Mean Serum Uric Acid Research Articles

English

BACKGROUND Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disorder. Uric acid is a by-product of purine metabolism, associated with diseases such as gouty arthritis, hypertension and cardiovascular disease (CVD). The association between serum uric acid concentrations and inflammation in patients with RA has been controversial. Some case reports suggest coexistence of gout and RA. Uric acid crystals can induce robust inflammation causing joint destruction and fibrosis. The purpose of this study was to estimate the serum uric acid levels in subjects with recently diagnosed rheumatoid arthritis and to correlate with disease activity. METHODS This cross-sectional study was done on 55 recently diagnosed RA subjects [American college of Rheumatology (ACR) criteria 2010] attending the rheumatology out-patient department (OPD) of a tertiary care institute in Chennai, Tamil Nadu. After clinical examination, evaluation of disease activity score (DAS), serum uric acid and rheumatoid factor (RF) were done. Data was analysed using Statistical Package for Social Sciences (SPSS trial version 28). Descriptive and inferential analysis was done. Correlation between serum uric acid levels and DAS was the main outcome. RESULTS The mean age was 41.51 ± 11.7 years. 87.3 % were females. Majority (58.2 %) were aged between 31 to 50 years. The mean duration of symptoms was 4.78 months. The mean serum uric acid level was 4.99 ± 1.2 mg/dl with 95 % C.I. of 4.66 to 5.31. The mean DAS was 5.34 ± 0.96. 56 % had high disease activity while only 44 % had moderate disease activity. 44 % were RF positive. There was no significant difference in serum uric acid levels across groups based on RF positivity and DAS severity respectively. There was no statistically significant correlation serum uric acid levels and DAS (-0.024, P value = 0.861). CONCLUSIONS Mean serum uric acid levels were elevated in recently diagnosed rheumatoid arthritis. Serum uric acid levels have no association with DAS and RF positivity in rheumatoid arthritis. Further studies are needed to investigate the role of specific treatment of elevated uric acid levels in rheumatoid arthritis independent of rheumatoid arthritis treatment. KEYWORDS Rheumatoid Arthritis, Uric Acid, Rheumatoid Factor, Disease Activity Score (DAS), Correlation, Recently Diagnosed Rheumatoid Arthritis

High Serum Uric Acid and High-Sensitivity C Reactive Protein Concentrations Predict Three-Year Cardiovascular Mortality in Patients Treated With Continuous Ambulatory Peritoneal Dialysis.

Aims: This study aims to access the predicting value of serum uric acid (UA) and high-sensitivity C reactive protein (hs-CRP) concentration on three-year cardiovascular-related mortality in patients performing continuous ambulatory peritoneal dialysis (CAPD).Methods: A total of267 CAPD patients [150 male (56.2%); mean age 48.93 ± 13.58 years] were included in our study. All patients had measured serum UA and hs-CRP concentration. A high-sensitivity particle-enhanced immunoturbidimetric assay determined serum hs-CRP; serum UA levels were determined using an enzymatic colorimetric assay. All patients were followed for three years to detect cardiovascular-related mortality by cardiologists and stroke specialists.Results: Mean serum UA level was 415.16 ± 84.28 µmol/L, 58.4% of patients had increased serum UA level. Median serum hs-CRP level was 2 (1-4) mg/L, 12.4% of patients had increased serum hs-CRP level. During 36 months of follow-up, 41 patients (15.4%) had cardiovascular-related mortality. The results of Cox proportional hazards regression showed that hypertension, diabetes, high serum UA and hs-CRP were risk factors that related to cardiovascular-related mortality (p<0.05). The receiver operating characteristic (ROC) curve and Kaplan-Meier analysis results showed that UA and hs-CRP level had predictive value for three-year cardiovascular-related mortality in CAPD patients [uric acid: area under the curve (AUC)=0.822; hs-CRP: AUC=0.834, p < 0.001].Conclusion: High serum UA and hs-CRP levels were predictive factors of cardiovascular-related mortality in CAPD patients.

Epidemiology and risk factors for progression in Chinese patients with IgA nephropathy

BackgroundIgA nephropathy (IgAN) is one of the main causes of primary glomerulonephritis worldwide, and it is also the main primary disease leading to chronic kidney disease. The purpose of this study is to evaluate the epidemiology and risk factors for progression in Chinese patients with IgAN. MethodsIn this retrospective study, 246 patients with renal biopsy-proven IgAN were enrolled from January 2012 to June 2018. The patients’ data were divided into two groups according to eGFR at the end of follow-up: a high-eGFR group (eGFR≥60ml/min) and a low-eGFR group (eGFR<60ml/min). ResultsAt the end of the study, we identified 49 (19.92%) patients with low-eGFR from 246 IgAN patients. Renal function, represented by serum creatinine, urea nitrogen and cystatin-C, was significantly decreased in the low-eGFR group (P<0.001 for all) at the time of renal biopsy. Compared with the high-eGFR group, the age, mean arterial blood pressure (MAP), proteinuria, cholesterol, triglycerides and serum uric acid were significantly higher (P<0.05 for all). According to the Oxford evaluation, the proportion of S1-2 (59.2%) and T1-2 (65.3%) was significantly increased (P<0.001 for both) and the proportion that had a MEST-C score ≥3 was statistically increased in the low-eGFR group (83.7%, P=0.001). ConclusionsMale, MAP, haematuria, Scr, cholesterol, hemoglobin, Lee classification more than 3 and C1-2 are independent risk factors for low-eGFR in Chinese IgAN patients.

Maternal serum uric acid: a reliable prognostic indicator of foetal outcome among pre-eclamptic patients in a low resource setting

Background Pre-eclampsia is a major cause of maternal and fetal morbidity and mortality in both developed and developing countries. Hyperuricemia is often associated with pre-eclampsia and when this occurs, fetal outcome may become worse. We evaluated the role of maternal serum uric acid as a prognostic indicator of fetal outcome in pre-eclamptic mothers. Methods A prospective case-control study in which 55 eligible pre-eclamptic patients at term were matched in maternal age and gestational age with 55 consecutive normotensive pregnant women. Venous blood samples were obtained and analyzed for serum uric acid. Following delivery, the fetal outcomes in the pre-eclamptic group and controls were determined. Data analysis was carried out using SPSS (version 21) and the level of statistical significance was set at p-value <.05. Results The mean serum uric acid levels of the pre-eclamptic subjects was significantly higher compared to their normotensive counterparts (12.7 ± 7.8 vs. 4.9 ± 1.2 mg/dL, p = .000). Babies with low birth weight, poor Apgar scores (at 1st and 5th minute of life) and those who required neonatal unit admission occurred more significantly among the pre-eclamptic women when compared with the controls (p = .000). However, the live birth rate of the case and control groups was comparable (94.5% vs. 100%, p = .079), Binary logistic regression analysis revealed a positive association between hyperuricemia and pre-eclampsia (OR = 18.8; 95% CI = 1.22–289.35, p = .035). Pre-eclamptic mothers with hyperuricemia had 4.41 odds of delivering babies with low birth weight when compared with pre-eclamptics without hyperuricemia (OR = 4.41; 95% CI = 0.76–25.5, p = .097); but Apgar scores and need for neonatal admission showed no association with maternal serum uric acid levels. Conclusion This study therefore suggests that hyperuricemia is a strong prognostic indicator of LBW babies among women with pre-eclampsia.

Colchicine for acute arthritis attacks prevention in patients with gout during urate-lowering therapy (results of a pilot study)

Objective: to investigate the efficacy and safety of low-dose colchicine in patients with gout receiving urate-lowering therapy (ULT).Patients and methods. A single-center prospective study included 113 patients with gout. The main group consisted of 92 patients who were prescribed colchicine 0.5 mg/day combined with ULT (allopurinol or febuxostat), control group – 21 patients with contraindications to colchicine therapy who received only ULT. Patient data were entered into individual registration cards at the first visit, as well as on the 90th and 180th day after the start of drug intake. The presence of arthritis attacks was recorded by doctor or patient using a validated questionnaire. We compared the mean frequency of arthritis attacks in the groups, their duration and maximum pain intensity according to the visual analogue scale (VAS). Laboratory tests included: complete blood count test, general urinary test, uric acid (UA), blood glucose, alanine aminotransferase, aspartate aminotransferase, creatinine, serum creatine phosphokinase.Results and discussion. Patients who did not receive prophylactic anti-inflammatory therapy had significantly longer duration of the disease and higher number of affected joints. For 6 months of follow-up, there were no arthritis attacks in 54% of patients who were prescribed colchicine, and only in 19% of patients who did not use prophylactic anti-inflammatory therapy (p=0.004). The duration of arthritis attacks and the intensity of pain according to the VAS were also statistically significantly lower in the colchicine group (p&lt;0.031 and p&lt;0.01, respectively). Due to the development of adverse events, related to colchicine therapy, only 3 were excluded from the study. The mean serum UA level by the end of the study in colchicine group did not differ from that in the control group.Conclusion. Administration of colchicine, 0.5 mg/dai for 6 months after initiation of ULT is safe and can reduce the frequency and severity of arthritis attacks.

Interventions for tophi in gout.

Interventions for tophi in gout.

Prevalence of hyperuricemia in cerebrovascular accidents and its correlation with their outcome

Introduction: Cerebrovascular accident or stroke is a disease of the vascular system of the brain.According to ICD 11, stroke is classified as a neurological disease and not under the circulatorysystem. It is the second leading cause of death worldwide. It cannot be said that high Serum UricAcid [SUA] amongst patients with cerebrovascular accidents is directly correlated with theiroutcome. The present study planned to estimate uric acid levels and their association in acute strokepatients, both ischemic and hemorrhagic. Method: A total of 100 stroke patients admitted under theneurology department were included in the study. Brain imaging (CT/MRI) was performed. Theserum uric acid was estimated. Results: Out of a total of 100 patients, 74 were males, and 26 werefemales. Nine patients were less than 45 years old and 91 patients were 45 and above. Thirty-ninepatients had ischemic, and 61 patients had a hemorrhagic stroke, respectively. Out of 100 patients,23 patients had normal uric acid levels (&lt;7mg/dl). Seventy-seven patients were with high uric acidlevels. The mean serum uric acid concentration in male patients was 8.48±2.7and 9.20±2.7 infemales. Among the total 100 cases, 69 survived, and the remaining 31 were among the non-survivor group at the time of discharge. Mean serum uric acid in stroke survivors was 8.5±2.6mg/dl, while in non-survivors, it was 8.6±2.2 mg/dl. There was no significant difference between thelevels of uric acid among survivors and non-survivors. Conclusions: The prevalence ofhyperuricemia (&gt;9mg/dl) amongst stroke patients was 77% in the present study. The values ofserum uric acid were significantly elevated in the patients aged &gt; 45 years. The serum uric acidvalues were high among the group of hyperglycemic and hypertensive patients at the time ofadmission. There was no significant difference between the levels of uric acid among survivors andnon-survivors.

A Study on Serum Uric Acid Level in Type II Diabetes Mellitus

Background and Aim: Morbidity and mortality from non-communicable diseases, particularly diabetes are increasing rapidly in Pakistan, the prevalence has reached 17.1%. A strong association has been witnessed between type II diabetes mellitus with atherosclerosis and serum uric acid level. The current study aim was to assess the levels of serum uric acid in type II diabetes mellitus. Materials and Methods: This cross-sectional study was carried out on 85 diagnosed patients of type II diabetes mellitus in Diabetes hospital, Peshawar and the Department of General Medicine, Shaikh Zayed Medical Complex, Lahore during the period from March 2020 to August 2020.Type II diabetes mellitus (DM) diagnosed patients 85 and healthy control 30 were evaluated in this study. The level of hyperuricemia was defined for women &gt; 6 mg/dl and men &gt;7 mg/dl in men. Results: In this study, a total of 85 diabetic diagnosed patients and 30 healthy controls were enrolled. No significant differences were there in the baseline characteristics like anthropometric and socio-demographic parameters. The mean age for diagnosed and control cases was 58.6±8.7 and 56.5±7.6 years with an age range of 40 and 80 years. Hyperuricemia proportion among diabetic patients was 12.13% while none of the control cases had hyperuricemia. The uric acid means level increased from 4.29±0.81 mg/dl with a diabetic duration between 3 and 4 years to 4.59±0.99 mg/dl with a diabetic duration of 5 to 7 years. Furthermore, mean serum uric acid level reached 6.50±1.08 in cases with diabetic duration 8 to 12 years. Statistically, a significant association was found between diabetic duration and serum uric acid. Also, a positive correlation was found in hyperlipidemia, serum uric acid levels, and hypertension. Conclusion: In diabetic patients serum uric acid levels were found to be significantly higher. Diabetic patients had hypertension, elevated serum uric acid levels, and high triglycerides with dyslipidemia. The rise in serum uric acid levels is proportional to the duration of diabetes. Keywords: Serum uric acid, Type 2 diabetes mellitus, Hypertension

ASSOCIATION OF HYPERURICEMIA WITH THE PRESENCE AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

Objectives: To determine the association of hyperuricemia with the presence and severity of coronary artery disease in patients undergoing coronary angiography.&#x0D; Methodology: This case control study was carried out in the Department of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan for six months. Total number of 292 patients (146 cases with coronary artery disease and 146 controls with normal coronary arteries) having age 40-60 years of both genders were included in this study. Coronary angiography was performed using standard angiographic techniques. After undergoing coronary angiography, patients with 50% luminal stenosis or more in any one of the coronary arteries were labeled case group. Patients with normal coronaries or less than 50% luminal stenosis in any one of the coronary vessels were taken as control group. Serum uric acid was advised and value was noted along with the basic demographic data and established risk factors of coronary artery disease.&#x0D; Results: Mean age was 50.79±6.08 years. Mean serum uric acid was 7.54±3.60 mg/dl. Hyperuricemia was diagnosed in 94 (64.40%) patients with significant CAD (case group) and in only 59 (40.40%) in control group. The odds ratio was 2.66 (95% CI 1.66 to 7.28) with p-value of &lt;0.001. Triple vessel disease was diagnosed in 66.7% patients with hyperuricemia and in only 33.3% patients without hyperuricemia [OR 4.0 (2.09-7.64), p-value &lt;0.001].&#x0D; Conclusion: There is a significant association between the presence and severity of coronary artery disease with hyperuricemia.

Association between elevated carotid intima-media thickness and serum uric acid levels among patients with essential hypertension in primary care setting in Sungai Buloh, Malaysia.

AimsOur study aimed to investigate the association between elevated carotid‐intima media thickness (CIMT) and serum uric acid (SUA) levels in hypertensive patients attending primary care clinics in Sungai Buloh, Malaysia.MethodsWe conducted a cross‐sectional study on 140 hypertensive patients attending outpatient follow‐up in two primary care clinics in Sungai Buloh, Malaysia, using a convenient sampling method. SUA levels were measured and divided into four quartiles. Two radiologist specialists performed B mode ultrasonography to assess the thickness of the right and left carotid intima media in all participants.ResultsParticipants' mean SUA level was 355.75 ± 0.13. Their mean age was 53.44 (± 9.90), with a blood pressure control of 137.09 ± 13.22/81.89 ± 8.95. Elevated CIMT taken at ≥75th percentile was 0.666 for the left and 0.633 for the right common carotid arteries. By using a hierarchical method of multiple logistic regression, compared with the first quartile of the SUA level as reference group, the odd of elevated CIMT in quartile 4 in the common carotid artery was (OR = 2.00; 95% CI = 0.64‐6.27, P = .576) for the right and (OR = 0.62; 95% CI = 0.20‐2.00, P = .594) for the left. Waist circumference (P = .001), body mass index (P = .013), triglycerides (P < .001), and high‐density lipoprotein cholesterol (P = .001) were significantly associated with the SUA quartiles.ConclusionAlthough there was an increasing trend in the odd of elevated right CIMT across the SUA quartiles, this association, however, was not significant. Preventive effort to tackle the clustering effect of metabolic markers within this study population is needed to reduce the future risk of developing cardiovascular disease.

Sodium-Glucose Cotransporter-2 (SGLT-2) Attenuates Serum Uric Acid (SUA) Level in Patients with Type 2 Diabetes.

Background Hyperuricemia has a strong association with diabetes mellitus. Hyperuricemia can lead to cardiovascular and renal complications in patients with diabetes. The goal of this study was to compare the effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors dapagliflozin and empagliflozin on serum uric acid (SUA) levels in patients with type 2 diabetes against traditional oral antihyperglycemic drugs (OADs). Methods In this double-blind randomized controlled trial, 70 patients with type 2 diabetes and elevated SUA levels were assigned to two treatment groups. Patients in group A received SGLT-2 inhibitors tablet dapagliflozin 5 mg to 10 mg and empagliflozin 10 mg to 25 mg. Group B patients received OADs such as glimepiride, metformin, sitagliptin, gliclazide, and glibenclamide as monotherapy or combination therapy. The changes in SUA level were primary end points while changes in body weight and body mass index (BMI) from baseline to end point were secondary end points. Results After four weeks of treatment, we noted a significant reduction of mean SUA levels in the SGLT-2 inhibitor group from 7.5 ± 2.5 to 6.3 ± 0.8 mg/dl versus comparator group from 7.1 ± 1.8 to 6.8 ± 2.2 mg/dl (p = 0.001). Mean body weight was significantly reduced in the SGLT-2 group from 82 ± 10.4 to 78 ± 12.5 kg versus comparator group from 78 ± 13.2 to 79.2 ± 9.7 kg (p = 0.001). Similarly, the mean BMI of patients in the SGLT-2 group was significantly reduced from 25.7 ± 3.2 to 24.2 ± 3.2 kg/m2 versus comparator group from 27.5 ± 4.2 to 28 ± 3.6 kg/m2 (p = 0.002). Conclusion SGLT-2 inhibitors have a strong potential to decrease SUA levels in patients with type 2 diabetes.

Relation Of Serum Uric Acid Concentrations With Etiology And Severity In Patients With Cirrhosis Of Liver

Background: Hyperuricemia is now an established factor to cause oxidative stress, insulin resistance and systemic inflammation. So it is likely that hyperuricemia might be involved in hepatic necro-inflammation and destruction which are the common underlying pathophysiology of cirrhosis. On the other hand, as uric acid is the end product of cellular degradation, increased hepatocyte destruction due to any etiology increases the level of serum uric acid which might further aggravate hepatic necro-inflammation, cirrhosis &amp; complications. Objectives: To assess serum uric acid concentrations in patients of cirrhosis of liver and its relation with cirrhosis of different etiology, disease severity and liver enzymes. Materials and Methods: This cross sectional observational study was carried out in the Department of Gastroenterology, BSMMU, Bangladesh during the period of September 2015 to October 2016. A total of 220 diagnosed cases of cirrhosis of liver due to any cause from inpatient &amp; outpatient Department of Gastroenterology of Banghabandhu Sheikh Mujib Medical University were enrolled as the study population. Serum uric acid level was measured in each patient and its relationship with different etiology of cirrhosis, severity of cirrhosis and liver enzymes were assessed. Results: The mean age was found to be 47.8 ± 14.6 years and male: female ratio was 1.9:1. Majority patients (52.3%) belonged to CTP Class C. The mean (±SD) value of serum uric acid was 6.19 (±3.25mg/dl) and hyperuricemia (&gt;7 mg/dl) was detected in 27.73% patients. Among all etiologies of CLD, the higher mean (±SD) level of serum uric acid was found in NAFLD (19.54 ±2.20 mg/dl). There was positive correlation of serum uric acid with liver enzymes. Conclusion: Mean serum uric acid level increased gradually as the cirrhotic patients progressed to higher CTP classes &amp; there was positive correlation of serum uric acid with liver enzymes. It requires further large scale multicenter studies with increased sample size &amp; prolong follow-up to establish serum uric acid as a risk factor of CLD.

Prevalence of Hyperuricemia and Its Related Risk Factors Among Students in Fangshan District, Beijing, China

Abstract Objectives To study the prevalence of hyperuricemia among students and explore factors related to hyperuricemia. Methods This is a cross-sectional prevalence study in 530 students aged 6 to 13 years old. The study was conducted from October to November 2019 in Fangshan District, Beijing, China. BMI, glucose, cholesterol HDL, triglycerides, cholesterol LDL and uric acid were measured. Results The overall serum uric acid concentrations was 301.7 ± 74.2 μmol/L. The mean serum uric acid concentrations in boys and girls were 311.1 ± 74.2 μmol/L and 311.1 ± 74.2 μmol/L, respectively. The overall prevalence of hyperuricemia (serum uric acid ≥ 416 μmol/L) was 7.0%. Logistic regression showed that hyperuicemia was worse in boys, students who were older and with high BMI. Conclusions The serum acid concentration among students was high, interventions for high-risk students should be taken. Funding Sources Beijing Center for Diseases Control and Prevention.

MO491ASSOCIATION BETWEEN SERUM URIC ACID LEVEL AND CHRONIC KIDNEY DISEASE INCIDENCE STRATIFIED BY SEX IN MIDDLE-AGED ADULTS

Abstract Background and Aims While previous studies have reported the association between serum uric acid (SUA) and chronic kidney disease (CKD) incidence, the sex differences in this association remain controversial. Therefore, we examined the association between SUA levels and CKD incidence in middle-aged adults stratified by sex using data from a large-scale health check-up. Method We analyzed information from the JMDC database, which included the annual health check-up data of Japanese employees and their dependents aged &amp;lt;75 years. Among those individuals, we analyzed data from 138,511 individuals without CKD, kidney disease, or a history of cardiovascular disease at baseline. CKD was defined as an estimated glomerular filtration rate (eGFR) &amp;lt;60 mL/min/1.73 m2 and/or proteinuria. We divided the participants into 9 and 7 groups according to SUA levels for men and women, respectively. A Cox model was applied to assess the adjusted hazard ratios (HRs) for CKD incidence in each SUA level group using an SUA concentration of 4.0–4.9 mg/dL as the reference after adjusting for age, body mass index, current or ex-smoker, current or ex-drinker, diabetes mellitus, dyslipidemia, systolic blood pressure, use of anti-hyperuricemic drugs, and baseline eGFR. Results The mean participant age was 44.1 years, and 29.6% were women. The mean SUA levels were 5.9 mg/dL and 4.1 mg/dL in men and women, respectively. During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The age-standardized incidence rates for CKD were 17.88/17.80 per 1000 person-years in men/women with SUA concentrations of 4.0–4.9 mg/dL, 209.76 per 1000 person-years in men with SUA ≥11.0 mg/dL, and 73.38 per 1000 person-years in women with SUA ≥ 9.0 mg/dL. The fully adjusted HRs (95% confidence interval [CI], P value) for CKD incidence in the groups with SUA concentrations of &amp;lt;4.0, 10.0–10.9, and ≥11.0 mg/dL compared with those with SUA of 4.0–4.9 mg/dL among men were 1.13 (1.01–1.26, P=0.030), 1.98 (1.32–2.97, P=0.0010), and 3.74 (1.68–8.35, P=0.0013), respectively. In women, the fully adjusted HRs for CKD incidence in the groups with SUA concentrations of &amp;lt;4.0, 8.0–8.9, and ≥9.0 mg/dL were 1.08 (1.01–1.16, P=0.032), 2.39 (1.07–5.35, P=0.034), and 3.20 (0.80–12.8, P=0.10), respectively. Similar results were observed when we performed the sensitivity analysis excluding 8,411 individuals with hypertensive treatment from the main analysis. The HRs for the outcomes caused by the onset of eGFR &amp;lt;60 mL/min/1.73 m2 or proteinuria separately were similar to those for the main results. Conclusion The results of the present study demonstrated an increased risk of CKD in men with SUA concentrations of &amp;lt;4.0 and ≥10.0 mg/dL and &amp;lt;4.0 and ≥8.0 mg/dL in women compared to those with SUA concentrations of 4.0–4.9 mg/dL after adjusting for various covariates. Both high and low SUA levels were risk factors for CKD in middle-aged men and women. Hyperuricemia was demonstrated to cause renal injury due to the intraluminal deposition of uric acid crystals in the renal collecting duct. Hyperuricemia may also induce endothelial dysfunction, activation of the renin-angiotensin system, and induction of inflammation and stimulation of vascular smooth muscle cell proliferation by the induction of cyclooxygenase-2. However, as uric acid is one of the most important antioxidants in human plasma, low SUA levels may increase the risk of CKD incidence through decreased antioxidant activity. These mechanisms are implicated in the pathogenesis of CKD caused by high and low SUA levels. In addition, the SUA levels and ranges associated with increased risks of CKD incidence differed by sex.

RELATION BETWEEN SERUM URIC ACID LEVELS AND ESSENTIAL HYPERTENSION

Hypertension is due to increased oxidative stress.As urate is natural anti-oxidant,increase in level of hypertension is a case or effect of raised uric acid level.Aim:Aim of the present study was to evaluate serum uric acid levels in cases of Essential Hypertension and comparison with normal controls in different grades of hypertension. Material and Methods: 100 subjects were taken out of which 50 were normal healthy control groups and 50 were of Essential Hypertension. Hypertensive subjects were further subdivided into 2 groups based on the level of Blood Pressure(JNC7). Results: Mean serum Uric Acid levels is found to be 4.8 mg/dl in 50 controls and 5.7 mg/dl in 50 cases of Essential Hypertension, 5.5 mg/dl in stage 1 hypertension(BP=140-159mmHg) and 5.8759 in stage 2 hypertension (BP&gt;160mmHg).Conclusion:It is seen that hypertension is related to rise in mean serum uric acid levels and this rise is directly related to severity of hypertension.Randomized control trials need to be done to see whether lowering serum uric acid level will ameliorate the level of blood pressure.

Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study.

Background: Hyperuricemia is an established risk factor for cardiovascular disease, including atrial fibrillation (AF). The prevalence of hyperuricemia and its clinical significance in patients with already diagnosed AF remain unexplored. Methods: The Polish Atrial Fibrillation (POL-AF) registry includes consecutive patients with AF hospitalized in 10 Polish cardiology centers from January to December 2019. This analysis included patients in whom serum uric acid (SUA) was measured. Results: From 3999 POL-AF patients, 1613 were included in the analysis. The mean age of the subjects was 72 ± 11.6 years, and the mean SUA was 6.88 ± 1.93 mg/dL. Hyperuricemia was found in 43% of respondents. Eighty-four percent of the respondents were assigned to the high cardiovascular risk group, and 45% of these had SUA >7 mg/dL. Comparison of the extreme SUA groups (<5 mg/dL vs. >7 mg/dL) showed significant differences in renal parameters, total cholesterol concentration, and left ventricular ejection fraction (EF). Multivariate regression analysis showed that SUA >7 mg/dL (OR 1.74, 95% CI 1.32–2.30) and GFR <60 mL/min/1.73 m2 (OR 1.94, 95% CI 1.46–2.48) are significant markers of EF <40% in the study population. Female sex was a protective factor (OR 0.74, 95% CI 0.56–0.97). The cut-off point for SUA with 60% sensitivity and specificity indicative of an EF <40% was 6.9 mg/dL. Conclusions: Although rarely assessed, hyperuricemia appears to be common in patients with AF. High SUA levels may be a significant biomarker of reduced left ventricular EF in AF patients.

Association between Serum Uric Acid Levels and Perinatal Outcome in Women with Preeclampsia

Objectives To compare serum uric acid levels with disease severity and perinatal outcome among preeclamptic and normal pregnant women. Materials and Methods This was a case-control study carried out in Federal Medical Centre, Umuahia, Nigeria. Consenting pregnant women were consecutively recruited into two groups comprising pregnant women diagnosed with preeclampsia and normotensive nonproteinuric pregnant women. Exclusion criteria included pregnant women who were current smokers, took alcohol, and diagnosed with multiple gestation, diabetes mellitus, or renal failure. Associations between categorical variables such as preeclampsia severity and perinatal outcomes were done using logistic regression while means of continuous variables such as serum uric acid were compared using Student's t-test. Data were presented using odds ratios (ORs) with 95% confidence intervals (95% CI) and a statistical significance level set at P value ˂ 0.05. Data analysis was done using Statistical Package for Social Sciences version 22. Results One hundred and two participants were finally analysed. Fifty-one participants were recruited in each arm. Women with preeclampsia had significantly high serum uric acid level versus controls (6.08 ± 0.49 mg/dL vs. 5.20 ± 0.19; P < 0.001). Women with elevated serum uric acid levels (˃6 mg/dL) were found to be 4 times more likely to have severe preeclampsia (P=0.022, OR = 4.00, 95% CI = 1.225–13.056), 66 times more likely to have APGAR score ˂7 in the first minute (P < 0.001, OR = 66.00, 95% CI = 6.991–623.128), and 3 times more likely to have lower birth weight (P=0.038, OR = 3.400, 95% CI = 1.073–10.775) than those with normal serum uric acid levels. Conclusions The mean serum uric acid level in a preeclamptic is higher than that of normal pregnant control, and higher levels are associated with severity of the disease and significantly associated with poorer perinatal outcome.

The relationship between anthropometric factors and hyperuricemia in adolescent athletes

PurposeHyperuricemia has been increasingly prevalent and linked to future cardio-metabolic risks in adolescent population. The study aims to explore the relationship between anthropometric indices and hyperuricemia among adolescent athletes. MethodsThis was a cross-sectional study of 387 student athletes (218 males and 169 females; mean age, 17.4 ± 1.3 years) in Northern Taiwan in 2013–2015. We exhibited the prevalence of hyperuricemia among this population, and tested the association of serum uric acid levels with different anthropometric parameters in males and females respectively. ResultsA total of 59 (27.1%) male and 37 (21.8%) female adolescent athletes had hyperuricemia. Both in male and female adolescents, several obesity-related anthropometric parameters were significantly higher in hyperuricemia groups than in non-hyperuricemia groups. The odds of having hyperuricemia significantly increased with increasing BMI, BMI z-score, waist circumference and waist-to-height ratio in logistic regression analysis. There was a U-shaped association between uric acid level and body fat percentage (BF%) in both genders. Subjects whose BF% in lowest-body-fat-percentage quintile (quintile 1) and highest-body-fat-percentage quintile (quintile 5) had higher mean serum uric acid level than subjects whose BF% in the middle three quintiles. In both genders, the odds ratio (OR) of having hyperuricemia in subjects whose BF% in quintile 1 remained significantly higher than the OR in the middle three quintiles (the reference) after adjusting for age and BMI z-score. ConclusionsIn addition to the positive association between obesity and hyperuricemia, there is a U shape association between BF% and prevalence of hyperuricemia among adolescent athletes of both genders.

Association between serum uric acid and major chronic diseases among centenarians in China: based on the CHCCS study

BackgroundThis study aims to analyze the distribution of serum uric acid (SUA) level based on more than 1000 centenarians and to explore the association with three common diseases including hypertension, diabetes and dyslipidemia.MethodsAll the 1002 centenarians from the CHCCS were included. Household survey was conducted.ResultsThe mean SUA level of centenarians was 329.04 ± 97.75 μmol/L and the prevalence of hyperuricemia in centenarians was 26.5%. There was no statistical difference in the distribution of SUA levels among centenarians with or without hypertension/diabetes. For dyslipidemia, there was an independent positive association. The risk of dyslipidemia among those with hyperuricemia was 1.646 (95%CI: 1.078–2.298) compared with those who didn’t have hyperuricemia. By comparing different subtypes of dyslipidemia, hyperuricemia was positively associated with hypertriglyceridemia and low-density lipoprotein cholesterolemia, with the corresponding ORs of 2.553 (95%CI: 1.282–5.083) and 1.927 (95%CI: 1.273–2.917) respectively, while there was no statistically significant association with hypercholesterolemia 0.998 (95%CI: 0.574–1.732).ConclusionsThere was no relation between SUA with hypertension or diabetes, while there was independently and positively association with hypertriglyceridemia and low-density lipoprotein cholesterolemia. The health benefits of controlling SUA in centenarians still require evidence based on prospective studies.

CORRELATION OF SERUM URIC ACID WITH SEVERITY OF HEART FAILURE

OBJECTIVE: To evaluate serum uric acid levels in patients with heart failure and to study the relationship of serum uric acid level with left ventricular Ejection Fraction in patients of heart failure. METHOD: The study was a hospital based observational cross-sectional study conducted in MLN Medical College, Prayagraj, carried out over a period of 12 months from March 2019 to February 2020. 130 patients presenting with Heart Failure as diagnosed by Framingham Criteria of Heart Failure were included in this study. RESULT: Out of 130 subjects with heart failure 10 (7.7%) had preserved ejection fraction, 49 (37.7%) had mid-range EF and 71 (54.6%) reduced ejection fraction. Serum Uric acid level was increased in more than two-third (72.3%) of our study population. Mean serum uric acid of study subjects was 8.19±2.56 mg/dl. Mean serum uric acid was signicantly increased with severity of heart failure. In NYHAclass I/II mean serum uric acid was 6.82±1.80 and in NYHAclass IV it was 10.37±3.36mg/dl. CONCLUSION: Moderate negative correlation was observed between Serum uric acid level and left ventricular ejection fraction which was found statistically signicant (r value =-0.37; p value &lt;0.001).