Highest Quartile Of Serum Uric Acid Research Articles

Association between serum uric acid and bone mineral density in males from NHANES 2011–2020

Currently, the relationship between serum uric acid (SUA) and bone mineral density (BMD) in men remains controversial. This study aims to investigate the relationship between SUA and lumbar spine BMD in American men using data from the National Health and Nutrition Examination Survey (NHANES). A total of 6254 male subjects aged 12–80 years (mean age 35.52 ± 14.84 years) in the NHANES from 2011 to 2020 were analyzed. SUA was measured by DxC using the timed endpoint method, and lumbar spine BMD was measured by dual-energy X-ray absorptiometry (DXA). Multivariate linear regression models were used to explore the relationship between SUA and BMD by adjusting for age, race/Hispanic origin, drinking behavior, smoking behavior, physical activity, body mass index (BMI), poverty-to-income ratio (PIR), total protein, serum calcium, cholesterol, serum phosphorus, and blood urea nitrogen. After correcting for the above confounders, it was found that SUA was positively associated with lumbar spine BMD in the range of SUA < 5 mg/dL (β = 0.006 95% CI 0.003–0.009, P < 0.001), and BMD of individuals in the highest quartile of SUA was 0.020 g/cm2 higher than those in the lowest quartile of SUA (β = 0.020 95% CI 0.008–0.032, P = 0.003). This study showed that SUA was positively correlated with lumbar spine BMD in American men within a certain range. This gives clinicians some insight into how to monitor SUA levels to predict BMD levels during adolescence when bone is urgently needed for growth and development and during old age when bone loss is rapid.

Serum uric acid and outcome in hospitalized elderly patients with chronic heart failure through the whole spectrum of ejection fraction phenotypes

IntroductionElevated serum uric acid (SUA) levels have been associated with poor outcome in patients with heart failure (HF). Uric acid is associated with inflammation and microvascular dysfunction, which may differentially affect left ventricular ejection fraction (EF) phenotypes. We aimed to identify the role of SUA across EF phenotypes in hospitalized elderly patients with chronic HF.MethodsWe analyzed 1355 elderly patients who were diagnosed with chronic HF. All patients had SUA levels measured within the first 24 h following admission. Patients with left ventricle EF were categorized as having HF with reduced EF (HFrEF, EF < 40%), HF with mid-range EF (HFmrEF, 40%≦LVEF ≦ 49%) or HF with preserved EF (HFpEF, LVEF ≥ 50%). Endpoints were cardiovascular death, HF rehospitalization, and their composite. The median follow-up period was 18 months.ResultsCompared with the lowest SUA quartile, the highest SUA quartile was significantly associated with the endpoints (adjusted HR: 2.404, 95% CI: 1.178–4.906, P = 0.016; HR: 1.418, 95% CI: 1.021–1.971, P = 0.037; HR: 1.439, 95% CI: 1.049–1.972, P = 0.024, respectively). After model adjustment, a significant association of SUA with cardiovascular death and the composite endpoint persisted among HFrEF and HFmrEF patients in the highest SUA quartile (P < 0.05 for all).ConclusionsIn hospitalized elderly patients with chronic HF, SUA is an independent predictor of adverse outcomes, which can be seen in HFrEF and HFmrEF patients.

Assocıatıon of serum urıc acıd level wıth dısease severıty and clınıcal outcomes ın COVID-19

Abstract. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is likely to cause uric acid dysregulation, resulting in abnormal serum uric acid concentrations. In this study, we aimed to evaluate the associations between admission serum uric acid levels and demographic, clinical and laboratory features of patients hospitalized with Coronavirus disease 2019 (Covid-19) and to explore the effect of admission serum uric acid values on clinical outcomes.&#x0D; Methods. In this retrospective study, the demographic, clinical and laboratory data of patients with confirmed Covid-19 were collected from the electronic health records of the hospital. The study population was stratified according to the quartiles of serum uric acid; Quartile 1: ≤ 3.5 mg/dl, Quartile 2: 3.6 mg/dl to 6 mg/dl for women and 3.5 mg/dl to 7 mg/dl for men, Quartile 3: ≥ 6 mg/dl for women and ≥ 7 mg/dl for men. The outcomes were the development of acute kidney injury (AKI) and in-hospital mortality.&#x0D; Results. 146 patients were included in the analysis. The median age of patients was 57 (IQR, 49-65) years and 70.5% were male. The overall median serum uric acid level on admission was 4.4 (IQR, 3.5-5.9) mg/dl. Participants in the highest serum uric acid quartile were significantly more hypertensive, and diabetics and showed significantly higher estimated glomerular filtration rate (eGFR) and troponin T levels compared to patients in the lowest serum uric acid quartile. On the other hand; patients in the lowest serum uric acid quartile were admitted with more severe disease than patients with Quartile 2. During follow-up, 19 (13.1%) participants experienced AKI and 15 (10.3%) died. There were significantly positive correlations between AKI and age, hypertension, serum creatinine (SCr), hyperuricemia, C-reactive protein (CRP) and Troponin T (r=0.263, P=0.001; r=0.192, P=0.02; r=0.182, P=0.028; r=0.235, P = 0.004; r=0.219, P=0.008; r=0.236, P=0.004, respectively). A significantly negative correlation was noted between AKI and eGFR (r=-0.189, P=0.023). According to multivariate logistic regression analysis, AKI development was independently associated with CRP and hyperuricemia (OR, 1.009; 95% CI, 1.0082-1.016, P=0.009 and OR, 4.314; 95% CI, 1.190-15.633, P=0.026). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the concentration of serum admission uric acid was 0.693 (95% CI 0.537–0.849, P=0.006) and the cutoff value was 5.45 mg/dl (sensitivity: 68.4%; specificity: 75.6%).&#x0D; Conclusions. Hyperuricemia and increased CRP were independent risk factors for the development of AKI. Although patients with lower uric acid values developed more severe symptoms, mechanical ventilation and mortality rates were not found to be significantly different among patients with Covid-19 grouped based on admission serum uric values. Following the patients admitted with high uric acid levels closely in terms of renal functions would be helpful for early detection of AKI.

Serum uric acid and risk of incident chronic kidney disease: a national cohort study and updated meta-analysis

BackgroundWe prospectively examined the association between serum uric acid (SUA) levels and chronic kidney disease (CKD) in China and updated the evidence through a comprehensive meta-analysis of prospective studies worldwide.MethodsOur original analyses were based on data from the China Health and Retirement Longitudinal Study. The primary exposure of interest was SUA at baseline, and the main outcome was incident CKD. Logistic regression models were used to examine the association between SUA levels and incident CKD. A meta-analysis was performed to pool our effect estimate and those from other cohort studies.ResultsDuring a 4-year follow-up, 180 participants developed incident CKD. Participants in the highest SUA quartile were 2.73 times as likely to develop incident CKD compared to those in the lowest quartile (multivariable-adjusted OR, 2.73; 95% CI, 1.65–4.50). Each 1 mg/dL increment in the SUA levels was associated with a 49% increased risk of incident CKD (multivariable-adjusted OR, 1.49; 95% CI, 1.28–1.74). In the meta-analysis of 30 cohort studies (including the current study), pooled relative risks (95% CIs) of incident CKD were 1.15 (1.10–1.21) for SUA each 1 mg/dL increment, 1.22 (1.14–1.30) for the highest versus lowest SUA group, and 1.17 (1.12–1.23) for hyperuricemia versus no hyperuricemia.ConclusionsBaseline SUA levels were associated with higher risk of incident CKD in middle-aged and elderly Chinese adults, and this positive association was confirmed in the meta-analysis of multiple cohort studies. Our findings may imply that SUA levels need to be routinely monitored for future CKD risk.

Serum uric acid is associated with the progression of left ventricular diastolic dysfunction in apparently healthy subjects

Abstract Background Left ventricular (LV) diastolic dysfunction (LVDD) which is one of major characteristics of diastolic heart failure (HF) is also prevalent in the community. Patients with LVDD are predisposed to poor cardiovascular outcomes. Serum uric acid (SUA), an important component of metabolic disorders, has been shown to have close relationship with cardiovascular events including LVDD. In the present study, we sought to investigate whether SUA is a potential predictor of LVDD progression in relatively healthy subjects. Methods From November 2018 to December 2019 in our Hospital, subjects who had physical examination were consecutively enrolled and followed up for ∼12 months. LVDD was graded by tissue doppler imaging (TDI). At baseline, only individuals with normal LV diastolic function or mild LVDD were finally enrolled and underwent repeated echocardiography and TDI assessment after follow-up. The incidence of LVDD progression, defined as LVDD grade 0–1 escalated to grade 2–3, and its relationship with SUA levels were analyzed. Multivariate regression models were constructed to test the predictive value of SUA for LVDD progression. Results A total of 1082 subjects were included in the final analysis. During a mean follow-up of 12.6 (IQR 12.0–13.8) months, the incidence of LVDD progression was 37.6% and mean change in E/e' ratio was 1.18±1.85 cm/s, which was positively correlated with baseline SUV level (Spearman's r=0.140, P&amp;lt;0.001). In multivariate analysis, SUA was independently associated with LVDD progression after adjustment for traditional risk factors. The highest quartile of SUA corresponded to a 1.851-fold [95% CI 1.215–2.828] increased risk for progression of LVDD as compared to the lowest quartile. A 100 μmol/L increase in SUA conferred a 1.351-fold [95% CI 1.125–1.625] higher risk of LVDD progression when treated as continuous variable. Principal component analysis revealed SUA accounted for 14.7% of the variance in patients with LVDD progression, following insulin resistance and cholesterol factor which accounted for 27.9% and 19.0%, respectively. Conclusions This study suggests that SUA is an independent predictor of LVDD progression in apparently healthy subjects. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China, Shanghai Municipal Commission of Health and Family Planning

Uric acid played a role in the association between gender and deep vein thrombosis in patients with stroke

Background and aimsGender-specific differences were found in serum uric acid (SUA) levels and the risk of isolated distal deep vein thrombosis (IDDVT). This study aimed to explore the association among gender, SUA, and IDDVT in stroke patients. Methods and resultsFinally, 3404 patients were recruited and divided into two groups: IDDVT (n = 1233) and Non-IDDVT (n = 2171) groups. Propensity score matching (PSM) was conducted to match the patients. Binary logistic regression was adopted to explore the association between SUA and IDDVT, with the SUA divided into quartiles. After PSM, 975 patients were included in each group. Non-IDDVT group had a larger proportion of male than IDDVT group (64.9% vs. 52.7%, p < 0.001). Moreover, males showed higher SUA levels than females (316.7 ± 102.1 vs. 261.8 ± 94.0 μmol/L, t = 12.1, p < 0.001). The highest quartile of SUA (≥346 μmol/L) showed a lower risk of IDDVT (OR = 0.629, p = 0.001), while the lowest quartile (≤225 μmol/L) showed a higher risk of IDDVT (OR = 1.361, p = 0.022). ConclusionIn patients with stroke, SUA played a protective role in IDDVT. Females had a higher risk of IDDVT, which may be owing to the lower SUA levels than males. In clinical practice, more attention should be paid to the risk of IDDVT in females, especially those with lower SUA levels.

Low serum uric acid levels increase the risk of all-cause death and cardiovascular death in hemodialysis patients

Background Elevated serum uric acid (SUA) is associated with increased cardiovascular (CV) and all-cause mortality risk in the general population, but the impact of UA on mortality in hemodialysis patients is still controversial. The aim of the study was to explore the relationship between SUA and all-cause mortality and CV mortality in hemodialysis patients. Methods This retrospective, observational cohort study included 210 HD patients with a mean age of 56.6 ± 16.6 years. All demographic and laboratory data were recorded at baseline. The Kaplan–Meier method and Cox proportional hazard regression model were used to examine the association between SUA and all-cause mortality and CV mortality in HD patients. Results With 420 µmol/L (20th percentile) and 644 µmol/L (80th percentile) as the boundary points, the patients were divided into three groups. After a median follow-up of 49.8 months, 68 (32.4%) all-cause deaths and 34 (16.2%) CV deaths were recorded. The Kaplan–Meier method showed that with a decrease in SUA, all-cause mortality (log rank χ 2 = 15.61, p = .000), and CV mortality (log rank χ 2=14.28, p = .000) increased. Each 100 µmol/L increase in SUA was associated with lower all-cause mortality with an hazard ratio (HR) of 0.792 (0.645–0.972) and lower CV mortality with an HR of 0.683 (0.505–0.924) after adjusting for age, sex, and complications. Compared to the lowest quartile, all-cause mortality [HR 0.351(0.132–0.934), p = .036] and CV mortality [HR 0.112 (0.014–0.925), p = .042] were lower in the highest SUA quartile. Conclusion A lower SUA level in HD patients was associated with a higher risk of all-cause mortality and CV mortality. Moreover, higher SUA concentrations may be cardioprotective in HD patients.

Associations of serum uric acid with total and cause-specific mortality: Findings from individuals and pooling prospective studies

Background and aimsThere is considerable controversy regarding the link between serum uric acid (SUA) and mortality. We prospectively evaluated the association between SUA and risk of total and cause specific (coronary heart disease [CHD], cerebrovascular and cancer) mortality by using the National Health and Nutrition Examination Surveys (NHANES, 1999–2010). Furthermore, a systematic review and meta-analysis of cohort studies was performed to investigate pooled associations of SUA with all-cause and cause-specific mortality. MethodsVital status through December 31, 2011 was ascertained. PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched (up to April 2018). Adjusted Cox proportional hazard regression models were used to determine the association between SUA and mortality. The DerSimonian-Laird method and generic inverse variance methods were used for quantitative data synthesis. ResultsOverall, 21,025 individuals were included (mean age = 47.6 years, 48.7% men) and 3520 deaths occurred during the 144 months of follow-up. In adjusted models, individuals in the highest quartile of SUA had 10 and 8% greater risk of CHD and stroke mortality, whereas there was no link between SUA, all-cause and cancer mortality. The associations of CHD and stroke mortality with SUA were more pronounced in women and, among women, in those aged >50 years. Furthermore, all-cause mortality was positively and significantly related to SUA concentrations only in women. In the meta-analysis, SUA was shown to predict the risk of total (21%), CHD (24%) and stroke (29%) mortality. Furthermore, participants with a higher level of central adiposity had a greater risk of mortality from CHD and stroke for the same level of SUA. ConclusionsOur results highlight the adverse impact of SUA on mortality, particularity in older (>50 years) women. The clinical implications of these findings remain to be established in future trials.

Associations between serum uric acid and depression among middle-aged and elderly participants in China

ABSTRACTFew studies have investigated the sex-related associations between serum uric acid and depression. This study aimed to explore the associations between serum uric acid and depression stratified by sex among middle-aged and elderly Chinese participants. Using the baseline data of the China health and retirement longitudinal study (CHARLS), a total of 10,522 participants aged 45 years and older were included in the final analysis. Depression symptoms were measured with the 10-term Center for Epidemiologic Studies Depression Scale (CES-D). A multivariable logistic regression model was performed to examine the associations between serum uric acid levels and depression, and the results are presented using odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of depression was 38% among middle-aged and elderly participants in China. In men, participants in the highest serum uric acid quartile had a decreased prevalence of depression relative to those in the lowest quartile (OR: 0.57; 95% CI: 0.41–0.81) after adjustment for potential confounders. However, there was no significant association between serum uric acid and depression among women. Participants with hyperuricemia were had no higher prevalence of depression relative to participants with normal serum uric acid level. Negative association between uric acid and depression was found in men, but not in women.

Relationship between serum uric acid levels and metabolic syndrome in Chinese premenopausal women, postmenopausal women, and men

Objective The study was conducted to investigate the incidence of metabolic syndrome (MS) and hyperuricemia in Chinese community residents, and to assess differences of menopausal status and genders in the relationship between MS and serum uric acid (SUA) levels. Methods A total of 10 191 subjects (5 838 postmenopausal women, 726 premenopausal women, and 3 627 men) were recruited in this cross-sectional study. All participants received standard questionnaire survey, physical examination, oral glucose tolerance test, and laboratory examination (serum uric acid, serum lipid, liver and kidney functions). MS was diagnosed according to the International Diabetes Federation (IDF) criteria. Hyperuricemia was defined as SUA>420 μmol/L for men and>360 μmol/L for women. Results The prevalence of hyperuricemia was 14.4% in men, 11.8% in postmenopausal women, and 6.2% in premenopausal women. The prevalence of MS was 35.2% in men, 46.2% in postmenopausal women, and 28.9% in premenopausal women. The body mass index, waist circumference, and triglycerides levels were most strongly associated with SUA levels in all groups, while the correlation coefficients of these factors were higher in females than those in males. Individuals in the highest SUA quartile had 3.538-fold, 2.088-fold, and 1.404-fold increased risk of MS as compared with those in the lowest quartile in premenopausal women, postmenopausal women, and men, respectively. The risks of developing each components of MS in females were higher than those in males. Conclusions There is an association between SUA level and MS, and the relationships between SUA levels and MS were much closer in females than those in males. Individuals with higher SUA levels were more likely to develop MS and its components than those with lower SUA levels. Premenopausal women with high level of SUA may have the highest risk of developing MS in Chinses community residents. (Chin J Endocrinol Metab, 2017, 33: 1031-1037) Key words: Metabolic syndrome; Serum uric acid; Hyperuricemia; Gender; Menopausal status

Serum Uric Acid is Independently Associated with Enlarged Perivascular Spaces

Enlarged perivascular spaces (EPVS) are reported to be associated with impaired cognitive function and sleep disorders. It is of clinical importance to understand the risk factors for EPVS. Hyperuricemia increases the risk of hypertension and endothelial dysfunction, which are well recognized to be associated with EPVS. Therefore, we postulated that serum uric acid (SUA) might be associated with EPVS. A total of 665 lacunar stroke patients were enrolled in this study. The SUA concentrations of patients with severe EPVS were much higher than those of patients with mild EPVS (for basal ganglia: 5.25 ± 1.40 mg/dl vs. 4.75 ± 1.40 mg/dl, p < 0.001; for white matter: 5.31 ± 1.41 mg/dl vs. 4.88 ± 1.37 mg/dl, p = 0.009). The percentage of subjects with severe EPVS tended to be higher in the highest quartile of SUA (chi-square test: P = 0.002 for basal ganglia and 0.006 for white matter). Spearman correlation analysis indicated that the SUA concentrations were positively correlated with the severity of EPVS (rho > 0, p < 0.05). Multivariate logistic regression analysis showed that high normal SUA was independently associated with a higher severity of EPVS. This finding suggests that high SUA levels might be an independent risk factor for EPVS in lacunar stroke patients.

Sex difference in the association of serum uric acid with metabolic syndrome and its components: a cross-sectional study in a Chinese Yi population

ABSTRACTObjectives: Since the association between serum uric acid (SUA) and metabolic syndrome (MetS) has been reported extensively, it remains unclear whether SUA is associated with MetS and its components in a Chinese Yi population.Methods: This study recruited 1,903 people (912 men, 991 women) older than 18 years old from the Liangshan region in Sichuan province. Anthropometric measurements and biochemical indexes were measured by a standard protocol. SUA levels were divided into four quartiles by sex.Results: The prevalence of hyperuricemia and MetS is 21.0% and 17.1%, respectively. The levels of SUA were positively correlated with waist circumference, body mass index and triglycerides while negatively correlated with high-density lipoprotein cholesterol in both sexes. Increased SUA levels were accompanied with prevalence of MetS and several components in both sexes (P < 0.05). Men with the highest SUA quartile had an increased risk of MetS [OR (95% CI): 3.101 (1.281–7.504)], and men with higher SUA levels had an increased risk of central obesity, high blood pressure and hypertriglyceridemia compared to the lowest SUA quartile. Women with higher SUA levels had an increased risk of MetS, central obesity, hypertriglyceridemia and a lower risk of high blood pressure compared to the lowest SUA quartile.Conclusions: SUA levels were closely associated with MetS and several components by sex in Chinese Yi population.

Hyperuricemia and risk of increased arterial stiffness in healthy women based on health screening in Korean population.

Hyperuricemia is a risk factor for cardiovascular disease and is associated with increased arterial stiffness in high-risk populations. However, given the possible sex-related differences in the prevalence of hyperuricemia, the association between elevated serum uric acid (SUA) level and increased arterial stiffness has yielded conflicting results. We investigated the relationship between SUA and arterial stiffness in asymptomatic healthy subjects who underwent a health examination. Subjects who underwent a comprehensive health examination were enrolled. After exclusion of extensive confounding factors, 2,704 healthy subjects with coronary calcium score < 100 were evaluated in the final analysis. All subjects underwent brachial—ankle pulse wave velocity (baPWV) to detect arterial stiffness. The SUA was divided into quartiles for its association with arterial stiffness and was analyzed separately for men and women. The mean SUA level was significantly lower in women than in men. The baPWV was significantly elevated in subjects with the highest quartile of SUA in women, but not in men. After adjusting for age, smoking, systolic blood pressure, body mass index, estimated glomerular filtration rate, fasting plasma glucose, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and coronary artery calcium score, the highest quartile of SUA in women was significantly associated with increased risk of high baPWV compared with the lowest quartile of SUA (OR = 1.7, p = 0.018), whereas in men, SUA level was not associated with high baPWV. Our study showed that elevated SUA is independently associated with increased baPWV in healthy Korean women, but not in men.

Sex-specific association between serum uric acid and self-reported snoring in rural China: a cross-sectional study.

Until now, information has been rare on the association of serum uric acid (SUA) with self-reported snoring. Therefore, the purpose of this study was to explore the sex-specific relationship between SUA and self-reported snoring in a general Chinese population. A large cross-sectional study of 10,912 participants aged ≥35years old were recruited from rural areas of Liaoning Province in China during 2012 to 2013. SUA were divided into quartiles separated for males and females. Anthropometric measurements and blood biochemical indexes were examined according to standard protocols. Sleep duration and self-reported snoring status were investigated by trained personnel using a structured questionnaire. The prevalence of self-reported snoring was 37.9% (n=2197) among females and 47.4% (n=2420) among males, respectively. The proportion of self-reported snoring presented a significant linear increase across the quartile of SUA level in both sexes. In multivariate logistic regression analysis adjusted for possible confounders, the odds ratio (OR) for SUA with regard to self-reported snoring was significantly higher in females. The OR of self-reported snoring associated with per 1 SD increase in SUA was 1.208 (95%CI 1.118-1.305, P<0.001). The highest quartile of SUA (>293μmol/L) conferred an independently increased risk for self-reported snoring with OR of 1.643 (95%CI 1.384-1.950, p<0.001) compared to the lowest quartile of SUA (<209μmol/L). However, there were no significant relationships between SUA and self-reported snoring among males in all the models. Our study showed that in rural China, SUA was positively correlated with an increased risk for self-reported snoring in females but not in males. The strong association of SUA levels with self-reported snoring in females emphasizes the necessity of stratifying the sex in investigations of self-reported snoring and encourages exploration of SUA as an effective clinical tool of self-reported snoring risk.

Increased Serum Uric Acid Level Is a Risk Factor for Left Ventricular Hypertrophy but Not Independent of eGFR in Patients with Type 2 Diabetic Kidney Disease.

Background Although the relation between serum uric acid (SUA) and left ventricular hypertrophy (LVH) has been studied for decades, however, their association remains debatable. Methods This is a retrospective study in which a total of 435 hospitalized Chinese patients with type 2 DKD were enrolled. The subjects were stratified into quartiles according to SUA level. LVH was assessed by two-dimensional guided M-mode echocardiography. Results There was a significant increase in the prevalence of LVH in patients with type 2 DKD across SUA quartiles (28.9, 26.5, 36.1, and 49.5%; p < 0.001). The Spearman analysis indicated that SUA was positively correlated to LVMI and negatively correlated to eGFR. The logistic regression analysis revealed that the odd ratio for LVH in the highest SUA quartile was 2.439 (95% CI 1.265–4.699; p = 0.008; model 1) or 2.576 (95% CI 1.150–5.768; p = 0.021; model 2) compared with that in the lowest SUA quartile. However, there was no significant increased risk of LVH in the subjects with the highest SUA quartile after adjusting the eGFR (OR = 1.750; 95% CI 0.685–4.470; p = 0.242; model 3). Conclusions In selected population, such as type 2 DKD, the elevated SUA level is positively linked with the increased risk of LVH, but this relationship is not independent of eGFR.

Relationship Between Serum Uric Acid and Incident Hypertension in Patients with Type 2 Diabetes.

Little is known about the relationship between high baseline serum uric acid (SUA) and incident hypertension in patients with type 2 diabetes (T2D). To evaluate the ability of baseline SUA to predict the incidence of hypertension in non-hypertensive patients with T2D. The association between SUA and mean 20-year incidence of hypertension was examined in 1,666 non-hypertensive patients with T2D from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran. The primary outcome was incident hypertension defined as systolic blood pressure (BP) of 140 mmHg or higher and/or diastolic BP 90 mmHg or higher and/or use of antihypertensive medications. The mean (standard error (SE)) age of participants was 49.4 years (0.25 years) with a mean (SE) duration of diabetes of 6.1 years (0.15 years) at initial registration. We used multiple logistic regression to estimate the odds ratio (OR) for the incidence of hypertension across quartiles of SUA, and plotted a receiver operating characteristic (ROC) curve to assess discrimination. The highest quartile of SUA was not associated with hypertension compared with the lowest quartile in multivariable adjusted models (OR: 1.22, 95% CI: 0.87, 1.73). The area under the ROC curve for SUA was 51.7% (95% CI: 48.9, 54.5). High initial SUA levels are not a predictor of incident hypertension in an Iranian T2D population.

Sex-specific association between serum uric acid and prolonged corrected QT interval: Result from a general rural Chinese population.

Recently, it has been found that high level of serum uric acid (SUA) is causally related to sudden cardiac death (SCD). We examined the sex-specific associations of SUA with prolonged heart rate-corrected QT (QTc) interval in a general Chinese population.A large sample of 11,206 Chinese research participants aged 35 years and older was recruited from rural areas of Liaoning Province during 2012 to 2013. SUA were divided into quartiles separated for males and females. Prolonged QTc interval, assessed by the Bazett formula, was defined as cut points of 460 ms or longer in females and 450 ms or longer in males. Mean (+/− standard deviation) QTc intervals were 422.1 ± 24.2 ms among 5104 males and 436.1 ± 23.5 ms among 6102 females, respectively. In both sexes, SUA showed significant correlations with QTc interval (both P < 0.001). Among male participants, the highest quartile of SUA (>379 μmol/L) was related to an increased risk for prolonged QTc interval (odds ratios: 1.402, 95% confidence interval: 1.073–1.831) compared to the lowest quartile (≤276 μmol/L) after fully adjustment. However, there were no significant relationships between SUA and prolonged QTc interval among females in all the models.Males with high SUA are prone to a higher risk for prolonged QTc interval. This study provides novel explanation for population-based findings on SUA and SCD, as well as important implications for management strategies for hyperuricemic patients in clinical practice.

Association between Serum Uric Acid and Mortality among Chinese Patients with Coronary Artery Disease

Objectives: Several studies have investigated the association between serum uric acid (SUA) and the risks of coronary artery disease (CAD) but have yielded inconsistent results. The aim of this study was to assess whether there is an independent association of SUA with all-cause and cardiovascular disease (CVD) mortality in Chinese patients with CAD. Methods: A prospective cohort study of 1,799 patients was conducted. Cox regression models were used to estimate the association of SUA with the risk of death. Results: During a median follow-up of 3.9 years, 177 deaths were recorded and 126 of these were due to CVD. Patients in the highest SUA quartile had a 2.43-fold risk of all-cause mortality and a 2.44-fold risk of CVD mortality compared with those in the lowest quartile. In the subpopulation analysis, the association between SUA and mortality remained similar when participants were stratified by age, gender, body mass index and type of CAD. In contrast, we found a significant interaction with estimated glomerular filtration rate (eGFR). There was a stronger association between SUA and the risk of all-cause and CVD mortality among patients with an eGFR ≥60 ml/min/1.73 m², but no significant association was found in the population with an eGFR <60 ml/min/1.73 m². Conclusions: Elevated SUA levels were positively associated with an increased risk of all-cause and CVD mortality among CAD patients.

Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the High-Risk Myocardial Infarction Database Initiative.

Serum uric acid (SUA) levels are associated with poorer outcomes in healthy cohorts and patients with stable and unstable coronary heart disease. We investigated the relationship between SUA and clinical outcomes in subjects with acute myocardial infarction (MI) complicated by reduced left ventricular (LV) function, heart failure (HF), or both. Univariable and multivariable Cox proportional hazards modelling was performed to study the association of baseline SUA and all-cause mortality, cardiovascular (CV) mortality, and HF hospitalization in an individual patient meta-analysis of four merged large randomized trials (CAPRICORN, EPHESUS, OPTIMAAL, and VALIANT). Three trials (excluding VALIANT) reported SUA, which was available in a total of 12 677 subjects. The ranges of SUA for quartiles I-IV were 45-280, 281-344, 345-420, and 420-1640 mmol/L, respectively. While almost 90% of patients in the lowest SUA quartile were alive after a mean follow-up of 23 ± 11 months, <70% were alive in the highest SUA quartile. Compared with the lowest SUA quartile as reference, hazard ratios (HRs) and 95% confidence intervals (CIs) of SUA quartiles III and IV showed an increase in all-cause mortality [HR 1.18, 95% CI 0.95-1.46, and HR 1.36, 95% CI 1.11-1.67) and CV mortality (HR 1.27, 95% 1.01-1.61, and HR 1.47, 95% CI 1.17-1.83). SUA quartiles III and IV also exhibited increased HF hospitalization (HR 1.22, 95% CI 1.09-1.36, and HR 1.28, 95% CI 1.14-1.43; P < 0.001 for all comparisons) in multivariable analyses. The addition of SUA was associated with a significant improvement in reclassification to predict CV mortality (net reclassification improvement 17.6%, 95% CI 14.9-20.5%, P < 0.001). Elevated SUA is associated with poor outcomes in patients after MI complicated by reduced LV function, HF, or both. The quantification of SUA, a low-cost routinely available biomarker, could improve risk stratification of patients with complicated MI.

Uric Acid as a Risk Factor for Cardiovascular Disease and Mortality in Overweight/Obese Individuals

BackgroundThe predictive value of serum uric acid (SUA) for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.MethodsThe relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death) and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD). Cox models were used to assess the role of SUA as an independent risk factor.Results9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death), and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20–2.10). In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72–1.36) nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08–2.12). No relationship was observed in men (HR: 1.06; 95% CI: 0.82–1.36).ConclusionSUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all-cause mortality in women.