Hyperuricemia Group Research Articles

Insulin resistance has closer correlation with the occurrence of metabolic dysfunction associated steatotic liver disease diagnosed by liver biopsy

ObjectiveTo explore any correlation between serum urate (SU) level or insulin resistance (IR) and metabolic dysfunction associated steatotic liver disease (MASLD) in patients with metabolic syndrome (MS).MethodsData from all MASLD patients, diagnosed by liver biopsy, were enrolled and divided into MASLD alone group and MASLD with MS group. They were subdivided into hyperuricemia group and normal SU group to find correlation between SU/IR and MASLD in patients with MS and independent risk factors for MASLD.ResultsData from 539 MASLD patients were analyzed. Body mass index (BMI) (p = 0.000), waist circumference (WC) (p = 0.004), and low-density lipoprotein (LDL) (p = 0.000) were dramatically higher in MASLD with MS group than those with MASLD alone; MASLD with MS patients had significantly more family history of diabetes (p = 0.000) and hypertension (p = 0.000) than patients with MASLD alone. Height (p = 0.000), weight (p = 0.000), BMI (p = 0.000) and WC (p = 0.001), and LDL (p = 0.007) were dramatically higher in hyperuricemia patients than those with normal SU. SU was inversely associated with age (p = 0.000) and high-density lipoprotein (HDL) (p = 0.003), and positively correlated with weight (p = 0.000), BMI (p = 0.000) and WC (p = 0.000), TG (p = 0.000), and LDL (p = 0.000). Logistic Regression analysis showed that age (p = 0.031), TG (p = 0.002), LDL (p = 0.010), HbA1c (p = 0.026), and family history of hypertension (p = 0.000) may be independent risk factors for MASLD in patient with MS.ConclusionInsulin resistance (IR) in MASLD patients with MS, but not higher SU levels, has closer correlation with the occurrence of MASLD in patients with family history of hypertension and diabetes having higher BMI, LDL, HbA1c.

Uric acid mediates kidney tubular inflammation through the LDHA/ROS/NLRP3 pathway

ABSTRACT Purpose Hyperuricemia (HUA) is an important factor leading to chronic kidney disease (CKD). The kidney tubular inflammatory response is activated in HUA. This study aimed to investigate whether lactate dehydrogenase A (LDHA) is involved in mediating uric acid-induced kidney tubular inflammatory response. Methods In vivo, an HUA mouse model was established by continuous intraperitoneal injection of potassium oxonate (PO) for one week. A total of 18 C57BL/6J male adult mice were divided into three groups: control group, HUA group, and HUA+oxamate group, with six mice in each group. Oxamate was intraperitoneally injected into the mice one hour after PO injection. In vitro, an HUA model was simulated by stimulating HK-2 cells with uric acid. Oxamate and tempol inhibited LDHA and reactive oxygen species (ROS) in HK-2 cells. Results In HUA mice, blood uric acid levels were significantly elevated. LDHA in kidney tubular cells was significantly increased in both in vivo and in vitro HUA models, accompanied by an increase in kidney tubular inflammation and ROS. Mechanistically, LDHA mediates uric acid-induced inflammation to kidney tubular cells through the ROS/NLRP3 pathway. Pharmacologic inhibition of LDHA or ROS in kidney tubular cells can significantly ameliorate inflammation response caused by uric acid. Conclusions LDHA in kidney tubular cells significantly was increased in HUA models. LDHA mediates kidney inflammation response induced by uric acid through the ROS/NLRP3 pathway. This study may provide a new intervention target for preventing kidney tubular inflammation caused by uric acid.

Association of serum uric acid levels with glycated haemoglobin in diabetic patients and healthy controls

ABSTRACT Introduction: Uric acid is formed from purine degradation. Hyperuricemia has emerged as a risk factor for various metabolic diseases including Diabetes mellitus (DM). Uric acid may act as a glucometabolic indicator for Type 2 Diabetes mellitus (T2DM). Glycated haemoglobin (HbA1c) is an indicator of long-term glycaemic control used for diagnosing and monitoring T2DM. However, the association between HbA1c and uric acid is controversial. The present study aimed to study the association of serum uric acid (SUA) levels with HbA1c. Materials and Methods: This cross-sectional comparative study was conducted in a Tertiary Care Hospital in Northern India after permission from the institutional Ethical committee. The study included patients attending the Outpatient Department of the hospital during the study period. Diagnosed cases of DM as per World Health Organization criteria were included as cases. Controls comprised of apparently healthy subjects of the age group 18–50 years attending OPD Patients and Health Care workers. Both cases and control were divided into two groups those with normal uric acid levels and the hyperuricemia group in both males and females to study the association between HbA1c and uric acid levels. Results: The study constituted 1460 participants of which 880 control and 580 DM. The overall prevalence of hyperuricemia was 17.8%. HUA prevalence was 17.04%–18.9% in the control and diabetic population, respectively. SUA levels in T2DM patients were negatively correlated with glycated HbA1c, and FBS whereas positively correlated with glycated HbA1c in controls. Conclusion: While non-diabetic individuals tend to exhibit higher SUA levels, a decreasing trend has been observed in diabetic individuals. A negative association was observed between SUA level and HbA1c in DM in contrast to controls. Therefore, the utilization of SUA as a marker for assessing glucose metabolism should be approached with careful consideration taking care of these complex dynamics.

Impact of Hyperuricemia on Clinical Outcomes in Sepsis Patients: A Retrospective Cohort Study.

Background: Hyperuricemia has been linked to various adverse clinical outcomes. Data on the clinical outcomes and the relationship between hyperuricemia and sepsis remain limited. The aim of this study was to evaluate the impact of hyperuricemia on clinical outcomes in sepsis patients and to identify whether it can predict the mortality in this patient population. Methods: This was a retrospective cohort study of adult patients with sepsis admitted to the intensive care unit (ICU) from 1 January 2021 to 31 December 2023. The patients were divided into hyperuricemia and non-hyperuricemia groups. Hyperuricemia was defined as a serum uric acid level > 416.4 µmol/L (7.0 mg/dL) in males or >357.0 µmol/L (6.0 mg/dL) in females based on the first serum uric acid reading within 24 h of ICU admission. The primary outcome of this study was ICU mortality. Secondary outcomes included in-hospital mortality, progression to septic shock, and ICU and hospital lengths of stay (LOSs). Results: A total of 599 patients were included in the study. Among these, 303 were in hyperuricemia group, while 296 were in the non-hyperuricemia group. The incidence of ICU and in-hospital mortality was higher in the hyperuricemia group compared to the non-hyperuricemia group (26.7% vs. 18.9% (p < 0.001) and 34.7% vs. 19.3% (p < 0.001), respectively). After adjusting for cofounders, hyperuricemia was not a predictor of ICU mortality (OR 1.52, 95% CI 0.95-2.43, p = 0.083). Most secondary outcomes were similar between the groups. However, the hyperuricemia group had a higher incidence of progression to septic shock (67.3% vs. 50.7%, p < 0.001), and hospital LOS was significantly longer in the hyperuricemia group (384 vs. 264 h, p = 0.004). Conclusions: Our findings demonstrated that hyperuricemia in sepsis patients was associated with worse clinical outcomes such as higher ICU and hospital mortality. Moreover, there was a higher incidence of septic shock progression and longer hospital LOS. The other outcomes were not statistically significantly different. Further prospective research is warranted to confirm these findings.

Serum Autotaxin Level Positively Associates with Metabolic Associated Fatty Liver Disease and Hyperuricemia in Postmenopausal Women.

Autotaxin is an adipokine known to affect energy metabolism and lipid homeostasis. We aimed to evaluate serum autotaxin levels in metabolic associated fatty liver disease (MAFLD) and other metabolic disorders in postmenopausal women. Postmenopausal women who received an annual health examination were included. The metabolic and demographic characteristics of the subjects were collected, including age, gender, weight, height, blood pressure, and biochemical parameters. Serum autotaxin level was determined by ELISA. This cross-sectional includes 20 postmenopausal women and 20 age-paired healthy controls. MAFLD patients showed significant metabolic disturbance presented with increased BMI, blood pressure (P＜0.001) and decreased HDL-C (P＜0.05), as well as liver injury companied by elevated ALT (P＜0.05). Serum autotaxin levels were statistically higher in MAFLD (253.1±52.1 vs. 202.2±53.2 ng/mL; P &lt; 0.01) and positively correlated with ALT (P＜0.001), GGT and BMI (P＜0.01), SBP and TG (P＜0.05). Higher autotaxin group demonstrated worsen metabolic states with greater proportion of MAFLD, higher BMI (P＜0.01) and ALT (P＜0.05). Logistic regression analysis revealed that serum autotaxin levels would positively independently predicted MAFLD (OR 1.049, 95% CI 1.001-1.098, P＜0.05) with AUC of 0.763. Serum level of autotaxin is significantly elevated in hyperuricemia group (257.3±60.9 vs. 214.5±49.4 ng/mL; P &lt; 0.05), and positively correlated with uric acid level (P＜0.01). Serum autotaxin would also act as diagnosing parameter of hyperuricemia with AUC of 0.706. Among postmenopausal women, serum autotaxin level is significantly elevated in MAFLD and related to multiple metabolic characteristics, especially hyperuricemia, which would thus serve as a potential non-invasive biomarker as well as a therapeutic target.

Clinical and instrumental characteristics of osteoarthritis in hyperuricemia

Objective: to investigate in a multicentre single-stage study the relationships between hyperuricemia (HU) and clinical, instrumental and laboratory parameters of osteoarthritis (OA).Material and methods. The study included 200 patients aged 40 to 75 years with a definite diagnosis of knee (KN) OA that met ACR criteria, with stage I–III OA by Kellgren–Lawrence. The mean age of the patients was 55.9±10.3 years and the body mass index (BMI) was 29.4±6.2 kg/m2. An individual chart was completed for each patient, including anthropometric parameters, medical history and clinical examination data, visual analogue scale (VAS) assessment of KN pain, WOMAC, patient's general health assessment (GHA) and information on comorbidities. All patients underwent standard radiography and magnetic resonance imaging (MRI) of the KN (WORMS), dual-energy X-ray absorptiometry of the lumbar spine and femoral neck, and laboratory examination.Results and discussion. HU was diagnosed in 57 (28.5) patients when the serum uric acid (UA) level was above 360 μmol/L. Patients were divided into two groups according to the presence or absence of HU. The age of the patients in the two groups was comparable, but they differed significantly in terms of disease duration, BMI, waist and hip circumference, which were greater in the HU group (p &lt;0.05). Statistically significant differences were also found in the assessment of the severity of OA course: there were higher pain indices according to VAS, WOMAC total score and its components (pain and functional impairment, FI), GHA in the HU group. On MRI, osteitis was more common in the medial aspect of the tibia (odds ratio 5.75; 95% confidence interval 1.29–25.6; p=0.03). Patients with HU had higher concentrations of CRP, COMP, leptin, insulin, triglycerides and creatinine (p &lt;0.05 for all values).Spearman correlation analysis confirmed the association between HU and duration and radiological stage of OA, the presence of osteitis in the medial aspect of tibia detected by MRI, pain according to VAS and WOMAC, FI according to WOMAC and GHA (p&lt;0.05).Conclusion. At high UA levels, pain values according to VAS and WOMAC are higher, GHA is worse, and CRP and COMP levels are elevated. MRI shows more frequent osteitis in the medial aspect of the tibia in patients with HU. Deciphering the mechanisms that determine the relationship between HU and OA is important for the development of new methods for the prevention and treatment of these diseases.

Hyperuricaemia elevates risk of short-term readmission and mortality in patients with heart failure.

Heart failure (HF) is a leading cause of morbidity and mortality worldwide. Serum uric acid (SUA), a product of purine metabolism, has been implicated in HF progression. However, the association between hyperuricaemia and the short-term readmission and mortality in patients with HF remains controversial. In this retrospective cohort study, we analysed data from a HF database specific to the Chinese population. The primary endpoint was short-term readmission or all-cause mortality within 90 days. Participants with HF were categorised into normouricaemia group (NUA) and hyperuricaemia group (HUA) based on a SUA threshold of 420 µmol/L. The association between SUA and primary endpoint was evaluated using Kaplan-Meier survival curves and Cox regression analysis. Baseline characteristics revealed significant differences between NUA and HUA groups, with the latter exhibiting a higher prevalence of males, chronic kidney disease (CKD) and elevated levels of various biomarkers. During a 90-day follow-up, 493 (26.6%) participants reached the primary endpoint, with a higher incidence observed in the HUA group at 31.2%, compared with 20.1% in the NUA group. When a threshold effect was identified at 420 µmol/L, a non-linear association was observed between SUA and the primary endpoint. After adjusting for gender, age, New York Heart Association class, CKD, systolic blood pressure (SBP) and potassium, the HUA group exhibited a higher risk for the primary endpoint compared with the NUA group (HR: 1.40, 95% CI: 1.14 to 1.72, p=0.001). Additionally, the risk increased across quartiles of SUA (P for trend=0.002). Furthermore, stratified analyses indicated a stronger association in patients without CKD (P interaction=0.033). Hyperuricaemia is independently associated with an increased risk of short-term readmission and mortality in patients with HF. Our findings suggest that monitoring and managing SUA could be crucial in improving patient with HF outcomes.

Effect of konjac glucomannan on gut microbiota from hyperuricemia subjects in vitro: fermentation characteristics and inhibitory xanthine oxidase activity.

The disorder of uric acid metabolism is closely associated with gut microbiota and short-chain fatty acids (SCFAs) dysregulation, but the biological mechanism is unclear, limiting the development of uric acid-lowering active polysaccharides. Konjac glucomannan (KGM) could attenuate metabolic disturbance of uric acid and modulate the gut microbiota. However, the relationship between uric acid metabolism and gut microbiota is still unknown. In this study, The fecal samples were provided by healthy volunteers and hyperuricemia (HUA) patients. Fecal samples from healthy volunteers was regarded as the NOR group. Similarly, 10% HUA fecal suspension was named as the HUA group. Then, fecal supernatant was inoculated into a growth basal medium containing glucose or KGM, and healthy fecal samples were designated as the NOR-GLU and NOR-KGM groups, while HUA fecal samples were designated as the HUA-GLU and HUA-KGM groups. All samples were cultured in an anaerobic bag system. After fermentation for 24 h, the samples were collected for further analysis of composition of intestinal microbiota, SCFAs concentration and XOD enzyme activity. The results showed that KGM could be utilized and degraded by the gut microbiota from HUA subjects, and it could modulate the composition and structure of their HUA gut microbiota to more closely resemble that of a healthy group. In addition, KGM showed a superior modulated effect on HUA gut microbiota by increasing Megasphaera, Faecalibacterium, Lachnoclostridium, Lachnospiraceae, Anaerostipes, and Ruminococcus levels and decreasing Butyricicoccus, Eisenbergiella, and Enterococcus levels. Furthermore, the fermentation solution of KGM showed an inhibitory effect on xanthine oxidase (XOD) enzyme activity, which might be due to metabolites such as SCFAs. In conclusion, the effect of KGM on hyperuricemia subjects was investigated based on the gut microbiota in vitro. In the present study. It was found that KGM could be metabolized into SCFAs by HUA gut microbiota. Furthermore, KGM could modulate the structure of HUA gut microbiota. At the genus level, KGM could decrease the relative abundances of Butyricicoccus, Eisenbergiella, and Enterococcus, while Lachnoclostridium and Lachnospiraceae in HUA gut microbiota were significantly increased by the addition of KGM. The metabolites of gut microbiota, such as SCFAs, might be responsible for the inhibition of XOD activity. Thus, KGM exhibited a superior probiotic function on the HUA gut microbiota, which is expected as a promising candidate for remodeling the HUA gut microbiota.

Serum creatinine is more strongly associated with hyperuricemia than eGFR in males but not in females.

Serum creatinine and estimated glomerular filtration ratio (eGFR) are factors associated with hyperuricemia, though which is more closely associated with hyperuricemia remains unclear. This retrospective cross-sectional study examined the associations of serum creatinine and eGFR with hyperuricemia using health check-up findings. Enrolled were 6020 individuals (3509 males, 2511 females) who underwent health check-ups from 2017 to 2021. The subjects were divided based on serum uric acid level into the normuricemia (males 1.5-7.0 mg/dl, females 1.5-< 6.0 mg/dl) and hyperuricemia (males >7.0 mg/dl, female ≥ 6.0 mg/dl) groups. Matched-pair analysis was used to evaluate the association between hyperuricemia and variables related to serum uric acid. Matched-pair analysis results showed a significant association of serum creatinine with hyperuricemia in male subjects but not in females. Furthermore, propensity score obtained by binominal logistic regression demonstrated that serum creatinine had a greater association with hyperuricemia than eGFR in the males but not in females. The present findings indicate an association of serum creatinine with hyperuricemia in males not only because of reduced renal function but other factors related to greater muscle mass, such as increased intake of protein-rich foods containing purines and increased uric acid production induced by accelerated creatinine metabolism.

The relationship between serum uric acid level and carotid intima-media thickness in hemodialysis patients.

We aimed to evaluate the relationship between carotid intima-media thickness (CIMT), which is a known indicator of cardiovascular risk and atherosclerosis, and uric acid level, which may be an easy marker for cardiovascular diseases due to its antioxidant and pro-oxidant properties in hemodialysis patients. In this cross-sectional study, we evaluated 77 hemodialysis patients. The mean CIMT of these patients was measured and recorded by Doppler ultrasonography. Patients were divided into two groups according to their serum uric acid levels. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. The mean CIMT levels in the normouricemic group and the hyperuricemic group were 0.95 ± 0.15 and 1.07 ± 0.15, respectively. There was a statistically significant difference between the two groups (p = 0.001). There was a statistically significant and moderate linear correlation between serum uric acid level and mean CIMT (r = 0.402; p = 0.002). Univariate and multivariate linear regression analyses were performed to identify variables that could independently affect the mean CIMT value. According to analysis, uric acid (p < 0.001), hypertension (p = 0.008), albumin (p = 0.029), and C-reactive protein (p = 0.042) were found independent risk factors for mean CIMT value. We found a significant relationship between serum uric acid level and CIMT, which indicates carotid atherosclerosis. Serum uric acid level is a low-cost laboratory parameter that can be measured in almost all laboratories, and it may be valuable in the hemodialysis patient group to identify patients at high risk of carotid atherosclerosis.

Association between Neck Circumference and Asymptomatic Hyperuricemia in Nearly Healthy Adults: A Review of 2019-2020 Cross-Sectional Korean Nationwide Data.

Neck circumference (NC) measurement has been recently developed as a simple and time-saving anthropometric method for predicting cardiovascular risk. Asymptomatic hyperuricemia is known as one of the cardiovascular risk factors. This study investigated the association between NC and asymptomatic hyperuricemia among the general population of Korea. This cross-sectional study examined data from 7,629 participants in the 2019-2020 Korea National Health and Nutrition Examination Survey. Multivariable logistic regression analysis was used to identify the factors associated with hyperuricemia. Approximately 10% of participants corresponded to hyperuricemia group who were likely to be male, have more comorbidities, poorer habits, and larger NC. Multivariable regression analysis revealed that NC was significantly associated with hyperuricemia in women (OR 1.17; 95% CI 1.06-1.30), but not in men (OR 1.04; 95% CI 0.96-1.12). A large NC is independently correlated with hyperuricemia among Korean women.

Preexisting Hyperuricemia Before High-Altitude Ascent is Associated with a Slower Recovery of Estimated Glomerular Filtration Rate Following Descent.

Zhao, Linggong, Yujie Huang, and Xiaoling Tan. Preexisting hyperuricemia before high-altitude ascent is associated with a slower recovery of estimated glomerular filtration rate following descent. High Alt Med Biol. 00:00-00, 2024. Objectives: Hypoxia at high altitudes results in elevated uric acid (UA) and reduced estimated glomerular filtration rate (eGFR). However, the impact of a prolonged high-altitude sojourn on UA levels and renal function in patients with preexisting hyperuricemia warrants further exploration. The study was to investigate the eGFR and related factors in patients with preexisting hyperuricemia following exposure to high altitude. Methods: The study included 345 participants, who worked at a high altitude for 1 year. Anthropometric and laboratory indices were collected before ascent (i.e., baseline), as well as 20 and 80 days after descent. The participants were categorized into individuals with hyperuricemia (HUA) or normal uric acid (NUA) group based on the presence or absence of hyperuricemia at baseline. Results: No difference in baseline eGFR was observed between the two groups before ascend or on day 20 after descent (p > 0.05). However, on day 80, eGFR of the HUA group was lower compared with the NUA group (p < 0.05). Correlations existed between post-descent eGFR levels and variables, including sampling time, UA levels, total and direct bilirubin, and baseline grouping. Conclusions: After high-altitude exposure, the recovery of eGFR was delayed in participants with preexisting hyperuricemia. Preexisting hyperuricemia and high-altitude hypoxia jointly contribute to renal impairment.

Study the Effect of Olibanum (Boswellia Carterii) on Hyperuricemia in Rat’s Module

A current investigation aimed to assess the antihyperuricemic activity of the Boswellia Carterii plant and investigate the action of urate-lowering effect in a rat pattern of hyperuricemia generated by potassium-oxonate. Rats used in the research were randomized into five groups (n=6). The rats in the negative group, allopurinol group, olibanum 50 mg/kg group, and olibanum 100 mg/kg group received intraperitoneal injections of potassium oxonate (PO) twice a week at a dose of 250 mg/kg. The normal control group was supplied food and drink without any intervention. As a positive one control group, the olibanum 50 mg/kg group received daily oral administration of 50 mg/kg of olibanum powder dissolved in 0.5 L of distal water, and the positive two olibanum 100mg/kg group treated with 100mg/kg of olibanum powder dispersed in 0.5L of distal water orally each day. Allopurinol (5mg/kg) was administered orally to rats in the allopurinol group daily. Each group's animals were slaughtered, blood was taken, and serum was isolated for uric acid (UA) laboratory analysis and other biochemical parameters. Uric acid (UUA) and creatinine (UCr) in urine were also measured. The investigation results demonstrated a significantly substantial reduction in blood UA and modest inhibition of xanthine oxide (XOD) in rats with hyperuricemia that were given olibanum solution. Compared to the hyperuricemic control group, all groups showed non-significant variations in the kidney (Urea and CreaC) and liver (ALT, AlkP, and AST) functioning.

Effect of hyperuricemia on paroxysmal atrial fibrillation after catheter ablation and influence of alcohol consumption.

Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence. Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; n = 114) and control (UA ≤7.0 mg/dL; n = 609) groups and were followed for a median of 24 (12-48) months after ablation. The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, p = .017) and a lower incidence of AF-free survival (p = .019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF-free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12-2.40), female gender (1.91, 1.36-2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14-2.22), and alcohol consumption ≥20 g/day (1.49, 1.03-2.15) (all p < .05). In addition, causal mediation analysis revealed that alcohol consumption of ≥20 g/day directly affected AF recurrence, independent of hyperuricemia. Patients with hyperuricemia may be at a high risk of arrhythmia recurrence after catheter ablation for paroxysmal AF. Although high alcohol consumption may contribute to increased UA levels, the presence of hyperuricemia may independently predict AF recurrence.

The Combination of Hyperuricemia and Elevated High-Sensitivity C-Reactive Protein Increased the Risk of Cardiac Conduction Block.

This study aimed to explore the impact of a combination of hyperuricemia (HUA) and excessive high-sensitivity C-reactive protein (hs-CRP) levels on the likelihood of developing cardiac conduction block (CCB). Additionally, it sought to assess whether the influence of uric acid (UA) on CCB is mediated by hs-CRP. A prospective study was executed utilizing data from the Kailuan cohort, including 81,896 individuals initially free from CCB. The participants were categorized into four groups depending on the existence of HUA and low-grade inflammation (hs-CRP>3 mg/L). Cox regression analysis was employed to ascertain hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of incident CCB. A mediation analysis was performed to determine if hs-CRP functioned as a mediator in the connection between UA levels and the incidence of CCB. During a median observation period of 11.8 years, we identified 3160 cases of newly occurring CCB. Compared with the low UA/low CRP group, the combination of HUA and low-grade inflammation elevated the CCB risks (HR:1.56, 95% CI:1.22-1.99), atrioventricular block (AVB) (HR:1.88, 95% CI:1.27-2.77), and right bundle branch block (HR:1.47, 95% CI:1.02-2.12), respectively. Mediation analysis revealed that in the HUA group, compared with the non-HUA group, the risk of CCB elevated by 14.0%, with 10.3% of the increase mediated through hs-CRP. HUA combined with elevated hs-CRP increasedthe risk of CCB, especially AVB. The connection between UA and the CCB risk was partly mediated by hs-CRP.

Dietary polyunsaturated fatty acids intake is negatively associated with hyperuricemia: The National Health and Nutrition Examination Survey 2003–2015

Background and aimsThe objective of this research was to explore the associations between dietary PUFAs intake and hyperuricemia risk. Methods and resultsBased on the National Health and Nutrition Examination Survey (NHANES) 2003–2015, all eligible individuals were divided into hyperuricemia and non-hyperuricemia groups based on diagnostic criteria for hyperuricemia (serum uric acid >420 μmol/L for men and >360 μmol/L for women). Multivariate-adjusted logistic regression was employed to explore the relationship between dietary PUFAs intake and hyperuricemia risk. Total PUFAs and their subtypes were modeled to isocalorically replace saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs). Higher intake of n-3 PUFAs, n-6 PUFAs, linoleic acid (LA), alpha-linoleic acid (ALA), and non-marine PUFAs intake correlated with decreased hyperuricemia risk, with adjusted odds ratio (OR) and 95% confidence interval (95%CIs) were 0.77 (0.63, 0.93), 0.75 (0.61, 0.92), 0.75 (0.61, 0.91), 0.69 (0.55, 0.87), and 0.73 (0.59, 0.91), respectively. Replacing 5% of total energy intake from SFAs with isocaloric PUFAs was associated with decreased odds of hyperuricemia in men (0.69 (0.57, 0.84)) and in individuals (0.81 (0.71, 0.92)). Similar trends were observed in the substitution of SFAs with non-marine PUFAs in men (0.87 (0.80, 0.94)) and in all individuals (0.92 (0.88, 0.98)). Sensitivity analyses exhibited consistent results with primary analyses. ConclusionHigher dietary intake of n-3 PUFAs, n-6 PUFAs, LA, ALA, and non-marine PUFAs was associated with decreased hyperuricemia risk. These results support the recommendation to substitute SFAs with PUFAs in diet.

Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study

PurposeIt is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DesignMulticenter prospective international cohort study. SettingFourteen university hospitals in Spain and the United Kingdom. ParticipantsWe studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥ 4 points, from July to December 2017. InterventionsNone. Measurements and main resultsAKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81–3; P = .17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93–1.19, P = .37). ConclusionsHyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.

Hyperuricemia Increases the Risk of Postoperative Recurrence in Chinese Patients with Chronic Rhinosinusitis.

Elevated serum uric acid is crucial in the pathophysiology of chronic inflammatory diseases. However, its impact on chronic rhinosinusitis (CRS) recurrence risk is unknown. This study investigates the association between elevated serum uric acid and the risk of CRS recurrence. A retrospective cohort study was conducted on 1004 CRS patients (including 638 males and 366 females) who received functional endoscopic sinus surgery. All patients were followed up for more than 2 years, and categorized into subgroups based on phenotype, gender, and postoperative recurrence. Cox regression analysis was performed to evaluate the associations between serum uric acid and the risk of CRS recurrence. After categorization, 104 males had hyperuricemia, and 54 females presented hyperuricemia. The rate of recurrent CRS in the hyperuricemia group was significantly higher compared to the non-hyperuricemia group in both males and females (P<0.05). In both male and female patients, the rate of hyperuricemia and uric acid levels were elevated in the recurrent CRS group in comparison with the non-recurrent CRS group (P<0.05). Unadjusted and adjusted Cox regression analysis demonstrated that serum uric acid was an independent risk factor for CRS recurrence (P<0.05). The receiver operator characteristic curve showed that serum uric acid was a potential biomarker for predicting the recurrence of CRS and its phenotypes in both genders (P<0.05). There is a close relationship between elevated serum uric acid and the recurrence risk of CRS and its phenotypes, suggesting that serum uric acid may be a novel biomarker for predicting recurrent CRS.

CLINICAL FEATURES OF MANAGEMENT OF PATIENTS WITH HYPERURICEMIA IN COMBINATION WITH ARTERIAL HYPERTENSION AND CHRONIC HEART FAILURE

Objective: To evaluate clinical and diagnostic features of patients with AH and CHF combined with hyperuricemia. Design and method: The study included 49 patients divided into two groups: Group 1 - 32 patients with AH and CHF on the background of elevated uric acid (UA) 24(75%) men, 8 (25%) women, median age 66.0 (59.0;75.0) years and Group 2 - 20 patients with AH and CHF without hyperuricemia: 13 (65%) men, 7 (35%) women, median age 69.0 (63.0;73.5) years). Clinical data, laboratory and instrumental investigations were analyzed. Results: Comparative analysis showed that patients in the group with normal MC levels compared to patients in the hyperuricemia group had higher SCF (62 and 57 ml/min/1.73 m2 (p=0.04) respectively). A negative correlation of medium strength between blood MC level and LVEF was also observed, with lower values in group 1 patients (52.4 and 59.5, respectively). Differences were also observed when NTproBNP level was determined (385.5-2500.4) (R=-0.64 p&lt;0.01). Separately it should be noted that out of 32 patients included in the study, 6 patients showed resistance to standard doses of diuretics, which required intensification of therapy in the form of increasing their dose. In a comparative analysis, MC levels were significantly higher in patients who subsequently underwent intensified therapy compared with patients with a satisfactory response to standard diuretic doses [543.8 (459.4-719.9) and 485(422.4-605.4), respectively; p=0.011]. Conclusions: The performance of this study further confirmed the high prevalence of hyperuricemia in AH and CHF. Moreover, the severity of hyperuricemia increased in parallel with the increase in the severity of CHF (according to NYHA FC and NUP concentration). Therefore, the patient management strategy should include screening and correction of purine metabolism. One of the main tasks in the algorithm of management of patients with hyperuricemia is rationalization of therapy with the main focus on cardiovascular risk factors and metabolic safety of drugs.

Prediction and causal inference of hyperuricemia using gut microbiota.

Hyperuricemia (HUA) is a symptom of high blood uric acid (UA) levels, which causes disorders such as gout and renal urinary calculus. Prolonged HUA is often associated with hypertension, atherosclerosis, diabetes mellitus, and chronic kidney disease. Studies have shown that gut microbiota (GM) affect these chronic diseases. This study aimed to determine the relationship between HUA and GM. The microbiome of 224 men and 254 women aged 40years was analyzed through next-generation sequencing and machine learning. We obtained GM data through 16S rRNA-based sequencing of the fecal samples, finding that alpha-diversity by Shannon index was significantly low in the HUA group. Linear discriminant effect size analysis detected a high abundance of the genera Collinsella and Faecalibacterium in the HUA and non-HUA groups. Based on light gradient boosting machine learning, we propose that HUA can be predicted with high AUC using four clinical characteristics and the relative abundance of nine bacterial genera, including Collinsella and Dorea. In addition, analysis of causal relationships using a direct linear non-Gaussian acyclic model indicated a positive effect of the relative abundance of the genus Collinsella on blood UA levels. Our results suggest abundant Collinsella in the gut can increase blood UA levels.