Serum UA Levels Research Articles

Association of Hyperuricemia with Chronic Low Back Pain

Background: The Back pain affects about 20% of the population in Bangladesh in each year between the ages of 30-60 years. A well-defined pathology is identified in only about 15% of patients. Objective: To identify the association of hyperuricemia in patients with chronic low back pain. Materials and Methods: A descriptive cross-sectional study was performed on 180 patients among the ages of 18 to 75 years with chronic low back pain (CLBP). Data was collected through a structured questionnaire. X-rays and Magnetic Resonance Imaging (MRI) of the lumbosacral spine had been used to evaluate any findings in terms of low back pain. Serum uric acid (sUA) levels had been tested and recorded. Results: Joint pain (p < 0.001), lumbar disc prolapse (p = 0.023), and disc degeneration (p = 0.011) were more in High-sUA than Low-sUA group. Female patients in H-sUA group had significantly higher occurrence of joint pain(p = 0.002), lumbar disc prolapse (p = 0.019), and disc degeneration (p = 0.004) than L-sUA group. In regression analysis, female sex (p = 0.036), duration of CLBP (p = 0.031), and sUA level (p = 0.025) were associated with radiological findings. In female patients association of duration of CLBP (p = 0.046) and sUA (p = 0.009). Conclusion: The serum UA level was significantly associated with CLBP in female patients. More studies are warranted to explore whether the two conditions exist simultaneously or there is a direct causal relationship between the conditions. KYAMC Journal. 2022;12(04): 213-217

Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China

BackgroundPeriodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy.MethodsThree hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications, multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables.ResultsThe median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95% CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001).ConclusionHigher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.

Psychological status and serum uric acid levels in narcolepsy with type 1: A case-control study

BackgroundThe relationship between uric acid and patients with type 1 (NT1) remains unclear. UA may contribute to the development of depression. Depression is also common in NT1. Our study aimed to evaluate serum levels of UA, creatinine, and UA/Cr ratio, and examine the association of serum UA levels with psychological status in NT1 patients. MethodsThis is a case–control study conducted on 48 patients diagnosed with NT1 and 40 healthy controls (HC). The 17-item Hamilton Depression Rating (HAMD-17) was used as screening tools for depressive symptoms for patients with NT1. Serum UA, creatinine, and UA/Cr ratio were measured. In addition, the correction of UA status and scores of depressive scales was statistically analyzed. ResultsApproximately 70% of all subjects with NT1 had depression or depressive symptoms compared with the HC group, the serum UA levels and UA/Cr ratios were higher in patients with NT1 (p < 0.05). In addition, there was a negative correlation between UA levels and HAMD-17 scores in NT1 patients (r = -0.334; p = 0.020). ConclusionWe found that serum UA levels were higher in patients with NT1, and the serum UA levels were negatively correlated with depressive symptom scores. Further well-designed prospective cohort studies are needed to determine the causality of the correlation and to further clarify the pathophysiological mechanisms of UA in NT1 patients.

Protective effect of carvacrol on liver injury in type2 diabetic db/db mice.

The present study aimed to investigate the protective effect of carvacrol on liver injury in mice with type 2 diabetes mellitus (T2DM) and to assess its potential molecular mechanism. Mice were divided into three groups (n=15/group): Non-diabetic db/m+ mice group, db/db mice group and db/db mice + carvacrol group. In the db/db mice + carvacrol group, db/db mice were administered 10 mg/kg carvacrol daily by gavage for 6 weeks. Fasting blood glucose and insulin levels were separately examined. Pathological changes were observed using hematoxylin and eosin, Masson's trichrome, periodic acid Schiff and reticular fiber staining. In addition, immunohistochemistry, immunofluorescence and western blotting were used to examine the expression levels of Toll-like receptor 4 (TLR4), NF-κB, NALP3, AKT1, phosphorylated (p)-AKT1, insulin receptor (INSR), p-INSR, mTOR, p-mTOR, insulin receptor substrate 1 (IRS1) and p-IRS1 in the liver tissues. The results revealed that carvacrol improved blood glucose and insulin resistance of T2DM db/db mice. After treatment with carvacrol for 6 weeks, the serum levels of TC, TG and LDL-C were markedly reduced, whereas HDL-C levels were significantly increased in db/db mice. Furthermore, carvacrol administration significantly decreased serum ALT and AST levels in db/db mice. Serum BUN, Cre and UA levels were markedly higher in db/db mice compared with those in the control group; however, carvacrol treatment markedly reduced their serum levels in db/db mice. Furthermore, histological examinations confirmed that carvacrol could protect the liver of db/db mice. Carvacrol could ameliorate liver injury induced by T2DM via mediating insulin, TLR4/NF-κB and AKT1/mTOR signaling pathways. The present findings suggested that carvacrol exerted protective effects on the liver in T2DM db/db mice, which could be related to insulin, TLR4/NF-κB and AKT1/mTOR signaling pathways.

Low serum uric acid levels are associated with the nonmotor symptoms and brain gray matter volume in Parkinson\u2019s disease

BackgroundUric acid (UA) plays a protective role in Parkinson’s disease (PD). To date, studies on the relationship between serum UA levels and nonmotor symptoms and brain gray matter volume in PD patients have been rare.MethodsAutomated enzymatic analysis was used to determine serum UA levels in 68 healthy controls and 88 PD patients, including those at the early (n = 56) and middle-late (n = 32) stages of the disease. Evaluation of motor symptoms and nonmotor symptoms in PD patients was assessed by the associated scales. Image acquisition was performed using a Siemens MAGNETOM Prisma 3 T MRI scanner.ResultsSerum UA levels in early stage PD patients were lower than those in healthy controls, and serum UA levels in the middle-late stage PD patients were lower than those in the early stage PD patients. Serum UA levels were significantly negatively correlated with the disease course, dysphagia, anxiety, depression, apathy, and cognitive dysfunction. ROC assessment confirmed that serum UA levels had good predictive accuracy for PD with dysphagia, anxiety, depression, apathy, and cognitive dysfunction. Furthermore, UA levels were significantly positively correlated with gray matter volume in whole brain.ConclusionsThis study shows that serum UA levels were correlated with the nonmotor symptoms of dysphagia, anxiety, depression, apathy, and cognitive dysfunction and the whole-brain gray matter volume. That is the first report examining the relationships between serum UA and clinical manifestations and imaging features in PD patients.

Serum Uric Acid Level and Inflammation in Obese Medical Students at Ain Shams University

Abstract Background: Overweight and obesity occur when excess fat accumulation increases risk to health, leading to expression of co-morbid diseases occur at different thresholds. That's why obesity is now recognized as a chronic or non-communicable disease. Aim of Study: To assess serum uric acid and diet contrib-uting in its increased concentration level in relation to inflam-mation in a subsample of obese medical students as compared to normal-weight medical students in Faculty of Medicine Ain Shams University. Subjects and Methods: The current study is a case control study of 63 students among 1220 Ain Shams medical students. Our study group was divided into two groups. Group 1 included 30 students with BMI between 18.5-24.9Kg/m2. Group 2 included 33 students with BMI >!30Kg/m2. Results: There was significant difference between the two groups in weight, waist circumference and waist hip ratio, but not for height. As regards CRP serum level, the obese group showed significant increase in serum level. In the same time there was a significant positive correlation between the CRP serum level and BMI, WC and WHR in both groups. On the other hand, protein intake was significantly higher in obese group than normal weight group, as a part of increased caloric intake. When comparing serum uric acid level in the two groups there was a statistically significant difference, and on searching for a relation between the serum uric acid and BMI, WC, CRP and protein intake serum level, a positive correlation was found. Conclusion: Serum UA level is a crucial biomarker, it could induce inflammation and hence increases adiposity or its increase results from increased obesity. Moreover, increased serum uric acid is correlated to increased protein intake in obese individuals with increased total caloric intake specially protein content.

FC 003HYPERURICEMIA HAS VASOACTIVE EFFECTS IN CHOLESTEROL CRYSTAL-INDUCED ACUTE KIDNEY INJURY

Abstract Background and Aims Numerous observational studies have reported an association between hyperuricemia (HU) and cardiovascular disease where atherosclerosis is a leading cause. In advanced atherosclerosis, cholesterol crystal (CC) embolism is a life-threatening complication with an average mortality of 62.8%. Clinical manifestations include skin necrosis, intestinal injury and acute kidney injury (AKI). Autopsies and tissue biopsies reveal CC inside the arterial lumen. In a new model of CC-induced AKI, we recently found that fibrin clots formed around CC obstruct peripheral arteries and cause tissue infarction and organ failure. However, the role of asymptomatic HU in CC-induced AKI is currently unknown. Thus, we hypothesized that asymptomatic HU improves the outcomes after CC-induced AKI. Method In vivo, 6 weeks old Alb-creERT2;Glut9lox/lox and Glut9lox/lox control mice were intraperitoneally injected with tamoxifen to deplete hepatic Glut9 expression. Both groups of mice were placed on a standard chow diet enriched with inosine for two weeks. Afterward, a solution of CCs was injected into the left kidney arteries of mice to induce AKI. Serum and kidneys were collected 24 hours later, and kidney function, infarct size and kidney injury evaluated using GFR measurement, colorimetric assays, ELISA and immunohistochemistry of kidney sections. For in vitro studies, we isolated platelets from healthy mice and cultured them in the presence or absence of soluble uric acid (sUA) prior to CC activation. After stimulation, platelet aggregation assays and flow cytometry were performed. Results Our in vivo data showed that Alb-creERT2;Glut9lox/lox mice developed asymptomatic HU without kidney impairment (serum UA levels 9-15 mg/dL), while Glut9lox/lox control mice remained healthy. HU mice displayed a rapid decline in GFR of approx. 80% as compared to only 30% in healthy mice after CC-induced AKI, which was in line with increased serum BUN and IL-6 levels. The rapid GFR decline was due to vasoconstriction in arteries of the contralateral kidney as determined by αSMA/fibrin staining and a reduced ratio of lumen versus artery area in mice with HU after AKI. HU mice also had significantly less kidney infarct size as well as reduced kidney injury (necrosis and edema) and arterial occlusion. The in vitro data showed that sUA had no impact on platelet aggregation, activation and degranulation as compared to medium control in response to CCs. Conclusion We now show that HU has vasoconstrictive effects in the contralateral kidney by reducing GFR, while at the same time protects mice from CC-induced AKI suggesting a compensatory physiological mechanism of autoregulation to protect nephrons. On the other hand, in patients with chronic kidney disease, HU-related vasoconstriction might lead to increased arterial blood pressure; thus, increasing the risk for cardiovascular complications due to platelet activation and aggregation.

Lactobacillus reuteri TSR332 and Lactobacillus fermentum TSF331 stabilize serum uric acid levels and prevent hyperuricemia in rats.

BackgroundUric acid (UA) is the end product of purine metabolism in the liver and is excreted by the kidneys. When purine metabolism is impaired, the serum UA level will be elevated (hyperuricemia) and eventually lead to gout. During evolution, humans and some primates have lost the gene encoding uricase, which is vital in UA metabolism. With the advances of human society, the prevalence of hyperuricemia has dramatically increased because of the refined food culture. Hyperuricemia can be controlled by drugs, such as allopurinol and probenecid. However, these drugs have no preventive effect and are associated with unpleasant side effects. An increasing number of probiotic strains, which are able to regulate host metabolism and prevent chronic diseases without harmful side effects, have been characterized. The identification of probiotic strains, which are able to exert beneficial effects on UA metabolism, will provide an alternative healthcare strategy for patients with hyperuricemia, especially for those who are allergic to anti-hyperuricemia drugs.MethodsTo elicit hyperuricemia, rats in the symptom control group (HP) were injected with potassium oxonate and fed a high-purine diet. Rats in the probiotic groups received the high-purine diet, oxonate injection, and supplements of probiotic strains TSR332, TSF331, or La322. Rats in the blank control group (C) received a standard diet (AIN-93G) and oxonate injection.ResultsPurine-utilizing strains of probiotics were screened using high-pressure liquid chromatography (HPLC) in vitro, and the lowering effect on serum UA levels was analyzed in hyperuricemia rats in vivo. We found that Lactobacillus reuteri strain TSR332 and Lactobacillus fermentum strain TSF331 displayed significantly strong assimilation of inosine (90%; p = 0.00003 and 59%; p = 0.00545, respectively) and guanosine (78%; p = 0.00012 and 51%; p = 0.00062, respectively) within 30 min in vitro. Further animal studies revealed that serum UA levels were significantly reduced by 60% (p = 0.00169) and 30% (p = 0.00912), respectively, in hyperuricemic rats treated with TSR332 and TSF331 for 8 days. Remarkably, TSR332 ameliorated the occurrence of hyperuricemia, and no evident side effects were observed. Overall, our study indicates that TSR332 and TSF331 are potential functional probiotic strains for controlling the development of hyperuricemia.

POS-139 HYPERURICEMIA IN WOMEN IS MORE CORELATED TO POOR PROGNOSTIC HISTOLOGY IN IgA NEPHROPATHY

Hyperuricemia is one of the significant risk factors for cardiovascular events and chronic kidney disease progression. There is a gender difference in UA level that women usually have a lower UA level than men. The male sex is significant risk factor for hyperuricemia and gout. The male sex is four times more affected than women. In IgA nephropathy, serum uric acid is independent factor that serum uric acid levels associated with renal outcome and all-cause mortality or kidney failure. The impact of renal outcome prognosis is more potential to female gender.Most previous studies focused on serum uric acid levels with tubular atrophy or interstitial fibrosis in IgA nephropathy. The severity of tubular atrophy is marked, when the serum uric acid level increasing The objective of this study is more specifically analyze histopathological parameters in relation to IgAN with serum uric acid level and stratified by sex difference. Total 658 patients receiving kidney biopsy were included in our study. The baseline characteristics were collected from at 8 university hospitals affiliated with the College of Medicine Catholic University of Korea database. Pathologic features were evaluated by each 8 university hospitals expert pathologist independently and shared its consensus. Statistical analysis was done using SPSS 23.0 Among 658 patient who underwent kidney biopsy and diagnosed as IgAN, 517 patients were included in final cohort. In this study, hyperuricemia was defined as a serum UA of >7.0 mg/dl for men and >5.6 mg/dl for women, hyperuricemia was 28% (n=74) and 42.7% (n=108) for women and male, respectively. In multivariable linear regression, segmental sclerosis, MME, MCP, ECP, IF, TA and C3 mesangial deposition were associated with serum UA level in IgAN total cohort. Global/segmental sclerosis, MME, MCP, IF, TA were positively associated with serum UA level in women. However, only IF and TA are associated with serum UA in men. Our data analysis suggested that In IgAN, serum uric acid is more potentially affect to histopathological features in female than male.

Decreased serum uric acid in patients with traumatic brain injury or after cerebral tumor surgery.

Objectives:To investigate changes in sUA in patients with TBI or patients after cerebral tumor surgery and the possible mechanism of these changes.Methods:This prospective cohort study enrolled patients with TBI or underwent cerebral tumor surgery at West China Hospital, China, from November 2014 to May 2018. Serum UA (sUA) levels, urine excretion, UA oxidant product allantoin and other clinical parameters were assessed.Results:100 patients were enrolled for analysis. sUA in patients with TBI or underwent cerebral tumor surgery started to decline from day 1 after injury or surgery compared to control. This decreasing trend continued from day 3 (143.2±59.3 μmol/L, 188.8±49.4 μmol/L vs 287.3±80.2 μmol/L, p<0.0001) until day 7. No difference in urinary UA excretion was found in the TBI group or cerebral tumor surgery group. Urine allantoin and the allantoin to sUA ratio of the TBI group decreased on day 3 compared with the control group. The structural equation model showed that the sUA level was related to the Glasgow coma score (GCS) (r=0.5383, p<0.0001), suggesting the potential association of UA with consciousness level, as well as serum protein and electrolytes including albumin, calcium and phosphate.Conclusion:The sUA was decreased in patients with TBI or underwent cerebral tumor surgery.

Role of asymptomatic hyperuricemia in the progression of chronic kidney disease and cardiovascular disease.

Previous research has investigated whether hyperuricemia serves as an independent risk factor for cardiovascular and renal diseases. Hyperuricemia is defined as an abnormally high level of uric acid (UA; i.e., serum urate level > 6.8 mg/dL). Hyperuricemia has been considered a complication of chronic kidney disease (CKD). However, it seems to play a pathogenic role in the progression of renal diseases. There has been increasing focus on the link between hyperuricemia and CKD. The results of randomized controlled trials have implied independent associations between hyperuricemia and the progression of cardiovascular and renal morbidities. These associations may be mediated by renin-angiotensin system activation, nitric oxide synthase inhibition, and macrovascular/microvascular disease development. There remains controversy regarding the use of serum UA level as an indirect index of renal vascular disease. This literature review focuses on the role of asymptomatic hyperuricemia in the progression of CKD, as well as the association between hyperuricemia and cardiovascular disease. It also provides a general overview of the physiological metabolism of UA.

Evaluation of serum uric levels in migraine.

In our study, the aim was to identify the serum uric acid levels, a marker of oxidative stress, according to migraine subtypes (aura/without aura and episodic/chronic migraine). The study included 300 migraine patients and 150 healthy controls for a total of 450 individuals. Migraine and subtypes were diagnosed according to International Classification of Headache Disorders-2013 criteria. Patients were evaluated during attendance at the neurology clinic. Our patient group was 77.0% female and disease duration was 9.2 ± 7.2years. Our control group comprised 77.3% females. The age intervals in the patient and control groups were 36.4 ± 10.4years and 36.0 ± 8.1years. There was no statistically significant difference between our control and patient groups in terms of age and gender (p = .937 and p = .655). The serum UA, ferritin, and urea levels in our patient group were found to be significantly low compared to the healthy control group (p < .001). The serum UA levels in the migraine and control groups were 3.7 ± 0.7 and 4.6 ± 0.7mg/dL, respectively (p < .001). There were no statistically significant differences observed between serum uric acid levels and other blood parameters between aura/without aura and episodic/chronic migraine subtypes (p > .05). Our study supports the hypothesis that the oxidative stress marker of serum uric acid levels may be associated with migraine diagnosis, concluding that serum uric acid levels were not significant for migraine subtypes.

Transplantation of a kidney with a heterozygous mutation in the SLC22A12 (URAT1) gene causing renal hypouricemia: a case report

BackgroundRenal hypouricemia (RHUC) is a genetic disorder caused by mutations in the SLC22A12 gene, which encodes the major uric acid (UA) transporter, URAT1. The clinical course of related, living donor-derived RHUC in patients undergoing kidney transplantation is poorly understood. Here, we report a case of kidney transplantation from a living relative who had an SLC22A12 mutation. After the transplantation, the recipient’s fractional excretion of UA (FEUA) decreased, and chimeric tubular epithelium was observed.Case presentationA 40-year-old man underwent kidney transplantation. His sister was the kidney donor. Three weeks after the transplantation, he had low serum-UA, 148.7 μmol/L, and elevated FEUA, 20.8% (normal: < 10%). The patient’s sister had low serum-UA (101.1 μmol/L) and high FEUA (15.8%) before transplant. Suspecting RHUC, we performed next-generation sequencing on a gene panel containing RHUC-associated genes. A heterozygous missense mutation in the SLC22A12 gene was detected in the donor, but not in the recipient. The recipient’s serum-UA level increased from 148.7 μmol/L to 231.9 μmol/L 3 months after transplantation and was 226.0 μmol/L 1 year after transplantation. His FEUA decreased from 20.8 to 11.7% 3 months after transplantation and was 12.4% 1 year after transplantation. Fluorescence in situ hybridization of allograft biopsies performed 3 months and 1 year after transplantation showed the presence of Y chromosomes in the tubular epithelial cells, suggesting the recipient’s elevated serum-UA levels were owing to a chimeric tubular epithelium.ConclusionsWe reported on a kidney transplant recipient that developed RHUC owing to his donor possessing a heterozygous mutation in the SLC22A12 (URAT1) gene. Despite this mutation, the clinical course was not problematic. Thus, the presence of donor-recipient chimerism in the tubular epithelium might positively affect the clinical course, at least in the short-term.

Protective role of serum uric acid for bone loss in postmenopausal women

Researchers had found that there is an association between oxidative stress and osteoporosis. Postmenopausal osteoporosis causes major public health problems. Since Uric acid has strong antioxidant properties, it will improve bone quality. This cross-sectional observational study was done to determine the association of Uric Acid and Bone Mineral Density of 75 healthy postmenopausal women who came for a master health checkup. The mean age was 60.5 years. After ethical clearance and informed consent, women were recruited for the study at Saveetha Medical Hospital Chennai. Women with medical conditions or who were using drugs affecting bone metabolism or uric acid were excluded. Basic investigations were Hb, serum UA, blood urea, serum creatinine, serum calcium and alkaline phosphatase, blood glucose and glycosylated Hb. Total Cholesterol, HDL, LDL, VLDL, 25 hydroxy Vitamin D were also done. Serum UA levels were graded as &lt;3.9, 3.9–4.9, 5–6.1, and ≥6.2 mg/dl. Bone Mineral Density (BMD) was calculated with Dual Energy X-ray Absorptiometer (DXA). Osteoporosis was defined as BMD T-score −2.5 and below. BMD with a T-score of -1 −2.5 was classified as osteopenia (WHO). In women with high UA, there were significantly higher levels of low-density lipoprotein, and calcium, as compared to women with low UA group (p&lt;0.05). High UA group, as compared to the low UA group, also had lower levels of high-density lipoprotein (p&lt;0.001). Women with higher Uric acid levels had lower BMI, lesser years of duration of Menopause and increased BMD. Serum UA level had a positive correlation with the Lumbar BMD T score and Right Femoral Neck BMD T Score. In UA &gt;5.4mg/dl group Osteoporosis was nil.

Comparison of Serum Uric Acid in Major Depressive Disorder and Bipolar Disorder: a Retrospective Chart Review Study.

BackgroundUric acid (UA) has been suggested as a possible biomarker of bipolar disorder (BD) in recent studies. We aimed to provide a clearer comparison of UA levels between BD and major depressive disorder (MDD).MethodsWe retrospectively reviewed the medical chart records of psychiatric inpatients aged 19–60 years, whose main discharge diagnoses were either MDD or BD, with an admission between January 1, 2015 and December 31, 2018 at Seoul National University Hospital. Data such as sex, age, body mass index (BMI), medication usage, and serum UA levels were extracted. Patients with medical conditions or on medications that could influence UA levels were excluded. Age, sex, BMI, and psychiatric drug usage were considered in the comparison of serum UA between MDD and BD patients.ResultsOur sample consisted of 142 MDD patients and 234 BD patients. The BD patients had significantly higher serum UA levels compared to the MDD patients, without accounting for other confounding variables (5.75 ± 1.56 mg/dL vs. 5.29 ± 1.59 mg/dL, P = 0.006). T-test comparisons between psychiatric medication users and non-users revealed that mood stabilizers and antipsychotics may be relevant confounding factors in our sample analysis. The likelihood of BD diagnosis was significantly correlated with higher UA levels (odds ratio, 1.410; 95% confidence interval, 1.150–1.728; P = 0.001) when accounting for sex, age, and BMI in the logistic regression analysis. Also, accounting for mood stabilizers or antipsychotics, the likelihood of BD diagnosis was still significantly correlated with higher UA levels.ConclusionOur study confirms that BD patients are significantly more likely to show higher serum UA levels than MDD patients. The high UA levels in BD point to purinergic dysfunction as an underlying mechanism that distinguishes BD from MDD. Further research is recommended to determine whether UA is a trait or a state marker and whether UA correlates with the symptoms and severity of BD.

Psychological status and uric acid levels in oral lichen planus patients - A case- control study.

Oral lichen planus (OLP) has varied etiology and clinical expression may be influenced simultaneously by different mechanisms. Psychological disturbances and oxidative stress are some such factors proposed in the etiopathogenesis of OLP. The aim was to assess the possible association of psychological traits like stress, anxiety, depression, serum and salivary uric acid levels with disease expression in OLP patients. A case-control study was conducted in OLP subjects (n = 43) with a clinical and histopathological diagnosis, age and gender matched healthy controls (n = 42) to evaluate psychometric properties through DASS - 42 scale and uric acid (serum and salivary levels) evaluation through "Modified Trinder Method, End point" method. The mean depression, anxiety, stress scores in OLP group were 16.51 ± 7.21, 15.58 ± 6.78 and 15.05 ± 6.11 and the scores in control group were 6.31 ± 3.48, 5.02 ± 2.70 and 5.69 ± 3.39 respectively. The mean value of serum UA level and salivary UA level in OLP group were 4.70 ± 1.33 mg/dl and 5.25 ± 1.61 mg/dl respectively, while the corresponding scores in control group were 5.86 ± 1.12 mg/dl and 6.18 ± 1.28 mg/dl. OLP group had significantly higher depression, anxiety, stress and total scores. Mean serum and salivary uric acid levels were significantly lower in OLP subjects when compared with controls. Correction of psychological traits in oral lichen planus patients may significantly improve the clinical picture, while uric acid levels can be employed for biochemical evaluation in lichen planus patients to analyse oxidative stress.

The prevalence of gout and hyperuricemia in middle-aged and elderly people in Tibet Autonomous Region, China: A preliminary study.

Objective:Gout and hyperuricemia are common public health problem. There has been no epidemiological survey of gout and hyperuricemia in Tibet Autonomous Region, the southwest of China. Therefore, we estimated the prevalence of gout and hyperuricemia in Luoma Town, Naqu City, Tibet Autonomous Region of China.Methods:A population-based cross-sectional survey was conducted among 1458 residents of Luoma Town, Tibet Autonomous Region, age ≥40 years. We used questionnaires in face-to-face interviews, anthropometric measurements and serum uric acid test. Hyperuricemia was defined as serum uric acid level ≥7 mg/dl in men and ≥6 mg/dl in women. The definition of gout in this study was on the basis of new 2015ACR/EULAR classification criteria.Results:Nine hundred eighty-nine participants completed all items of gout and 818 participants attended to be taken blood samples for serum UA levels test. The overall crude prevalence of gout and hyperuricemia was 0.30% and 1.83% respectively. It was more prevalent in men than in women (2.86% vs 0.75%, P = .034) in hyperuricemia group. Tibetan had a lower age-standardized prevalence of gout 0.26% (95% confidence interval (CI): 0%–0.60%) and hyperuricemia 2.05% (95% confidence interval (CI): 0.99%–3.44%) compared with the China Health and Retirement Longitudinal Study results.Conclusion:This is the first large-scale population-based survey to demonstrate the prevalence of gout and hyperuricemia of the middle-aged and elderly population in Tibet Autonomous Region, China. The prevalence of gout and hyperuricemia is relatively lower than other places in China, and that might be influenced by ethnicity, genetic and environment factors. These findings will be useful for the future researches and health care strategies.

Evaluation of the role of serum uric acid in patients with multiple sclerosis; An Observational case-control study

Objectives: To evaluate the role of uric acid in patients with MS as an investigational marker in true relapse events.&#x0D; Methods: 108 patients with relapsing-remitting and Secondary progressive MS, compared to case-control of about 120 patients (manifested other neurological diseases OND) who were included in this study which was conducted from March 2008 to July 2009 at Baghdad Teaching Hospital multiple sclerosis clinic. A study protocol sheet was done and filled from the patient's database in the MS clinic.&#x0D; Results: In the overall MS group, serum UA levels were lower than in controls, the difference did reach statistical significance (P=0.01). Serum UA was found to be lower in patients during relapse than when they are in remission. The mean serum UA level from patients after one month of follow up shows an inverse correlation with MS type, age, and EDSS score, and positive correlation with gender and clinical activity, but none of these correlations reach statistical significance.&#x0D; Conclusions: The question whether reduced serum UA level in MS is a primary deficit or an epiphenomenon remains open. Despite the fact that UA level was lower in clinically-documented active patients, a general mean UA decrease is evident also in clinically and MRI inactive MS patients as compared to OND.

Influence of muscle mass on the serum uric acid levels in children and adolescents

Background and aimUric acid (UA) is an end-product of purine catabolism and its increase in blood is a risk factor for several diseases. UA levels in men are usually higher than in women. This difference is partially due to sex hormones. We sought to investigate the onset of sexual difference in UA levels during pubertal development and the determinants of UA levels in children and adolescents. Methods and resultsThe muscle mass and fat mass were measured by multi-frequency bioelectrical impedance in a cross-sectional study involving 823 children and adolescents (both sexes; 6–18 years). Serum UA was determined using a commercially available kit. UA levels started to become higher in boys (5.0 ± 1.0 mg/dL) than in girls (4.1 ± 0.9 mg/dL) around 13 years. Boys in the highest quartile of muscle mass presented higher UA levels (5.2 ± 0.7 mg/dL) when compared with the third (4.2 ± 0.7 mg/dL), second (3.7 ± 0.9 mg/dL) and first (3.4 ± 0.9 mg/dL). Similarly, girls in the highest quartile of muscle mass presented higher UA levels (4.2 ± 0.7 mg/dL) when compared with the second (3.8 ± 0.9 mg/dL) and first (3.3 ± 0.9 mg/dL). Muscle mass explained 43.0% and 7.7% of the variability of UA in boys and girls, respectively. ConclusionSexual differences in serum UA levels begin at puberty and partially result from a direct influence of muscle mass.

High serum uric acid level is associated with greater handgrip strength in the aged population

BackgroundWe aimed to investigate the association of serum UA level with muscle strength assessed by handgrip strength (HGS) in a large Korean adult population.MethodsCross-sectional data were obtained from the seventh Korea National Health and Nutrition Examination Survey (KNHANES) 2016. The KNHANES 2016 study included 8150 subjects, of whom 4230 subjects were analyzed in this study. The association between serum UA level and HGS was investigated with adjustment for confounding factors.ResultsSerum UA was divided into sex-specific tertiles After adjustment for potential confounding factors, HGS was significantly greater in the high serum UA group (the third tertile) than in the low UA group (the first tertile) in the elderly (age ≥ 60 years) population (coefficient β [95% confidence interval (CI)] = 1.017 [0.115–1.920]). When the elderly population was subdivided according to the presence of metabolic syndrome (metS), the impact of UA remained significant only in individuals with metS. In the aged population, high serum UA level reduced the risk for low HGS (OR, 95% CI = 0.69, 0.48–0.98, p = 0.041) only in male subjects.ConclusionsA population-based cross-sectional survey in Korea revealed that high serum UA level is associated with increased HGS in the aged population. The antioxidant property of UA may enhance muscle strength, especially in the elderly population.