Quartiles Of Uric Acid Levels Research Articles

Uric acid and evaluate the coronary vascular stenosis gensini score correlation research and in gender differences

Background and aimsRecent studies have shown that the negative effect of uric acid (UA) on coronary arteries determines the severity of atherosclerotic disease. This study aims to explore the relationship between serum UA level and Gensini score, which reflects the severity of coronary artery disease.MethodsA total of 860 patients with suspected coronary heart disease who were admitted to hospital due to angina pectoris or myocardial ischemia related symptoms and received coronary angiography were selected. Based on the findings of the angiography, they were categorized into two groups: the coronary heart disease (CHD) group (n = 625) and the control group (n = 235). The uric acid levels and other clinical data were compared between these groups. Additionally, the prevalence of coronary heart disease and Gensini score were compared between the groups, considering gender-specific quartiles of uric acid levels. The clinical baseline data were analyzed using appropriate statistical methods, and multivariate logistic regression analysis was conducted to identify independent risk factors for coronary heart disease.ResultsOf 860 patients (mean age, 63.97 ± 11.87 years), 528 were men (mean age, 62.06 ± 11.5 years) and 332 were women (mean age, 66.99 ± 10.11 years). The proportion of smoking, diabetes, hypertension, and hyperlipidemia in the coronary heart disease group was higher than that in the control group (P < 0.05). HbA1C, Gensini score, BMI, TG and hsCRP in the coronary heart disease group were higher than those in the control group (P < 0.05), and HDL-C was lower than that in the control group (P < 0.05). There were no significant differences in age, heart rate, Cr, TC and LDL-C between the two groups (P > 0.05).Multivariate logistic regression analysis showed that age, hypertension, hsCRP and SUA levels increased the risk of coronary heart disease, and the difference was statistically significant(OR = 1.034,95%CI 1.016–1.052, P = 0.001; OR = 1.469,95%CI 1.007–2.142, P = 0.046;OR = 1.064,95%CI 1.026–1.105, P = 0.001; OR = 1.011,95%CI 1.008–1.014, P < 0.001).ConclusionSerum uric acid is positively correlated with Gensini score in patients with coronary heart disease, which is an independent factor for evaluating the degree of coronary artery stenosis and has a predictive effect.

Association between Serum Uric Acid Levels and Bone Mineral Density in Taiwanese Elderly Population.

Osteoporosis is a progressive metabolic bone disorder characterised by a decline in bone mineral density (BMD). Some previous studies have reported a controversial relationship between uric acid and osteoporosis. This cross-sectional study aimed to assess the association between serum uric acid levels and BMD in older adults from Taiwan. Data from participants aged ≥ 60 years were collected from 2008 to 2018. Furthermore, the participants were classified based on uric acid level quartiles. Regression models were used to assess the association between uric acid levels and bone health, including BMD values and risk of at least osteopenia. Crude and adjusted models of potential confounders, including age, sex and body mass index (BMI), were used. Compared with the first quartile of uric acid levels, the odds ratios for osteoporosis decreased in the higher uric acid level groups after adjustment for age, sex and BMI. The boxplot analysis showed that BMD values were higher in the groups with higher uric acid levels; moreover, the results of the multivariable linear regression model showed a consistent pattern. Notably, uric acid levels were positively correlated with BMD values. Higher uric acid levels in the elderly population might decrease the risk of at least osteopenia. As opposed to the anti-hyperuricemic policy for younger adults with a relatively lower risk of osteoporosis, BMD evaluation and urate-lowering therapy, goal adjustments should be considered for older adults with lower uric acid levels.

The Inter-Trimester Variation and Prognostic Value of Creatinine, Cystatin C and Uric Acid in Preeclamptic Patients: A Retrospective Study

Background: This study aimed to evaluate the clinical significance of maternal serum creatinine, cystatin C, and uric acid levels in relation to fetal death in pregnant women with preeclampsia. Methods: This retrospective study evaluated 708 women with preeclampsia, and 738 healthy pregnant women were selected as control. Medical records were reviewed to collect obstetric, neonatal, and biochemical data, including creatinine, cystatin C, and uric acid concentrations. Results: Maternal serum creatinine, cystatin C, and uric acid concentrations were significantly higher in the preeclamptic group than in the control (p &lt; 0.05). Preeclamptic women in the fetal death group had significantly higher creatinine levels during their second and third trimesters, and higher uric acid concentrations throughout the pregnancy compared to the fetal survival group. Preeclamptic patients were divided into four groups based on quartiles of uric acid levels. The overall fetal survival rate in patients with upper-quartile uric acid concentrations was significantly lower than those with low uric acid levels during pregnancy. Multivariate logistic regression analysis revealed that uric acid concentration was a significant risk factor for fetal death in the first and second trimesters in the preeclamptic group (p &lt; 0.05). Conclusions: In pregnant women with preeclampsia, fetal death was associated with upper-quartile uric acid concentrations in the first and second trimesters. Uric acid levels can be an indicator of fetal death in the early and middle stage of pregnancy.

Abstract 14079: Association Between Serum Uric Acid Level and Metabolic Syndrome in a Rural Japanese Population: A Multi-Center Study

Introduction: Several reports have showed associations between serum uric acid (UA) levels and metabolic syndrome (MetS). Limited information, however, is available concerning the prospective relation between UA and the risk of developing MetS. Hypothesis: Hyperuricemia would be related to higher odds for MetS in a rural Japanese population. Methods: We evaluated 2406 subjects (1275 male subjects, 1131 female subjects; mean age 49.9 years) who underwent health examination programs in 2008 and 2013, who were free of MetS in 2008. We conducted this multi-center study in two hospitals located in northern Hiroshima prefecture. Results: At baseline, hyperuricemia was detected in 258 male subjects (20%) and 41 female subjects (3.6%). Subjects with hyperuricemia at baseline had significantly higher MetS prevalence in 2013 than those without (male subjects: 14.7% vs. 9.1%, P=0.01; female subjects: 9.8% vs. 1.7%, P=0.008). Compared with subjects in the first quartile of uric acid levels at baseline, the age-adjusted odds ratios (ORs) for cumulative incidence of MetS among subjects in the second, third, and fourth quartile were, 0.77 (95% confidence interval (CI), 0.40-1.48; P=0.43), 1.79 (95% CI, 1.05-3.06; P=0.03) and 2.17 (95% CI, 1.28-3.70; P=0.004), for male subjects. Compared with subjects in the second quartile of uric acid levels at baseline, the age-adjusted ORs for cumulative incidence of MetS among subjects in the third, and fourth quartile were 2.46 (95% CI, 0.47-12.9; P=0.29), 7.34 (95% CI, 1.65-32.6; P=0.009), for female subjects. Multivariable logistic analysis revealed that hyperuricemia was significantly associated with cumulative incidence of MetS in male and more significantly in female subjects (male: OR, 1.79 [95% CI, 1.19-2.69; P=0.005], female: OR, 6.34 [95% CI, 2.03-20.0; P=0.002]). Conclusions: Hyperuricemia is a significant predictor of MetS in rural Japanese population and more significantly in female.

TELOMERE LENGTH IS NEGATIVELY ASSOCIATED WITH BMI, R WAVE IN AVL AND IL-6 LEVEL IN PATIENTS WITH NEW CASES OF HYPERTENSION

Objective: The aim of the study was to investigate the association between lymphocyte telomere length and cardiovascular risk factors in patients with new cases of hypertension according to 10-years prospective study in urban randomised population. Design and method: In 2007/2008 10-years prospective study of 3500 persons living in a district of Vitebsk (Belarus) and selected by the random number method started (coverage of the survey was 97.9%). According to the results of first examination 2170 persons had normal blood pressure. 1862 of them were examined on the second stage of the study in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (&gt; = 339 mol/l), determined on the first stage of the study. A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Results: We examined 2170 persons with normal blood pressure in 2007/2008. On the second stage of the study 286 new cases of hypertension were diagnosed in these subjects (14,4% of men and 12,2% of women). According to multifactorial regression analysis of 145 randomized subjects of 286 new cases of hypertension, adjusted for age and sex, the IV quartile of uric acid level (339–527 mol/l), determined on the first stage of the study, was associated with the I quartile of telomere length in 10 years (df = 1; 2Wald = 4,5; p &lt; 0,05). Cross-sectional analysis of these subjects showed that the level of telomere length had a significant negative association with BMI (=-0,19; p &lt; 0,05), R wave in aVL (=-0,18; p &lt; 0,05), IL-6 level (=-0,20; p &lt; 0,05) in 2017/2018. Conclusions: Regardless of age and sex, telomere length has negative association with BMI, R wave in aVL and IL-6 level in patients with new cases of hypertension.

Longitudinal association between serum uric acid level and carotid atherosclerotic plaques in patients with new cases of hypertension

Abstract Objective To reveal the relationship between uric acid level and carotid atherosclerotic plaques in hypertensive subjects in randomized urban population according to 10-years prospective study. Design and methods A 10-years prospective study included 3,500 randomized individuals living in the district of Vitebsk (2007/2008 - 2017/2018). The coverage of the survey was 97,9% (3427 participants). There was revealed 2170 persons with normal blood pressure. 1862 of them were examined on the second stage in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (≥339 μmol/l). A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Specially developed registration form was filled in for all the participants and it included socio-demographic data, standard questionnaires for detection of cardiovascular risk factors, anthropometry, blood pressure measurements, electrocardiography, blood chemistry, ultrasound examination of brachiocephalic arteries and echocardiography. Results According to the results of 10-years prospective study serum uric acid level ≥339 μmol/l, revealed at the start of the study, is a predictor of the detection of carotid atherosclerotic plaques in 2017/2018 in subjects with new cases of hypertension (df=1; χ2 Wald=6,63; p&amp;lt;0,05) adjusted for age and gender. Cross-sectional analysis of these subjects showed that the level of uric acid, regardless of age and gender, is associated with the level of triglycerides (p&amp;lt;0,001), apo B (p&amp;lt;0,001), apo A1 (p&amp;lt;0,05), LDL (p&amp;lt;0,05), VLDL (p&amp;lt;0,05), HDL (p&amp;lt;0,05), non-HDL-C (p&amp;lt;0,05), total cholesterol (p&amp;lt;0,05), high-sensitivity CRP (p&amp;lt;0,05), TNF-α (p&amp;lt;0,05), apoB/apoA1 ratio (p&amp;lt;0,05), glycated hemoglobin percentage (p&amp;lt;0,05), body mass index (p&amp;lt;0,001), waist circumference (p&amp;lt;0,05), metabolic syndrome (p&amp;lt;0,05) and alcohol abuse (p&amp;lt;0,05). In stepwise multiple linear regression model the most significant of these factors were the level of triglycerides (β=0,23, p&amp;lt;0,05), alcohol abuse (β=0,18, p&amp;lt;0,05), body mass index (β=0,18, p&amp;lt;0,05), apoB/apoA1 ratio (β=0,17, p&amp;lt;0,05) and level of high-sensitivity CRP (β=0,15, p&amp;lt;0,05). Conclusions Serum uric acid level ≥339 μmol/l predicted detection of carotid atherosclerotic plaques in patients with new cases of hypertension in 10-years prospective study. The most significant factors, regardless of age and gender, associated with serum uric acid levels in these patients were level of triglycerides, alcohol abuse, body mass index, apoB/apoA1 ratio and level of high-sensitivity C-reactive protein. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Republican Scientific and Practical Centre of Cardiology

HYPERURICEMIA AND TELOMERE LENGTH IN SUBJECTS WITH NEW CASES OF HYPERTENSION ACCORDING TO THE 10-YEAR PROSPECTIVE STUDY

Objective: To reveal the association of high level of serum uric acid and telomere length in 10-year prospective study using the data from Belarusian national representative survey. Design and method: In 2007/2008 a 10-year prospective analysis of 3500 randomized individuals living in a district of Vitebsk started (coverage of the survey was 97.9%). In 2012/2013 there was a second screening of this population (coverage of the survey was 84.3%) respectively. In 2017/2018 a 10-years prospective analysis included subjects with newly diagnosed hypertension in the second screening. Examination of these patients included standard questionnaires for detection of cardiovascular risk factors, measurements of blood pressure, blood chemistry, electrocardiography, echocardiography, ultrasound examination of brachiocephalic vessels, real-time PCR for the detection telomere length of peripheral blood lymphocytes. Results: We examined population of 2171 persons with normal blood pressure and 1257 persons with hypertension in 2007/2008. 286 new cases of hypertension developed in 5 years (14,4% of men and 12,2% of women). According to multifactorial regression analysis we revealed significant positive relationship between the frequency of new cases of hypertension and IV quartile of serum uric acid level (339–527 mmol/l) (df = 1; c2Wald = 5,1; p &lt; 0,05) as well as other risk factors, adjusted for age and sex. Regression analysis of 170 randomized subjects showed that the IV quartile of uric acid level (339–527 mmol/l), determined at first screening, was associated with the I quartile of telomere length in 10 years in subjects with newly diagnosed hypertension adjusted for age and sex (df = 1; c2Wald = 4,9; p &lt; 0,05). Conclusions: Level of serum uric acid &gt; = 339 mmol/l was a risk factor for the development hypertension in 5 years in randomized urban population and detection of lower level of telomere length in 10 years in persons with new cases of hypertension.

Telomere length and uric acid in patients with new cases of hypertension according to the 10-year prospective study in urban randomized population

Abstract Objective To reveal the association between lymphocyte telomere length and serum uric acid level in 10-year prospective randomized study of Belarusian urban population. Design and method In 2007/2008 a 10-year prospective study of 3500 persons living in a district of a belarussian city and selected by the random number method started (coverage of the survey was 97.9%). In 2012/2013 according to the results of the second screening 2888 people were examined (coverage of the survey was 84.3%). A 10-year prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed in the second screening. Examination of these patients consisted of standard cardiovascular risk factors questionnaires, measurements of blood pressure, blood chemistry, electrocardiography, echocardiography, ultrasound examination of brachiocephalic vessels, real time PCR for the detection of telomere length of peripheral blood lymphocytes. Results 2171 persons with normal blood pressure and 1257 persons with hypertension were examined in 2007/2008. In the second screening we established 286 new cases of hypertension (14,4% of men and 12,2% of women). According to multifactorial regression analysis, adjusted for age and sex, a significant positive relationship between new cases of hypertension and IV quartile of uric acid level (339–527 μmol/l) was revealed in 5 years (df=1; χ2 Wald=5,1; p&amp;lt;0,05). Regression analysis of 145 randomized subjects of 286 new cases of hypertension showed that, adjusted for age and sex, the IV quartile of uric acid level (339–527 μmol/l), determined in the first screening, was also associated with the I quartile of telomere length in 10 years (df=1; χ2 Wald=4,5; p&amp;lt;0,05). It was investigated that the level of telomere length had a significant negative association with BMI (p&amp;lt;0.05), R wave in aVL (p&amp;lt;0.05), IL-6 level (p&amp;lt;0,05) in these subjects in cross-sectional study in 2017/2018. Conclusions Regardless of age and sex, level of serum uric acid ≥339 μmol/l was a risk factor for development of hypertension in randomized population in 5-year prospective analysis and predicted lower telomere length in patients with new cases of hypertension in 10-year prospective analysis. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): State scientific and technical program “Medical and diagnostic technologies”, subprograms “Heart and blood vessels”

Serum uric acid in Korean children and adolescents: reference percentiles and association with metabolic syndrome.

PurposeTo establish age/sex-specific reference intervals for serum uric acid and to examine the associations between serum uric acid level and metabolic syndrome (MetS) and its components in Korean children and adolescents.MethodsWe analyzed data for 1,349 subjects aged 10 to 19 years from the Korea National Health and Nutrition Examination Survey 2016–2017.ResultsThe mean uric acid levels were 5.9±1.3 mg/dL (interquartile range, 5.0–6.8 mg/dL) in males and 4.6±0.9 mg/dL (interquartile range, 3.9–5.2 mg/dL) in females. The mean uric acid level increased significantly from 10–13 years of age in males, but not in females. The overall prevalence of MetS was 5.9% (7.3% in males and 4.3% in females; P=0.022). The prevalences of MetS in the lowest, second, third, and highest quartiles of uric acid level were 4.4%, 3.3%, 6.1%, and 15.2%, respectively, in males (P for trend <0.001) and 1.9%, 0.0%, 4.1%, and 10.9%, respectively, in females (P for trend <0.001). Compared with the lowest quartile of uric acid level, the odds ratio (with 95% confidence interval) for MetS in the highest quartile was 2.897 (1.140–7.361) in males and 5.173 (1.459–18.342) in females. Subjects in the highest quartile exhibited increased risk for abdominal obesity and low high-density lipoprotein cholesterol in both sexes.ConclusionsSerum uric acid level is positively associated with MetS and its components abdominal obesity and low high-density lipoprotein cholesterol.

Impact of uric acid levels on the risk of long-term cardiovascular mortality in patients with type 2 diabetes mellitus

BackgroundHyperuricemia is associated to cardiovascular disease. However, the contribution of uric acid (UA) to cardiovascular mortality in diabetic patients is controversial. ObjectiveTo assess the impact of UA levels on the risk of cardiovascular mortality risk in a cohort of patients with type 2 diabetes mellitus (T2DM). Patients and methodsA prospective cohort study on outpatients with T2DM. The clinical endpoint was cardiovascular death. Anthropometric, demographic, clinical, and biochemical variables were collected, including UA levels, urinary albumin excretion and estimated glomerular filtration rate. The independent contribution of UA levels to cardiovascular mortality was assessed using multivariate Cox regression models, progressively adjusted for potential confounders. ResultsA total of 452 patients with a mean age of 65.9 (SD 9.5) years were enrolled. Mean UA level was 4.2mg/dl. Quartiles of UA levels were Q1<3.3; Q2: 3.3–4.2; Q3: 4.3–5.1; Q4>5.1mg/dl. UA levels significantly correlated with estimated glomerular filtration rate (Rho=−0.227; p<0.001). During a median follow-up time of 13 years, cardiovascular mortality rates were higher in Q4 of the UA distribution (Q1: 10.7; Q2: 11.7; Q3: 10.7; Q4: 21.6 per 1000 patient-years; p=0.027). UA was a predictor of cardiovascular mortality in the univariate analysis (HR1mg/dl=1.30; p=0.002), but not in a multivariate analysis adjusted for urinary albumin excretion and eGFR (HR1mg/dl=1.20; p=0.12). Discussion and conclusionsHigh UA levels are associated to cardiovascular mortality in patients with T2DM. However, the role of UA may be mediated by impaired kidney function in patients with hyperuricemia.

Influencia de los niveles de ácido úrico sobre el riesgo de mortalidad cardiovascular a largo plazo en pacientes con diabetes de tipo 2

BackgroundHyperuricemia is associated to cardiovascular disease. However, the contribution of uric acid (UA) to cardiovascular mortality in diabetic patients is controversial. ObjectiveTo assess the impact of UA levels on the risk of cardiovascular mortality risk in a cohort of patients with type 2 diabetes mellitus (T2DM). Patients and methodsA prospective cohort study on outpatients with T2DM. The clinical endpoint was cardiovascular death. Anthropometric, demographic, clinical, and biochemical variables were collected, including UA levels, urinary albumin excretion and estimated glomerular filtration rate. The independent contribution of UA levels to cardiovascular mortality was assessed using multivariate Cox regression models, progressively adjusted for potential confounders. ResultsA total of 452 patients with a mean age of 65.9 (SD 9.5) years were enrolled. Mean UA level was 4.2mg/dL. Quartiles of UA levels were Q1 < 3.3; Q2: 3.3-4.2; Q3: 4.3-5.1; Q4 > 5.1mg/dL. UA levels significantly correlated with estimated glomerular filtration rate (Rho=−0.227; p<0.001). During a median follow-up time of 13 years, cardiovascular mortality rates were higher in Q4 of the UA distribution (Q1: 10.7; Q2: 11.7; Q3: 10.7; Q4: 21.6 per 1000 patient-years; p = 0.027). UA was a predictor of cardiovascular mortality in the univariate analysis (HR1mg/dL = 1.30; p=0.002), but not in a multivariate analysis adjusted for urinary albumin excretion and eGFR (HR1mg/dL=1.20; p=0.12). Discussion and conclusionsHigh UA levels are associated to cardiovascular mortality in patients with T2DM. However, the role of UA may be mediated by impaired kidney function in patients with hyperuricemia.

Hyperuricemia and uncontrolled hypertension in treated hypertensive patients: K-MetS Study.

Previous epidemiological studies have suggested that uric acid is an independent risk factor for incident hypertension, whereas few studies have evaluated the effect of hyperuricemia on blood pressure control in hypertensive patients. We investigated whether hyperuricemia predicts uncontrolled hypertension through a large-scale prospective cohort study with hypertensive patients treated with fimasartan in the Republic of Korea (the Kanarb-Metabolic Syndrome study).Of the 10,601 hypertensive patients who were recruited from 582 private clinics and 11 university hospitals at baseline, 7725 completed the follow-up after 3 months of fimasartan medication, and 6506 were included in the analysis after excluding those with missing values. We estimated the risk of uncontrolled hypertension after 3 months (≥130/80 mm Hg in those with diabetes or chronic renal failure and ≥140/90 mm Hg in the remaining patients) related with baseline hyperuricemia (serum uric acid ≥7 mg/dL in males ≥6 mg/dL in females) using multiple logistic regression models.Hyperuricemia increased the risk of uncontrolled hypertension after 3 months of fimasartan medication (odds ratio, 1.247; 95% confidence interval, 1.063-1.462). Males in the highest quartile of uric acid level were at a 1.322 (95% confidence interval, 1.053-1.660) times higher risk of uncontrolled hypertension in reference to the lowest quartile; the same analyses in females were not significant. Patients without metabolic syndrome had significantly higher odds of uncontrolled hypertension with hyperuricemia (odds ratio, 1.328; 95% confidence interval, 1.007-1.751).Hyperuricemia predicted uncontrolled hypertension even after 3 months of fimasartan treatment in hypertensive patients.

Association Between Serum Uric Acid and Prevalence of Type 2 Diabetes Diagnosed using HbA1c Criteria Among Chinese Adults in Qingdao, China

ObjectiveTo determine whether elevated serum uric acid (UA) levels are associated with type 2 diabetes diagnosed using HbA1c levels among Chinese adults. MethodsWe conducted two population-based cross-sectional studies in Qingdao in China in 2006 and 2009. A total of 6894 (39.4% men) subjects aged 35–74 years were included in the data analysis. Newly diagnosed diabetes was defined as HbA1c level of ≥6.5%, and prediabetes was classified as HbA1c level between 5.7% and 6.4% according to the International Diabetes Federation criteria. Multivariate logistic regression was employed to assess the association between UA and prevalence of type 2 diabetes defined using Glycated hemoglobin A1c (HbA1c levels. ResultsSubjects with prediabetes had higher UA levels than those with normal glucose tolerance, newly diagnosed diabetes, and known diabetes, with corresponding values of 325.1 (82.5) μmol/L, 310.9 (84.2) μmol/L, 291.3 (81.7) μmol/L, 305.2 (83.6) μmol/L, respectively (P<0.001 for all comparisons). Binary logistic regression analysis showed that UA was a possible predictor for the prevalence of type 2 diabetes diagnosed using HbA1c levels, and the second quartile of UA levels had a higher odds ratio (OR: 4.088; 95% CI: 2.900-5.765) for HbA1c than the other quartiles after adjusting for age, body mass index, sex, marital status, education, income, alcohol consumption, smoking, and cardiometabolic parameters. ConclusionSerum UA is significantly associated with type 2 diabetes diagnosed using HbA1c levels, independent of other cardiometabolic parameters.

Uric Acid Levels, Kidney Function, and Cardiovascular Mortality in US Adults: National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2002

Chronic kidney disease (CKD) and hyperuricemia often coexist, and both conditions are increasing in prevalence in the United States. However, their shared role in cardiovascular risk remains highly debated. Cross-sectional and longitudinal. Participants in the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2002 (n = 10,956); data were linked to mortality data from the National Death Index through December 31, 2006. Serum uric acid concentration, categorized as the sex-specific lowest (< 25th), middle (25th- < 75th), and highest (≥ 75th) percentiles; and kidney function assessed by estimated glomerular filtration rate (eGFR) based on the CKD-EPI (CKD Epidemiology Collaboration) creatinine-cystatin C equation and urinary albumin-creatinine ratio (ACR). Cardiovascular death and all-cause mortality. Uric acid levels were correlated with eGFR(cr-cys) (r = -0.29; P < 0.001) and were correlated only slightly with ACR (r = 0.04; P < 0.001). There were 2,203 deaths up until December 31, 2006, of which 981 were due to cardiovascular causes. Overall, there was a U-shaped association between uric acid levels and cardiovascular mortality in both women and men, although the lowest risk of cardiovascular mortality occurred at a lower level of uric acid for women compared with men. There was an association between the highest quartile of uric acid level and cardiovascular mortality even after adjustment for potential confounders (HR, 1.48; 95% CI, 1.13-1.96), although this association was attenuated after adjustment for ACR and eGFR(cr-cys) (HR, 1.25; 95% CI, 0.89-1.75). The pattern of association between uric acid levels and all-cause mortality was similar. GFR not measured; mediating events were not observed. High uric acid level is associated with cardiovascular and all-cause mortality, although this relationship was no longer statistically significant after accounting for kidney function.

Association of Serum Uric Acid and Metabolic Syndrome in Type 2 Diabetes

The relationship between elevated serum uric acid level and metabolic syndrome (MS) has been debated. There is no data concerning this relation in Iranian population-based studies. The aim of this study was to determine the prevalence of hyperuricamia and its association with MS in type 2 diabetes mellitus (DM). This was a cross- sectional study in 1978 diabetic patients. Hyperuricamia was defined as uric acid ≥ 7 and ≥ 5.5 mg/dl for men and women respectively. Diagnosis of metabolic syndrome was based on ATPIII criteria. Clinical and biochemical parameters in hyperuricaemic and normouricaemic patients compared with other. The prevalence of hyperuricaemia and metabolic syndrome was 12.7% and 65.5% respectively. The prevalence of MS significantly increased in the highest quartile of uric acid levels compared with lowest quartile (74.4% vs 55.9%, p<0.001). Serum uric acid had positive association with cholesterol, triglyceride, non-HDL cholesterol and a negative association with fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C) and HDL cholesterol. Possible independent biochemical predictors of hyperuricamia were cholesterol, triglyceride, creatnine and FBS. The prevalence of MS and its components increases with increasing levels of uric acid in type 2 diabetes. Regular assessment of uric acid could give information for predicting of MS and prevention of atherosclerosis in type 2 diabetes.

Correlation between serum uric Acid and renal function in patients with stable coronary artery disease and type 2 diabetes.

BackgroundThe aim of this study was to investigate the relationship between serum uric acid and renal function, expressed as estimated glomerular filtration rate (eGFR), in patients with stable coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM) in China.MethodsSerum levels of uric acid and creatinine were determined in 526 enrolled patients diagnosed with stable CAD and T2DM. To assess renal function, eGFR was calculated using a modified MDRD formula suitable for the Chinese population. Patients’ anthropometric measurements were collected using standardized protocols, and 6-month follow-up results were collected and analyzed. Pearson’s correlation coefficient r was calculated and multivariate analysis was performed to evaluate the relationship between uric acid and renal function. Patients with eGFR < 60 mL/min/1.73 m2 were classified as having reduced renal function or chronic kidney disease (CKD) in this study.ResultsUric acid levels were negatively associated with eGFR (P = 0.002), especially in patients with CKD (eGFR < 60 mL/min/1.73 m2) (P < 0.001). In patients with reduced renal function, the risk in the highest quartile of uric acid levels was higher than in the lowest quartile (odds ratio 9.18, 95% confidence interval: 4.01 - 21.01, P < 0.001). These associations remained after multiple adjustments for potential confounders and were recapitulated after 6-month follow-up.ConclusionsSerum uric acid level is negatively associated with renal function, as assessed by eGFR, and serves as an independent predictor for CKD in patients with stable CAD and T2DM.

Association of serum uric acid and metabolic syndrome in type 2 diabetes

AIM The relationship between elevated serum uric acid level and metabolic syndrome (MS) has been debated. There is no data concerning this relation in Iranian population-based studies. The aim of this study was to determine the prevalence of hyperuricamia and its association with MS in type 2 diabetes mellitus (DM). PATIENTS AND METHODS This was a cross- sectional study in 1978 diabetic patients. Hyperuricamia was defined as uric acid ≥ 7 and ≥ 5.5 mg/dl for men and women respectively. Diagnosis of metabolic syndrome was based on ATPIII criteria. Clinical and biochemical parameters in hyperuricaemic and normouricaemic patients compared with other. RESULTS The prevalence of hyperuricaemia and metabolic syndrome was 12.7% and 65.5% respectively. The prevalence of MS significantly increased in the highest quartile of uric acid levels compared with lowest quartile (74.4% vs 55.9%, p<0.001). Serum uric acid had positive association with cholesterol, triglyceride, non-HDL cholesterol and a negative association with fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C) and HDL cholesterol. Possible independent biochemical predictors of hyperuricamia were cholesterol, triglyceride, creatnine and FBS. CONCLUSION The prevalence of MS and its components increases with increasing levels of uric acid in type 2 diabetes. Regular assessment of uric acid could give information for predicting of MS and prevention of atherosclerosis in type 2 diabetes.

Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes

ObjectiveWe aimed to investigate whether elevated serum uric acid concentrations are associated with higher risk of metabolic syndrome (MetS) and carotid atherosclerosis in patients with type 2 diabetes.MethodsWe conducted a population-based cross-sectional survey in Shanghai, with a total of 395 men and 631 women age 41 to 92 years. The carotid artery intima-media thickness (IMT) and carotid atherosclerotic plaques (PLQ) were measured by B-mode ultrasound. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans.ResultsUric acid levels were negatively associated with duration of diabetes, fasting plasma glucose, glycohemoglobin, eGFR, HDL-cholesterol (all P < 0.001) and positively with BMI, CRP, waist circumference, triglycerides, systolic blood pressure, ACR, HOMA-IR and IMT (all P < 0.05). In the highest quartile of uric acid levels, the risks were substantially higher for MetS [odds ratio 3.97, (95% confidence interval 2.58-6.13)] (P < 0.001 for trend) and PLQ [odds ratio 2.71 (95% confidence interval 1.62-4.47)] (p = 0.013 for trend) compared with that in the lowest quartile of uric acid levels after multiple adjustment. These associations remained significant after further adjustment for potential confounders.ConclusionsSerum uric acid level is associated with MetS and is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.

Association among serum uric acid, cardiovascular risk, and arterial stiffness: a cross-sectional study in She ethnic minority group of Fujian Province in China.

To investigate the association between serum uric acid levels, cardiovascular risk, and arterial stiffness in She ethnic minority in South China's Fujian Province. 5109 participants aged 20-79 yr were enrolled in analysis. Tpeak-Tend interval (Tp-e), QT interval, and height of the R wave in lead aVL (aVLR) were measured on 12-lead electrocardiogram (ECG), and Minnesota code-indicated major abnormal ECG MA-ECG was used as a risk indicator of cardiovascular disease. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Longer Tp-e interval, greater Tp-e/QT ratio, and higher aVLR were observed in the highest quartile of uric acid level. The incidence of MA-ECG was gradually increased from lowest to highest quartile of serum uric acid in males (p for trend <0.01). After adjusting traditional cardiovascular risk factors, multivariate analysis revealed that the fourth quartile of serum uric acid level was independently associated with MA-ECG in males [odds ratios (OR) (95% confidence interval): 2.129 (1.376-3.295)] but not in females. Serum uric acid was also associated with abnormal baPWV, when adjusted for atherogenic confounders. Compared with the lowest serum uric acid quartile, the OR (95% confidence interval) of the second, third, and fourth quartile were 1.920 (1.246-2.957), 1.650 (1.064-2.558), and 2.501 (1.600-3.908) in males. Among China's She ethnic minority, uric acid level was independently related to arterial stiffness assessed by baPWV in both genders. The evaluation of uric acid level was related to higher cardiovascular risk in males but not in females.

Serum uric acid level is associated with metabolic syndrome and microalbuminuria in Korean patients with type 2 diabetes mellitus

Aims To determine the relationship between serum uric acid, metabolic syndrome (MetS), and albuminuria in type 2 diabetic patients. Methods A total of 504 Korean patients with type 2 diabetes aged 57.3 years were retrospectively evaluated for clinical histories, anthropometric measurements, and biochemical studies. Urinary albumin excretion (UAE) was measured by a 24-h urine collection. Results Prevalence of MetS increased according to the quartiles of uric acid levels (≤3.7, 3.8 to 4.5, 4.6 to 5.5, and >5.5 mg/dl; 52.1%, 52.1%, 57.5%, and 71.6%, respectively, P<.001). Individual components of MetS (abdominal obesity, hypertriglyceridemia, low HDL-cholesterol, high blood pressure) were also significantly associated with the highest quintile of uric acid levels. Serum uric acid levels had significantly increased risk of albuminuria [odds ratio (OR) 1.425, 95% confidence interval (CI) 1.085-1.873] after adjusting for age, gender, and conventional risk factors. Uric acid level remains a significant predictor for abnormal albuminuria after adjusting for MetS presence as well as the use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) (OR 1.414, 95% CI 1.071-1.868). Conclusion An elevated uric acid level was significantly associated with MetS and was an independent predictor of albuminuria after adjusting for conventional risk factors and MetS. Regular measurements of uric acid level could give information for predicting the presence of MetS and albuminuria in Korean type 2 diabetic patients.