ± 3.6 cm at baseline, 41.2 ± 3.8 cm at 24 weeks) and grip strength (33.3 ± 9.5 kg at baseline, 32.3 ± 9.0 kg at 24 weeks) did not decrease significantly. The main adverse reactions were mild gastrointestinal dysfunction (nausea, diarrhea and vomiting), without ketoacidosis. In a real-world setting, semaglutide can reduce the weight and fat of obese patients while effectively maintaining muscle mass and muscle strength.

Efficient removal of purine compounds from solutions via biomass carbons derived from pomelo peel

The high purine diet could result in the increase of the level of blood uric acid, causing serious health problems such as hyperuricemia, gout, nephropathy and cardiovascular diseases. To find out a safe, cheap and super adsorption material for removing purines in stomach or pretreating high-purine beverages, we used different tissues of pomelo peel to prepare biomass carbon by drying, chemical modification and carbonization and then applied it to remove purine compounds in strong acidic solution, beer and soybean milk. The characteristic analysis of pomelo-peel-derived carbons (PPCs) indicated that the preparation methods significantly affected the structures and adsorption capacities of PPCs. Compared with the biomass carbon derived from bamboo, PPCs exhibited higher adsorption capabilities for purine compounds in strong acidic solution (adsorption rates > 99% in 15min) and soybean milk (adsorption rates > 56% in 30min) but slightly lower adsorption capabilities in beer (adsorption rates > 52% in 30min). In addition, the adsorption capabilities of PPCs for purine compounds in beer and soybean milk were not obviously affected by temperatures. Therefore, PPCs are promising absorbents for applications in removing purine compounds from beverages to produce low-purine, healthier products for treating hyperuricemia. The strong adsorption capabilities of PPCs on purine compounds in strong acidic environment also provides a possibility of using the PPCs as food additives for removing purines in stomach for healthcare applications such as gout prevention after confirming their biosafety.

Clinical Significance of Serum Creatinine, Urea Nitrogen and Uric Acid Levels in Patients with Chronic Renal Failure

Chronic renal failure (CRF) is a clinical syndrome characterized by chronic progressive renal parenchymal damage caused by various reasons, resulting in obvious atrophy of the kidney and inability to maintain basic functions. Metabolite retention, imbalance of water, electrolyte and acid-base balance, and systemic involvement of various systems are the main manifestations in clinic. Due to its complicated metabolic disorder, once it develops to the stage of renal failure or even the end stage of uremia, it is often more difficult to treat other renal diseases. Therefore, early detection, early diagnosis and early treatment of chronic renal failure are of great significance to improve the therapeutic effect of patients. In this project, 150 subjects were divided into chronic renal failure group (75 cases) and healthy group (75 cases). By analyzing the data of renal function indexes (blood creatinine, urea nitrogen, uric acid) of patients with chronic renal failure and healthy control group, the clinical significance of blood creatinine, urea nitrogen and uric acid level detection for chronic renal failure was discussed, and the importance of blood creatinine, urea nitrogen and uric acid monitoring for chronic renal failure was explained, providing scientific basis for timely prevention or delay of chronic renal failure. Biochemical tests were carried out on 150 serum samples from the combined healthy group of chronic renal failure. the values of uric acid, urea nitrogen and serum creatinine detected by the two groups were counted and treated with statistical methods. the results showed that the values of urea nitrogen, uric acid and serum creatinine in the chronic renal failure group were significantly higher than those in the healthy group, and the same indexes in the two groups were compared, P&lt;0.05. statistics showed that the difference of the same data between the two groups was significant. Serum uric acid, urea nitrogen and creatinine are easy to detect and the test results are relatively accurate. The results can be used for auxiliary diagnosis of patients with chronic renal failure and have clinical significance for diagnosis of patients with chronic renal failure.

Early Diagnostic Value of KIM-1, NGAL, and NLR in Acute Kidney Injury Caused by Diquat Poisoning

Background. The kidney is the main excretory organ after diquat absorption. Acute kidney injury (AKI) is a common complication in diquat poisoning patients. Objectives. To identify the value of combined detection of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and neutrophil-lymphocyte ratio (NLR) in the early diagnosis of diquat-induced AKI. Materials and Methods. The retrospective cohort study included 42 diquat poisoning patients. Results. Forty-two patients with diquat poisoning were included, of which 20 had fulminant poisoning (47.6%). At admission (0 h), levels of KIM-1, NGAL, NLR, and acute physiology and chronic health evaluation (APACHE) II scores in the fulminant poisoning group were higher than that of the moderate to severe poisoning group ( P &lt; 0.05), and they were all higher than in the control group ( P &lt; 0.05), while blood urea nitrogen (BUN) and uric acid (UA) levels did not significantly differ across the three groups ( P &gt; 0.05). At 12 h and 24 h, the levels of KIM-1, NGAL, NLR, UA, BUN, and APACHE II scores of patients in the fulminant poisoning group were higher than those in the moderate to severe poisoning group ( P &lt; 0.05), 12 h were higher than 0 h, and 24 h were higher than 12 h ( P &lt; 0.05). Among 42 patients with diquat poisoning, 28 had AKI (66.7%). At 0 h, the AKI group had higher levels of KIM-1, NGAL, NLR, and APACHE II scores than in the non-AKI (NAKI) group ( P &lt; 0.05), while there was no significant difference in BUN and UA levels between the two groups ( P &gt; 0.05). At 12 h and 24 h, the levels of KIM-1, NGAL, NLR, UA, BUN, and APACHE II scores in the AKI group were higher than those in the NAKI group ( P &lt; 0.05), 12 h were higher than 0 h, and 24 h were higher than 12 h ( P &lt; 0.05). KIM-1, NGAL, and NLR are independent risk markers for AKI in diquat poisoning patients. At admission (0 h), the combined application of KIM-1, NGAL, and NLR’s sensitivity, specificity, and area under the curve (AUC) for predicting AKI in diquat poisoning patients was 0.893, 0.859, and 0.903, respectively. Conclusions. KIM-1, NGAL, and NLR can be employed as early diagnostic indicators for the clinical prediction of AKI in diquat poisoning patients. Our findings may help clinicians reduce the occurrence of AKI.

Association of hyperuricemia with ischemic stroke in adult population

Background: Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. In addition to the conventionally recognized risk factors including smoking, diabetes, hypertension, ischemic heart disease, etc. Recent research on acute ischemic stroke has identified fresh risk variables, such as blood calcium, uric acid, homocysteine, and albumin levels. Hyperuricemia is frequently seen in patients with vascular risk factors and either directly or indirectly through the conventional risk factors.&#x0D; Study: Case control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factor and hyperuricemia and odds ratio was calculated.&#x0D; Results: Out of 100 patients in the case group, 25 (25%) and 75 (75%) had and did not have hyperuricemia. Whereas, out of 100 patients in the control group, 07 (7%) and 9 3 (93%) had and did not have hyperuricemia. The P-value was 0.001. Odds ratio was 4.42.&#x0D; Conclusion: Hyperuricemia is linked positively to occurrence of ischemic stroke as evidenced by the positive odds ratio, further studies need to be done whether uric acid lowering therapy is useful in preventing stroke or reducing mortality.

The predictive role of serum uric acid levels before pregnancy in the development of gestational diabetes mellitus.

With the prevalence of obesity, growing age of first pregnancy, highly processed high-calorie diet, consumption of saturated fats as well as sedentary and stressful life, the prevalence of gestational diabetes mellitus (GDM) is increasing. We aimed to determine the predictive role of pre-pregnancy serum uric acid levels and the occurrence of GDM during pregnancy. This study was a descriptive-analytical study that was performed retrospectively through case-control. The Subjects of this study were women over 18 years of age who were 24-28 weeks pregnant. All subjects of this study were evaluated for GDM based on the ADA guideline and were divided into case and control groups. All data relating to the period of 6 months before pregnancy of the study participants including blood uric acid level, blood pressure, etc. were collected and analyzed. In this study, 454 normal individuals without GDM and 478 others with GDM were examined. The mean serum uric acid showed to be 4.47 ± 1.33 mg/dl in patients with GDM but 3.7 ± 1.25 mg/dl in patients without GDM (p value = 0.001). The results of the regression test showed that the incidence of GDM in people with blood uric acid levels of 4.1-5, 5.1-6, and more than 6 mg/dl is 2.46, 3.42, and 4.9 times higher in people with uric acid levels less than 3 mg/dl, respectively. The present study identified that serum uric acid levels in the period of 6 months before pregnancy can be used as an independent predictor marker for future GDM.

The therapeutic effects of fermented milk with lactic acid bacteria from traditional Daqu on hypertensive mice

Lactic acid bacteria (LAB), a type of microorganism widely used in functional foods, has gained notable research attention in recent years. Certain strains possess the proteolytic ability to release potentially antihypertensive peptides from dairy proteins, which prompted us to explore the LAB strains from an understudied and unique ingredient, Daqu. We screened for 67 strains of LAB strains from traditional Daqu using the calcium dissolution ring method. Sixteen strains exhibiting angiotensin-converting enzyme inhibition (ACE-I) activity exceeding 50% were chosen for 16S rDNA sequencing and safety assessment. It is noteworthy that Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 exhibited significant ACE-I activity, which was the result of strain fermentation in reconstituted skim milk. These 2 strains did not exhibit hemolytic activity or antibiotic resistance. They also did not produce biogenic amines and showed high survival rates in the gastrointestinal tract. Additionally, Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 fermented milk exhibited a notable reduction in blood pressure levels in spontaneously hypertensive rats (SHR) compared with negative controls in SHR. Importantly, no adverse effect was observed in normal Wistar-Kyoto rats. Through the analysis of physiological, serum, and urine-related indicators, it was observed that Enterococcus faecium CP640 and Lacticaseibacillus rhamnosus CP658 have the potential to promote weight gain in SHR, alleviate excessive heart rate, improve renal function indicators, and effectively regulate blood sugar and uric acid levels in SHR. These 2 strains showed optimal properties in lowering blood pressure and have the potential to be used in functional dairy products in the future.

Analysis of clinical efficacy of comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia.

To evaluate the clinical efficacy of the comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia. This was a retrospective study. One hundred elderly patients with hypertension combined with hyperuricemia admitted to the Baoding No.1 Central Hospital from May 2019 to May 2020 were included and randomly divided into two groups. Patients in the control group were treated with conventional nursing intervention, while those in the experimental group were treated with comprehensive nursing intervention based on the therapy in the control group. The improvement of compliance behavior, clinical efficacy, quality of life and satisfaction with hypertension combined with hyperuricemia before and after treatment were compared and analyzed between the two groups. The proportion of patients in both groups who developed gout or renal insufficiency was recorded, and their long-term treatment outcomes were compared and analyzed. After the comprehensive nursing intervention, the number of cases of compliance behaviors in the experimental group was significantly higher than that in the control group(p<0.05). The systolic and diastolic blood pressure and uric acid levels were significantly lower in the experimental group compared to the control group after the intervention(p=0.00). The scores of physical function, psychological function, social function and material life status improved significantly in the experimental group compared to the control group after the intervention(p=0.00). The satisfaction rate of the experimental group was significantly higher than the control group(p=0.02). The proportion of patients in the experimental group who developed gout was significantly lower than that in the control group(p=0.03). Comprehensive nursing intervention plays a vital role in the treatment and prognosis of hypertension combined with hyperuricemia.

Clinical Significance of Elevated Xanthine Dehydrogenase Levels and Hyperuricemia in Patients with Sepsis.

Patient outcomes for severe sepsis and septic shock remain poor. Excessive oxidative stress accelerates organ dysfunction in severe acute illnesses. Uric acid (UA) is the most abundant antioxidant. We hypothesized that UA and related molecules, which play a critical role in antioxidant activity, might be markers of oxidative stress in sepsis. The study aimed to clarify the clinical significance of UA and the relationship between UA, molecules related to UA, and outcomes by measuring blood UA, xanthine dehydrogenase (XDH), and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels over time. Blood UA levels in septic patients were correlated with the SOFA score (ρ = 0.36, p < 0.0001) and blood XDH levels (ρ = 0.27, p < 0.0001). Blood XDH levels were correlated with the SOFA score (ρ = 0.59, p < 0.0001) and blood 8-OHdG levels (ρ = -0.32, p < 0.0001). Blood XDH levels were persistently high in fatal cases. Blood XDH level (OR 8.84, 95% CI: 1.42-91.2, p = 0.018) was an independent factor of poor outcomes. The cutoff of blood XDH level was 1.38 ng/mL (sensitivity 92.8%, specificity 61.9%), and those 1.38 ng/mL or higher were associated with a significantly reduced survival rate (blood XDH level > 1.38 ng/mL: 23.7%, blood XDH level < 1.38 ng/mL: 96.3%, respectively, p = 0.0007). Elevated UA levels due to elevated blood XDH levels in sepsis cases may reduce oxidative stress. Countermeasures against increased oxidative stress in sepsis may provide new therapeutic strategies.

A predictive model for hyperuricemia among type 2 diabetes mellitus patients in Urumqi, China

BackgroundPatients with type 2 diabetes Mellitus (T2DM) are more likely to suffer from a higher uric acid level in blood—hyperuricemia (HUA). There are no conclusive studies done to predict HUA among T2DM patients. Therefore, this study aims to explore the risk factors of HUA among T2DM patients and finally suggest a model to help with its prediction.Method In this retrospective research, all the date were collected between March 2017 and October 2019 in the Medical Laboratory Center of the First Affiliated Hospital of Xinjiang Medical University. The information included sociodemographic factors, blood routine index, thyroid function indicators and serum biochemical markers. The least absolute shrinkage and selection operator (LASSO) and multivariate binary logistic regression were performed to screen the risk factors of HUA among T2DM patients in blood tests, and the nomogram was used to perform and visualise the predictive model. The receiver operator characteristic (ROC) curve, internal validation, and clinical decision curve analysis (DCA) were applied to evaluate the prediction performance of the model.ResultsWe total collected the clinical date of 841 T2DM patients, whose age vary from 19-86. In this study, the overall prevalence of HUA in T2DM patients was 12.6%. According to the result of LASSO-logistic regression analysis, sex, ethnicity, serum albumin (ALB), serum cystatin C (CysC), serum inorganic phosphorus (IPHOS), alkaline phosphatase (ALP), serum bicarbonate (CO2) and high-density lipoprotein (HDLC) were included in the HUA risk prediction model. The nomogram confirmed that the prediction model fits well (χ2 = 5.4952, P = 0.704) and the calibration curve indicates the model had a good calibration. ROC analysis indicates that the predictive model shows the best discrimination ability (AUC = 0.827; 95% CI: 0.78–0.874) whose specificity is 0.885, and sensitivity is 0.602.ConclusionOur study reveals that there were 8 variables that can be considered as independent risk factors for HUA among T2DM patients. In light of our findings, a predictive model was developed and clinical advice was given on its use.

The Role of Sarcopenia in Overactive Bladder in Adults in the United States: Retrospective Analysis of NHANES 2011-2018.

To investigate the association between sarcopenia and overactive bladder (OAB) in a United States adult population from 2011 to 2018, and whether sarcopenia can predict the risk of OAB. We analyzed data from the 2011-2018 National Health and Nutrition Examination Survey in a cross-sectional study(NHANES) of 8746 participants, of whom 1213 were diagnosed with OAB, we analyzed correlations by sex, age, race, education level, marital status, household income-to-poverty ratio, hypertension, diabetes, strenuous work activity, moderate work activity, strenuous recreational activity, moderate recreational activity, blood urea nitrogen, creatinine, and uric acid levels using restricted cubic spline plots of dose-response curves, univariate and multivariate Logistic regression. Models based on sex, age, education, household income to poverty ratio, hypertension, diabetes, sarcopenia index, and cotinine were developed and evaluated using Nomogram, calibration curves, receiver operating characteristic curves, and clinical decision curves. Of the 1213 OAB patients, 388 (32.0%) were male and 825 (68.0%) were female. Univariate and multivariate Logistic regression analysis showed that sarcopenia index was negatively correlated with the prevalence of OAB (OR=0.084, 95% CI, 0.056 - 0.130, P <0.001;OR=0.456, 95%CI, 0.215-0.968, P= 0.0041). Dose curve analysis of the sarcopenia index and prevalence of OAB showed that the prevalence of OAB decreased significantly with increasing sarcopenia index. Sarcopenia was positively correlated with OAB (OR=2.400, 95%CI, 2.000 - 2.800, P <0.001;OR=1.46, 95%CI, 1.096 -1.953, P = 0.010). In addition, our model shows that sarcopenia can predict the prevalence of OAB (AUC = 0.750) and has some clinical decision-making implications. Sarcopenia is positively associated with the risk of OAB in United States adults and can be used as a predictor of OAB prevalence.

Effect of Intestinal Flora on Hyperuricemia-Induced Chronic Kidney Injury in Type 2 Diabetic Patients and the Therapeutic Mechanism of New Anti-Diabetic Prescription Medications.

This article examined the current research on hyperuricemia (HUA) exacerbating diabetic kidney damage and novel anti-diabetic medications for treating these people. Hyperuricemia and type 2 diabetes (T2D), both of which are frequent metabolic disorders, are closely connected. Recent studies have shown that hyperuricemia can increase kidney injury in T2D patients by aggravating insulin resistance, by activating the renin-angiotensin-aldosterone system (RAAS), and by stimulating inflammatory factors, and the diversity, distribution, and metabolites of intestinal flora. Considering this, there are just a few of the research examining the effect of hyperuricemia on diabetic kidney injury via intestinal flora. Through the gut-kidney axis, intestinal flora primarily influences renal function. The primary mechanism is that variations in diversity, distribution, and metabolites of intestinal flora led to alterations in metabolites (such as short-chain fatty acids, Indoxyl sulfate and p-cresol sulfate, Trimethylamine N-oxide TMAO). This article reviewed the research and investigates the association between hyperuricemia and T2D, as well as the influence of hyperuricemia on diabetic kidney injury via intestinal flora. In addition, the current novel antidiabetic drugs are discussed, and their characteristics and mechanisms of action are reviewed. These novel antidiabetic drugs include SGLT2 inhibitors, GLP-1 receptor agonists, DDP-4 inhibitors, glucokinase (GK) enzyme activators (GK agonists), and mineralocorticoid receptor antagonists (MRA). Recent studies suggest that these new anti-diabetic medications may have a therapeutic effect on hyperuricemia-induced kidney impairment in diabetes patients via various mechanisms. Some of these medications may reduce blood uric acid levels, while others may improve kidney function by attenuating the overstimulation of RAAS or by decreasing insulin resistance and inflammation in the kidneys. These novel antidiabetic medicines may have a multifaceted approach to treating hyperuricemia-induced kidney impairment in diabetic patients; nevertheless, additional study is required to establish their efficacy and comprehend their specific mechanisms.

A wide-range UAC sensor for the classification of hyperuricemia in spot samples

Hyperuricemia (HUA) has received wide attention as an independent risk factor for various chronic diseases. HUA is usually asymptomatic, and the related damage can be reduced by effective classification and treatment according to uric acid clearance (UAC). UAC is a calculated ratio based on the uric acid level in blood and urine. This important method is not universally used due to the inconvenience of collecting 24-h urine samples in the clinic, and most sensors are limited by the need for wide ranges and for two testing samples. In this study, a pH-sensitive urate oxidase-modified electrochemical sensor with filter membrane was proposed to calculate UAC by detecting uric acid in blood and urine. The results demonstrated that the sensor had high selectivity for uric acid with a detection limit of 0.25 μM in 5 μL spot sample, the wide linear range was 2.5–7000 μM, and the impact of the sample pH was calibrated. The linear correlation of the measurement results between the UAC sensor and clinical instrument was higher than 0.980 for 87 patients. The change in UAC in spot urine may reflect alteration in body-transport mechanisms. Thus, the UAC sensor may open a new window for the management of HUA and broaden its application in point-of-care testing.