Mean Uric Acid Level Research Articles

Comparison of Serum Stability against Uric Acid and Glucose

The selection of tools, especially the use of vacutainer tubes, affects the results of the examination to determine the stability of serum from plain vacutainer with vacutainer separation gel on the quality of uric acid and glucose test results. This study used an experimental design. The study took blood samples of 3 ml each in SST vacutainer and plain vacutainer serum. The mean uric acid levels using plain vacutainer and SST vacutainer were 4.5875±0.59048 and 4.9250±0.56318, respectively. The mean glucose levels using plain vacutainer and SST vacutainer were 90.64±12.33 and 94.12±13.30, respectively. Uric acid and glucose levels using gel-separated vacutainer were higher than uric acid levels using plain vacutainer. There was a significant difference in uric acid levels between regular vacutainers and SST vacutainers, similar to glucose levels (p = 0.000, p = 0.000). Uric acid and glucose levels using SST vacutainer were higher than uric acid levels using plain vacutainer. The following types of vacutainer separator gel and plain vacutainer affect the quality of uric acid and glucose test results.

Renoprotective Effect Of Sambiloto (Andrographis Paniculata) Leaf Extract On Lipopolysaccharide – Induced Septic Rats

Background: Associated with sepsis is the illness known as acute kidney injury (AKI). AKI may be mediated by uric acid, and blood creatinine levels can be utilized to diagnose the condition to measure kidney function. Sambiloto (Andrographis paniculata) is a traditional medicine that has flavonoid compounds that can reduce creatinine levels and Xanthine Oxidase Inhibitors which can reduce uric acid levels.Objective: Septic model rats generated by lipopolysaccharide were used to test the effects of sambiloto (Andrographis paniculata) leaf extract on serum creatinine and uric acid levels (LPS).Methods: This study was experimental employing 25 rats split into 5 groups as the post-test alone control group: healthy control with standard feed (HC), negative control with LPS injection(NC), Treatment (T)1 (A.Paniculata 200 mg/kgBW+LPS), T2(A.paniculata 400 mg/kgBW+LPS), and T3(A.paniculata 500mg/kgBW+ LPS). A.paniculata leaf extract was given via oral gavage on day 8-21. Intraperitoneal injection of LPS 5 mg/kgBW was given on day 22. On the 25th day, the blood serum was analyzed for creatinine levels using Jaffe method and uric acid was analyzed using the enzymatic photometric method. One-way analysis of variance (Kruskal-Wallis) and the Kruskal-Wallis test were used to evaluate the data.Results: The mean creatinine levels of HC,NC,T1,T2,T3 were 0.7±0.01;3.5±0.04;2.9±0.03;1.9±0.05; 1.3 ±0.04 mg/dl respectively. The mean uric acid levels of HC.NC.T1.T2.T3 were 1.7±0.05;8.2±0.11; 4.5±0.03;4.0±0.12;3.0±0.19 mg/dl respectively. There were significant differences (p<0.05) in creatinine levels in groups T2(p=0.031) and T3(p=0.001) to NC group and serum uric acid levels in groups T1(p<0.001), T2(p<0.001), and T3(p<0.001) to NC group which creatinine and uric acid levels were lower than NC group.Conclusion: Andrographis paniculata leaf extract has renoprotective effect against AKI in LPS-induced septic ratsKeywords: Andrographis paniculata, creatinine, uric acid, lipopolysaccharide, AKI, sepsis

A Hospital-Based Cross-Sectional Study of Patients With Plantar Fasciitis: Is Hyperuricemia Screening Needed?

Background and aim Generally, asymptomatic hyperuricemia is considered a benign metabolic abnormality with little clinical significance in the absence of gout or renal calculus. However, its clinical association with plantar fasciitis is still not known and is a subject of interest. The study aims to investigate the association between asymptomatic hyperuricemia and plantar fasciitis in otherwise healthy patients. Materials and methods A cross-sectional study was performed, which included 284 patients aged 21-65 years with plantar fasciitis and without any comorbidities between February 2020 and November 2022. One hundred and fifty patients with hyperuricemia who attended the endocrinology and medicine outpatient department without heel pain were included as a control group. Serum uric acid levels were assessed in all cases. Student's t-test, correlation tests, and multiple linear regression were used to ascertain the association between uric acid levels and plantar fasciitis. Statistical analyses were conducted using IBM SPSS Statistics for Windows, Version 19.0 (Released 2010; IBM Corp., Armonk, New York, United States). Results Among the 284 patients, 189 were female (66.5%) and 95 were male (33.4%). Their mean age was 43 ± 9 years (range: 21-65 years). The p-values of the duration of symptoms, visual analog scale for pain (VAS), and foot function index (FFI) total score were p = 0.061, p = 0.068, and p < 0.001, respectively. The mean uric acid levels were 7.6 ± 1.5 mg/dL in males and 7.3 ± 1.3 mg/dL in females in the sample group, and 8.3 ± 1.8 mg/dL in males and 8.1 ± 1.5 mg/dL in females in the control group. According to a Pearson correlation analysis, there was no correlation between serum uric acid level and BMI, VAS, duration of symptoms, FFI pain, disability sub-scores, or FFI total score. Conclusion Although asymptomatic hyperuricemia is a common metabolic abnormality, the present study did not find any significant association between it and plantar fasciitis. Therefore, we can conclude that routine screening for asymptomatic hyperuricemia is not recommended in plantar fasciitis. Evidence level: II.

Can We Take Hyperuricemia as a Cardiovascular Risk?

Study conducted for Gouty arthritis at Pan Pakistan level in 2017 showed mean Uric Acid levels of 6.11±1.7mg/dl with frequency of hyperuricemia of 39% and having 27.9% male and 49.35 women respectively.1 This type of arthritis results from monosodium urate crystal deposition in and around the joints affecting big toe around the joints of hands and feet. Gout has been shown to increase with age and associated with diabetes &amp; hypertension.2,3 It has also been shown that hyperuricemia may be tied to increased risk of cardiovascular disease mortality.4 Hyperuricemia has also shown to increase atherosclerosis by systemic inflammation and oxidative stress. It also causes endothelial dysfunction and oxidation of lipoproteins with formation of atherosclerotic plaques.5 Recent studies have shown hypertension, coronary artery disease, cardiovascular diseases, vascular dementia and preclampsia to be associated with high uric acid levels. The studies include Rotterdam (Serum Uric Acid Level and Myocardial infraction),2 PUMA study (Serum Uric Acid levels with cardiovascular events and deaths in hypertensive patients),6 PAMELA study (increased risk of cardiovascular deaths with increase of every 1mg /dl).4 Three important co-relation i.e. Hyperuricemia, atherosclerosis and heart failure need bit of understanding. In one study elevated uric acid levels (75.5mg/dl) in 90% of adolescents with essential hypertension7 and lower uric acid levels in teens with either white coat or secondary hypertension.7 Secondly association between increased uric acid levels and coronary artery calcification has shown an independent risk factor for subclinical atherosclerosis in young adults.8 Similar association was also seen in atherosclerotic vulnerable carotid plaque.9 Thirdly in cardiovascular health study incidence of heart failure was 21% with Chronic hyperuricemia and 18% without.10 For management of hyperuricemia (gout) multidisciplinary approach involving primary care physicians, rheumatologist and cardiologists might improve associated cardiovascular diseases other than primary pathology. Drugs like non-steroidal anti-inflammatory drug (NSAIDS), steroids &amp; colchicine may improve Gout but improvement in cardiovascular comorbids are questionable.11,12 Though different epidemiological studies have shown hyperuricemia as an independent risk factor for cardiovascular diseases and hypertension. Further studies are needed that my elucidate association of increased uric acid level with cardiovascular diseases. Multidisciplinary approach, awareness and counselling patient will hopefully prevent onset of heart disease and improve survival outcomes for gouty patients.

Correlation of Uric Acid Levels with Feto-Maternal Outcomes in Hypertensive Disorders in Pregnancy

Objective: To explore the correlation between uric acid levels and feto-maternal outcomes in women with hypertensive disorders of pregnancy.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Obstetrics &amp; Gynaecology Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2021.&#x0D; Methodology: In this cross-sectional study, 90 pregnant women with hypertensive disorders having greater than 26 weeks of gestation were included after seeking Ethical Committee approval. Selected parameters were noted on a structured proforma.&#x0D; Results: Among the participants, 38(42.2%) had pregnancy-induced hypertension, 32(35.5%) had pre-eclampsia, 13(14.5%) had chronic hypertension with pre-eclampsia, and 7(7.8%) had eclampsia. Mean Uric acid levels ranged between 363.66±50.45 μmol/L and 451.86±120.62μmol/L, with a significant difference between PIH and eclampsia (p&lt;0.001). Mode of delivery was avaginal, primary cesarean section, and repeat cesarean section in 31(34.4%), 38(42.2%), and 21(23.4%) patients, respectively(p&lt;0.001). Liquor was meconium stained in 49(54.4%) while clear in 41(45.6%) births, with (p&lt;0.001). Early neonatal deaths6(6.7%) participants had significantly higher uric acid levels than no NICU admission 22(24.4%). In maternal outcomes, 83 patients (92.2%) required routine post-operative care, while 7(7.8 %) went to the intensive care unit. Uric acid levels had a negative correlation with gestational age.&#x0D; Conclusion: Maternal uric acid levels differ significantly in different hypertensive disorders of pregnancy and affect the mode of delivery and neonatal outcomes.

Serum Levels of Uric Acid in Females of Polycystic Ovarian Syndrome with and without Insulin Resistance

Females suffering from polycystic ovarian syndrome have marked insulin resistance, independent of obesity. These women also have multiple risk factors for cardiovascular diseases, such as dyslipidemia, insulin resistance and hypertension. Uric acid level has also been recognized recently as a risk factor for cardiovascular diseases, females with PCOS may have abnormal profile of uric acid. Objectives: To compare uric acid levels in females of polycystic ovarian syndrome with and without insulin resistance. Methods: Cross-sectional comparative study was conducted in Biochemistry Department of Islam Medical College, Sialkot. Patients were divided into 2 groups based on their insulin resistance. In group-A patients were taken with PCOS and in group-B patients were taken with PCOS without insulin resistance. A total of 108 cases (54 in each group) fulfilling the inclusion/exclusion criteria. In both groups uric acid level was measured by standard procedure. Data were entered and analyzed using SPSS version 22 accordingly. Results: The mean age for all the cases was 29.43 ± 4.08 years, while mean age in insulin resistance group was 29.33 ± 4.06 years and mean age in non-insulin resistance group was 29.52 ± 4.13 years. The mean uric acid in insulin resistance and non-insulin resistance group was 4.92 ± 0.89 mg/dl and 4.48 ± 0.95 mg/dl with significantly higher mean uric acid in insulin resistance group, p-value &lt; 0.05. Conclusion: We conclude that females having PCOS with insulin resistance had higher mean uric acid levels. Females with insulin resistance must be prevented from hyperuricemia to minimize the further risk of insulin resistance.

Cancer antigen 125 and C-reactive protein inflammatory mediators and uric acid in association with preeclampsia in North Kordofan State, Western Sudan.

Pathophysiology of pre-eclampsia depends on a defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia and induction of an inflammatory process within the placenta. This process may trigger the expression of Cancer antigen 125 (CA 125), C-reactive protein (CRP) and uric acid (UA). This research aimed to evaluate the association of serum CA 125, CRP and uric acid with Preeclampsia. The study recruited 200 singleton Sudanese pregnant women, who were divided into three groups: controls (n = 100), mild preeclampsia (n = 46) and severe preeclampsia (n = 54). The study subjects were matched for maternal age, gestational age and body mass index. Blood samples were taken for measurement of the different variables using immune- assay and enzymatic automated chemical analysis. The levels of CA 125 in mild and severe preeclampsia were (21.94±0.749 IU/ml) and (40.78±1.336 IU/ml) respectively, which was significantly different (P<0.001) from the control mean (16.48±0.584 IU/ml). There was also a significant difference between the mean levels of CRP in mild and severe preeclampsia (15.17±0.788 mg/L), (31.50±1.709 mg/L) compared with controls (4.79±0.178 mg/L), (P<0.01). There was also a significant difference in the mean levels of UA in mild and severe cases (6.44±0.293 and7.37±0.272) in comparison with the controls (4.00±0.061); (P<0.001). There were significant differences between severe and mild groups (P<0.05). Cancer antigen 125, CRP and UA levels‎ correlated positively with mean arterial blood pressure (MAP) where (r >0.7; P < 0.001). ROC curve validates the utility of these biomarkers for monitoring preeclampsia (AUC >0.8; P < 0.001). In conclusion CA 125, CRP and UA were significantly higher in preeclampsia compared with the controls. The rise of the analytes was directly associated with the severity of the disease.

The problem of hyperuricemia in the hypertensive population of the Nizhny Novgorod region

Objective. To assess the prevalence of hypertension (HTN) in the population of the Nizhny Novgorod region and its relationship with hyperuricemia (HU) and other cardiovascular risk factors. Design and methods. We examined 2501 people aged 35–74 in the population of the Nizhny Novgorod region, selected by the stratified multi-stage random sample. All respondents underwent a laboratory study of the following parameters: total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins, triglycerides (TG), fasting glucose, creatinine, uric acid, highly sensitive C-reactive protein (Hs-CRP) and fibrinogen. We also calculated body mass index (BMI), visceral obesity index with Amato formula and glomerular filtration rate with CKD-EPI formula. Binary logistic regression method was used to construct a predictive model for the risk of HTN. Statistical analysis was performed with IBM SPSS Statistics 26 software (USA). Results. HU was identified in 29,3 % of respondents with HTN. The mean uric acid level in this group was 345,1 [285,6; 410,55] µmol/l and significantly differed from the same indicator in residents without HTN — 297,5 [249,9; 351,1] µmol/L (p &lt; 0,001). In the multiple logistic regression model, the most significant factors associated with HTN were age over 53 years (odds ratio (OR) 2,954, 95 % confidence interval (CI) 2,456-3,554 p &lt; 0,001), abdominal obesity (OR 2,112, 95 % CI 1,663-2,730, p &lt; 0,001) and HU (OR 1,709, 95 % CI 1,341–2,177, p &lt; 0,001). A lesser contribution was made by such factors as the respondents’ BMI over 25 kg/m2 (OR 1,634, 95 % CI 1,262–2,117, p &lt; 0,001), elevated TG level (OR 1,567, 95 % CI 1,289–1,906, p &lt; 0,001), male gender (OR 1,553, 95 % CI 1,281–1,883, p &lt; 0,001), elevated Hs-CRP (OR 1,498, 95 % CI 1,242–1,806, p &lt; 0,001), elevated LDL (OR 1,277, 95 % CI 1,038–1,570, p = 0,020). Conclusions. The results of the study indicate the widespread prevalence of HU in residents of the Nizhny Novgorod region with HTN: almost every third (29,3 %) had this disorder. In a multiple logistic regression model, HU was found to be highly correlated with HTN (OR 1,709, 95 % CI 1,341–2,177, p &lt; 0,001), along with traditional cardiovascular risk factors such as male gender, age, overweight and obesity, lipid metabolism disorders. The high frequency of HU, its independent correlation with HTN, and the prospects for urate-lowering therapy in the prevention of cardiovascular diseases determine the need for further research.

Renal biomarkers in pre-eclampsia and their associations with severity of pre-eclampsia

Background: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in Nigeria and worldwide. It is not yet concluded as to whether or not elevated levels of serum creatinine and/or uric acid could be regarded as a predictive indicator for the severity of the disease. Objectives: To compare the mean serum levels of uric acid and creatinine in preeclamptic and normotensive pregnant women and assess for any associations between these renal biomarkers and the severity of preeclampsia in Nigeria. Materials and Methods: It was a cross-sectional analytical study of 132 women with preeclampsia (n = 61) and normotensive pregnant women (n = 61). The study group comprised eligible consecutive women diagnosed with preeclampsia, whereas the control group comprised appropriately matched normotensive pregnant women. Main outcome measures included the mean serum levels of uric acid and creatinine in both groups, and their levels in cases with mild and severe degrees of preeclampsia. Results: The mean serum levels of uric acid and creatinine were significantly higher in women with preeclampsia than in normotensive pregnant women (7.67 ± 2.9 versus 4.56 ± 1.1; P < 0.001, and 0.76 ± 0.3 versus 0.53 ± 0.1; P < 0.001, respectively). There was no significant difference in the mean serum levels of uric acid and creatinine in women with mild and severe degrees of preeclampsia (6.66 ± 2.3 versus 7.77 ± 2.9; P = 0.37, and 0.56 ± 0.2 versus 0.79 ± 0.4; P = 0.12, respectively). Conclusions: This study has demonstrated that serum uric acid and serum creatinine levels are elevated in pregnancies complicated by preeclampsia. However, there is no significant association between serum levels of these renal biomarkers and the severity of preeclampsia. The studied renal biomarkers are therefore important in the diagnostic workup of preeclampsia but of limited value in the disease prognostication.

Association between uric acid and height during growth hormone therapy in children with idiopathic short stature.

Serum uric acid (UA) within appropriate levels is reported to be beneficial in patients with idiopathic short stature (ISS). This study aimed to evaluate the association between serum UA levels and height standard deviation scores (SDS) in patients with ISS during growth hormone (GH) therapy. A longitudinal study (LG Growth Study) of 182 children (mean age: 7.29±2.60 years) with ISS was performed. All participants were in the prepubertal stage and treated with GH, and the data within a treatment period of 30 months were analyzed. In the adjusted Pearson's correlation, UA was significantly correlated with height SDS after controlling for sex, age, and body mass index (BMI) SDS (r=0.22, p=0.007). In the adjusted multiple regression analyses, the height SDS was significantly associated with UA after controlling for sex, age, and BMI SDS (β=0.168, p=0.007). Within the 30-month treatment period, the UA levels significantly increased as the height SDS increased, and the mean UA levels at baseline and 30 months after treatment were 3.90±0.64 mg/dL and 4.71±0.77 mg/dL, respectively (p=0.007). In conclusion, UA is related to height SDS, and GH treatment leads to a significant increase in UA without hyperuricemia. Elevated UA is considered a favorable outcome of GH therapy, and further studies are needed to determine its role as a monitoring tool.

Status of Serum Uric Acid and Hyperuricemia among Adults in China: China Nutrition and Health Surveillance (2015)

ObjectiveThe purpose of this study was to determine the serum uric acid levels and the prevalence of hyperuricemia among Chinese adults in 2015 and compare the differences between urban and rural areas, as well as the differences between eastern, central, and western regions. MethodsA national representative sample of 180,208 participants were included using a stratified, multistage, and random sampling method. The demographic characteristics and blood samples were collected to determine the serum uric acid levels and prevalence of hyperuricemia among subgroups using complicated sampling weight. A t-test or ANOVA was used for normally-distributed data. The Kruskal-Wallis rank test was used for skewed-distributed data. The Mantel-Haenszel chi-square test was used to compare the difference in categorical variables. ResultsThe weighted mean uric acid level in Chinese adults was 310.4 μmol/L (317.5 μmol/L in urban areas and 302.9 μmol/L in rural areas). The weighted average values of uric acid in eastern, central, and western China were 315.5 μmol/L, 303.5 μmol/L, and 310.4 μmol/L, respectively. The weighted prevalence of hyperuricemia in Chinese adults was 14.6%, with a prevalence of 16.5% in urban areas and 12.5% in rural areas. The weighted prevalence of hyperuricemia in eastern, central, and western China was 16.0%, 12.5%, and 14.8%, respectively. ConclusionThe uric acid level in Chinese adults is relatively high. Effective actions are warranted to improve this metabolic abnormality.

Inflammatory Mediators (CA125, CRP) and Uric Acid in Association with Severity of Preeclampsia in North Kordofan State, Western Sudan

Introduction: Inflammatory mediators could be laboratory markers of preeclampsia, as the induction of an inflammatory process within the placenta may trigger the expression of cancer antigen 125(CA125), C-reactive protein (CRP) and uric acid (UA). Regarding the pathophysiology of pre-eclampsia, there is defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia, and induction of an inflammatory process within the placenta.&#x0D; Objective: To evaluate the association of serum levels of cancer antigen (CA125), C-reactive protein (CRP) and serum uric acid with the Severity of Preeclampsia.&#x0D; Materials and Methods: The study recruited 200 singleton Sudanese pregnant women. These participants were divided into two groups: control (n = 100) and cases (n = 100). The cases were further subdivided into; mild preeclampsia (n =46), and severe preeclampsia (n = 54). The study groups were well-matched in maternal age, gestational age and body mass index. Blood samples were taken for measurement of serum cancer antigen-CA125, uric acid and C - reactive protein using immune- assay and enzymatic automated chemical analysis.&#x0D; Results: The mean levels of cancer antigen-CA125 in mild and severe preeclampsia groups were; 21.94±5.08 (IU/ml) and 40.77±9.82 (IU/ml) respectively, which were significantly higher, (P&lt;0.001) in comparison with the control group (16.88±7.36 (IU/ml). The mean levels of C-reactive protein in mild and severe preeclampsia were; 15.17±5.35 (mg/L), 31.49±12.56 (mg/L) respectively. There was significant difference in their levels, compared to the control group (4.79±1.78 (mg/L), (P&lt;0.01). Also, the mean levels of uric acid in mild and severe cases were; 6.44±1.98 and 7.37±2.00 which was significantly higher, in comparison with the control (4.00±0.61); (P&lt;0.001). The level of uric acid also, showed significant difference within the case (severe and mild) group (P&lt;0.05). CA125, CRP and UA level‎s correlated positively with Mean Arterial blood pressure (MAP), (r&gt;0.7; P &lt; 0.001). ROC curve validate the utility of these biomarker for the detection of preeclampsia severity (AUC&gt;0. 8; P &lt; 0.001).&#x0D; Conclusion: Serum cancer antigen 125(CA125), C- reactive protein and uric acid in studied preeclampsia groups were found to be significantly higher compared with the control group, and the rises were directly associated with the severity of preeclampsia.

Uric acid as a prognostic predictor in COVID-19.

The purpose of our study was to investigate the incidence and prognostic significance of baseline and control uric acid values in COVID-19. The study population included patients admitted with the diagnosis of SARS-CoV-2 between March 2020 and March 2021. The demographic data, clinical, laboratory, and radiological findings were recorded. Uric acid levels were measured at the time of admission for 498 patients and at the most severe period of the disease in 143 patients. Length of hospital stay, need for admission to intensive care unit, the course, and outcomes during hospitalization were recorded. The mean age of 261 male and 207 female patients was 62.7(21-95) years. At the time of admission, 21 patients had hypouricemia and 170 had hyperuricemia. The need for ICU was 47.6% in the hypouricemic, 19.2% in the normouricemic, and 21.2% in the hyperuricemic groups. The mean uric acid level was 5.24±2.54 mg/dl in patients who required ICU admission and 5.18±1.98 mg/dl in patients who were discharged from the ward. The difference was not statistically significant. The mean uric acid level was not significantly different in the deceased and survivors. In 143 subjects, uric acid levels were measured after the progression of COVID-19; 73 of them were admitted to the ICU. The mean uric acid levels were found to be significantly decreased in patients with a negative prognosis. In our study, hypouricemia was not found to be a major feature of SARS-CoV-2 infection. Low baseline uric acid levels were associated with increased ICU admission. The decline in uric acid levels during hospital stay predicted poor prognosis, as well.

ASSOCIATION BETWEEN SERUM URIC ACID AND METABOLIC SYNDROME COMPONENTS AT TERTIARY CARE HOSPITAL, NORTH WEST RAJASTHAN

Objective: The term “metabolic syndrome” (MetS) refers to a concept rather than a specific illness. All cardiovascular events seen in participants cannot be explained by the established risk factors for metabolic syndrome. We investigated the relationship between uric acid levels and the different elements of the metabolic syndrome. Methods: The Department of Medicine, S.P. Medical College, Bikaner, Rajasthan, conducted a case control study from January 2020 to December 2020 on 150 cases of metabolic syndrome as per NCEP ATP III definition criteria and harmonizing definition criteria, admitted in various wards, and 150 healthy individuals taken as controls selected by simple random sampling and matched for confounding factors. Results: Both the study group and the control group had comparable socio-demographics. In the metabolic group (study group), the prevalence of hyperuricemia was 20% with a mean of 6.00±0.98 mg/dL, compared to 22.3% in men and 16.07% in women. When the maximal number of metabolic syndrome components (4 or 5) were present, the mean blood uric acid level was 6.4 1.03 mg/dL (p = 0.001). Conclusion: The incidence of the metabolic syndrome and its elements was substantially correlated with serum uric acid levels.

An angiogenic marker for early prediction of preeclampsia

Background: Preeclampsia is a pregnancy-specific disease associated with a high incidence of maternal and fetal morbidity and mortality with classical features of hypertension, proteinuria, and edema. Aims and Objectives: The aims of the study were to study the angiogenic marker for the early predicting of preeclampsia. Materials and Methods: Blood samples were collected from 75 healthy singleton pregnant women from 19 to 29 years between 12 and 16 weeks of gestation with no underlying medical illness. The serum soluble endoglin (sEng) level and serum uric acid levels were estimated. Patients who developed preeclampsia were classified as mild and severe. They were classified as severe preeclampsia if their serum sEng levels are above 8.5 ng/ml and mild preeclampsia was grouped when the serum sEng level varies from 7.1–8.4 ng/ml. The serum sEng and serum uric acid levels were compared. Serum sEng was processed by ELISA technique and serum uric acid was measured by Uricase method in autoanalyzer. Results: The mean uric acid level was 4.0±0.5 mg/dl in severe preeclampsia and 3.6±0.2 mg/dl in mild preeclampsia patients. The levels were within normal limits. The serum sEng levels were 8.7±1.4 ng/ml in severe preeclampsia and 7.7±0.3 ng/ml in mild preeclampsia. The levels are elevated in preeclampsia. Women with serum sEng levels between 7.1 and 8.2 ng/ml developed symptoms of mild preeclampsia between 28 and 30 weeks of gestation, whereas women with serum sEng levels between 8.5 and 13.4 ng/ml developedsymptoms of severe preeclampsia between 26 and 28 weeks of gestation. Conclusion: Serum uric acid levels were within normal limits in preeclampsia patients, whereas serum sEng levels were elevated in these patients. Thus, this study concludes that serum sEng will be a good predictor of severity of preeclampsia compared to serum uric acid level.

Diagnostic Accuracy of First Trimester Hyperuricemia for Prediction of Subsequent Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus (GDM) is a condition in which pregnant females develop. GDM causes significant and often potentially maternal and fetal complications. Uric acid is the end product of purine metabolism. Recent literature suggests a bidirectional causal relationship between hyperuricemia and insulin resistance. So we conducted this study. Objective: To find diagnostic accuracy of first trimester hyperuricemia for prediction of subsequent gestational diabetes mellitus confirmed on oral glucose tolerance test. Methods: This was a Cross-sectional study conducted at Department of Obstetrics and Gynecology CMH Lahore during time duration 25-4-2017 to 24-10-2017. All females met inclusion criteria were enrolled in this study. Blood samples in first trimester were collected for analysis of serum uric acid. Then after 26-28 weeks of gestation, OGTT was done and presence of GDM was recorded. All the data was collected on proforma. SPSS version 22 was used for data entry and analysis. A 2 x 2 table was generated find the diagnostic accuracy of hyperuricemia taking OGTT as gold standard. Results: The mean age of females was 26.70±5.21years. The mean height, weight and BMI of females were 1.62±0.07m, 61.07±8.54kg and 23.32±3.72kg/m2. The mean gestational age of females was 9.96±.37weeks at time of enrolment in the study. The mean uric acid level at time of presentation was 4.43±3.61mg/dl. In this study, the sensitivity and specificity of hyperuricemia for prediction of GDM were 91.1% and 95.7%. The PPV and NPV of hyperuricemia were 86.8% and 97.2%. The overall diagnostic accuracy was 94.5%. Conclusion: Thus the accuracy of hyperuricemia was high and it is now accepted as reliable marker for prediction of GDM in later pregnancy. Keywords: Diagnostic accuracy, first trimester, hyperuricemia, gestational diabetes mellitus, oral glucose tolerance test, uric acid

Antioxidant Status of Serum Bilirubin, Uric Acid and Albumin in Pemphigus Vulgaris

Objective: To determine antioxidant status of serum bilirubin, uric acid and albumin in pemphigus vulgaris. Study Design: Cross sectional study Place of Study and Duration: This study was done at Department of Dermatology Mayo Hospital Lahore from July 11, 2019 to January 11, 2020. Methodology: All 60 cases meeting inclusion criteria was enrolled after taking informed consent, from outdoor Department of Dermatology Mayo Hospital Lahore. A total of 200 cases meeting inclusion criteria was taken after getting approval from CPSP. A brief demographic information and contact detail was taken. Venous blood was collected from each subject for the evaluation of Serum Bilirubin, Uric Acid and Albumin. Total bilirubin, direct bilirubin, indirect bilirubin, UA and albumin levels was determined using an automatic biochemical analyzer (Model 7600‐120; Hitachi High Technologies, Tokyo, Japan). All the values was recorded as per operational definition. Results: The mean age of patients was 40.08±12.89 years with minimum and maximum age as 18 and 60 years. There were 22(36.7%) male and 38(63.3%) female cases with higher female to male ratio. The mean BMI was 29.08±2.70 with minimum and maximum BMI as 24 and 33.90. The mean serum bilirubin level was 8.51±1.64µmol/L with minimum and maximum serum bilirubin was 5.80µmol/L and 11µmol/L. The mean uric acid levels in this study was 234.37±33.46µmol/L with minimum and maximum value as 160.00µmol/L and 280.00µmol/L. The mean Albumin level in this study was 34.20 ±3.69g/l with minimum and maximum albumin level as 29.00g/l and 41g/l. Conclusion: It is concluded that oxidative stress and antioxidant status are important in the pathogenic mechanism of PV. Hence by keeping these profile in mind that it can be of benefit to administer bilirubin, UA and albumin or their precursors as a replacement therapy to patients with PV who have low antioxidant status. Key Words: Antioxidant status, serum bilirubin, uric acid, albumin, pemphigus vulgaris.

Relationship between maternal serum uric acid level and preeclampsia with or without severe features

Hyperuricaemia is common in preeclampsia. Its relationship and the utility in predicting of preeclampsia must be evaluated. The objective was to determine the association between maternal serum uric acid level and preeclampsia with or without severe features, including maternal and neonatal outcomes. A retrospective study was conducted at Rajavithi Hospital between June 2015 and May 2019. Inferential analysis comparison using binary logistic regression analysis and correlation using Chi-Square test/Fisher’s exact test were used for analysis. Among the 400 participants, 331 (82.7%) women were preeclampsia with severe features. The mean uric acid level was significantly higher in women with preeclampsia with severe features compared to those without (6.44 ± 1.44 vs 5.87 ± 1.53 mg/dL, p-value = .016). Uric acid greater than 7 mg/dL was associated with renal involvement and preeclampsia with severe features. Uric acid 5–7 and greater than 7 mg/dL correlated with preterm birth (OR 2.67, 95% CI 1.59–4.49 and OR 4.89, 95% CI 2.75–8.68, respectively). Uric acid greater than 7 mg/dL also increased the risk of RDS and NICU admission. In conclusion, a high uric acid level is associated with preeclampsia with severe features and adverse pregnancy outcomes and may be the predictor of the severity of preeclampsia. Impact statement What is already known on this subject? Hyperuricaemia is a common finding in preeclamptic pregnancy due to reduction of uric acid clearance secondary to reduced glomerular filtration rate, increased reabsorption, and decreased secretion. The correlation of increase maternal uric acid level and preeclampsia including adverse pregnancy outcomes has been evaluated and supported the use of uric acid as a predictor for preeclampsia development. However, its clinical utility is still debateable. What the results of this study add? The present study demonstrated the association between higher maternal serum uric acid level and severity of preeclampsia. Particularly, serum uric acid greater than 7 mg/dL was associated with preeclampsia with severe features. Additionally, serum uric acid level 5–7 mg/dL and greater than 7 mg/dL had a positive correlation with adverse maternal and neonatal outcomes. What the implications are of these findings for clinical practice and/or further research? Maternal serum uric acid may be used as the predictor of severity of preeclampsia. However, the sensitivity and specificity and the precise clinical utility of uric acid related to preeclampsia need to be further evaluated in larger sample size.

The effect of metabolic risk factors on urinary stone composition: An observational study.

To investigate how the risk factors of metabolic diseases affect urinary stone composition, particularly uric acid (UA) stones. Overall, 583 patients with data on urinary stone composition were retrospectively analyzed and classified into UA and nonUA stone formers according to the presence of the UA component. Various factors were compared between both groups. Participants were categorized according to age, glucose level, HbA1c level, and estimated glomerular filtration rate (eGFR) into subgroups, and the incidence of UA stone was compared. Overall, 137 UA stone formers (23.5%) and 446 nonUA stone formers (76.5%) were included. Mean age and male-to-female ratio were higher in the UA group than in the nonUA group. The rates of diabetes mellitus (DM), hypertension, chronic kidney disease, and coronary artery disease, all of which were associated with differences in urinary stone composition, were higher in the UA group than in the nonUA group. The UA group exhibited lower mean eGFR and higher glucose and HbA1c levels. Similarly, the UA group had higher mean UA levels and predictably lower urinary pH. In subgroup analysis, higher age, glucose level, HbA1c level, and lower eGFR were associated with an increased risk of UA stone formation. In the multivariate logistic regression analysis, the UA group showed a significantly higher age (P < .001), DM frequency (P = .049), and HbA1c level (P = .032), but significantly lower eGFR than the nonUA group (P < .001). Age and DM were independent risk factors for UA urolithiasis, implying a relationship between urinary stone composition and metabolic diseases. Additionally, renal function and HbA1c level were risk factors for UA stones.

Analysis of Correlation between Hyper-Uricemia and Renal Resistivity Index in Normoglycemic Normotensive Patients

Introduction: Hyperuricemia is associated strongly with the development of renal disease and progression. Medical therapy decreases serum uric acid levels by inhibiting the enzyme xanthine oxidase. Objective of the study: To evaluate correlation of mean uric acid level and Renal Resistive Index in normoglycemic and normotensive adult subjects. Material and methods: This descriptive cross-sectional study was conducted in THQ Hospital Fort Abbas during 31-10-2018 to 30-04-2019. One hundred (n=100) non-diabetic, non-hypertensive, recently diagnosed hyperuricemic otherwise healthy subjects irrespective of gender between age 20-40 years were included in the study. After complete history taking and full physical examination laboratory testing including: serum uric acid, serum creatinine to exclude renal decompensation patients, fasting blood sugar and 2 h post prandial were advised. Results: 55.0% (n=55) of patients were males with the mean age of 33.40 years ± 3.85 SD and 45.0% (n=45) of patients were females with mean age of 34.67 years ± 3.33 SD. Cumulative mean age was 33.97 years ± 3.66 SD. The mean value of the RI of the renal arterial vasculature was 0.765 ± 0.0155 SD. The maximum, minimum and range values of the RI were 0.79, 0.74, and 0.04 respectively. The mean serum uric acid value found to be 10.947±0.562 SD. The maximum, minimum and range values of the RI were 0.79, 0.74 and 0.05 respectively. Correlation between the serum uric acid and renal arterial RI prior to the medical therapy and 3 weeks after therapy. A positive correlation was found between both values with a Pearson’s correlation coefficient = 0.103 and p-value 0.308. Conclusions: It is concluded that that medical treatment of hyperuricemia results in lowering of serum uric acid which correlates with the decrease in renal resistive index.