Normal Serum Uric Acid Levels Research Articles

Utility of serum uric acid levels in excluding pulmonary hypertension in severe chronic lung disease: insights from a tertiary care center

Hyperuricemia is a known predictor of World Health Organization (WHO) Group 1 pulmonary hypertension (PH) (pulmonary arterial hypertension), but its role in excluding PH secondary to chronic lung diseases (WHO Group 3) remains unclear. We retrospectively analyzed data from 323 patients with severe chronic pulmonary diseases who underwent evaluation for lung transplantation at a tertiary medical center between June 2017 and February 2023. We examined the association between hyperuricemia (serum uric acid > 6 mg/dL or > 0.357 mmol/L) and PH [mean pulmonary arterial pressure (MPAP) > 20 mmHg]. Compared to the normouricemia group (n = 211), hyperuricemic patients (n = 112) were more likely to be younger (P = 0.02), male (P < 0.001), and present with PH (P = 0.001) and severe PH (MPAP > 35 mmHg; P < 0.001). These patients also had a higher body mass index (P = 0.004), plasma N-terminal pro-B-type natriuretic peptide (P < 0.001), serum creatinine (P < 0.001), and C-reactive protein levels (P = 0.03). Significant associations with PH included higher body mass index (P = 0.005), uric acid levels (P < 0.001), total lung capacity (P = 0.02), and residual volume (P = 0.01); shorter 6-min walk test distance (P = 0.005); and lower forced expiratory volume in one second (P = 0.006) and diffusing capacity for carbon monoxide (P < 0.001). Multivariate analysis showed elevated uric acid levels remained significantly associated with PH (OR 1.29, 95% CI 1.05–1.58, P = 0.01). In conclusion, normal serum uric acid levels serve as a significant predictor for excluding pulmonary hypertension in patients with severe chronic lung diseases.

Establishment and evaluation of a nomogram prediction model for the risk of vascular calcification in stage 5 chronic kidney disease patients

Vascular calcification (VC) is a common complication of chronic kidney disease (CKD) that has a detrimental effect on patients' survival and prognosis. The aim of this study was to develop and validate a practical and reliable prediction model for VC in CKD5 patients. The medical records of 544 CKD5 patients were reviewed retrospectively. Multivariate logistic regression analysis was used to identify the independent risk factors for vascular calcification in patients with CKD5 and then created a nomogram prediction model. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow test, and decision curve analysis (DCA) were used to assess model performance. The patients were split into groups with normal and high serum uric acid levels, and the factors influencing these levels were investigated. Age, BUN, SUA, P and TG were independent risk factors for vascular calcification in CKD5 patients in the modeling group (P < 0.05). In the internal validation, the results of model showed that the AUC was 0.917. No significant divergence between the predicted probability of the nomogram and the actual incidence rate (x2 = 5.406, P = 0.753) was revealed by the calibration plot and HL test, thus confirming that the calibration was satisfactory. The external validation also showed good discrimination (AUC = 0.973). The calibration chart and HL test also demonstrated good consistency. Besides, the correlation analysis of serum uric acid levels in all CKD5 patients revealed that elevated uric acid levels may be related to gender, BUN, P, and TG.

Evaluation of school achievements in adolescents with primary hypertension.

Primary hypertension (HT) is a global public health problem with increasing prevalence in recent years. HT may have caused decreased neurocognitive functions and learning difficulties. In this study, clinical characteristics of adolescents with primary HT were examined and the relationship between semester grade point average (GPA) and HT was evaluated. This is an observational, cross-sectional, descriptive study conducted on adolescents with primary HT attending high school. Patient records (number of hospital visits, HT-related complaints, blood pressure measurements, and laboratory tests) were evaluated retrospectively. End-of-semester report card grades of Mathematics, Turkish Language and Literature and English courses were noted, and compared with the clinical characteristics of the patients. The study included 83 patients with a mean age of 15.6±1.2 years. Patients with higher body mass index had lower grades in Mathematics (p=0.007) and Turkish Language and Literature (p=0.004). Patients with HT-related symptoms such as headache, epistaxis and palpitations had lower GPAs for all courses. Also, patients with hyperuricemia or proteinuria had lower semester GPAs compared to patients with normal serum uric acid levels or without proteinuria (p<0.05). GPAs for Mathematics (p=0.000) and Turkish Language and Literature (p=0.006) decrease as the number of hospital visits increases. HT may cause not only cardiovascular complications but also decreased neurocognitive functions through various mechanisms and may have a negative impact on academic skills. Therefore, HT should be followed up with a multidisciplinary approach and intensive efforts should be made to approach the goal of normotension.

Correlation of glycated hemoglobin with serum uric acid levels among type 2 diabetic patients: a cross-sectional study

Background: Diabetes Mellitus Type 2 (DMT2) is one of the commonest disorders of endocrinology which is characterized by the raised blood glucose level due to insulin resistance in body cells. This study was aimed to determine the correlation between the glycated hemoglobin (HbA1c) and serum uric acid (SUA) in patients with DMT2. Methods: This cross-sectional study was conducted in a tertiary care hospital of Lahore. 73 Patients’ recruitment was made via convenient sampling technique and a developed inclusion and exclusion criteria. Self-structured proforma was used for data collection. Data analysis was done in SPSS version 25.0. Results: From total patients, 40 (54.79%) were women while 33 (45.21%) were men. Means of different variables like age, HbA1c, and serum uric acid level were 54.98 years with standard deviation (SD) of ±11.67 years, 7.90 with SD of ±1.85%, and 7.51 with SD of ±0.81 respectively. 32 (43.83%) patients had good glycemic control whereas 41 (56.17%) patients had poor glycemic control. The frequencies of hyperuricemia and normal SUA in study population were 35 (47.94%) and 38 (52.06%) respectively. The means of the HbA1c across gender had statistically significant difference. Difference in the means of the SUA level, across gender and between patients with hyperuricemia and normal SUA level, was also statistically significant. Moreover, correlation between the HbA1c and SUA was positive and statistically significant. Conclusions: In a nutshell, this study suggests that increase in SUA level, worsen the glycemic control by raising glycated hemoglobin level among patients with DMT2.

Evaluation of serum ischemia modified albumin (IMA) level and serum uric acid level as a preliminary biomarker of epilepsy

Oxidative stress, hypoxia, and ischemia are considered prime factors in the pathogenesis of epilepsy. Hyperuricemia (HU) is a common incidental finding in epileptic patients, but the importance of HU as a risk factor in epilepsy is debated. Many hypothetical mechanisms that link HU to increased oxidative stress in epilepsy have been put forward. This research aimed to evaluate the role of serum Ischemia Modified Albumin (IMA) level and serum uric acid (UA) level as a preliminary biomarker in the diagnosis of epilepsy.: The present cross-sectional research was conducted on 25 individuals having epilepsy and 25 healthy individuals. Serum uric acid level had estimated by the uricase method. Serum IMA was evaluated by albumin cobalt binding assay to assess oxidative stress, hypoxia, and ischemia. Mean Serum UA and IMA level were found significantly high (p&amp;#60;0.001) in epileptic group. In the epileptic group, 76 % (19/25) individuals had HU. Mean serum IMA was higher in epileptic individuals with HU compared to epileptic individuals with normal serum UA levels. Correlation between serum UA level and serum IMA level was found positive among the study population. Serum UA showed a significant odd ratio to predict epilepsy on binary logistic analysis.: The present study revealed that serum UA levels and IMA levels escalated in epileptic patients. Thus, serum UA levels and IMA levels can be deemed as preliminary biomarkers for the diagnosis of epilepsy.

Correlation of Friesinger Score of Angiographic Severity of Coronary Artery with or without Hyperuricaemia among Acute Coronary Syndrome Patients

Background: Angiographic severity of coronary artery is essential to correlate with serum uric acid among acute coronary syndrome patients. Objective: The purpose of the present study was to correlate the Friesinger Score of angiographic severity of coronary artery with or without hyperuricaemia among acute coronary syndrome patients. Methodology: This cross-sectional study was carried out in the Department of Cardiology at National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period of December 2011 to November 2012. Patients who were newly diagnosed as acute coronary syndrome during admission undergoing coronary angiography in National Institute of Cardiovascular Diseases, Dhaka during the specified period of time were the study population. Coronary angiography was done within 4 weeks after hospital admission. Study subjects were divided into two groups on the basis of serum uric acid levels. Patients who were newly diagnosed as acute coronary syndrome having normal serum uric acid levels (&lt;7 mg/dl in men &amp; &lt;6 mg/dl in women) were included in group I. Patients who were newly diagnosed as acute coronary syndrome having elevated serum uric acid levels (&gt;7 mg/dl in men &amp; &gt;6mg/dl in women) were included in group II. Results: A total number of 103 patients were recruited for this study who were divided into two groups and 53 patients having normal serum uric acid were considered in group I and 50 patients having hyperuricaemia acid were considered in group II. The mean age of study subjects among group I and group II are 50.45±10.33 years and 52.98±10.559 years respectively. The value of stenosis in Friesinger score in group II (9.30±3.955) was remarkably higher than that of group I (3.77±3.43) and it was statistically highly significant (p=0.001). Here, the vessel score is also markedly higher in group II (2.14±0.83) than that of group-I (0.77±0.75) (p=0.001). The Pearson's correlation coefficient (r) was 0.288 which was significant (p&lt; 0.037). Conclusion: In conclusion it showed that there was a positive linear correlation between Friesinger scores and normal level of serum uric acid. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):60-64

Association of Normal Serum Uric Acid Level and Cardiovascular Disease in People Without Risk Factors for Cardiac Diseases in China.

Background Healthy individuals with normal level of serum uric acid (SUA) may not be truly at the lowest risk of cardiovascular disease (CVD). This study aimed to assess the association of SUA levels with CVD and its subtypes in people without CVD risk factors and determine a suitable target of SUA to prevent CVD. Methods and Results We enrolled 25 284 participants who were free of CVD, absent of CVD risk factors, and with an SUA level between 180 and 359 μmol/L (3-6 mg/dL) at baseline from the Kailuan study. Cox proportional hazards models were applied to calculated adjusted hazard ratio (HR) and 95% CI for the risk of CVD and its subtypes. During a median follow-up of 12.97 years (interquartile range, 12.68-13.16 years), we identified 1007 cases of CVD. There was an increase in the risk of incident CVD with increasing SUA levels (Ptrend=0.0011). Compared with participants with SUA levels of 180 to 239 μmol/L (3-4 mg/dL), the HR of CVD was 1.12 (95% CI, 0.96-1.31) and 1.28 (95% CI, 1.08-1.52) for SUA levels of 240 to 299 μmol/L (4-5 mg/dL) and 300 to 359 μmol/L (5-6 mg/dL), respectively. A multivariable-adjusted spline regression model showed a J-shaped association between SUA and the risk of CVD. Similar results were observed for stroke and myocardial infarction. Conclusions The risk of incident CVD increased with elevating SUA levels among individuals without hyperuricemia or other traditional CVD risk factors. These findings highlighted the importance of primordial prevention for SUA level increase along with other traditional CVD risk factors.

Frequency of hyperuricemia and fetal outcome in preeclampsia.

Objective: To determine the frequency of hyperuricemia and fetal outcome in pre-eclamptic pregnant patients. Study Design: Cross-Sectional Study. Setting: Department of OBG Allied Hospital Faisalabad. Period: January 15, 2022 to January 15, 2023. Material &amp; Methods: Total 200 preeclamptic patients were enrolled and 5c.c of blood was drawn for serum uric acid level. The normal values took 3.1-6.3 mg/dl. Fetal outcome were intrauterine death, premaurity, intrauterine growth restriction with low birth weight recorded. Results: Frequency of hyperuricemia was calculated as 42% (n=84) where normal uric acid levels were recorded in 58% (n=116). IUD in hyperuricemia was 8.33%(n=7) and 2.59%(n=3) in normal uric acid levels, p=0.06, preterm delivery in hyperuricemia was 52.38%(n=44) and 20.69%(n=24) in normal uric acid level, p=0.000, CS in 55.95%(n=47) in hyperuricemia and 22.41%(n=26) in normal uric acid levels whereas SVD was 44.05%(n=37) in hyperuricemia and 77.59%(n=90) in normal uric acid levels, p=0.000, low birth weight was recorded in 52.38%(n=44) in hyperuricemia whereas 14.66%(n=17) in normal uric acid levels, p=0.000. Conclusion: the frequency of fetal outcome is adverse in hyperuricemia in pre-eclamptic patients as compared to normal serum uric acid levels.

The Association between Water Consumption and Hyperuricemia and Its Relation with Early Arterial Aging in Middle-Aged Lithuanian Metabolic Patients.

Hyperuricemia is well-known as an independent risk factor for the development of hypertension, metabolic syndrome, and cardiovascular disease. Water is essential to most bodily functions, and its consumption rates appear to decline with age. The aim was to evaluate the influence of water intake on early vascular aging in metabolic middle-aged patients with hyperuricemia. The study included 241 men aged 40-55 years and 420 women aged 50-65 years from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program. Anthropometric characteristics, blood pressure, laboratory testing, and the specialized nutrition profile questionnaire were evaluated. Carotid-femoral pulse wave velocity (cfPWV), assessed using applanation tonometry, was evaluated as an early vascular aging parameter in patients with hyperuricemia and with normal serum uric acid (sUA) levels. 72.6% of men and 83.1% of women drink insufficient amounts of water (less than 1.5 L per day). However, our results showed statistically significant relationships only among a group of women. The women in the hyperuricemic group had a higher cfPWV than women with normal sUA levels. In hyperuricemic women, drinking less than 0.5 L per day in combination with other risk factors, such as age, increasing fasting glucose, and systolic blood pressure, was statistically significantly associated with an increased cfPWV (R2 = 0.45, Adj. R2 = 0.42, p < 0.001). Drinking an insufficient amount of water daily is associated with increased arterial stiffness and has a negative effect on vascular health in metabolic women with hyperuricemia.

Hyperuricemia, gout and comorbidity

Hyperuricemia is most often combined with lipid metabolism disorders, modifiable risk factors for coronary heart disease, stroke, abdominal obesity, type 2 diabetes mellitus, arterial hypertension, urolithiasis, chronic kidney disease. Current data indicate the presence of pro-inflammatory, pro-oxidant and vasoconstrictive effects of uric acid, which may contribute to the development of cardiometabolic disorders. Normal serum uric acid levels are &lt;6 mg / dl (&lt;360 mmol / l) for women and &lt;7 mg / dl (&lt;420 mmol / l) for men. Currently, the role of hyperuricemia as an independent biomarker of the risk of cardiovascular events is emphasized. Both gout and subclinical hyperuricemia are associated with unfavorable cardiovascular outcomes. Patients should be informed about the risk factors of hyperuricemia; the need for lifestyle modification, diet compliance, and correction of drug therapy for comorbid conditions. According to international and domestic recommendations, urate-lowering therapy is indicated for asymptomatic hyperuricemia (&gt;360 mmol / l) and high cardiovascular risk. The data available today allow us to consider the target serum uric acid level &lt;5 mg / dl (&lt;300 mmol / l) for patients with high cardiovascular risk, including at least 2 of the following risk factors: hypertension, diabetes mellitus, dyslipidemia, stroke, heart attack, chronic disease kidneys, and &lt;6 mg / dl for patients who do not have these risk factors. The urate-lowering drug is selected taking into account the concomitant pathology and the presence or absence of liver or kidney dysfunction. Xanthine oxidase inhibitors are still the first-line drugs for the correction of hyperuricemia. The superiority of xanthine oxidase inhibitors is due to the potential inhibition of the production of reactive oxygen species and their antioxidant effect. Treatment of gout is aimed at achieving clinical improvement in acute and chronic arthritis, preventing recurrence of arthritis and damage to internal organs, as well as reducing the risks of negative effects on comorbid pathology. Clinicians are faced with the task of controlling cardiovascular diseases in patients with asymptomatic hyperuricemia and gout. Further studies are needed to investigate the relationship between gout, hyperuricemia and increased risk of cardiovascular diseases, as well as to establish a more complete picture of the prevalence of a wide range of comorbid conditions.

Moderate increase of serum uric acid within a normal range is associated with improved cognitive function in a non-normotensive population: A nationally representative cohort study.

BackgroundAssociations between serum uric acid (SUA) and changes in cognitive function are understudied in non-normotensive populations, and many previous studies only considered the baseline SUA at a single time point. We aimed to examine the effects of baseline SUA and 4-year changes in SUA on cognitive changes in the non-normotensive population.Materials and methodsIn the China Health and Retirement Longitudinal Study (CHARLS), cognitive function was measured based on executive function and episodic memory in four visits (years: 2011, 2013, 2015, and 2018). We identified two study cohorts from CHARLS. The first cohort included 3,905 non-normotensive participants. Group-based single-trajectory and multi-trajectory models were applied to identify 7-year cognitive trajectories. Adjusted ordinal logistics models were performed to assess the association between baseline SUA and 7-year cognitive trajectories, and subgroup analyses were conducted according to the presence of hyperuricemia or SUA levels. The second cohort included 2,077 eligible participants. Multiple linear regression was used to explore the effect of a 4-year change in SUA on cognitive change during the subsequent 3-year follow-up.ResultsFour distinct single-trajectories of global cognitive performance and four multi-trajectories of executive function and episodic memory were identified. Higher baseline SUA levels were significantly associated with more favorable cognitive single-trajectories (ORQ4 vs. Q1: 0.755; 95% CI: 0.643, 0.900) and multi-trajectories (ORQ4 vs. Q1: 0.784; 95% CI: 0.659, 0.933). Subgroup analyses revealed that the protective effect of SUA was significant in the non-hyperuricemia groups or the low-level SUA groups. Additionally, changes in SUA could influence future cognitive changes. Compared with non-hyperuricemia participants with elevated SUA, non-hyperuricemia participants with decreased SUA and patients with persistent hyperuricemia had a higher risk for cognitive decline. Furthermore, only the Q3 group of changes in SUA could enhance global cognitive function compared with the Q1 group (β: 0.449; 95% CI: 0.073, 0.826).ConclusionOur study indicates that the maintenance of normal SUA levels and a moderate increase of SUA were advantageous in improving cognitive function or trajectories in a non-normotensive population. Conversely, SUA may impair cognitive function in patients with persistent hyperuricemia.

Association of Serum Uric Acid Levels in Patients with Acute Ischemic Stroke and Clinical Outcome

Background: Stroke is one of the most common, most fatal, and debilitating neurologic diseases. Numerous risk factors are involved in the development of strokes, such as hypertension, cigarette smoking, hyperlipidemia, and diabetes. In addition, other factors may influence the disease's development or course, like uric acid serum level.&#x0D; Objective: To determine the association between serum uric acid (SUA) levels in patients with acute ischemic stroke and clinical outcomes.&#x0D; Material and method: This was a longitudinal descriptive study carried out among one hundred and twenty consecutive patients with acute ischemic stroke (AIS) admitted to the Department of Neuromedicine, Rajshahi Medical College Hospital ( during a period of two years from July'2015 to July' '2017 were included in the study. 12.11 years. Of 120 patients with AIS, 60.8% were male, and 39.2% were female. The study revealed that AIS patients with high SUA levels have significantly lower Glasgow Coma Scale (GCS) scores in comparison to normal SUA levels (p&lt;0.001). There is also a considerably higher modified Rankin Score (mRS) at discharge (4.02 ± 1.47), at one month (4.03 ± 1.01), and at three months (4.21 ± 1.12) (p&lt; 0.001). Thus in our study, mRS analysis showed a significant clinical deterioration in patients with high SUA levels. A comparison of clinical outcomes of AIS patients by MRS between high and normal SUA levels revealed that at three months of follow-up, there is significant deterioration in patients with high SUA levels (p&lt;0.001). There was significantly less improvement with high SUA levels (p&lt;0.001).In this study, a total of 20 patients died at different intervals; at discharge (11), at one month (3), and three months (6). The study showed that patients with high SUA levels had significantly increased mortality in comparison to patients having normal SUA levels. It was statistically significant at discharge and one month (p&lt;0.01 and p&lt;0.05) but not significant at three months (p&gt;0.05).&#x0D; Conclusion: A significant association was found between high serum uric acid levels and the clinical outcome of AIS patients. Estimation of serum uric acid offers a simple, inexpensive, quick, and non-invasive method for identifying such high-risk patients.&#x0D; TAJ 2022; 35: No-1: 63-69

Retinal Microvasculature and Choriocapillaris Flow Deficit in Relation to Serum Uric Acid Using Swept-Source Optical Coherence Tomography Angiography.

PurposeTo explore the relationship between serum uric acid (SUA) and retinochoroidal microcirculation in the Chinese population.MethodsThis prospective cross-sectional study was conducted among the residents of Guangzhou, southern China. A commercially available optical coherence tomography angiography (OCTA) device was used to obtain the superficial vessel density (SVD) and deep vessel density in the retina and the choriocapillaris flow deficit (CFD) in the macular region. Univariable and multivariable linear regression models were used to assess the association of hyperuricemia and SUA levels with OCTA parameters.ResultsA total of 638 participants with normal SUA and 296 participants with hyperuricemia were included in the study. Parafoveal SVD was significantly reduced among the participants with hyperuricemia compared to participants with normal SUA (P < 0.001), while the parafoveal CFD was higher in hyperuricemic participants than those of normal SUA levels (P = 0.007). After adjusting for potential confounders, greater SUA levels was associated with lower SVD (β = −0.078; P < 0.001) and greater CFD (β = 0.015; P = 0.011). Gender difference analysis indicated that a 10-µmol/L increase in SUA levels among the female participants led to a 0.144 decrease in SVD (P < 0.001), but it was not statistically significant for the male participants (P = 0.653).ConclusionsAn elevated uric acid level and its fluctuations were independently associated with impaired retinal and choroidal microcirculation using OCTA in the study population. Women appear to be more sensitive to high SUA levels than men.Translational RelevanceElevating uric acid concentration may play a role in the development and progression of cardiovascular diseases through microvascular alteration, as demonstrated by OCTA parameters.

Examining an Association of Single Nucleotide Polymorphisms with Hyperuricemia in Chinese Flight Attendants.

BackgroundBoth genetic and environmental factors strongly affect serum uric acid (SUA) concentrations. The incidence of hyperuricemia tends to be younger in the Chinese population. In particular, we have found a high prevalence of hyperuricemia among Chinese flight attendants, aged from 20 to 40, in our survey. This study aims to evaluate whether there is an association between gene polymorphisms and hyperuricemia among Chinese flight attendants.MethodsA total of 532 flight attendants with high and normal serum uric acid levels were recruited. Allele-specific polymerase chain reaction (AS-PCR) was performed using blood samples of enrolled subjects.ResultsPrevious studies have reported single nucleotide polymorphisms (SNPs) that are tightly associated with uric acid levels. Among them, six SNPs that are strongly associated with SUA or gout in Asians, for instance ABCG2 (rs2231142, rs72552713 and rs2231137), GCKR (rs780094), SLC2A9 (rs1014290) and SLC17A1 (rs1183201), were selected for AS-PCR analyses. We found that SNPs such as ABCG2 rs2231142, GCKR rs780094 and SLC2A9 rs1014290 are strongly associated with hyperuricemia in male flight attendants, and SLC2A9 rs1014290 among female flight attendants.ConclusionOur study provides evidences of an association between SNPs and hyperuricemia in the Chinese flight attendants, and highlights the significance of improving diagnostics and prevention of disease development in uric acid metabolism disorders and gout using these SNPs.

Prevalence of High Serum Uric Acid in Patients with Acute Myocardial Infarction in Rajshahi Medical College Hospital

Coronary artery disease is one of the commonest causes of death of our hospitalized patients. It has a number of risk factors such as age, sex, family history, smoking, hypertension, diabetes, dyslipidemia and obesity. Serum uric acid appears to be another risk factor found in several researches. This study was done to find out the prevalence of high serum uric acid in hospitalized acute myocardial infarction patients. This was a descriptive cross-sectional study carried out in department of Cardiology, Rajshahi medical college hospital from January 2015 to December 2016. 115 (one hundred fifteen) AMI patients were included. Baseline characteristics such as age, sex, body mass index, blood pressure, risk factors-hypertension, diabetes mellitus, smoking, family history of IHD, dyslipidemia was recorded. We measured serum uric acid of this patient at admission. Out of 115 patients, 83.5% were male and 16.5% were female. Among risk factors 65.2% had history of hypertension, 20.9% diabetes mellitus, 64.3% smoking, 16.5% family history of IHD and 47.8% dyslipidemia. Out of 115 patients, 35.7% had high serum uric acid and 64.3% had normal serum uric acid. There was no significant difference of confounding variables between high and normal serum uric acid level patients. We found larger number of AMI patients with high serum uric acid. So, high serum uric acid may be a risk factor for acute myocardial infarction. TAJ 2021; 34: No-2: 102-107

A study to assess the relationship between donor uric acid levels and supernatant hemolysis in stored packed red blood cell units.

Most of the red blood cell (RBC) storage lesions can be attributed to oxidative stress encountered by the RBCs throughout the duration of their storage. Various donor variables at the time of donation may be responsible for the total antioxidant capacity of the supernatant and thus, the "storability" and the magnitude of development of these RBC storage lesions. It is known that uric acid (UA) is responsible for more than 60% of the TAC of the blood. This study aims to explore the relationship between donor UA levels and the difference in percentage hemolysis, an important RBC storage lesion, on day 1 and day 21, in stored packed RBCs (PRBCs) units. The serum UA of 100 healthy voluntary male blood donors was estimated at the time of blood donation. The percentage hemolysis in the supernatant of the leukoreduced citrate phosphate dextrose/saline-adenine-glucose-mannitol RBC units (n = 100) prepared from these donors was calculated on day 1 and day 21. The difference in percentage hemolysis between donors with high normal serum UA levels (>7 mg/dL) was compared to that of the donors with low normal serum UA levels (<5 mg/dL) to observe the effect of donor UA levels on the difference in percentage hemolysis. The mean of the differences in percentage hemolysis in the supernatant in low UA group (<5 mg/dL) was higher than the mean of the differences in percentage hemolysis in the supernatant in high UA group (>7 mg/dL) and this was statistically significant (P < 0.001). The donor serum UA level and difference in percentage hemolysis on day 21 and day 1 were found to be negatively co-related. Higher levels of serum UA of blood donors seem to have a protective effect on the stored PRBC units as shown in this study. Hence, the potential of UA as one of the constituents of RBC additive solutions might lead to the enhancement of the quality of stored PRBC units by decreasing the RBC storage lesions.

Association between hyperuricaemia and clinical pathological characteristics of patients with IgA nephropathy.

To study the association of hyperuricaemia with clinical and pathological characteristics of patients with IgA nephropathy, and to clarify adverse effects of hyperuricaemia on the onset and progression of IgA nephropathy. A total of 244 patients with IgA nephropathy enrolled in Jiangjin Center Hospital were divided into a group with normal serum uric acid level and a group with elevated level. Age, gender, course of disease, blood pressure, liver function, renal function, blood lipid levels, blood glucose level, 24-hour urine protein level and pathological grades were recorded. The correlations of serum uric acid level with clinical indices and pathological grades were analyzed. The incidence rate of IgA nephropathy complicated with hyperuricaemia was 25.4%. The two groups had significantly different course of disease, body mass index (BMI), and levels of urea nitrogen, creatinine, triglyceride and urine protein (p<0.05). The group with elevated serum uric acid level had higher Lee's grade, tubulointerstitial lesion grade and renal arteriolar lesion grade. Patients with IgA nephropathy were prone to hyperuricaemia, being closely correlated with BMI, course of disease, blood pressure, triglyceride level and renal function. High pathological grades were important indices for poor prognosis. The serum uric acid levels of patients with IgA nephropathy should be monitored to effectively control hyperuricaemia and to avoid its complications.

Prognostic impact of uric acid in patients with acute decompensated heart failure

To evaluate the prognostic impact of serum uric acid (SUA) on clinical outcomes in patients with acute decompensated heart failure, as well as identify the correlation between hyperuricemia and renal function and diuretic resistance in these patients. The study included 175 patients (125 men and 50 women) with NYHA class IIIV acute decompensated heart failure. Median age was 64 (5675) years. The Information regarding the survival was obtained 3 years after the admission by telephone calls. 57 patients reached the end point (death from all causes); therefore, all patients were divided into groups: "alive", "dead". The SUA levels did not differ in the groups. The only significant difference in the studied parameters was the estimated glomerular filtration rate (eGFR), which was significantly higher in the "alive" group [70.5 (52.894) and 56 (4079), respectively; p=0.006]. A moderate negative correlation was found between SUA levels and eGFR in the correlation analysis (r=-0.313, p0.001). A comparative analysis showed, that SUA level on admission was significantly higher in patients who subsequently received increased doses of diuretics than in patients with a satisfactory response to standard doses of diuretics [567.8 (479.6791.9) and 512 (422.4619.4), respectively; p=0.011]. Also, higher eGFR level on admission was observed in patients from the normal SUA level group than in patients from the hyperuricemia group [94 (74.5101.5) and 63 (48.881.3), respectively; p=0.002]. We found no significant differences in the uric acid level in patients who reached the end point and those who did not reach it during the three-year follow-up. However, the found correlation between uric acid levels and diuretic resistance calls for further research.

Individual and combined association analysis of famine exposure and serum uric acid with hypertension in the mid-aged and older adult: a population-based cross-sectional study

BackgroundMalnutrition in early life may affect health in later life. The associations between malnutrition and serum uric acid (SUA) and hypertension were inconsistent. The present study aimed to investigate the individual and combined association between famine exposure and serum uric acid and hypertension in middle-aged and older Chinese.MethodsData were selected from the China Health and Retirement Longitudinal Study (CHARLS) Wave2011. The analytic sample included 9368 individuals aged 45 to 90. Differences between baseline characteristics and famine exposure/SUA level were evaluated using the Chi-square test, t-test, and F-test. Then, the differences in the prevalence of hypertension between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined association of famine exposure and serum uric acid with odds of prevalence of hypertension.ResultsA total of 9368 individuals were enrolled in the study, 4366 (46.61%) and 5002 (53.39%) were male and female, respectively. Among males, 459 (10.51%) had been exposed to the Chinese famine during the fetal stage, whereas 1760 (40.31%) and 1645 (37.68%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Among females, 635 (12.69%) had been exposed to the Chinese famine during the fetal stage, whereas 1988 (39.74%) and 1569 (31.37%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with SUA level measurements, 290 (6.64%) reported having Hyperuricemia (HUA) in males and 234 (4.68%) in the females. Furthermore, 1357 (31.08%) reported having hypertension in male and 1619 (32.37%) in the female. In multivariable-adjusted model, famine exposure and serum uric acid were associated with prevalence of hypertension independently in total populations [(1) Model fourd, fatal exposed group vs non-exposed group: 1.25 (95% CI 1.03, 1.52); childhood-exposed group vs non-exposed group:1.60 (95% CI 1.37, 1.87); adolescence/adult exposed group vs non-exposed group: 2.87 (95% CI 2.44, 3.37), P for trend < 0.001; (2) Model four e, high vs normal:1.73 (95% CI 1.44, 2.08)]. When stratified by sex, the results in both males and females were similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal SUA level and no-exposed famine stage, all groups trended towards higher odds of prevalence of hypertension [the greatest increase in odds, adolescence/adult exposed stage and high SUA level in total participants: OR4.34; 95%CI 3.24, 5.81; P for interaction < 0.001]. When stratified by sex, the results in both males and females were also similar to those in the total population.ConclusionOur data support a strongly positive individual and combined association of famine exposure and serum uric acid with hypertension in middle-aged and elderly Chinese.

Analysis of the effect of asymptomatic hyperuricemia on the effectiveness after arthroscopic rotator cuff repair

To investigate the effect of asymptomatic hyperuricemia on the effectiveness of arthroscopic rotator cuff repair. The clinical data of 80 patients who underwent arthroscopic rotator cuff repair and met the selection criteria between March 2018 and December 2019 were retrospectively analyzed. According to the serum uric acid level, the patients were divided into hyperuric acid group (46 cases, the serum uric acid level was more than 417 μmol/L in males and was more than 357 μmol/L in females) and normal group (34 cases, serum uric acid level was lower than the above standard). There was no significant difference in gender, age, side, body mass index, blood glucose level, total cholesterol level, rotator cuff tear size, and preoperative shoulder motion, visual analogue scale (VAS) score, University of California-Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and other general data between the two groups ( P>0.05). The range of motion of abduction, forward flexion, and external rotation at 90° abduction were recorded and compared between the two groups before operation and at last follow-up; the improvement of shoulder pain was evaluated by VAS score; the improvement of shoulder function was evaluated by UCLA score, Constant score, and ASES score; and the shoulder joint MRI grade was evaluated according to Sugaya evaluation criteria. All patients were followed up 9-16 months, with an average of 11.9 months; there was no significant difference in the follow-up time between the two groups ( t=0.968, P=0.336). There were 2 cases of retear in the hyperuric acid group (including 1 case of severe tear) and 1 case of light retear in the normal group. The remaining patients in the two groups had no early-related complications. At last follow-up, the range of motion of the shoulder joints (abduction, forward flexion, external rotation at 90° abduction), VAS score, UCLA score, Constant score, and ASES score of the two groups were significantly improved when compared with preoperative ones ( P<0.05); the above indicators in the normal group were significantly better than those in the hyperuric acid group ( P<0.05). The MRI grade of the shoulder joint in the normal group was significantly better than that in the hyperuric acid group ( Z=-2.000, P=0.045). Compared with patients with normal serum uric acid level, asymptomatic hyperuricemia can lead to worse recovery after arthroscopic rotator cuff repair in patients with rotator cuff tears.