Elevated Serum Uric Acid Concentrations Research Articles

Ethnic disparities in bidirectional causal effects between serum uric acid concentrations and kidney function: Trans-ethnic Mendelian randomization study

IntroductionResearchers have investigated the causal effect between serum uric acid (SUA) concentrations and kidney function for decades, but studies produced inconsistent results. This study aimed to clarify the bidirectional causal effects between SUA concentrations and kidney function and to explore the potential ethnic disparities by conducting a trans-ethnic Mendelian randomization study in European, African, and Asian ancestries. Materials and methodsThe summary-level data for this study were obtained from the Global Urate Genetics Consortium, CKDGen Consortium, UK Biobank, and Japan Biobank for different outcomes and exposures, respectively. The traits of kidney function were estimated glomerular filtration rate from serum creatinine (eGFRcr), estimated glomerular filtration rate from cystatin C (eGFRcys), and blood urea nitrogen (BUN). Using the multiplicative random-effects inverse variance weighting mode, our primary analysis produced robust results despite heterogeneity. Additionally, we performed the Mendelian randomization pleiotropy residual sum and outlier test to eliminate the horizontal pleiotropy and obtain accurate results. ResultsOur findings revealed that elevated SUA concentrations had causal effects on declined eGFRcys, BUN, and a diagnosis of chronic kidney disease in European ancestries and eGFRcr in Asian ancestries. Additionally, the causal effects of declined eGFRcr and elevated BUN concentrations on elevated SUA concentrations were observed in both European and Asian ancestries. However, no bidirectional causal effect was found between SUA concentrations and eGFRcr among African ancestries. ConclusionsThis trans-ethnic Mendelian randomization study confirmed the bidirectional causal effects between SUA concentrations and kidney function and highlighted the importance of considering ethnic disparities in clinical treatments.

Serum uric acid levels and health outcomes in CKD: a prospective cohort study.

Hyperuricemia is prevalent in individuals with chronic kidney disease (CKD). Elevated serum uric acid (SUA) concentrations have been considered an independent risk factor for the onset of CKD. However, the relationship between SUA concentrations and long-term health outcomes among patients with CKD remains unclear. We performed a prospective cohort study with nationally representative sample to investigate the relationship between SUA concentrations and mortality risk including all-cause, cardiovascular disease (CVD) and cancer mortality, among patients with CKD. The weighted restricted cubic spline analyses combined with the multivariate-adjusted Cox proportional hazard models were used to test the nonlinearity of relationship. The 6642 patients participating in National Health and Nutrition Examination Survey 1999-2018 were enrolled. During 656885 person-months of follow-up time, 2619 all-cause deaths were recorded, including 1030 CVD deaths and 458 cancer deaths. Our study presented J-shaped non-linear relationships between SUA concentrations and all-cause and CVD mortality with inflection points at 311.65μmol/L and 392.34μmol/L, respectively. When SUA concentration was higher than those inflection points, every increase of 50μmol/L SUA was associated with 11.7% and 17.0% greater multivariable-adjusted hazard ratio of all-cause and CVD mortality, respectively. In addition, a negative linear correlation with cancer mortality was detected. These findings suggested that maintaining appropriate SUA concentrations may improve long-term health outcomes among CKD patients. The corresponding inflection points of J-shaped non-linear relationships were 311.65 and 392.34μmol/L for all-cause and CVD mortality. Further clinical trials are required to investigate uric acid-lowering targets.

Association between serum uric acid concentration and radiographic axial spondylarthritis: a cross-sectional study of 202 patients.

Association between serum uric acid concentration and radiographic axial spondylarthritis: a cross-sectional study of 202 patients.

Frequency of Hyperuricemia In Patients Presenting with Acute Ischaemic Stroke

Hyperuricemia refers to elevated serum uric acid concentration above the upper limit of normal. Objective: To determine hyperuricemia in patients presenting with acute ischemic stroke to the Neurology ward of Lady Reading Hospital, Peshawar. Methods: A total of 153 patients were observed to the frequency of hyperuricemia in patients presenting with acute ischemic stroke. Study design was cross sectional study which was conducted for the period of 6 months. The total Sample size was calculated by using WHO sample size calculator. It was calculated using the World Health Organization software. Results: A total of 153 patients were observed to the frequency of hyperuricemia in patients presenting with acute ischemic stroke. Mean age of study participants was 52.45±1.14 years. Distribution of hyperuricemia was 114(74.5%). Mean serum uric acid level among cases of acute ischemic stroke was 06.15 ± 01.91 mg/dl while the mean serum uric acid level among control group was 05.1 ± 01.4 mg/dl. The results were highly significant p-value < 0.0001. Conclusions: Serum uric acid levels can be used to predict stroke risk. Moreover, serum uric acid can be utilized to stratify risk following a stroke. Long-term prospective research is needed to determine the involvement of serum uric acid in ischemic stroke. A trial of serum uric acid reducing medications in stroke patients as well as those at high risk of stroke may also be worthwhile.

Acute effect of fructose, sucrose, and isomaltulose on uric acid metabolism in healthy participants.

Fructose is associated with hyperuricemia and gout development. Focusing on fructose and fructose-containing disaccharides, we investigated the effects of three different types of carbohydrates (fructose, sucrose, and isomaltulose) on uric acid metabolism and gene expression profiling in peripheral white blood cells. In a randomized crossover study, ten healthy participants ingested test drinks of fructose, sucrose, and isomaltulose, each containing 25 g of fructose. Plasma glucose, serum and urine uric acid, and xanthine/hypoxanthine concentrations were measured. Microarray analysis in peripheral white blood cells and real-time reverse transcription polymerase chain reaction were examined at 0 and 120 in after the intake of test drinks. Serum uric acid concentrations for group fructose were significantly higher than group sucrose at 30-120 min and were significantly higher than those for group isomaltulose at 30-240 min. Several genes involved in the "nuclear factor-kappa B signaling pathway" were markedly changed in group fructose. No significant differences in the mRNA expression levels of tumor necrosis factor, nuclear factor-kappa B, interleukin-1β, and interleukin-18 were noted. This study indicated that fructose intake (monosaccharide) elevated serum uric acid concentrations compared with disaccharide intake. Differences in the quality of carbohydrates might reduce the rapid increase of postprandial serum uric acid concentrations.

Association of serum uric acid with the risk of developing hypertension: A prospective cohort study with mediation analysis.

Elevated serum uric acid (SUA) is associated with the incidence of hypertension, but whether relevant metabolic factors have mediating effects is not certain. Our study was based on a functional community cohort established in Beijing. In 2015, a total of 7482 individuals without hypertension were recruited and followed up until 2019. Multivariate logistic regression analysis was used to investigate the association between SUA and hypertension. Cross-lagged panel analysis and mediation analysis were used to explore the effects of metabolic factors on the association between SUA and incident hypertension. During the average 4-year follow-up, the cumulative incidence of hypertension was 10.9% (n = 580). SUA was an independent risk factor for hypertension, and the RRs (95% CI) for subjects with baseline SUA levels in quartile 2, quartile 3 and quartile 4 were 1.20 (0.88-1.63), 1.50 (1.10-2.05), and 1.57 (1.11-2.22) compared to those in quartile 1, respectively. The cross-lagged panel analysis showed that the increases in Cr, TG, LDL, ALT, AST and WBC occurred after SUA increased (P < 0.001). Among these factors, TG, WBC and ALT played an intermediary role in both men (TG: 14.76%; WBC: 11.61%; ALT: 15.93%) and women (TG: 14.55%; WBC: 8.55%; ALT: 6.89%). The elevated SUA concentration was an independent risk factor for hypertension in the Chinese population, and TG, WBC and ALT had important mediating effects on the association between SUA and hypertension.

Xanthine oxidase inhibition for cardiovascular disease prevention

In the metabolic process of purine degradation into uric acid, activated xanthine oxidase produces oxygen species and causes a pro-inflammatory vascular state, resulting in an increased risk of cardiovascular disease.1 Elevated serum uric acid concentrations and gout have also been recognised as independent residual risk factors for cardiovascular disease,2 contributing to the hypothesis that xanthine oxidase inhibition can prevent the development of cardiovascular disease.

Urate Transporter ABCG2 Function and Asymptomatic Hyperuricemia: A Retrospective Cohort Study of CKD Progression

Treatment of asymptomatic hyperuricemia is not commonly implemented. However, it is unclear whether urate deposition that begins during asymptomatic hyperuricemia can induce nephropathy. Dysfunction of ATP-binding cassette subfamily G member 2 (ABCG2), a urate efflux transporter, leads to elevated serum uric acid concentration (SUA). We investigated the association between asymptomatic hyperuricemia and decreased estimated glomerular filtration rate (eGFR), and the impact of ABCG2 on this relationship. Retrospective cohort study. 1,885 Japanese adults undergoing routine health care follow-up between 2007 and 2017 who had eGFR≥60 mL/min/1.73 m2, of which 311 had asymptomatic hyperuricemia (SUA >7.0 mg/dL). Study participants were classified into 3 categories of estimated ABCG2 function (full, 75%, and≤50% function). Baseline SUA and estimated ABCG2 function. Change in eGFR over time. Linear mixed-effect models were used to analyze the relationship between asymptomatic hyperuricemia, ABCG2 function, and eGFR decline. Asymptomatic hyperuricemia was negligibly associated with eGFR decline overall. However, among those with eGFR 60-89 mL/min/1.73 m2 and≤50% ABCG2 function, eGFR decline was associated with asymptomatic hyperuricemia (P= 0.03). ABCG2 was not associated with eGFR reductions when the SUA was<6.0 mg/dL. Among participants with SUA≥6.0 mg/dL and eGFR 60-89 mL/min/1.73 m2,≤50% ABCG2 function was associated with approximately 1.2-fold faster eGFR decline compared with fully functional ABCG2 (P= 0.02). Among the participants with SUA≥6.0 mg/dL and eGFR 60-89 mL/min/1.73 m2, the adjusted eGFR slopes (given as mean ± standard error of the mean, in mL/min/1.73 m2 per year) were-0.946 ± 0.049,-1.040 ± 0.046, and-1.148 ± 0.069 for full, 75%, and≤50% ABCG2 function, respectively. Lack of measurement of urinary urate and uremic toxins that are known to be transported by ABCG2, and no independent validation cohort. Asymptomatic hyperuricemia was not associated with eGFR decline, except when in the presence of≤50% ABCG2 function. The urate transporter ABCG2 is a protein that regulates serum urate concentrations; when dysfunctional, it can lead to elevated serum concentrations of this compound (ie, hyperuricemia). Although persistent hyperuricemia induces gout and kidney injury, the effects on organs during the asymptomatic phase have yet to be established. Therefore, to clarify the relationship between ABCG2, asymptomatic hyperuricemia, and kidney function, we conducted a retrospective cohort study of 1,885 healthy participants, including 311 participants with asymptomatic hyperuricemia. We found that the coexistence of asymptomatic hyperuricemia and severe ABCG2 dysfunction was associated with the age-dependent decline in kidney function. We concluded that asymptomatic hyperuricemia represents a risk factor for chronic kidney disease, at least in individuals with highly dysfunctional ABCG2. This new finding highlights the potential importance of ABCG2 in the pathogenesis of hyperuricemia-induced kidney injury.

Effect and Potential Mechanism of Lactobacillus plantarum Q7 on Hyperuricemia in vitro and in vivo

Hyperuricemia (HUA) is a disorder of purine metabolism resulting in abnormally elevated serum uric acid (UA) concentration. It is believed that there is an association between gut microbiota and HUA, and probiotics have the potential palliative effect. However, the underlying mechanism of probiotics in ameliorating HUA remains unclear. The purpose of this study was to investigate the effect and mechanism of Lactobacillus plantarum Q7 on HUA in Balb/c mice. The results showed that L. plantarum Q7 had an excellent capability to affect UA metabolism, which could degrade nucleotides by 99.97%, nucleosides by 99.15%, purine by 87.35%, and UA by 81.30%. It was observed that L. plantarum Q7 could downregulate serum UA, blood urea nitrogen (BUN), creatinine (Cr), and xanthine oxidase (XOD) by 47.24%, 14.59%, 54.59%, and 40.80%, respectively. Oral administration of L. plantarum Q7 could restore the liver, kidney, and intestinal injury induced by HUA and the expression of metabolic enzymes and transporters to normal level. 16S rRNA sequencing analysis showed that L. plantarum Q7 treatment could restore the imbalance of species diversity, richness, and community evenness compared with the model group. The ratio of Bacteroidetes to Firmicutes was recovered nearly to the normal level by L. plantarum Q7 intervention. The dominant microorganisms of L. plantarum Q7 group contained more anti-inflammatory bacteria than those of the model group. These findings indicated that L. plantarum Q7 might regulate UA metabolism and repair the liver and kidney injury by reshaping the gut microbiota and could be used as a potential probiotic strain to ameliorate HUA.

Longitudinal changes in uric acid concentration and their relationship with chronic kidney disease progression in children and adolescents.

Elevated serum uric acid concentration is a risk factor for CKD progression. Its change over time and association with CKD etiology and concomitant changes in estimated glomerular filtration rate (eGFR) in children and adolescents are unknown. Longitudinal study of 153 children/adolescents with glomerular (G) and 540 with non-glomerular (NG) etiology from the CKD in Children (CKiD)study. Baseline serum uric acid, change in uric acid and eGFR over time, CKD etiology, and comorbidities were monitored. Adjusted linear mixed-effects regression models quantified the relationship between within-person changes in uric acid and concurrent within-person changes in eGFR. Participants with stable uric acid over follow-up had CKD progression which became worse for increased baseline uric acid (average annual percentage changes in eGFR were - 1.4%, - 7.7%, and - 14.7% in those with G CKD with baseline uric acid < 5.5mg/dL, 5.5 - 7.5mg/dL, and > 7.5mg/dL, respectively; these changes were - 1.4%, - 4.1%, and - 8.6% in NG CKD). Each 1mg/dL increase in uric acid over follow-up was independently associated with significant concomitant eGFR decreases of - 5.7% (95%CI - 8.4 to - 3.0%) (G) and - 5.1% (95%CI - 6.3 to - 4.0%) (NG) for those with baseline uric acid < 5.5mg/dL and - 4.3% (95%CI - 6.8 to - 1.6%) (G) and - 3.3% (95%CI - 4.1 to - 2.6%) (NG) with baseline uric acid between 5.5 and 7.5mg/dL. Higher uric acid levels and increases in uric acid over time are risk factors for more severe progression of CKD in children and adolescents. A higher resolution version of the Graphical abstract is available as Supplementary information.

Бессимптомная гиперурикемия как маркер обестрения артериальной гипертензии

Introduction. Elevated serum uric acid (UA) concentration is considered to be as one of the factors contributing to endothelial dysfunction. However, it does not lead to clinical manifestations, so it is called asymptomatic hyperuricemia (ASH). The aim of the investigation was to study the effect of ASH on arterial hypertension (AH) followed by its correction. Materials and Methods. A retrospective analysis of patients with AH undergoing inpatient treatment was performed. The control group of patients received standard hypotensive therapy. Although, the main group received standard therapy combined with urate-reducing therapy. Results. Comparative analysis showed that hypotensive therapy was effective in both investigated groups. By the way, index of the main group experienced better results, i.e., the systolic blood pressure (SBP) decreased by 18 Hg (11.6%) compared to the control group. In terms of diastolic blood pressure (DBP), it is dropped by 11.8 Hg (12,1%). The positive effect of urate-reducing therapy is the reason for rising efficiency of the therapy at all. Moreover, significant decrease of UA level was experienced from both researched groups. It averaged 38,3 mmol/l, which is 39.2% of the original result. Conclusion. Thus, the adverse effect of ASH on BP in patients with AH can be compensated by prescription of additional urate-reducing therapy to hypotensive drugs, which helps to reduce the adverse effect of ASH. The obtained data should be taken into account when physicians implement a disease management program.

A study of the association of serum uric acid levels with alanine aminotransferase and gamma-glutamyl transferase levels in non-alcoholic fatty liver disease patients diagnosed by imaging studies

Background: Non-alcoholic fatty liver disease (NAFLD) is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver. In recent years, an association between elevated serum uric acid concentrations and NAFLD has been reported. The aim of the study was to perform cross-sectional study to determine the association between serum uric acid levels and the levels of serum alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), in NAFLD patients.Methods: In this hospital-based cross-sectional study, 300 patients with diagnosed NAFLD were included during the one-year period from July 2015 to June 2016.Results: Elevation of alanine aminotransferase levels was seen in a total of 93 cases (31%) and elevation of GGT levels in NAFLD patients was seen in 112 patients out of a total of 300 (37.33%). Hyperuricemia was observed in 99 cases out of a total of 300 cases of NAFLD (33%). A significant association was observed between the two parameters.Conclusions: The prevalence rate of NAFLD was significantly higher in subjects with hyperuricemia than that in those without hyperuricemia (78.19% versus 40.83 %) (p&lt;0.001), and the prevalence rate increased with progressively higher serum uric acid levels (p&lt;0.001). The relationship between rising uric acid levels with rising ALT and GGT levels in these patients was also found to be statistically significant.

The Prevalence, Distribution, and Extent of Subclinical Atherosclerosis and Its Relation With Serum Uric Acid in Hypertension Population.

Background: Data are limited on the prevalence, distribution, and extent of subclinical atherosclerosis (SCA) in populations with primary hypertension and an in-depth evaluation is required to explore the impact of elevated serum uric acid (SUA) levels on the systemic extent of SCA.Methods: A total of 1,534 individuals with blood pressure-controlled primary hypertension registered from January 1, 2015 to May 31, 2018 were included. The systemic extent and risk factors of SCA in the carotid, coronary, thoracic, and renal territories were investigated by Doppler ultrasound and computed tomography.Results: SCA was present in 85.9% of patients. The proportion of focal, intermediate and generalized SCA was 17.9, 21.3, and 46.6%. Plaques were most common in the thoracic aorta (74%), followed by the coronary (55.3%), carotid (51.6%), and renal (45.8%) arteries, respectively. Participants were stratified into quartiles based on gender-specific SUA levels. Compared with patients in the first quartile, the Odds Ratio (OR) [95% confidence interval] for SCA in the second, third and fourth quartile were 1.647 (1.011–2.680), 3.013 (1.770–5.124), and 5.081 (3.203–10.496), respectively. Patients with elevated SUA levels at high 10-year Framingham risk had a higher likelihood of a more severe risk of SCA (95.8%). However, extensive SCA was also present in a substantial number of low 10-year-Framingham risk patients at the higher quartiles of SUA (53.8%).Conclusions: SCA was highly prevalent in the hypertension population and the thoracic aorta was the most frequently affected vascular site. Elevated SUA concentration was significantly associated with the prevalence and severity of SCA regardless of territories.

The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study.

BackgroundThe relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM).MethodsA total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications.ResultsSUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, ∗P = 0.0013; ORs Female = 1.002, ∗P = 0.015) and DN (ORs Male = 1.006, ∗P < 0.001; ORs Female = 1.005, ∗P < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, P = 0.004) and 4th quartile (ORs = 2.064, P = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, P = 0.039), quartile 3 (ORs = 3.967, P = 0.024) and quartile 4 (ORs = 9.133, P < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, P = 0.042) in womenConclusionFor patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.

A study of the prevalence of hyperuricemia as well as its association with non-alcoholic fatty liver disease in three hundred patients at a tertiary care centre in North-East India

Background: Non-alcoholic fatty liver disease (NAFLD) is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver. In recent years, an association between elevated serum uric acid concentrations and NAFLD has been reported. Thus, we intended to perform this cross-sectional study to establish the prevalence of hyperuricemia in NAFLD patients and its association with NAFLD in 300 patients at a tertiary care centre in North-East India.Methods: In this hospital based cross-sectional study, 300 patients presenting in Assam medical college and hospital (AMCH) with diagnosed NAFLD were included during the one year period from July 2015 to June 2016.Results: Hyperuricemia was observed in 99 cases out of a total of 300 cases of NAFLD (33%), and a statistically significant association was observed between the two parameters.Conclusions: The prevalence rate of NAFLD was significantly higher in subjects with hyperuricemia than that in those without hyperuricemia (78.19% versus 40.83%) (p&lt;0.001), and the prevalence rate increased with progressively higher serum uric acid levels (p&lt;0.001).

The study of serum uric acid in cerebrovascular accident patients and correlation with hypertension

Background: Cerebrovascular accident (CVA) is also called Stroke. These is a well-recognized epidemiological link between elevated serum uric acid and increased cerebrovascular risk. Several studies have identified as elevated serum uric acid concentration as a predictor of cerebrovascular events. The aim of this study was to correlate serum uric acid in cerebrovascular accident (CVA) patients with Hypertension.Methods: A prospective study was conducted on 100 patients aged &gt;18 years of admitted with new onset focal/global neurological deficit/event with cerebrovascular accident (CVA). Brain imaging (CT/MRI) was performed on the patients within 24-48 hrs of admission. Data was collected with regards to patient’s demography, medical history, risk factors for stroke or vascular disease. Serum uric acid was measured as part of fasting biochemical profile taken within 24-48 hrs of admission by standard analytical methods in Biochemistry department.Results: Out of 100 patients included in this study 74 of them were male and 26 were female. Among 100 patients 61 patients had hemorrhage, out of which 45 (73.77%) were male and 16 (26.23%) were female, followed by 39 patients had infract, out of which 29 (74.35%) were male and 10 (25.65%) were female. Mean value of serum uric acid levels in hypertensive patients was significantly high in comparison to normotensive patients.Conclusions: Concluded that correlation of serum uric acid in cerebrovascular accident (CVA) patients with Hypertension was found statistically significant.

Elevated serum uric acid, hyperuricaemia and dietary patterns among adolescents in mainland China.

Background Elevated serum uric acid concentrations have been associated with metabolic syndrome. However, only limited information is available on the prevalence of hyperuricaemia in adolescents. Therefore, the aim of our cross-sectional study was to study the prevalence of hyperuricaemia and dietary patterns in adolescents aged 13-16 years living in Yangzhou, China. Methods Adolescents were asked to complete a 20-item food frequency questionnaire (FFQ) and provide an overnight fasting finger-prick sample. Principal component analysis (PCA) with varimax rotation was used to derive the dietary patterns that might be associated with high uric acid concentrations. Results A total of 1070 adolescents were recruited. Of these, 53.6% (n = 574) were females, and 58.5% (n = 625) were within the normal body mass index (BMI) range. The males had a significantly higher serving size and frequency in their weekly food consumption, including meat, poultry, Chinese cereal staple foods and Western-style fast foods, than the females (all p < 0.02). The overall mean serum uric acid concentration and prevalence of hyperuricaemia were 368.6 ± 114.5 μmol/L and 37.9%, respectively. The prevalence of hyperuricaemia was 4.633 times greater among the participants who were overweight and obese than among those who were underweight. On the other hand, the prevalence of hyperuricaemia was 0.694 times lower among the participants who had normal weight than those who were underweight. Conclusions The prevalence of hyperuricaemia was relatively high in Chinese adolescents. The prevention of hyperuricaemia measures should be strengthened in adolescents to effectively control for obesity and gout, which tend to persist into adulthood.

Elevated Serum Uric Acid And Heart Failure In U.S. Adults: 2007-2016 NHANES

There is limited evidence examining the relationship between elevated serum uric acid (UA) concentration and heart failure (HF) in U.S. adults. PURPOSE: Examine the associations between elevated UA and HF using a nationally representative sample of U.S. adults. METHODS: The final sample with complete data for this analysis (N=17,412) included men and women aged ≥40 years who participated in the 2007-2016 National Health and Nutrition Examination Survey. Self-reported diagnosis of HF was assessed via interview. Elevated UA was defined as values >6.0 mg/dL for women and >7.2 mg/dL for men. Multivariable gender-stratified logistic regression was utilized to examine the odds of HF. RESULTS: The estimated prevalence of HF was 3.85% and 3.39% among men and women, respectively. Age adjusted analysis revealed significantly increased odds of HF in men (odds ratio [OR], 2.78; 95% confidence interval [CI] 2.09-3.71, P<0.01) and women (OR, 3.25; 95% CI 2.37-4.45, P<0.01) with elevated UA. Significance remained following adjustment for education, income, race, body mass index, alcohol consumption, hypertension, diabetes, physical activity, and creatinine in men (OR, 1.59; 95% CI 1.04-2.43 P=0.03) and women (OR, 2.03; 95% CI 1.33-3.08, P<0.01). CONCLUSIONS: In a representative sample of U.S. adults, having an elevated UA concentration was associated with significantly increased odds of HF when compared to adults with normal UA.

Elevated Serum Uric Acid and Self-Reported Heart Failure in US Adults: 2007–2016 National Health and Nutrition Examination Survey

Introduction: There is limited evidence examining the relationship between elevated serum uric acid (sUA) concentration and heart failure (HF) in United States (US) adults. The aim of the present study was to examine the association(s) between elevated sUA and HF using a nationally representative sample of US adults. Methods: The final sample with complete data for this analysis (n = 17,349) included men and women aged ≥40 years who participated in the 2007–2016 National Health and Nutrition Examination Survey. Self-reported diagnosis of HF was assessed via interview. Elevated sUA was defined as values >6.0 mg/dL for women and >7.2 mg/dL for men. Multivariable gender-stratified logistic regression was utilized to examine the odds of self-reported HF. Results: The estimated prevalence of HF was 3.9 and 3.4% among men and women, respectively. Age-adjusted analysis revealed significantly increased odds of HF in men (OR 2.79; 95% CI 2.15–3.84, p < 0.01) and women (OR 3.24; 95% CI 2.37–4.44, p < 0.01) with elevated sUA. This relationship remained statistically significant following adjustment for age, race, education, income, alcohol consumption, smoking status, blood pressure, diabetes, physical activity level, cholesterol, creatinine level, and body mass index in men (OR 1.70; 95% CI 1.13–2.57 p < 0.05) and women (OR 1.74; 95% CI 1.18–2.58, p < 0.05). Conclusions: In a representative sample of US adults, having an elevated sUA concentration was associated with significantly increased odds of HF when compared to adults with normal sUA.

A2698 Relation of Serum Uric Acid to Asymptomatic Proximal Extracranial Artery Stenosis in a Middle-Aged Chinese Population

Objectives: Serum uric acid (SUA) has been associated with cardiovascular diseases, including atherosclerosis and carotid artery stenosis. However, data on the relationship between SUA level and proximal extracranial artery stenosis (PEAS) is limited. Therefore, this study investigates the association between SUA levels and the risk of PEAS in asymptomatic Chinese population. Methods: This community-based cross-sectional study was conducted in Jidong community hospital, Tangshan, Hebei, China between July 2013 and August 2014. The study examined 3,325 asymptomatic participants 40 to 60 years of age to evaluate the risk of PEAS. Results: For the participants stratified into quartiles based on gender-specific SUA levels, the prevalence of PEAS increased from Q1 to Q4 from 12.3% to 29.8% in the vertebral artery (VA), and from 2.8% to 5.8% in the common carotid artery (CCA). The proportion of PEAS relative to the detected number of arterial stenosis was lower in Q1 than in Q2-Q4. The multivariable odds ratios and 95% confidence interval (CI) of PEAS in the second through fourth compared to the lowest quartiles for arterial stenosis were 1.278(0.980–1.665), 1.117(0.851–1.468) and 1.375(1.033–1.830) (Ptrend = 0.0399); and for VA stenosis, 1.285(0.966–1.709), 1.085(0.808–1.457), and 1.439(1.061–1.952) (Ptrend = 0.0235). Conclusion: Elevated serum uric acid concentration is significantly associated with PEAS in an asymptomatic middle-aged Chinese population, and vertebral arteries appeared to be the most vulnerable vessels.