Serum Uric Acid Levels In Patients Research Articles

The association between serum uric acid and low birth weight in advance maternal age women with hypertension: An observational study.

In China, the implementation of 2-child policy since 2015 entitles increasing number of advanced maternal age. Recently, Chinese hypertensive disorders of pregnancy (HDP) in advanced-age women have attracted significant clinical and epidemiological research interest. Previous studies have shown an association between serum uric acid (SUA) levels and low birth weight (LBW) in children. Several studies have reported that advanced maternal age is a risk factor for many complications in pregnancy, including LBW. However, it remains unclear whether SUA affects LBW risk in advanced maternal age mothers with hypertensive diseases. The study was observational in nature. A total of 692 advanced maternal age with hypertension were enrolled in our study. A variety of demographic and vital sign data, laboratory test results, and pregnancy outcomes were collected. Children born with LBW served as the clinical endpoint. On admission, blood samples were taken, and women with advanced maternal ages were divided into 2 groups based on their SUA levels. In order to investigate the association between SUA and LBW, a logistic regression model was used. E-value analysis was used to determine the residual unmeasured confounding. The mean SUA level was increased in advanced maternal age patients with HDP. Of 692 newborns, 244 (35.26%) have LBW. With possible confounders adjusted, high SUA levels were independent risk factors for LBW (odds ratio [OR]2.88, 95% confidence intervals [CI]1.22-6.81), multivariate logistic regression analysis using SUA as a continuous variable recapitulated the pattern (OR 1.01, 95% CI 1.00-1.01). In addition, SUA levels in women with advanced maternal age and hypertension were linearly related to LBW incidence. According to this study, SUA levels in patients with advanced maternal age and HDP are associated with LBW incidence.

Effect of Dapagliflozin on Serum Uric Acid Levels in Patients with Advanced Chronic Kidney Disease.

Objective Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are hypoglycemic agents, have been shown to be cardioprotective through a variety of mechanisms, and the effect of lowering uric acid (UA) levels may be one of the mechanisms. In the present retrospective study, we investigated the changes in serum UA levels in patients with chronic kidney disease (CKD) treated with SGLT2 inhibitors. Methods We included 31 patients with CKD who were newly started on dapagliflozin for renal protection and evaluated trends in various parameters, including serum UA levels and UA excretion from urine. Results The patients' median age was 71 years old, 20 patients were men, 7 patients had diabetes, and the median estimated glomerular filtration rate was 33.9 mL/min/1.73 m2 (CKD stage 3: 21 cases, stage 4: 10 cases). The differences in UA and fractional excretion of UA after three weeks and three months of prescription showed significantly decreased UA values and an increased fractional excretion of UA. Conclusion Our findings suggest that dapagliflozin can lower serum UA levels via increased UA excretion, even in patients with advanced CKD.

Insulin resistance and hyperuricemia in patients with type 1 diabetes mellitus: clinical and biochemical correlates

Background. Some patients with type 1 diabetes mellitus (DM) have clinical symptoms that are characteristic of the type 2 DM: obesity, insulin resistance, hypertension, hyperuricemia (HU), dyslipidemia, or the metabolic syndrome, which has been called double diabetes. It is associated with an increased frequency of chronic micro- and macrovascular complications (nephropathy, arteriosclerosis obliterans and ischemic heart disease). The purpose of the study is quantitative assessment of insulin resistance severity using indirect (non-insulin) methods and determination of its correlation with serum uric acid (UA) levels in patients with type 1 DM. Materials and methods. One hundred and eighty-one patients with type 1 DM were examined, their average age was 42.5 ± 12.1 years. Anthropometric research was conducted. Indirect methods for quantitative assessment of insulin resistance were used. The analysis was conducted using non-parametric and parametric statistical methods. Results. In patients with HU, anthropometric indices were significantly higher than in those with normouricemia, which indicated an abdominal type of fat deposition. In HU, a more pronounced insulin resistance was observed compared to that in normouricemia. It was found that in type 1 DM, the serum UA level positively correlated with body mass index, waist circumference, waist-to-hip ratio, triglycerides/high-density lipoprotein cholesterol and negatively with the estimated rate of glucose utilization, sensitivity to insulin and the natural logarithm of the rate of glucose utilization. A group of variables with the greatest contribution to the variation of the serum UA level was selected by stepwise multifactorial regression analysis of models from the studied predicates. Conclusions. It has been shown that patients with type 1 DM and HU have a significantly more severe insulin resistance. There was a correlation between anthropometric and calculated indices, reflecting the severity of insulin resistance, with the serum level of UA. The group of predicates with the greatest contribution to the variance of the serum UA level in patients with type 1 DM was selected.

Hyperuricemia is associated with heart failure readmission in patients with heart failure and preserved ejection fraction-an observational study in Chinese

Background and aimsThis study aimed to explore the association between hyperuricemia and heart failure (HF) readmission in HF patients with preserved ejection fraction (HFpEF) because the impact of hyperuricemia on the prognosis of these patients has not been fully understood. Methods and resultsThis retrospective observational study included 538 hospitalized patients diagnosed with HFpEF. A total of 57.6 % of patients with HFpEF suffered from hyperuricemia (serum uric acid (SUA) was >7 mg/dL in men and >6 mg/dL in women). Compared to those without hyperuricemia, patients with hyperuricemia were more likely to be female (62.6 % vs. 53.9 %, p = 0.044) and older (78.0 ± 8.4 vs. 75.9 ± 9.0 years, p = 0.008). Our Cox analysis revealed that SUA level (hazard ratio (HR) = 1.158, 95 % confidence interval (CI): 1.087–1.234, p<0.001) and hyperuricemia (HR = 1.846, 95 % CI: 1.308–2.606, p<0.001) were associated with HF readmission in patients with HFpEF, respectively. Kaplan-Meier analysis showed that patients with hyperuricemia had a significantly worse prognosis (p<0.001). The receiver operating characteristic analysis revealed that the area under the ROC curve of SUA for predicting HF readmission was 0.6276 (95 % CI: 0.5763–0.6790) and a designated cut-off value of 7.53 mg/dL. ConclusionsHyperuricemia is a common comorbidity among patients with HFpEF. Moreover, SUA level and hyperuricemia have been shown to be associated with HF readmission. Therefore, it is meaningful to monitor SUA levels in patients with HFpEF during the whole treatment period of HF. Whereas, whether intervention of hyperuricemia could benefit patients with HFpEF needs further studies.

Analysis of the prognostic value of uric acid on the efficacy of immunotherapy in patients with primary liver cancer

PurposeUric acid (UA) plays a dual role as an antioxidant and a prooxidant in patients with malignant tumors; however, the relationship between serum UA and malignancy is currently unclear. This study aims to investigate the prognostic value of serum uric acid level before immunotherapy on the efficacy of primary liver cancer (PLC) immunotherapy, which might provide a basis for optimizing the comprehensive treatment scheme.MethodsPatients with PLC who were admitted to the First Affiliated Hospital of Gannan Medical College from January 2019 to June 2022 and underwent immunotherapy were collected retrospectively. The difference between serum UA levels in patients with PLC, the correlation between serum UA levels, and the clinical characteristics of patients with PLC were analyzed using the chi-square test, and the survival was estimated using the Kaplan–Meier analysis. To further assess the prognostic significance of UA concentrations, univariate and multivariate Cox regression analyses were performed.ResultsNinety-nine patients were included in this study cohort. The median follow-up was 7 months (range: 1–29 months), and 76 (76.8%) of the 99 patients with PLC died as of December 31, 2022. Serum UA concentrations ranged from 105 to 670 μmol/l, with a median of 269 μmol/l. The results showed that the serum UA level of patients with PLC was higher than that of healthy subjects (P < 0.001). After subgroup analyses, only male patients with liver cancer had higher serum UA levels than healthy men (P = 0.001). The results of the Kaplan–Meier analysis showed that higher UA levels were associated with poor overall survival (OS) (P = 0.005). In univariate analysis, the OS rate of patients with elevated serum UA levels was significantly lower than the cut-off value (hazard ratio [HR]: 3.191, 95% confidence interval [CI]: 1.456–6.993, P = 0.004), with a median survival time of 151 and 312 days in the high and low serum UA groups, respectively. The results of multivariate analysis showed that the UA level was an independent prognostic factor for immunotherapy in patients with PLC (HR: 3.131, 95% CI: 1.766–5.553, P < 0.001).ConclusionsThe serum UA level is a reliable biomarker for predicting the prognosis of patients undergoing immunotherapy for PLC, and might provide a basis for the individualized treatment of these patients. Dynamic monitoring of the serum UA level may compensate for the deficiency of the current liver cancer staging system.

Serum uric acid level in male patients with androgenetic alopecia: A prospective study in China

BackgroundThe aim of this study was to investigate the serum level of uric acid (UA) in male patients with androgenetic alopecia (AGA) and to compare the level with that of men without AGA. In addition, the comparison of the serum level of uric acid (UA) before and after treatment with finasteride was performed. MethodA total of 120 male patients with AGA and 120 males without AGA were enrolled in this prospective study. Patients with AGA were randomized into two groups: 60 patients were given 1 mg finasteride orally every day for 6 months, and 60 patients were given placebo. Serum UA level was detected at the first visit and after the 6-month treatment by colorimetric analysis. ResultsBefore treatment, the mean serum UA level in patients with AGA was higher than that in the control group (401.52±83.27 umol/L vs 362.67±60.88 umol/L, P<0.050), and a higher proportion of hyperuricemia was found in patients with AGA (2 9.17% vs 15.00%, P<0.050). After treatment, the mean serum UA level in the finasteride group decreased significantly, from 405.87±87.12 umol/L to 381.84±82.50 umol/L (P<0.050), and from 397.17±79.73 to 394.18±78.09 umol/L in the placebo group (P = 0.370). Patients with AGA with hyperuricemia had a higher BMI (25.38±3.43 kg/m2) when compared to the patients without hyperuricemia (23.88±2.64 kg/m2). For every unit of BMI increase in patients with AGA, the risk of hyperuricemia increased by 30.5% (P = 0.030). Furthermore, the levels of UA were different in the finasteride group before and after treatment (P = 0.049, 95%CI, 0.080, 47.970). ConclusionsWe found that AGA has a relationship with hyperuricemia, and the level of serum UA can decrease with the treatment of finasteride.

A CROSS-SECTIONAL STUDY ON CORRELATION BETWEEN SERUM URIC ACID LEVEL AND CAROTID ATHEROSCLEROSIS IN PATIENTS OF TYPE 2 DIABETES

Objective: The objective of the study was to assess correlation between uric acid (UA) level and carotid intima media thickness (CIMT) in type 2 diabetes mellitus (DM) patients. Methods: The study was conducted in the Department of Medicine, SMS Medical College and Attached Hospital, among adults with type 2 DM. It was cross-sectional study conducted from April 1, 2019, to December 31, 2020. Sample size is calculated 60 patients of Type 2 DM. As per previous study show correlation coefficient between serum UA (SUA) level and CIMT (r=0.779)52 (For 90% power and 1% α error). CIMT and carotid artery plaques were measured through Doppler ultrasound. The thickness was measured at 1 cm proximal to the dilatation of the carotid bulb. The mean of maximum IMT of both the common carotid artery is taken as the average CIMT. Results: Most patients (60%) were diabetics since 5 years and nearly 30% had diabetes since 5–15 years while only 10% had diabetes since more than 15 years. Mean duration of diabetes was 6.91±5.88 years. Two thirds of diabetic individuals (67%) had HDL cholesterol level above 40 mg/dL. About 42% of diabetic individuals had triglyceride level &lt;150 mg/dL and 5% of diabetic individuals had LDL cholesterol level &lt;100 mg/dL. Mean HDL cholesterol, Triglycerides, and LDL cholesterol were 47.4±15.49 mg/dL, 153.78±81.56 mg/dL, and 92.33±57.28 mg/dL, respectively. Mean bilirubin and serum creatinine in study population were 0.65±0.48 mg/dL and 0.96±0.18 mg/dL, respectively. Mean CRP was 3.95±2.40 mg/L. Mean SUA level in study population was 5.78±2.18 mg/dL. Mean of average CIMT was found to be 8.0±1.16 mm. Glycated hemoglobin (HbA1c) and UA had negative weak linear correlation which was statistically significant. HbA1c and average CIMT had no or week negative correlation which was not statistically significant and SUA and average CIMT showed positive moderate linear correlation which was statistically significant. Conclusion: Carotid atherosclerosis as measured by IMT is associated with SUA levels in patients with type 2 DM. In type 2 DM patients, HbA1C is negatively correlated with UA while HbA1C has no correlation with CIMT.

The effect of dapagliflozin on uric acid excretion and serum uric acid level in advanced CKD

Sodium–glucose cotransporter 2 inhibitors (SGLT2i) exhibit renoprotective effect in patients with chronic kidney disease (CKD) and reduce serum uric acid (UA) in patients with diabetes mellitus. However, it is not clarified whether SGLT2i reduce serum UA levels in patients with advanced CKD. This study aimed to investigate the impact of SGLT2i on change in serum UA levels in patients with advanced CKD. Data of 121 Japanese patients with CKD who were newly administered 10 mg dapagliflozin in our department between August 2021 and August 2022 were analyzed. Changes in UA and fractional excretion of UA (FEUA) were analyzed using multiple regression analysis. Of 75 patients, 21 (28.0%) patients, 24 (32.0%) patients, 29 (38.7%) patients, and 1 (1.3%) patient were categorized as having CKD stage 3a, 3b, 4, and 5, respectively. The median age was 67 years, and 72.0% were male. 23 (30.7%) of patients had diabetes mellitus. The median estimated glomerular filtration rate, serum UA, and FEUA were 35.7 mL/min/1.73 m2, 6.4 mg/dL, and 6.76%, respectively, at the time of dapagliflozin administration. After administration, serum UA decreased to 5.6 mg/dL and FEUA increased to 9.22%. Dapagliflozin increases FEUA and reduces serum UA levels in patients with advanced CKD.

Association between serum uric acid levels of patients with gout and their complications and examination fees: A cross-sectional analysis.

Correlation influence factor analysis of gout patients' serum uric acid (SUA) levels, their examination fees, and various complications were explored. From January 2017 to December 2021, 17 666 patients with gout were obtained. Conduct quartile grouping according to gout patients' SUA levels was used to compare the differences between groups in terms of examination fees and complications. Kernel density estimation method was adopted to analyze the data distribution, Spearman and Mantel-Haenszel χ2 tests were used to analyze the correlation between SUA levels and examination fees and complications. Binary logistic regression analysis was used to analyze the correlation influence factor between SUA levels and complications. Of the 17 666 gout cases, 85.46% were male. Among them, 7637 (43.23%) were inpatients and 10029 (56.77%) were outpatients. Compared with outpatients, age, SUA levels, and examination fees were significantly higher, and there were more complications among inpatients (P < 0.05). Correlation analysis revealed that outpatients and SUA levels of patients with gout were positively correlated with examination fees, cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases (P < 0.01). Binary logistic regression analysis showed that SUA level is an independent influence factor for cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases (odds ratio [95% confidence interval]: 1.002 [1.002-1.002], 1.001 [1.000-1.001], 1.003 [1.002-1.003], and 1.001 [1.001-1.002], respectively). As SUA levels increased, examination fees, cardiovascular disease, pulmonary disease, liver disease, and kidney disease complications increased. SUA level is an independent influence factor for the combination of gout with cardiovascular diseases, pulmonary diseases, liver diseases, and kidney diseases.

A study of the relationship between serum uric acid levels and pain in patients with migraine.

Serum uric acid (SUA), the end product of purine metabolism acts as an antioxidant and is related to oxidative stress. It has been reported that SUA may be involved in the pathogenesis of neurodegenerative diseases including Alzheimer disease, Huntington disease, Parkinson disease, and multiple sclerosis. However, studies evaluating SUA levels in migraine are scarce. This study aimed to explore the relationship between pain characteristics and SUA levels in patients with migraine and compare SUA levels in migraine patients during a headache attack and headache-free period with those control groups. This prospective, cross-sectional study included 78 patients with migraine and 78 healthy subjects who were randomly selected from hospital personnel as the control group. Headache characteristics (duration of attack, pain intensity, and headache frequency) and sociodemographic features were recorded. The SUA level was measured once in the control group and twice in the migraine patients, during the migraine attack and headache-free periods. Although the SUA levels of the migraine group in the headache-free period were higher than those of the control group, the difference was not statistically significant. Gender was not significantly related to the change in SUA levels between the attack and headache-free period. When the correlation between age, duration of migraine, frequency, duration, and intensity of pain was evaluated; the difference between SUA levels in female migraine patients was weakly correlated with headache intensity, whereas male patients had a moderate correlation. (P < .05; R > 0.250, and R > 0.516, respectively). The difference in SUA level in the migraine attack period compared to the headache-free period showing a positive correlation with pain intensity suggested that SUA may have a role in migraine due to its antioxidant role.

Estimation of serum uric acid in patients of acute myocardial infarction

BACKGROUND: Acute myocardial infarction (AMI), often known as a heart attack, is a medical emergency that is the top cause of mortality for both men and women worldwide. Recent evidence suggests that it is caused by the sudden blockage of a coronary artery by a blood clot, also known as coronary thrombosis. Due to the regional impending of blood supply, heart muscles become damaged. Uric acid has been shown in large cohort studies to be an important independent risk factor for cardiovascular mortality. As serum uric acid (SUA) is an early predictor hence study will help to devise a better remedy for AMI.AIM: This study aims to study the levels of SUA in patients with AMI as compared to the control.OBJECTIVE: The primary goal of this study is to examine SUA levels in patients with AMI and to correlate uric acid levels with associated mortality in AMI. The secondary goal is to predict AMI early diagnosis, better management and treatment, and prognosis.METHODS: The current study was conducted at the department of biochemistry and the central investigation laboratory at our institute, in partnership with the department of medicine, intense cardiac care units, medical intensive care units, and emergency and private hospitals. A total of 100 patients were investigated. There were 50 instances of AMI and 50 age-matched healthy controls. The Microlab 300 analyzers (semi-autoanalyzer) were used to assess SUA concentrations, and the comparisons between the two groups were examined using an unpaired t-test. A P < 0.05 was deemed statistically significant.RESULTS: There was a substantial rise in the mean level of SUA in cases on the 0, 3rd, and 7th days were 8.503 + 2.976 mg/dl, 5.472 + 2.683 mg/dl, and 4.992 + 1.707 mg/dl day, respectively, which were higher than controls group (3.976 + 0.947 mg/dl). Comparison between control and AMI SUA on 0 and 3rd days was found to be more significant than the 7th day. There was a substantial rise in blood uric acid levels in cases when compared to healthy controls (P < 0.005).CONCLUSION: Thus, the study shows that blood uric acid levels play a significant role in the diagnosis and therapy of AMI.

Association of Serum Uric Acid With All-Cause and Cardiovascular Mortality in Diabetes.

To investigate whether serum uric acid (SUA) level is associated with all-cause and cardiovascular disease (CVD) mortality among individuals with diabetes. In this prospective cohort study, we included patients with diabetes from the U.S. National Health and Nutritional Examination Survey (NHANES) 1999-2018. Mortality and underlying causes of death were ascertained by linkage to national death records through 31 December 2019. Weighted Cox proportional hazards regression models were used to evaluate hazard ratios (HRs) and 95% CIs for all-cause and CVD mortality. We also performed a meta-analysis of available cohort studies to combine the association between SUA level and mortality in diabetes. Among the 7,101 patients with diabetes from NHANES 1999-2018, the weighted mean of SUA level was 5.7 mg/dL. During 57,926 person-years of follow-up, 1,900 deaths (n = 674 deaths from CVD) occurred. In the fully adjusted model, when compared with patients with diabetes in the lowest SUA quintile, those in the highest SUA quintile had the HRs (95% CIs) of 1.28 (1.03, 1.58) for all-cause mortality and 1.41 (1.03, 1.94) for CVD mortality. We included 13 cohort studies in the meta-analysis and found that the pooled HRs (95% CIs) were 1.08 (1.05, 1.11) for all-cause mortality and 1.05 (1.03, 1.06) for CVD mortality per 1 mg/dL increment of SUA level in patients with diabetes. This study indicated that higher SUA levels were associated with increased risks of all-cause and CVD mortality in diabetes. Interventional studies are needed to elucidate the health effect of treatments to lower SUA levels.

The perirenal fat thickness was independently associated with serum uric acid level in patients with type 2 diabetes mellitus

BackgroundObesity is an important risk factor for hyperuricemia. We aimed to explore the relationship between perirenal fat thickness (PrFT) and paranephric fat thickness (PnFT) and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM).MethodsThis was a cross-sectional study involving 257 patients with T2DM recruited from Beijing Luhe Hospital from September 2019 to May 2020. The basic and clinical information such as age, gender, duration of diabetes was collected through the medical records. All patients underwent a physical examination including height, weight, waist circumference, hip circumference, systolic blood pressures and diastolic blood pressure. The venous blood and urine samples were collected to measure SUA, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, serum creatinine, blood urea nitrogen and glycosylated hemoglobin. PrFT and PnFT were measured via ultrasonography. Pearson correlation test and linear regression analysis were used to analyze the association between PrFT and PnFT and SUA.ResultsWe found that PrFT and PnFT increased according to the tertiles of SUA level (P = 0.001 and P = 0.009, respectively). In addition, the PrFT and PnFT were positively associated with SUA level (r = 0.25, P < 0.001, r = 0.23, P < 0.001, respectively). Moreover, this association was stronger in males, non-obesity patients and patients with normal renal function. In the multivariate analysis, the PrFT was independently associated with SUA level after adjusting confounding factors.ConclusionsThe PrFT was independently associated with SUA level in patients with T2DM.

Correlation between Uric Acid and Lipid Profile in Untreated Dyslipidemic Patients

Background: The effects of cholesterol and statin therapy on serum uric acid (SUA) concentration are poorly known, and the latter's effects are even less clear. A mean atorvastatin dosage of 24 mg/dl satisfies the American Cardiovascular Assessment Campaign management objectives and dramatically lowers prevalence of chronic in individuals with cardiovascular events, according to the Greek Drug and Cardiovascular Evaluation research. We compare the temporal evolution of SUA levels in patients receiving standard treatment who received insufficient statin therapy (12 percent received statins) to patients receiving formalised care who received atorvastatin therapy almost exclusively (98 percent). Methods: In this study 160 individuals with abnormal lipid profiles in their blood were enrolled to investigate the connection between lipid profile and uric acid in dyslipidemic patients (dyslipidemia). It was a 5-month cross-sectional study conducted at Dr Abdul Sattar Lab Sialkot using a convenient sampling method. The uric acid, total cholesterol, triglycerides, LDL, and HDL cholesterol levels of enrolled participants were measured. In short, we performed uric acid and lipid profile tests on under-observation samples to investigate the association between uric acid and lipid profile parameters in the enrolled (dyslipidemic) individuals. Result: This research looks at people between the ages of 20 and 60. The Graph shows that (15) patients are between the ages of 20 and 30, (46) patients are between the ages of 31 and 40, (74) patients are between the ages of 41 and 50, and (25) patients are between the ages of 51 and 60.Patients of both sexes are covered. It was found that there exist significant positive relationship between uric acid and lipid profile in dyslipidemic patients. This study shows a positive correlation between LDL, triglycerides, total cholesterol and uric acid whereas a negative correlation was observed between HDL and uric acid. According to the current results, when uric acid rises, Total Cholesterol, Triglycerides, and Low Density Lipoproteins (LDL) rise as well. But High Density Lipoproteins (HDL) falls with the increase in uric acid levels. As a result, this study may be useful in reducing the incidence of related cardiovascular morbidities, and we will be able to predict dyslipidemia more accurately, which may further leads to CVDs. As the rate of CVDs rises in Pakistan, it is becoming increasingly necessary to investigate the factors that are directly linked to the disease. Conclusion: This article's objective was to investigate any connections between Uric Acid and Lipid Profile. Because dyslipidemia predicts the risk of coronary artery disease, so uric acid levels should be considered in these individuals for more complete risk factor prediction and treatment. Increased levels of lipid profile parameters can lead to serious heart diseases, and the only way to avoid this is to get a quick diagnosis of the disease.

Effects of allopurinol on renal function in patients with diabetes: a systematic review and meta-analysis

Background/Objective Diabetes mellitus is a common “non-gout” disease with high incidence. Several studies have shown that serum uric acid level in patients with diabetes is higher than that in healthy individuals, and is accompanied by severe albuminuria and high serum creatinine (Scr). Recent clinical studies have found that uric acid-lowering therapy (such as allopurinol) could reduce urinary albumin excretion rates (UAER) and Scr, increase eGFR, and thus reduce kidney damage in patients with diabetes. Therefore, this meta-analysis [PROSPERO CRD42021274465] intended to evaluate the efficacy and safety of allopurinol in patients with diabetes mellitus. Methods We thoroughly searched five electronic resource databases for randomized controlled trials (RCTs) that compared the efficacy and safety of allopurinol versus conventional treatment or placebo for the treatment of patients with diabetes mellitus. Predetermined outcomes were considered continuous variables, mean difference (MD) was used for the determination of effect size (standardized mean difference [SMD] was used to determine the effect size when there were different evaluation criteria in different articles), and the corresponding 95% confidence interval (CI) was calculated. All outcome measures were analyzed using a random-effects model for data analysis. Results Ten eligible trials with a total of 866 participants were included in the meta-analysis. Allopurinol was more effective in decreasing serum uric acid (SUA) levels compared with conventional treatment (p = 0.0001) or placebo (p < 0.00001). Moreover, the levels of 24-hour urine protein were significantly lower in the allopurinol group (p < 0.00001). The subgroup analysis of Scr showed that the Scr of patients with an allopurinol treatment duration of fewer than six months was significantly lower than that of the control group (p = 0.03). No significant difference in adverse events (AEs) was identified between the treatment and control groups. Conclusions Our meta-analysis of RCTs showed that oral administration of allopurinol effectively reduced SUA levels in patients with diabetes, and patients’ renal function was protected. More RCTs with larger sample sizes and higher quality are needed to clarify the role of allopurinol use in decreasing blood pressure, maintaining blood glucose levels, and improving renal function in patients with diabetes.

Uric Acid and Cognitive Impairment in Patients with Acute Ischemic Stroke: A Meta-Analysis.

Serum uric acid (UA) has been suggested to be correlated with outcomes after stroke. We performed a meta-analysis to evaluate the association between serum UA and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke (AIS). Relevant observational studies were identified by search of electronic databases including PubMed, Embase, and Web of Science. A randomized-effect model incorporating the possible between-study heterogeneity was used to pool the results. Overall, eleven studies with 4246 patients of AIS were included, 2073 (48.8%) of them had PSCI. Pooled results showed that patients with PSCI had significantly higher level of serum UA as compared to those without PSCI (mean difference: 35.70 μmol/l, 95% confidence interval (CI): 8.36 to 63.01, p=0.01; I2=95%). Subgroup analysis showed significant higher level of serum UA in patients with PSCI evaluated during follow-up of 3 months to 3 years, but not for those evaluated during hospitalization (p for subgroup difference=0.01). In addition, results of meta-analysis also showed that compared to patients with lower serum UA, AIS patients with higher serum UA had increased risk of PSCI (odds ratio: 1.33, 95% CI: 1.02 to 1.73, p=0.04; I2=72%). Higher level of serum UA after disease onset may be a marker of increased risk of PSCI in patients with AIS. Although these findings need to be validated in large-scale prospective studies, the possible mechanisms underlying the association between UA and PSCI should be also investigated.

Washed microbiota transplantation reduces serum uric acid levels in patients with hyperuricaemia.

BACKGROUNDPrevious studies have found that hyperuricaemia (HUA) is closely related to intestinal flora imbalance.AIMThe current study investigated the effects and safety of washed microbiota transplantation (WMT) on serum uric acid (SUA) levels in different populations.METHODSA total of 144 patients who received WMT from July 2016 to April 2020 in the First Affiliated Hospital of Guangdong Pharmaceutical University and had SUA data before treatment were selected. Changes in SUA levels before and after treatment were retrospectively reviewed based on short-term and mid-term effects of WMT regimens. SUA levels measured in the last test within 3 mo after the first WMT represented the short-term effect, and SUA levels measured in the last test within 3-6 mo after the first WMT represented the mid-term effect. The patients were divided into an HUA group (SUA > 416 μM) and a normal uric acid (NUA) group (SUA ≥ 202 μM to ≤ 416 μM) based on pretreatment SUA levels.RESULTSAverage short-term SUA levels in the HUA group decreased after WMT (481.00 ± 99.85 vs 546.81 ± 109.64 μM, n = 32, P < 0.05) in 25/32 patients and returned to normal in 10/32 patients. The short-term level of SUA reduction after treatment moderately correlated with SUA levels before treatment (r = 0.549, R² = 0.300, P < 0.05). Average SUA levels decreased after the first and second courses of WMT (469.74 ± 97.68 vs 540.00 ± 107.16 μM, n = 35, and 465.57 ± 88.88 vs 513.19 ± 78.14 μM, n = 21, P < 0.05). Short-term and mid-term SUA levels after WMT and SUA levels after the first, second and third courses of WMT were similar to the levels before WMT in the NUA group (P > 0.05). Only 1/144 patients developed mild diarrhea after WMT.CONCLUSIONWMT reduces short-term SUA levels in patients with HUA with mild side effects but has no obvious effect on SUA levels in patients with NUA.

Retrospective Study from a Single Center to Evaluate the Association Between Sex and Serum Uric Acid Levels in 950 Patients with Atrial Fibrillation.

BackgroundThe association between patients’ serum uric acid (SUA) levels and sex in atrial fibrillation (AF) remains controversial. This retrospective study from a single center in China aimed to evaluate the association between sex and SUA levels in 950 patients with AF.Material/MethodsWe retrospectively analyzed clinical information of 1913 consecutive hospitalized patients (male/female: 949/964, 68.26±11.02 years). The sample of 950 patients with AF served as the AF group and 963 age- and sex-matched patients without AF with sinus rhythm served as controls. The uricase method was used to determine SUA levels. The analysis of variance, t test, and chi-squared test were performed to analyze clinical baseline data. Pearson correlation analysis was performed to identify interrelationships and multivariate regression analysis was performed to determine the independent risk factor for AF.ResultsSUA levels in the AF group were significantly higher in both sexes (P<0.05), especially for permanent AF. In patients with AF, SUA levels were positively correlated with serum creatinine (r=0.235, P<0.05) and prealbumin (r=0.129, P<0.05) and were negatively correlated with high-density lipoprotein cholesterol (r=−0.207, P<0.05) and apolipoprotein A1 (r=−0.167, P<0.05). SUA was independently associated with AF after adjusting for confounding factors (OR=1.244, 95% CI: 1.133–1.365, P<0.05).ConclusionsIn both sexes, increased SUA was significantly associated with AF. These findings supported the importance of monitoring SUA levels in patients with AF and other cardiac diseases.

Serum uric acid levels and diabetic kidney disease in patients with type 2 diabetes mellitus: A dose-response meta-analysis

ObjectiveOur study aimed to assess the existing evidence on whether serum uric acid (SUA) levels are associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). MethodsWe conducted a systematic search of articles up to October 2021 in Medline, Embase, The Cochrane Library and Web of Science that estimated DKD by SUA levels in patients with T2DM. Pooled relative risks with 95% CI were calculated using random effects models ResultsA total of eight cohort studies involving 25,741 T2DM patients were included. Meta-analysis showed that compared the highest with the lowest category of SUA level, the summary risk ratios were 2.04 (95%CI 1.43–2.92, P < 0.001). The linear dose-response analysis revealed that the risk of DKD increased by 24% for each 1 mg/dl increase of SUA. The non-linear dose-response analysis also showed a significant relevance between SUA and the risk of DKD in patients with type 2 diabetes mellitus (P < 0.001). ConclusionsSerum uric acid is associated with an increased risk of diabetic kidney disease in patients with type 2 diabetes mellitus. Serum uric acid level could be a good indicator for predicting diabetic kidney disease in patients with type 2 diabetes mellitus.

Association between serum uric acid level and non-alcoholic fatty liver disease in Koreans.

The association between serum uric acid (SUA) levels and non-alcoholic fatty liver disease (NAFLD) is controversial. We compared the association of SUA levels with NAFLD, abnormal alanine transferase (ALT), and the degree of liver fibrosis to clarify the association of SUA levels with NAFLD. We conducted a retrospective cross-sectional study. Adult patients who underwent a health check-up (N = 1,343) were included for analysis. Fatty liver was diagnosed by abdominal ultrasonography. The degree of liver fibrosis was determined using the NAFLD fibrosis score (NFS). Pearson correlation analysis showed a stronger correlation of SUA level with the fatty liver index (r = 0.40, P < 0.001) than the correlation with serum ALT level (r = 0.28, P < 0.001), or NFS (r = 0.018, P = 0.51). SUA levels in patients with NAFLD and an abnormal liver function test (LFT) result were significantly higher than levels in patients without NAFLD and abnormal LFT results. By contrast, there was no significant association of SUA level with NFS grade. When age, male sex, body mass index, the presence of hypertension, diabetic mellitus, and NAFLD, abnormality of ALT level, and SUA level were included in binary logistic regression to evaluate risk factors for elevated NFS grade, hyperuricemia was not significantly associated with NFS grade (OR = 0.94, P = 0.75). Pearson correlation and logistic regression together indicated SUA level is more closely associated with hepatic steatosis than abnormal liver function test or hepatic fibrosis.