Cutoff Value Of Uric Acid Research Articles

Association of maternal serum uric acid levels with LBW/SGA: a large retrospective cohort study

BackgroundElevated maternal serum uric acid (UA) levels were associated with adverse perinatal outcomes. This study aimed to examine the association between UA and the risk of low birth weight (LBW) / small for gestational age (SGA).MethodsA cohort study of women delivered in Shanghai maternity hospital was included between 2017 and 2021. Electronic medical records were utilized to extract information and antenatal care records. The cut-off value of UA was 360 μmol/L. The outcome was LBW/SGA, with LBW defined as birth weight below 2500 g and SGA indicating birth weight below the 10th percentile of average weight for gestational age. The assessment of SGA was based on the Chinese standard curve for birth weight at various gestational ages. Univariate, multivariate logistic regression models, restricted cubic spline were used in this study, with adjustments made for confounding factors.ResultsSixty-nine thousand six hundred seventy-four live births and singleton pregnancies were included. The ratio of LBW/SGA was 3.3%/9%. Maternal UA levels were significantly negatively correlated with birth weight. High UA levels were associated with high risk of LBW/SGA, especially in third trimester. In BMI < 25 group, the risk of LBW increased to 2.35-fold (95%CI, 1.66–3.31) in hyperuricemic group (UA > 360 μmol/L). The SGA risk was 1.66-fold (95%CI, 1.37–2.00). Gestational hypertension (GH) with hyperuricemica increased the risk of LBW (aOR = 4.00, 95%CI, 2.01–7.93) and SGA (aOR = 2.63, 95%CI, 1.83–3.78). Preeclampsia (PE) with hyperuricemia increased the risk of LBW (aOR = 1.38, 95%CI, 0.63–3.03) and SGA (aOR = 1.81, 95%CI, 1.18–2.78). In delivery gestational week (DGW) ≥ 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.46-fold (95%CI, 1.62, 3.73) and the incidence of SGA increased to 1.52-fold (95%CI, 1.24, 1.87). In DGW < 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.70-fold (95%CI, 1.92, 3.80) and the incidence of SGA increased to 2.13-fold(95%CI, 1.50, 3.02).ConclusionsThe study found an inverse correlation between UA levels and birth weight. High UA levels were associated with increased risk of LBW/SGA, particularly in third trimester. GH or PE complicated by hyperuricemia were found to have significantly higher risk of developing LBW/SGA. This relationship also existed in pregnant women with BMI < 25.

Sex-related differences for uric acid in the prediction of cardiovascular events in essential hypertension. A population prospective study.

Uric acid (UA) is an independent prognostic factor for cardiovascular events, but there are no data demonstrating a different risk profile between women and men. Thus, we tested whether UA is associated with a possible sex-related difference in fatal and non-fatal cardiovascular events. In this prospective population-based study we enrolled 1,650 never-treated Caucasian hypertensive outpatients referred to Catanzaro University Hospital (Italy). Inclusion criteria were newly diagnosed hypertensive patients, aged 20years or more. Exclusion criteria were secondary form of hypertension, previous cardiovascular events, rheumatic and non-rheumatic valvular heart disease, prosthetic valves, cardiomyopathies, type-2 diabetes, chronic kidney disease, malignant diseases, gout arthritis and secondary forms of hyperuricemia, liver diseases, peripheral vascular diseases, and heart failure. Anthropometric, clinical, and biochemical parameters were measured. UA prognostic role was investigated by Cox regression analyses. Receiver-operating characteristic curve analyses and area under the curve were used to determine the predictive validity and the optimal cut-off point of UA. We investigated following endpoints: coronary events (fatal and nonfatal myocardial infarction, unstable angina, coronary revascularization procedures, coronary death); fatal and nonfatal stroke; all-cause mortality and major adverse cardiovascular events (MACE). We enrolled 830 males and 820 females aged 52.2 ± 11.3years. During 9.5 ± 3.1years follow-up, there were 424 new clinical events (2.71%): 250 coronary (1.59%), 118 (0.75%) cerebrovascular, and 56 (0.40%) deaths. Comparison between groups demonstrated a higher and significant difference in incidence rate in females for MACE (3.08 vs 2.33%, P = 0.001), coronary (1.82 vs 1.36%, P = 0.014) and cerebrovascular events (0.93 vs 0.57%, P = 0.006). UA at multiple Cox regression analysis resulted a strong and significant predictor of coronary events (HR = 1.493;95% CI 1.375-1.621), cerebrovascular events (HR = 1.256;95% CI 1.109-1.423), MACE (HR = 1.415;95% CI 1.328- 53 1.508), and all-cause mortality (HR = 1.469;95% CI 1.237-1.745) in the whole population and in both groups with a HR higher in females. The best estimated cut-off values of uric acid for males and females predicted these endpoints equally well, but it was always lower in females than males. We demonstrate, that UA operates with a sex-related impact and best cut-off value in predicting cardiovascular outcomes and all-cause mortality, reflecting a possible sex difference in disease pathophysiology.

Relationship between uric acid/ albumin ratio and coronary slow flow

Objectives: Although the pathophysiology of coronary slow flow is not fully understood, evidence suggesting endothelial dysfunction and subclinical widespread atherosclerosis in genesis has grown in recent years. Our aim in this study is to investigate the relationship between uric acid/ albumin ratio and coronary slow flow. Methods: One hundred and five coronary slow flow patients (determined by the Thrombolysis in Myocardial Infarction-frame count method) and one-hundred patients with normal coronary low were included retrospectively. The uric acid/ albumin ratio was investigated in all patients participating. Results: In the logistic regression analysis, it was revealed that high uric acid levels, uric acid/ albumin ratios, and male gender were independent predictors for coronary slow flow. Among these parameters, the uric acid/ albumin ratio was the best predictor of coronary slow flow. Based on the receiver operating characteristics (ROC) analysis, the cut-off value of uric acid/ albumin ratio ≥ 0.57 was found to predict coronary slow flow with 68.3% sensitivity and 68.7% specificity. In multivariate logistic regression analysis, high uric acid levels (OR: 2.22; 95% CI (1.551-3.200), p &amp;lt; 0.001), high serum uric acid/ albumin ratio (OR: 37.7 95% CI (8.176-234.387), p &amp;lt; 0.001), male gender (OR: 0.157; 95% CI (0.078-0.318), p &amp;lt; 0.001) were independent predictors of coronary slow flow. Conclusions: High uric acid/ albumin ratio was detected as an independent predictor for coronary slow flow. Larger studies are needed to elucidate its role in the pathophysiology of coronary slow flow.

Prediction of Uric Acid on Renal Function among Adolescents: A Ten-Year Analysis

Aims: The prevalence of hyperuricemia in adolescents is increasing with each passing year. During adolescence, hyperuricemia tends to develop into adult hyperuricemia and affects renal function. The study aims to explore the relationship between hyperuricemia values and renal function and examine predictors affecting renal function risk factors among senior high school students.&#x0D; Methods: The retrospective study adopted 2011–2019 health examination database of 6597 male freshmen. The Chi-squared test, t-test, ROC curve, and logistic regression were used for analysis to find out the best cut-off points of hyperuricemia for male adolescents.&#x0D; Results: The best cut-off values of uric acid were 6.5 mg/dL among male adolescents and the prevalence of hyperuricemia is 55.2% in male adolescents. Uric acid was the critical predictor of renal function and the risk of a worse eGFR (&lt;90) in the uric acid &gt;6.5 group was increased by 2.51 times compared with the &lt; 6.5 group.&#x0D; Conclusions: The school administrators should pay attention to the diet and body size of male adolescents and prevent obesity and diets that lead to hyperuricemia to promote health in adolescents. Adolescents with uric acid &gt;6.5 mg/mL can be followed up if uric acid has different effects on renal function.

Association between uric acid levels and incidence of type 2 diabetes: Population-based Panasonic cohort study 11

AimsThis cohort study intended to assess the association between serum uric acid levels and incidence of type 2 diabetes in a Japanese population. MethodsIndividuals who participated a medical health checkup program carried out by Panasonic Corporation from 2008 to 2018 were included in this study. A total of 122,123 participants (92,718 men and 29,405 women) were included. During the research period, 6,386 participants developed type 2 diabetes. ResultsMultivariate analysis showed that, in men, serum uric acid levels were not significantly associated with incident type 2 diabetes after adjusting for diabetes risk factors. However, in women, the risk of type 2 diabetes incidence was higher in the group with uric acid levels 5.1–6.0 mg/dL (hazard ratio, 2.01 [95 % confidence interval: 1.26–3.42]) or > 6.1 mg/dL (hazard ratio, 1.85 [95 % confidence interval: 1.11–3.22]) than in the group with uric acid levels ≤ 3 mg/dL. Furthermore, in women, the area under the receiver operating characteristic curve and optimized cut-off values of uric acid for the incidence of type 2 diabetes at 10 years were 0.720 and 4.8 mg/dL, respectively. ConclusionsSerum uric acid levels were associated with incident type 2 diabetes in Japanese women but not in Japanese men.

MO293: Evaluation of Uric Acid Concentration and Acute Renal Impairment in Patients on Admission for Hospital Treatment

Abstract BACKGROUND AND AIMS Elevated uric acid (UA) is associated with comorbidities such as hypertension, diabetes, cardiovascular disease and chronic kidney disease. There are more studies that discuss the importance of uric acid (UA) for acute kidney failure. Anaemia is a common risk factor for the development of AKI in hospitalized patients. There is an association between elevated iron and urate production in healthy people. The aim of this study was to evaluate value of UA as a risk factor for the development of acute kidney damage on admission for hospital treatment. We also determined, risk factors related to UA value and its relationship with anaemia. METHOD The study included 86 hospitalized patients with acute renal impairment who were divided according to the stage of renal impairment at admission to hospital treatment into three groups. The assessment of acute renal impairment and the classification of disease stages were based on the diagnostic stages by the KDIGO group. All the examined patients were &amp;gt;18 years of age. In the first stage of the disease, it was 12.79%, in the second stage, it was 15.12% and in the third, it was 72.09% of patients. RESULTS UA values were the lowest in the first stage 551.00 ± 225.64 μmol/L and highest in the third stage 670.02 ± 86.72 μmol/L, but without statistical significance. The lowest percentage with renal function was 12.9% in patients with stage 3 acute renal impairment. There was a statistically significant difference with patients with stage 1 and stage 2 (P &amp;lt; .017) renal impairment. The ROC curve for the cut-off value of uric acid 903.00 μmol/L based on the Youden index method with a sensitivity of 91.70% and a predictive value of 17.00% as a marker of acute kidney damage in stage 2 disease is larger than in other stages acute kidney injury. Although there is a significant relationship with risk of UA with haemoglobin values according to the following results: OR 1.036 [95% confidence interval (95% CI) 1.003–1.071; P = .030] and haematocrit level based on predicted probability and OR 1.149 (95% CI 1.028–1.285; P = .015). CONCLUSION The study showed that high values of uric acid in patients with acute kidney damage at the beginning of hospital treatment did not show the same significance in different phases of kidney damage. We confirmed the link between anaemia and UA levles. Ineffective renal UA clearance means progression of the disease course to the next stage, and over time as a sign of progression of the renal continuum to chronic damage.

Association between Uric Acid and In-Hospital Heart Failure in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

Objective To investigate the association of serum uric acid levels with in-hospital heart failure (HF) in patients with acute myocardial infarction (AMI) who are undergoing percutaneous coronary intervention (PCI). Methods Two hundred sixteen patients with AMI who were treated with PCI were enrolled in our study. Univariate and multivariate logistic regression analyses were performed to estimate the associations between uric acid levels and the risk of in-hospital HF in AMI patients. Analyses of the areas under the receiver operating characteristic (ROC) curve were performed to determine the accuracy of uric acid levels in predicting in-hospital HF. Results A dose-response relationship was found for the incidence of in-hospital HF and levels of uric acid, showing increased HF from the lowest to the highest tertile of uric acid. Compared with subjects in the bottom tertile, the adjusted odds ratio for in-hospital HF was 1.92 (95% CI 0.70–5.24) and 3.33 (95% CI 1.18-9.46) in the second tertile group and the third tertile group, respectively. Every 1 mg/dl increase in the serum uric acid level was associated with a 1.60-fold increased risk of incident in-hospital HF (OR, 1.60; 95% CI 1.22–2.11; P = 0.001). ROC curve analysis showed that the optimal cut-off value of uric acid to predict in-hospital HF was 5.75 mg/dl with a sensitivity of 69.2% and specificity of 56.3%. Conclusions Our study showed that the serum uric acid level on admission is an independent predictor of in-hospital heart failure in patients with AMI.

Cut-Off Value of Serum Uric Acid for Development of Gout Disease in Patients with Multiple Co-Morbidities.

Objective:This study aimed to determine the association between hyperuricemia, comorbid diseases and risk of developing gout disease in a Turkish population in a long follow-up period.Methods:A total of 2000 Turkish adults were cross-sectionally analysed for serum urate levels in 2009 at the Pamukkale University Faculty of Medicine. All patients on regular follow-up at our tertiary health center (n=1322) were included in this study. Demographic features (age and gender), comorbid clinical conditions, and medication use were noted. The risk of developing gout and the determinant factors were investigated. Multivariate logistic regression analysis was performed to analyse causative effects of factors while receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of uric acid level for predicting the development of gout.Results:Among 1322 patients, the mean age was 56.9 (SD:14.68) years. 57.3% (n=758) of the patients were female. The most common co-morbid disease was chronic kidney disease (581, 43%), followed by hypertension (522, 39.4%). Gout developed in 25 patients (1.8%). Gout development risk and presence of all the above comorbidities were significantly higher in patients with serum urate ≥7mg/dl compared with <7mg/dl. Male gender and not using urate lowering drugs were the main risk factors for developing gout disease. ROC analysis of serum uric acid levels identified a cut-off value of >7 (AUC: 0.776, sensitivity 86.96%, specificity 66.74%).Conclusion:There is still a dilemma concerning the culprit effects of both comorbidities and hyperuricemia on the risk of developing gout disease.

Prediction of maternal diabetes and adverse neonatal outcome in normotensive pregnancy using serum uric acid

Diabetes mellitus, with adverse neonatal events are challenging issues to all obstetricians and pediatricians, where uric acid could play a vital role. We aimed to assess the relationship and prognostic benefits of serum uric acid measured at about 20 weeks’ gestation in normotensive pregnancy, with subsequent maternal diabetes, and neonatal complications. All singleton normotensive pregnant women with normal blood glucose, serum creatinine, and weight before pregnancy, whom attended Medical City Hospital, Department of Obstetrics and Gynecology in Baghdad, were involved and regarded as the case group, on the condition that their serum uric acid measured at 20 weeks’ gestation &gt; 3 mg/dl, but if ≤ 3 mg/dl, they would be registered as a control group. A complete follow up was performed regularly during pregnancy, and after delivery; regular assessments of maternal blood glucose were done up to one year. Maternal diabetes mellitus (DM), small for gestational age (SGA) neonates, and preterm delivery (PD) constituted (27.59%), (43.60%), and (1.97%), respectively in case group which had significantly included maternal DM and SGA (P &lt;0.001). Also, elevated mid-pregnancy serum uric acid was strongly associated (P &lt;0.0001) with maternal DM (5.86 ± 0.69) and SGA (4.78 ± 0.34). Cut-off values of uric acid of 4.76 mg/dl were best associated with maternal DM, while 4.33 mg/dl with SGA. In conclusion, the cut-off points of 4.76 and 4.33 mg/dl of maternal mid- normotensive pregnancy serum uric acid have the potential ability to predict Maternal DM and SGA, respectively.

Relationship Between Serum Uric Acid Levels and Nonalcoholic Fatty Liver Disease in Non-Obese Patients.

Background and objectives: Nonalcoholic fatty liver disease (NAFLD) is associated with multiple factors such as hypertension, diabetes, dyslipidemia, obesity, and hyperuricemia. We aim to investigate the relationship between uric acid and NAFLD in a non-obese and young population. Materials and Methods: This study was performed in January 2010–2019 with a group of 367 (225 patients in the NAFLD group and 142 in the control group) patients with liver biopsy-proven NAFLD or no NAFLD. Patients with NAFLD were classified according to the percentage of steatosis as follows, group I had 1–20% and group II >20%. Demographic, clinical, and laboratory (biochemical parameters) features were collected retrospectively. Results: The mean body mass index (BMI) and age of the patients were 26.41 ± 3.42 and 32.27 ± 8.85, respectively. The BMI, homeostatic model of assessment (HOMA-IR), and uric acid (UA) values of the NAFLD group were found to be significantly higher than those of the controls. A positive correlation was found between the NAFLD stage and UA. The following factors were independently associated with NAFLD: BMI, HOMA-IR, and UA. In addition, the cut-off value of UA was 4.75 mg/dl with a sensitivity of 45.8% and a specificity of 80.3%. Conclusions: UA is a simple, non-invasive, cheap, and useful marker that may be used to predict steatosis in patients with NAFLD.

Serum uric acid concentration is associated with ascending aortic dilatation in newly diagnosed nondiabetic hypertensive patients

ABSTRACTObjectives: Recently, serum uric acid (UA) has emerged as an important independent risk factor for adverse outcomes in hypertension. The aim of the study was to evaluate the relationship between UA levels and ascending aortic dilatation (AAD) in newly diagnosed nondiabetic hypertensive subjects.Methods: A total of 818 patients with a new diagnosis of hypertension for which they had never received treatment were enrolled in this cross-sectional study. All patients underwent comprehensive transthoracic echocardiography measurement. AAD was defined as a diameter of ascending aorta equal to or more than 35 mm.Results: There were 302 patients with AAD (mean age 69 ± 11 years; 157 male) and 516 subjects with normal ascending aorta diameters (mean age 64 ± 12 years; 158 male). The correlation analysis pointed out positive correlations between ascending aorta size and serum UA levels (r = 0.30, P<0.001). In multiple logistic regression analysis, the OR of a 1 mg/dL increase in serum UA was 1.29(95% CI, 1.18 to 1.43; P < 0.001) for AAD. In reference to the first quartile, the prevalence of AAD increased such that the OR for the fourth quartile was 4.03 (95% CI, 2.38 to 6.82; P for trend < 0.001) of the serum UA concentration. The optimal UA cutoff value for detecting AAD was 6.45 mg/dL, based on receiver operating characteristic curve analysis with a sensitivity of 68.0% and a specificity of 70.0%.Conclusion: Serum UA concentration was significantly associated with AAD prevalence in newly diagnosed nondiabetic hypertensive patients.

Association between Serum Uric Acid and Metabolic Syndrome in Koreans.

BackgroundAlthough previous studies have highlighted the importance of serum uric acid as a risk factor of metabolic syndrome, no study has previously used a national Korean survey to examine the association between serum uric acid level and metabolic syndrome. This study aimed to investigate this association among Korean adults, to determine whether it varies by age and gender, and to identify optimal serum uric acid level cutoffs for predicting the presence of metabolic syndrome by gender and age.MethodsWe included 5,758 Korean adults (aged ≥ 19 years) who participated in the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1), 2016. Logistic regression analyses were performed to examine the association between serum uric acid and the presence of metabolic syndrome. Receiver operating characteristic analyses were used to assess optimal uric acid cutoff values for predicting the presence of metabolic syndrome.ResultsHigh serum uric acid levels were found to be associated with risk of metabolic syndrome. Area under the receiver operating characteristic curve (AUC) analyses of uric acid levels for the detection of metabolic syndrome produced good performances. Women subjects had significantly higher AUC values than men subjects, but this gender difference may also have been influenced by age. Among men, AUC values of those in their 20s, 30s, or 40s were significantly higher than those in their 70s (P < 0.05). The optimal uric acid cutoff was 6.05 mg/dL for men and 4.45 mg/dL for women, and men had higher cutoffs than women in all age groups.ConclusionAmong Korean adults, serum uric acid levels were found to be strongly associated with the presence of metabolic syndrome. More importantly, our findings suggest that derived optimal cutoff values of uric acid might offer a useful means of diagnosing metabolic syndrome in clinical settings.

Effect of serum uric acid on the positive predictive value of dobutamine stress echocardiography.

There is controversial data regarding the relationship between uric acid (UA) and coronary artery disease and cardiovascular events. Despite the deleterious effects of hyperuricemia on endothelial function, the effect of UA on myocardial ischemia has not been previously studied. We aimed to investigate the relationship between UA and myocardial ischemia that was identified using dobutamine stress echocardiography (DSE). In this retrospective study, the laboratory and DSE reports of 548 patients were reviewed. The patients were divided into two groups based on the presence of ischemia and further subdivided into three groups according to the extent of ischemia (none, ischemia in 1-3 segments, ischemia in >3 segments). Serum UA levels were compared. Determinants of ischemia were assessed using a regression model. UA was increased in patients with ischemia and was correlated with the number of ischemic segments (p < 0.001). A cutoff value of UA > 5 mg/dl had 63.9 % sensitivity, 62.0 % specificity, 42.5 % positive predictive value (PPV), and 79.6 % negative predictive value for ischemia. When the positive DSE exams were further sorted according to the UA cutoff, the PPV of DSE increased from 80.2 to 94.0 %. Uric acid (odds ratio 1.51; 95 % CI 1.14-1.99), diabetes mellitus, HDL and glomerular filtration rate were found to be independent determinants of myocardial ischemia in DSE. Increased UA is associated with both the presence and extent of DSE-identified myocardial ischemia. A UA cutoff may be a good method to improve the PPV of DSE.