Serum Uric Acid Research Articles

Serum Uric Acid in Women with Preeclampsia and its Relation to Perinatal and Maternal Outcomes

Background and objective: Preeclampsia is a dangerous, progressive condition that is linked to maternal and neonatal death and morbidity. The purpose of this study was to determine the association between serum uric acid levels in preeclampsia with maternal and fetal outcomes. Method: A case-control study was conducted on 300 women delivered at the labour room of Duhok Obstetrics and Gynecology Hospital, from 1st of April 2021 to 1st of April 2022. The study participants were divided into two groups, pregnant women with preeclampsia and normotensive women. The serum uric acid levels of these women were estimated with the impact on fetal and mother outcomes. Results: There was a highly significant association between preeclamptic and normotensive women in relation to mean serum uric acid (5.862 ±1.416) mg/dL and (3.570 ±0.982) mg/dL respectively. A highly significant association was seen between uric acid test levels and maternal eclamptic fit, HELLP syndrome and admission to intensive care unit. A highly significant association also seen with newborn birth weight, APGAR scores and admission to neonatal intensive care unit. Conclusion: The current study demonstrates a significant raise in serum uric acid level in preeclamptic women and associated with adverse perinatal and maternal outcomes.

Uric acid and alterations of purine recycling disorders in Parkinson’s disease: a cross-sectional study

The relationship between reduced serum uric acid (UA) levels and Parkinson’s disease (PD), particularly purine metabolic pathways, is not fully understood. Our study compared serum and cerebrospinal fluid (CSF) levels of inosine, hypoxanthine, xanthine, and UA in PD patients and healthy controls. We analyzed 132 samples (serum, 45 PD, and 29 age- and sex-matched healthy controls; CSF, 39 PD, and 19 age- and sex-matched healthy controls) using liquid chromatography-tandem mass spectrometry. Results showed significantly lower serum and CSF UA levels in PD patients than in controls (p < 0.0001; effect size r = 0.5007 in serum, p = 0.0046; r = 0.3720 in CSF). Decreased serum hypoxanthine levels were observed (p = 0.0002; r = 0.4338) in PD patients compared to controls with decreased CSF inosine and hypoxanthine levels (p < 0.0001, r = 0.5396: p = 0.0276, r = 0.2893). A general linear model analysis indicated that the reduced UA levels were mainly due to external factors such as sex and weight in serum and age and weight in CSF unrelated to the purine metabolic pathway. Our findings highlight that decreased UA levels in PD are influenced by factors beyond purine metabolism, including external factors such as sex, weight, and age, emphasizing the need for further research into the underlying mechanisms and potential therapeutic approaches.

Low detection limit of uric acid based on Prussian blue-enhanced photothermal effect with microfiber knot resonator

The human serum uric acid (UA) level is a crucial indicator for diagnosing dementia in middle-aged and elderly individuals, with decreased levels being expressed in patients. Therefore, developing a high-performance sensor for online uric acid detection is of significant research interest. Herein, a microfiber knot resonator (MKR) sensor for quantitative detection of UA levels is reported. Combining polydimethylsiloxane (PDMS) with an adiabatic MKR, the specificity of UA detection in serum is improved using the photothermal effect of Prussian blue-enhanced uricase reaction. During the sensor operation, UA generates the photothermal effect under 650 nm laser irradiation, causing the PDMS film to expand with heat absorption, thereby shifting the resonance spectrum of the PDMS-MKR sensor. Experimental results demonstrate a sensitivity of 0.0559 nm/(μmol/L) within a UA concentration range of 40–120 μmol/L and a detection limit as low as 0.3578 μmol/L. The proposed sensor shows potential applications in clinical point-of-care early diagnosis and prognosis of dementia due to its specificity, fast detection speed, robustness, and high integration.

Prediction factors and models for chronic kidney disease in type 2 diabetes mellitus: A review of the literature

AbstractDiabetes mellitus (DM) has become a major chronic disease seriously affecting human health. Type 2 diabetes mellitus (T2DM) accounts for about 90% of DM patients, which is the largest type. Approximately 25–35% of T2DM patients develop kidney disease, which not only impacts the survival rate and quality of life but also, to the family and society, are of great economic burden. Early identification of high‐risk T2DM patients with kidney disease is crucial for initiating targeted prevention and treatment measures in time to reduce or delay the occurrence and progression of diabetic kidney disease. Previous studies have identified a variety of clinical predictors for the progression of renal function in T2DM patients, including proteinuria, estimated glomerular filtration rate, blood glucose, blood pressure, serum uric acid, dyslipidemia, obesity, smoking, duration of DM, age, gender, race, family history of DM, and diabetic retinopathy. Clinical prediction models based on conventional clinical indicators are instrumental in evaluating the risk of kidney disease in T2DM patients, assisting in patient risk stratification. This article systematically reviews the clinical prediction factors and prediction models associated with the progression of renal function in T2DM patients, providing a comprehensive and current reference for improved clinical assessment of the risk of renal function progression.

Serum creatinine is more strongly associated with hyperuricemia than eGFR in males but not in females.

Serum creatinine and estimated glomerular filtration ratio (eGFR) are factors associated with hyperuricemia, though which is more closely associated with hyperuricemia remains unclear. This retrospective cross-sectional study examined the associations of serum creatinine and eGFR with hyperuricemia using health check-up findings. Enrolled were 6020 individuals (3509 males, 2511 females) who underwent health check-ups from 2017 to 2021. The subjects were divided based on serum uric acid level into the normuricemia (males 1.5-7.0 mg/dl, females 1.5-< 6.0 mg/dl) and hyperuricemia (males >7.0 mg/dl, female ≥ 6.0 mg/dl) groups. Matched-pair analysis was used to evaluate the association between hyperuricemia and variables related to serum uric acid. Matched-pair analysis results showed a significant association of serum creatinine with hyperuricemia in male subjects but not in females. Furthermore, propensity score obtained by binominal logistic regression demonstrated that serum creatinine had a greater association with hyperuricemia than eGFR in the males but not in females. The present findings indicate an association of serum creatinine with hyperuricemia in males not only because of reduced renal function but other factors related to greater muscle mass, such as increased intake of protein-rich foods containing purines and increased uric acid production induced by accelerated creatinine metabolism.

Effectiveness of a Single Fixed Dose of 3 mg Rasburicase for the Prevention and Management of Hyperuricemia in Tumor Lysis Syndrome in Adults With Cancer.

Tumor lysis syndrome (TLS) is a critical and potentially fatal complication linked to specific types of cancer. Rasburicase stands as a crucial medication necessary for the prevention and treatment of hyperuricemia, a condition commonly associated with TLS. Due to a shortage of rasburicase during the COVID-19 pandemic, a fixed-dose strategy of 3 mg rasburicase was used in many adult cancer patients in our center. The objective of this study was to assess the effectiveness of a fixed dose of 3 mg rasburicase in preventing and managing hyperuricemia associated with TLS in adult cancer patients. We conducted a retrospective, observational cohort study between March 2020 and February 2022. The study included adult patients who received a fixed dose of 3 mg rasburicase. The primary outcome measure was the reduction in serum uric acid (UA) levels at 24 and 48 hours after treatment, with the aim of achieving and maintaining normal UA levels. Seventeen patients in the treatment group and 20 patients in the prevention group were included. In the treatment group, 15 (88%) patients had normalization of serum UA, which is considered to be <7 mg/dL (median: 4.48 mg/dL) at 24 hours, and 16 (94%) patients had achieved normal UA at 48 hours (median: 2.78 mg/dL) after receiving the rasburicase dose. In the prevention group, all 20 (100%) patients achieved normal UA at 24 hours after receiving the rasburicase dose. Based on these findings, a single fixed dose of 3 mg rasburicase is effective for preventing and managing hyperuricemia associated with TLS in high-risk patients.

Serum uric acid and pulmonary arterial hypertension: A two-sample Mendelian randomization study

BackgroundObservational studies have suggested a correlation between hyperuricemia and pulmonary arterial hypertension (PAH), yet the causal relationship remains uncertain. We aimed to establish this link using Mendelian Randomization (MR) methods. ObjectivesBased on publicly accessible data, our study employs MR to determine the causal relationship between uric acid (UA) and PAH. MethodMR analysis was conducted among individuals of European descent. Genetic instruments linked to UA (p-value < 5 × 10–8) were extracted from the Chronic Kidney Disease Genetic Consortium and genome-wide association study databases. PAH risk genetic associations were sourced separately. We employed four MR methods (MR-Egger, weighted median, inverse variance weighted, and weighted mode) with selected instrumental variables to assess the causal association between UA and PAH. MR-PRESSO was used to evaluate pleiotropy and outlier Single Nucleotide Polymorphisms (SNPs), while Cochran's Q test and funnel plot assessed SNP heterogeneity. Leave-one-out analysis examined SNP impacts on causal assessment. ResultTwo-sample MR analysis revealed a positive, causal relationship between UA levels and PAH. ConclusionOur MR analysis provides robust evidence of a causal link between serum UA and PAH, suggesting UA's potential as a biomarker and therapeutic target for PAH.

Effect of low-purine diet on the serum uric acid of gout patients in different clinical subtypes: a prospective cohort study

BackgroundThe pathogenic causes of primary gout include urate overproduction and/or renal or extra-renal urate underexcretion. The aim of this study was to evaluate the association of gout subtypes with the response to low-purine diet (LPD).MethodsThis is a single-center prospective clinical study. Gout patients visiting from 2019 to 2022, from Shandong Gout Clinic Center at the Affiliated Hospital of Qingdao University, China, assigned to three groups according to clinical subtypes, were enrolled and all treated with 2-week low-purine diet. General characteristics, serum uric acid (sUA) and other clinical biochemical variables before and after the diet were evaluated.ResultsA total of 626 gout patients (age 41.20 ± 13.41 years, male 98.0%) were included. Of these, 69 (11.0%) were overproduction type, 428 (68.37%) were underexcretion type, and 129 (20.61%) were combined type. Overall, there was a substantial decrease in sUA after a 2-week LPD (p < 0.001). In addition, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), serum triglycerides (TG), serum total cholesterol (TC), blood urea nitrogen (BUN) and serum creatinine (Scr) levels were lower than those at baseline (p < 0.05). On the other hand, there were significant differences in the reduction of sUA among different types, the rank order being overproduction type (− 88.81 ± 63.01 μmol/L) > combined type (− 65.22 ± 44.13 μmol/L) > underexcretion type (− 57.32 ± 61.19 μmol/L). After adjusting for age, BMI and baseline sUA and eGFR, there were still significant differences in the decline of serum uric acid among different types. Higher baseline sUA (95%CI − 0.285, − 0.191; p < 0.001) and BUN (95%CI − 6.751, − 0.602; p < 0.001) were correlated with greater decrease of sUA.ConclusionsOur findings support the protective role of low-purine diet on sUA levels in gout patients, especially overproduction type. Furthermore, LPD could exert a beneficial effect on gout patients’ blood pressure, BMI, blood lipid, BUN and Scr levels.Trial registration Registered with ChiCTR, No. ChiCTR1900022981 at 06/05/2019.

Causal pathways in preeclampsia: a Mendelian randomization study in European populations.

Our study utilizes Mendelian Randomization (MR) to explore the causal relationships between a range of risk factors and preeclampsia, a major contributor to maternal and perinatal morbidity and mortality. Employing the Inverse Variance Weighting (IVW) approach, we conducted a comprehensive multi-exposure MR study analyzing genetic variants linked to 25 risk factors including metabolic disorders, circulating lipid levels, immune and inflammatory responses, lifestyle choices, and bone metabolism. We applied rigorous statistical techniques such as sensitivity analyses, Cochran's Q test, MR Egger regression, funnel plots, and leave-one-out sensitivity analysis to address potential biases like pleiotropy and population stratification. Our analysis included 267,242 individuals, focusing on European ancestries and involving 2,355 patients with preeclampsia. We identified strong genetic associations linking increased preeclampsia risk with factors such as hyperthyroidism, BMI, type 2 diabetes, and elevated serum uric acid levels. Conversely, no significant causal links were found with gestational diabetes, total cholesterol, sleep duration, and bone mineral density, suggesting areas for further investigation. A notable finding was the causal relationship between systemic lupus erythematosus and increased preeclampsia risk, highlighting the significant role of immune and inflammatory responses. This extensive MR study sheds light on the complex etiology of preeclampsia, underscoring the causal impact of specific metabolic, lipid, immune, lifestyle, and bone metabolism factors. Our findings advocate for a multidimensional approach to better understand and manage preeclampsia, paving the way for future research to develop targeted preventive and therapeutic strategies.

Serum uric acid and mortality in metabolic dysfunction-associated steatotic liver disease: Subgroup differences

Background and aimsThis study aims to investigate the association between serum uric acid (SUA) and both the risk and long-term mortality of dysfunction-associated steatotic liver disease (MASLD), and to explore differences between the pure MASLD and metabolic and alcohol related/associated liver disease (MetALD) subgroups. Methods and resultsWe included 11,675 participants from the Third National Health and Nutrition Examination Survey, with matched mortality data up to 2019. Logistic regression and Cox proportional hazards regression evaluated the relationship between SUA and both the risk and mortality of MASLD. Non-linear correlations and threshold effects were explored using restricted cubic splines and a two-piecewise Cox proportional hazards model. We found that SUA was positively associated with the risk of MASLD [odds ratio (OR): 1.19, 95 % confidence interval (CI) 1.12–1.27]. For pure MASLD, SUA showed a positive association with all-cause mortality [<4.7 mg/dL: hazard ratio (HR): 1.34, 95 % CI 1.04–1.73; ≥4.7 mg/dL: HR: 1.08, 95 % CI 1.02–1.15] and cardiovascular mortality (HR: 1.12, 95 % CI 1.02–1.22). For MetALD, there was an inverse J-shaped relationship (threshold: 6.6 mg/dL) between SUA and all-cause mortality. Below the threshold, SUA was negatively correlated with all-cause mortality (HR: 0.42, 95 % CI 0.19–0.93), but no association was found above it (HR: 0.81, 95 % CI 0.54–1.21). Additionally, no association was observed between SUA and cardiovascular mortality. ConclusionsSUA serves as an independent predictor of the risk and all-cause mortality of MASLD. The relationship between SUA and both all-cause and cardiovascular mortality differs between the pure MASLD and MetALD subgroups.

Uric acid reference values for children and adolescents should be stratified by pubertal stage

Background and AimTo establish reference values for hyperuricemia (HUA) in children and adolescents. Methods and ResultsThe study enrolled 4,807 students from "The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen study." Utilizing quantile regression, associations between age, body mass index (BMI), pubertal stage, and serum uric acid (SUA) were examined, alongside the relationship between SUA and cardiovascular disease (CVD) risk factors. Reference values for SUA were explored using receiver operating characteristic analysis, considering sex and pubertal stage. The prevalence of HUA was 34.3% for boys and 29% for girls (using the adult HUA diagnostic criteria: >420 μmol/L for males, >360 μmol/L for females), increasing with higher BMI, age, and pubertal stage. Pubertal stage had the largest influence on SUA in boys, while nutritional status was the most significant factor affecting SUA in girls. Adjusting for age and pubertal stage, higher SUA levels correlated with an increased risk of CVD risk factors. Proposed reference values included > 360 μmol/L for girls ages 6–17 years and prepubertal boys. For pubertal boys, reference values varied based on age: >392 μmol/L for ages 9–11 in early-middle puberty, >429 μmol/L for ages 12–14 in early-middle puberty, >478 μmol/L for ages 12–14 in late puberty, and >505 μmol/L for ages 15–17 in late puberty. ConclusionsStratifying HUA reference values by pubertal stage, particularly for boys, is crucial. Long-term follow-up of individuals with high SUA levels may aid in refining SUA reference values.

P003 ASSOCIATION BETWEEN SERUM URIC ACID AND BLOOD PRESSURE IN BOYS, GIRLS AND ADOLESCENTS WITH OVERWEIGHT and OBESITY ATTENDED IN PEDIATRIC HOSPITALS IN THE AUTONOMOUS CITY OF BUENOS AIRES. “MULTICENTRIC STUDY

Introduction: Childhood overweight and obesity are modifiable risk factors for the development of Hypertension (HTN). Elevated serum uric acid (UA) is a known cardiovascular risk factor in adults. Objective: To evaluate whether there is an association between high serum UA values and elevated BP in overweight and obese children and adolescents. Methods: Multicenter prospective cross-sectional study. Overweight and obese patients aged 5 to 18 years attended in HTN outpatient clinics of three tertiary pediatric hospitals in Buenos Aires were included. Office BP control, 24-hours ambulatory BP monitoring (ABPM) and laboratory tests (metabolic and lipid profile and serum UA measurement) were performed. Results: 173 patients were enrolled, mean age 11.7±2.9 years, 63 women (36.4%), 50 were overweight (28.9%) and 123 obese (71.1%). 143 normotensive (NT) patients were registered, 14 with white-coat HTN, 11 with masked hypertension (MH) and 5 with sustained HTN. The mean value of serum UA was 5.1±1.2, 113 subjects were above the mean value and 24 were above 2SD. Taking serum UA higher than the average (n:113) according to BP we observed 89/143 in NT vs. 13/14 in white-coat HTN (OR 7.8 95% CI 1.1-62.1 p=0.04), 89/143 in NT vs. 8/11 in MH (OR 1.6 95% CI 0.4-6.3 p=0.7) and 89/143 in NT vs. 3/5 in sustained HTN (OR 0.9 95% CI 0.1-5.2 p=0.9). Using serum UA &gt;2SD (n:24) 14/143 above this value in NT vs. 7/14 in white-coat HTN (OR 9.2 95% CI 2.8-30.1 p&lt;0.001), 14/143 in NT vs. 3/11 MH (OR 3.4 95% CI 0.8-14.5 p=0.1) and no subject with sustained HTN had serum UA values &gt;2SD. Conclusions: Elevated serum UA was observed in subjects with white-coat HTN. The number of subjects with sustained HTN was not sufficient to evaluate the association with serum UA values. These findings emphasize the importance of the systematic implementation of 24-hours ABPM for detection of white-coat HTN in overweight and obese children and adolescents.

Serum Uric Acid and Microalbuminuria: Predictors of Renal Dysfunction in Type 2 Diabetes Patients in South-Western Uganda.

Background Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by insulin resistance and high blood glucose levels, which has become a global pandemic in recent decades and is associated with several health complications, including renal dysfunction. Serum uric acid levels are associated with kidney damage and have been linked to various health conditions. Urine microalbumin is a sensitive marker of kidney damage and is commonly used to monitor renal dysfunction in diabetes. The study aimed to compare the predictive value of serum uric acid and urine microalbumin in detecting kidney damage among T2D patients. Method This secondary data analysis used a cross-sectional dataset of 140 diabetic patients from Mbarara Regional Referral Hospital(MRRH) in Mbarara, Uganda. The main outcome was renal dysfunction, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m². Key variables included serum uric acid, urinary microalbumin, and various demographic and clinical factors. Data were analyzed using logistic regression and receiver operating characteristic (ROC) curve analysis to evaluate predictive performance. Ethics approval was obtained from the Mbarara University Research Ethics Committee. Results This study involved 140 participants with a median age of 53 years (interquartile range (IQR) 44-60.5), predominantly females (95, 67.9%), primarily educated (76, 54.3%), and mostly married (104, 74.3%). Participants with renal dysfunction were older (median age 61 years, IQR 52-69) compared to those without (median age 49, IQR 40-56), with significant differences in urinary microalbumin and serum uric acid levels (p <0.05). Renal dysfunction prevalence was 33.6% (95% CI: 26.2-41.9), higher in participants with diabetes duration ≥5 years, microalbuminuria, certain marital statuses, and higher diastolic blood pressure. Microalbuminuria (adjusted odds ratio (aOR) 4.71, 95% CI: 1.27-17.50, P = 0.021) and serum uric acid (aOR 1.01, 95% CI: 1.0002-1.0153, P = 0.045) were significantly associated with renal dysfunction. Other associated factors included age, female gender, and diastolic hypertension. Both biomarkers had significant predictive power for renal dysfunction (area under the curve (AUC) 0.62 and 0.65, respectively). Conclusion This study confirms the high prevalence of renal dysfunction among T2D patients, with a finding of 33.6%. The significant association between microalbuminuria and renal dysfunction, as well as the predictive capacity of serum uric acid and urinary microalbumin, highlight the importance of these biomarkers in identifying individuals at risk of kidney complications.

Association of Serum Uric Acid Level and Thyroid Function in Chronic Kidney Disease: A Hospital-Based Cross-Sectional Study From Northeast India.

Although the prevalence of thyroid dysfunction and hyperuricemia are independently high in patients with chronic kidney disease (CKD), there are limited data showing the association of serum uric acid and thyroid function in those with CKD. The aim of this study was to observe the alteration of both the serum uric acid level and thyroid function in CKD patients and to find the association between both. This observational cross-sectional study was conducted in a tertiary care hospital over a period of one year in Northeast India. A total of 50 CKD patients were enrolled. Their demographic profiles were studied. Serum urea, creatinine, thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), free triiodothyronine (FT3), total tetraiodothyronine (TT4), and free tetraiodothyronine (FT4) levels were measured to establish the correlation of serum uric acid along with each of the parameters separately. A p-value of <0.05 was considered statistically significant. In the CKD patients studied, serum uric acid exhibited positive correlations with serum creatinine (p = 0.001, r = 0.67), serum urea (p = 0.001, r = 0.69), and serum TSH levels (p = 0.001, r = 0.5). Conversely, serum uric acid showed negative correlations with serum TT4 (p = 0.001, r = -0.74), TT3 (p = 0.001, r = -0.6), FT4 (p = 0.001, r = -0.53), and FT3 (p = 0.001, r = -0.58) levels. There was a significant positive correlation between uric acid and TSH levels in CKD patients. Thus, early estimation of both parameters should be considered in CKD patients.

Correlation of Serum Uric Acid With Cardiovascular Risk in Nigerian Patients.

Studies exploring the relationship between serum uric acid (sUA) and cardiovascular risk in the Nigerian population remain sparse. The study aimed to assess the association between sUA levels and two measures of cardiovascular risk, namely the Framingham 10-year Cardiovascular Risk Score (FRS) and the Atherogenic Index of Plasma (AIP). This retrospective study used data from clinical records of new, previously unregistered patients presenting at a private cardiac hospital over one year from November 2022 to October 2023. In total, 428 patients presented newly to the hospital in that period. The records of 138 patients were included in the project after various exclusions were made including for incomplete anthropometric and laboratory data. Statistical tests of association were used to determine the significance of the relationship between sUA levels and the measures of cardiovascular risk. Two-tailed p <0.05 was deemed statistically significant. Hyperuricemia was more prevalent in individuals with central obesity, i.e., waist circumference ≥94cm in males or 80cm in females (93.4% vs 6.6%; p=0.03). Serum uric acid also positively correlated with FRS (correlation coefficient: 0.190; p<0.05) and serum triglyceride levels and AIP (correlation coefficient: 0.259 and 0.294, respectively; p<0.001 for both). After multivariate analyses, uric acid was significantly and independently associated with high FRS and AIP after adjusting for age, smoking and diabetes history, blood pressure, total and high-density lipoprotein cholesterol, serum triglyceridesand waist circumference (p<0.001). The results emphasize the emergence of sUA as a pertinent cardiovascular risk factor in clinical settings. More research is needed to deduce the relationship, if any, between cardiovascular risk reduction and pharmacological reduction of sUA levels.

Impact of Empagliflozin on the Outcomes of β-Thalassemia Major in Patients With Type 2 Diabetes Mellitus: The THALEMPA Observational Study.

Beta-thalassemia major (β-TM) is a genetic disorder characterized by ineffective erythropoiesis and chronic hemolytic anemia, necessitating lifelong blood transfusions and leading to severe complications. This study, termed THALEMPA by the authors, investigated the effect of empagliflozin (EMPA) on β-TM outcomes in patients with type 2 diabetes mellitus (T2DM), focusing on disease severity and associated complications of iron overload and hyperuricemia. This study conducted a single-center prospective observational investigation involving adults diagnosed with β-TM and T2DM. A total of 20 carefully selected patients were stratified into two groups based on their medical condition: the EMPA group, receiving 10 mg of empagliflozin, and a control group, receiving standard care. This focused cohort size was chosen to ensure a detailed, in-depth analysis of the treatment effects within this specific patient population. Over three months, both groups were closely monitored for β-TM outcomes. The study assessed β-TM severity parameters such as hemoglobin levels, blood transfusion frequency, aspartate aminotransferase (AST), alanine aminotransferase (ALT), left ventricular ejection fraction percentage, and spleen size. Additionally, β-TM complications were evaluated through serum ferritin and uric acid levels. Our analysis revealed that EMPA increased hemoglobin levels by up to 0.56 g/dL compared to baseline (P< 0.05). Liver enzyme levels significantly improved with EMPA by the third month. AST and ALT decreased by 36.22% and 33.36%, respectively, from baseline levels (P< 0.05), highlighting EMPA's potential benefits for β-TM severity. Serum ferritin and uric acid levels decreased by 27.93% and 21.29%, respectively, over three months on EMPA (P< 0.05). However, other parameters did not show significant changes post-EMPA. This study demonstrates the significant impact of EMPA treatment over three months on β-TM patients with T2DM, evidenced by notable improvements in hemoglobin levels and reductions in liver enzymes, as well as in complications related to iron overload and hyperuricemia. Future research should confirm these benefits over longer durations and assess broader patient outcomes such as quality of life.

A Case-Control Study of the Correlation Between Blood Parameters and Obesity.

Obesity has become a global health crisis in adults, and islinked to conditions like diabetes, cardiovascular diseases, and cancer. This study explored associations between body mass index (BMI) and laboratory parameters in healthy individuals to identify risk factors and guide targeted interventions in Turkey. It was found that screening and lifestyle changes can help prevent and manage obesity-related health issues. This retrospective case-control study analyzed 2153 adult participants using medical records between 2021 and 2024. The study included those with good overall health; those under 18 years of age or had organ failure, chronic metabolic disorders, obesity complications, or were on multiple obesity-related medications were excluded. Data collected included demographic details, waist-to-hip ratio (WHR), BMI, and laboratory findings. Statistical analyses, including Pearson and Spearman correlations, Mann-Whitney U testand t test, and receiver operating characteristic analysis, were performed using SPSS 24.0 (IBM Corp., Armonk, NY). The study, comprising 1016 men and 1137 women, revealed that 31.8% of adults were obese. Gender disparities were evident, with a higher prevalence of obesity observed in women: 76.5%, 68.8%, and 45.3% for classes 1, 2, and 3, respectively, compared to corresponding rates of 23.5%, 31.2%, and 54.7% in men. BMI significantly correlated with WHR. Despite the disparity between BMI and WHR between men and women, positive correlations were found between BMI and age (r=0.4) and serum uric acid (SUA) levels (r=0.5). The Mann-Whitney U test also demonstrated a significant association between BMI andfasting plasma glucose level, low-density lipoprotein(LDL), triglycerides, alanine aminotransferase (ALT), uric acid, platelet count, and lymphocyte count (all p values<0.005).Despite the poor correlation with BMI, SUAlevelsemerged as a potential obesity predictor, with a 4.1 mg/dl cutoff value, exhibiting 50% sensitivity and 34% specificity (p<0.001; area under the curve, or AUC, 0.67; 95% CI 0.65-0.70). There was no significant link between BMIandaspartate aminotransferase, hemoglobin, mean platelet volume, neutrophil and lymphocyte count, vitamin D, thyroid-stimulating hormone, and free thyroxine 4 levels. This study found significant associations between BMI and laboratory parameters, including serum uric acid, fasting glucose, LDL, triglycerides, and ALT. WHRwas also closely linked to BMI, with notable gender differences in body composition. These significant findings underscore the complex nature of obesity and highlight the importance of gender-specific considerations and biomarkers in research and management strategies that are crucial for understanding and addressing this global health crisis.

Estimation of urea, uric acid and creatinine levels in patients of primary hypothyroidism - A cross-sectional study.

The thyroid gland is one of the largest endocrine glands in the body, secreting thyroxine (T4) and triiodothyronine (T3). Mild hypothyroidism can have negative consequences for a variety of tissues, even though clinically the patients are euthyroid. Many research studies were conducted to evaluate the serum creatinine levels of people with hypothyroidism; however, relatively little research was conducted to evaluate serum urea and serum creatinine levels in subclinical hypothyroidism. As a result, the current study was carried out to investigate urea, uric acid, and creatinine levels in hypothyroidism. Our study aimed to determine and correlate the levels of urea, uric acid and creatinine in newly diagnosed primary hypothyroidism cases. In this cross-sectional study, 96 newly diagnosed cases of primary hypothyroidism were included. The findings were correlated with 20-60-year-old and sex-matched cases. Serum urea was determined by the kinetic method (Glutamate Dehydrogenase Method), serum uric acid by the uricase method and serum creatinine by Jaffe's method in Erba's Mannheim fully automated analyser. This study showed a positive correlation between uric acid and thyroid stimulating hormone (TSH) and a negative correlation between urea and creatinine. There was no statistical significance in the mean values of urea, uric acid and creatinine but an increased level of urea, uric acid and creatinine was seen in the age group 20-30 years when compared with the other age groups. The study concludes that serum urea showed a positive correlation with TSH, whereas uric acid and creatinine showed a negative correlation with TSH, and there was no statistical significance in the mean values of urea, uric acid and creatinine in hypothyroid patients.

Association Between Serum Uric Acid Levels and Metabolic-Associated Fatty Liver Diseasein Southeast China: A Cross-Sectional Study.

This study aimed to explore the association between serum uric acid (sUA) levels and metabolic-associated fatty liver disease (MAFLD) in Southeast China. We performed a cross-sectional study of 2605 subjects who underwent physical examination between 2015 and 2017 in Southeast China. To explore the association between sUA levels and the risk of MAFLD, we employed logistic regression, restricted cubic spline (RCS), subgroups and multiplicative interaction analysis. Logistic regression analysis showed a positive association between sUA and MAFLD [aOR total population (95% CI)= 1.90 (1.49 ~ 2.42)], [aOR male (95% CI)= 2.01 (1.54 ~ 2.62)], [aOR female (95% CI)= 1.15 (0.62 ~ 2.11)], respectively. The RCS plot presented a significant nonlinear dose-response relationship between sUA levels and MAFLD risk, and the risk of MAFLD increased significantly when sUA> 5.56 mg/dL (P nonlinear< 0.001). Subgroups analysis revealed that the positive association between sUA and MAFLD was consistent across strata of gender, age, BMI, drinking status, smoking status and tea drinking status. Significant associations between sUA and MAFLD were not only found in males but also existed in subjects whose age ≤60, BMI ≥24 kg/m2, drinkers, smokers and tea-drinkers. Adjusted ORs were estimated to be 2.01, 1.95, 2.11, 2.29, 2.64 and 2.20, respectively. Multiplicative interactions were not observed between gender, age, drinking status, smoking status, tea drinking status and sUA (all P interaction> 0.05). According to our study, sUA was positively associated with the risk of MAFLD. Additionally, the risk of MAFLD increased significantly when sUA levels exceeded 5.56 mg/dL. Our study may help clarify whether sUA plays a diagnostic role in MAFLD.

Abstract P136: Phosphorylation and regulation of URAT1 by insulin and NaCl: a possible mechanism linking insulin resistance and excessive salt intake to hyperuricemia

Objective: Insulin resistance (IR) is the key environmental factor associated with hyperuricemia; however, the underlying mechanisms are not fully understood. Although several studies suggested that excessive salt intake results in hyperuricemia, the association still remains controversial. Focusing on urate transporter 1 (URAT1), we here investigated the mechanisms by which insulin and salt intake contribute to hyperuricemia. Methods: In a large UK Biobank (UKB) dataset involving 377,358 participants, we evaluated the association of TyG index (a surrogate of IR) and habitual salt intake with serum uric acid levels using multivariable regression models. We addressed whether single nucleotide polymorphisms (SNPs) that influence URAT1 expression (eQTL) modify the association of TyG index with serum uric acid levels. We also analyzed underlying mechanisms by using HEK cells expressing hURAT1. Results: In UKB dataset, TyG index and habitual salt intake were significantly and independently associated with elevated serum uric acid levels (P &lt; 0.05). From previous studies and imputation accuracy, we extracted an eQTL SNP for SLC22A12 gene and found that there is a positive interaction between TyG Index and the eQTL SNP. As post-translational modification is the key mechanism that enables adaptation to environmental changes, we evaluated the contribution of phosphorylation by AGC kinases, such as Akt, as possible downstream effectors of insulin signaling and salt-sensing pathway. Western blotting with phospho-Akt substrate motif antibody confirmed URAT1 phosphorylation and identified T350 and T408 as candidate sites. Among them, URAT1 carrying non-phosphorylatable A408 substitution (T408A-URAT1) suppressed glycosylation and plasma membrane translocation, while T350A had no effect. By using kinase screen assay involving 53 AGC and related Ser/Thr kinases, we found that SGK1, PKA, and PKG also phosphorylated URAT1-T408. Insulin and NaCl loading induced Akt and SGK1 expression respectively, which resulted in URAT1 phosphorylation and increased cell-surface membrane expression; this effect was abolished in T408A-URAT1. Finally, we found that URAT1-T408 phosphorylation was also detected in human kidney sections. Conclusion: IR and excessive salt intake contribute to hyperuricemia, and the effect is in part mediated by hURAT1. Mechanistically, insulin and NaCl promote membrane trafficking of URAT1 by inducing T408 phosphorylation through Akt and SGK1, respectively.