sUA Levels Research Articles

Chlorogenic Acid Prevents Hyperuricemia Nephropathy via Regulating TMAO-Related Gut Microbes and Inhibiting the PI3K/AKT/mTOR Pathway.

Hyperuricemia is an independent hazard factor of renal injury and can induce renal fibrosis, promoting the development of chronic kidney disease (CKD). This study aimed to explore the probability of chlorogenic acid (CGA) as a potential substance for preventing hyperuricemia nephropathy (HN). Pretreatment with CGA downregulated SUA, BUN, and CR levels, relieved oxidative stress and inflammatory response, alleviated kidney fibrosis, and contributed to the prevention of HN. In the gut microbiota, Blautia, Enterococcus, and Faecalibaculum related to trimethylamine N-oxide (TMAO) synthesis were significantly increased in HN rats. In addition, it showed a significant increase in serum TMAO content in HN rats. However, CGA regulated the cascade response of the microbiota-TMAO signaling to reverse the increase of serum TMAO. CGA also decreased the protein expression of protein kinase B (AKT) phosphorylation, phosphatidylinositide 3-kinase (PI3K), and mammalian target of rapamycin (mTOR) by reducing the production of TMAO. CGA delayed kidney fibrosis in HN rats as evidenced by regulating the cascade response of the microbiota-TMAO-PI3K/AKT/mTOR signaling pathway. In summary, CGA can be an excellent candidate for HN prevention.

Correlation of obesity, dietary patterns, and blood pressure with uric acid: data from the NHANES 2017–2018

BackgroundPrevalence rates of hyperuricemia and gout are increasing. Clinical investigations of hyperuricemia-related risk factors aid in the early detection, prevention, and management of hyperuricemia and gout. Ongoing research is examining the association of obesity, dietary patterns, and blood pressure (BP) with serum uric acid (sUA).MethodsA cross-sectional study was conducted based on the National Health and Nutrition Examination Survey. The exposures included body mass index (BMI), dietary patterns, and BP. The outcome variable was sUA level. The weighted multivariate linear regression models and smooth curve fittings were used to assess the association of BMI, dietary patterns, and BP with sUA.ResultsThere was a significantly positive correlation between BMI and sUA (β = 0.059, 95% CI: 0.054 to 0.064, P < 0.00001). Overweight and obese individuals had higher sUA levels than those with the normal BMI (β = 0.451, 95% CI: 0.357 to 0.546, P < 0.00001; β = 0.853, 95% CI: 0.760 to 0.946, P < 0.00001; respectively). Dietary energy intake was positively correlated with sUA (β = 0.000, 95% CI: 0.000 to 0.000, P = 0.01057). Dietary intake of carbohydrate and fiber were negatively correlated with sUA (β = − 0.001, 95% CI: − 0.002 to − 0.000, P < 0.00001; β = − 0.008, 95% CI: − 0.011 to − 0.004, P = 0.00001; respectively). Moreover, systolic BP was positively correlated with sUA (β = 0.006, 95% CI: 0.003 to 0.009, P = 0.00002). However, no statistical differences were found about the associations of dietary intake of total sugars, protein, total fat, cholesterol, and diastolic BP with sUA.ConclusionsThe current cross-sectional investigation of a nationally representative sample of US participants showed that BMI, dietary energy intake, and systolic BP were positively correlated with sUA levels; dietary carbohydrate and fiber intake were negatively correlated with sUA levels. The findings might be helpful for the management and treatment of hyperuricemia and gout.

STUDY OF SERUM CALCIUM, CREATININE AND URIC ACID IN HYPOTHYROID PATIENTS

Aim: The study is to determine Serum Calcium, Creatinine and Uric acid levels in hypothyroidism cases. Materials and methods: A total of 25cases were selected randomly for one year study from SVRRGGH, Tirupati with exclusion criteria (renal disease, bone disease, diabetes mellitus and other medical conditions and patients who are on medication that going to affect purines and mineral metabolism). Sca2+, creatinine and SUA were done on Erbachem 5X and thyroid hormones were done chemiluminescence. Results: The mean values of serum calcium were low and creatinine and SUA levels were high in hypothyroidism cases. The p value is &lt;0.0001 and is considered highly significant and TSH were correlated with this parameters for knowing effect of hypothyroidism on renal function, mineral and purine metabolism. Conclusion : Hypothyroidism patients need to be regularly evaluated for these parameters, as early detection and correction can prevent the complications associated with this metabolic dysfunction.

Effectiveness and Safety of Allopurinol, Febuxostat, and Rasburicase in the Prevention of Tumor Lysis Syndrome: A Systematic Review and Network Meta-analysis

AbstractAlthough prevention is vital in managing tumor lysis syndrome (TLS), no study directly compares various regimens. This study compared the effectiveness and safety of urate-lowering agents in preventing TLS. Databases were searched for randomized controlled trials involving adults with hematologic or solid malignancies on chemotherapy or cytoreductive agents given allopurinol, febuxostat, or rasburicase alone or in combination at any dose, form, or frequency published in English by December 2021. Outcomes included laboratory and clinical TLS expressed as relative risks, adverse events as described by authors, and mean serum uric acid (sUA) as mean differences of area under the curve. A network of meta-analysis and post-hoc meta-analysis based on TLS risk using a random-effects model was done using Stata 14.0 and Review Manager 5.3, respectively. Certainty of evidence was assessed using the GRADE approach. Three studies with a total of 633 participants given allopurinol, febuxostat, rasburicase, or rasburicase combined with allopurinol were included. Rasburicase is more effective than allopurinol in preventing laboratory TLS (relative risk: 0.51; 95% confidence interval [CI]: 0.32–0.81) based on moderate quality evidence. No significant differences were observed in clinical TLS. Adverse events were attributable to toxicities of chemotherapy. Rasburicase alone or in combination with allopurinol was better than allopurinol or febuxostat alone in reducing sUA level. Febuxostat is more effective than allopurinol in lowering sUA levels among patients at high-risk of TLS (mean difference −125.75; 95% CI: −223.47 to −28.02). Rasburicase may be the most effective agent in preventing laboratory TLS and maintaining low sUA levels.

The association of serum uric acid with cognitive impairment and ATN biomarkers.

BackgroundCognitive impairment (CI) has become a worldwide health problem. The relationship between CI and uric acid (UA) is contradictory.ObjectiveWe included participants with a full spectrum of CI, from cognitively unimpaired (CU) to dementia, from the Chongqing Ageing & Dementia Study (CADS).MethodsFirst, we identified the relationships between serum UA (sUA) and cognitive function in different stages of CI. Second, we analyzed these relationships among different stages and types of CI. Finally, we explored the association between sUA and amyloid/tangle/neurodegeneration (ATN) biomarkers.ResultsWe recruited 427 participants from the CADS, including 382 participants with mini-mental state examination (MMSE) evaluation. The levels of sUA were positively correlated with MMSE scores (p < 0.001), and the correlation was prominent in the course of dementia and in the type of Alzheimer’s disease (AD). The levels of UA had a positive correlation with plasma amyloid-β 42 (Aβ42) (p = 0.004). Higher levels of sUA weakened the correlation of MMSE scores with CSF ATN biomarkers and the correlation of CSF Aβ42 with tau.ConclusionUA is positively correlated with cognitive function, especially in the advanced stage of AD. The probable neuroprotective effects of sUA mainly act on Aβ42 and the downstream pathological cascade.

Sugar-Sweeten Beverage Consumption Is Associated With More Obesity and Higher Serum Uric Acid in Chinese Male Gout Patients With Early Onset.

BackgroundEarly onset gout has received increasing interest from researchers. Previous studies have reported that serum urate (sUA) levels and prevalence of obesity are higher in early onset gout patients than in later-onset gout patients. We explored the dietary habits of early onset and later-onset gout patients and their association with clinical features.Materials and MethodsGout patients completed a 10-item food frequency questionnaire. Early onset gout patients were defined as gout onset before the age of 40, and onset after age 40 was classified as later-onset. Associations between dietary factors, obesity, and sUA level of ≥600 μmol/L were assessed using logistic regression.ResultsAmong the 655 gout patients, 94.6% were males, and 59.1% presented with early onset gout. All early onset patients were males. sUA level was significantly higher in the early onset group than in the later-onset group (550.7 vs. 513.4 μmol/L). The proportion of patients with a sUA level of ≥ 600 μmol/L (40.3 vs. 26.2%) and obesity (27.6 vs. 10.7%) was higher in the early onset group than in the later-onset group (all p < 0.05). The early onset group consumed more red meat (101–200 g/day: 43.6 vs. 26.0%), sugar-sweetened beverages (>4 times/week: 27.9 vs. 7.7%), and milk and milk products (1–2 times/week: 28.5 vs. 16.6%), but less alcohol (>84 g/day: 8.5 vs. 21.5%) and tea (>4 times/week: 35.7 vs. 52.4%; all p < 0.05). Sugar-sweetened beverage intake was positively correlated with sUA level of ≥600 μmol/L (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.4, 3.7) and obesity (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.2, 3.7). These correlations remained significant for early onset gout patients.ConclusionSugar-sweetened beverage intake replaced alcohol as the main dietary risk factor for gout in early onset patients, and this change was associated with a greater prevalence of obesity and higher sUA level. Clinicians should provide specific dietary education for different generations of gout patients. The epidemic of sugar-sweetened beverage consumption should be considered for the development of public health policies for the prevention of gout.

The safety and urate-lowering efficacy of febuxostat in patients undergoing peritoneal dialysis: a retrospective single-arm cohort study of 84 patients.

Studies have shown that hyperuricemia (HUA) is an independent risk factor for all-cause death and residual kidney function loss in peritoneal dialysis (PD) patients. The control of blood uric acid (UA) is an important link to improve the prognosis of end-stage renal disease (ESRD). As a therapeutic drug for HUA, febuxostat is rarely studied in PD patients. The purpose of our study is to investigate the safety, efficacy, and effect on residual renal function (RRF) of febuxostat in patients undergoing PD. This is a retrospective single-arm cohort study. During the study period which from September 2016 to November 2020, 191 patients underwent PD at this hospital. Among these patients, 84 were administrated for over a period of 3 months and were eventually included. These 84 patients (51 males and 33 females; average age: 55.18 years) were undergoing PD complicated with HUA or gout who received febuxostat during a regular follow-up from January 2018 to November 2020. Serum UA (sUA) levels, blood routine, liver function, and RRF were compared before and after febuxostat administration. Adverse events (AEs) resulting from febuxostat treatment were collected from medical records. All 84 patients were administered febuxostat for over 3 months, including 39 for over 6 months and 26 for over 12 months. Some 60 patients were treated with febuxostat dose of 20 mg/day and the remaining 24 patients received 40 mg/day. Compared with pretreatment level, the mean sUA level was observed to be markedly reduced at 1 month after febuxostat administration (320.2±87.27 vs. 498.8±81.47 µmol/L, P<0.0001) and at 3 months (291.6±82.66 vs. 498.8±81.47 µmol/L, P<0.0001) and subsequently remained at a significantly low level for 12 months. Only 5 patients stopped febuxostat because of its associated AEs. An initial dose of 40 mg/day was associated with a higher rate of AEs compared with dose of 20 mg/day (25% vs. 18.33%, respectively). After febuxostat treatment, no significant differences were observed between RRF in the two groups. Febuxostat may be safe and efficient in patients undergoing PD and may not impair RRF. Febuxostat administration at dose of 20 mg/day may be an appropriate dose for patients undergoing PD.

Carotid Plaque Vulnerability Assessed by Contrast-Enhanced Ultrasound and Clinical Risk Factors

To evaluate the vulnerability of carotid plaque by contrast-enhanced ultrasound, to study the clinical risk factors of the plaque, and to analyze the relationship between plaque vulnerability and clinical indicators.244 patients with carotid plaque were selected for contrast-enhanced ultrasound examination, biochemical and other indicators were detected, and the stability of plaque was evaluated by semi-quantitative visual grading of intraplaque neovascularization (IPN), and correlation between plaque and each indicator was analyzed.Different grades of neovascularization in plaque had statistical differences with BMI, arm circumference, WHR, WBC, CRP, tHcy, TBIL, DBIL, SUA, LP (a) and DD (P<0.05). Correlation analysis showed that TBIL, DBIL were negatively correlated with the grading, while others were positively correlated.The expression levels of SUA, tHcy, TC, TG, LDL-C, LP (a), DD, WBC and CRP are closely related to contrast-enhanced ultrasound grading, which further indicated the vulnerability of plaque and provides theoretical basis for clinical treatment.

Association Between Serum Uric Acid Level and Carotid Atherosclerosis and Metabolic Syndrome in Patients With Type 2 Diabetes Mellitus.

BackgroundSerum uric acid (SUA) is associated with many cardiovascular risk factors, such as metabolic syndrome (MetS) and subclinical atherosclerosis. However, the relationship of SUA with carotid atherosclerosis remains controversial. We aimed to investigate whether elevated SUA levels are associated with a high risk of carotid atherosclerosis and MetS in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was performed with a sample of 1,947 hospitalized patients with T2DM. Carotid intima-media thickness and carotid artery plaques were measured via Doppler ultrasound.ResultsUric acid levels were negatively associated with HbA1C, eGFR, and HDL-C (all P < 0.001) and positively associated with WBC, BMI, ACR, creatinine, total cholesterol, triglycerides, LDL-C, systolic blood pressure, and diastolic blood pressure (all P < 0.001). After adjusting for multiple potential confounders, the risks were substantially higher for MetS in the highest quartile of SUA levels (odds ratio: 2.91, 95% confidence interval: 1.54–5.51, P = 0.003 for trend) than in the lowest quartile of SUA levels. Furthermore, a significant increase was observed in the prevalence of overweight/obesity, hypertension, and dyslipidemia across the SUA quartiles independent of confounders. However, no significant association was found between SUA quartile with the presence of carotid atherosclerosis.ConclusionsIn patients with T2DM, SUA levels were closely associated with MetS and its components but not with carotid atherosclerosis.

Fetal out comes in Pre-Eclampsia with raised Maternal Serum Uric Acid

Aim: To compare adverse fetal outcome of hyperuricemic pre-eclamptic pregnancy with normouricemic pre-eclamptic pregnancy. Study design: A Cohort Study Methodology: In this study patients with serum uric acid level(SUA) &gt;5.5mg/dl were included in group A and patients with SUA level &lt;5.5mg/dl were included in group B. Patients with medical disorders like renal disease, hypertension, diabetes and currently using drugs affecting uric acid levels like thiazide diuretics were excluded. Both groups were followed until delivery. Intrauterine growth restriction, low birth weight was recorded. Results: A total of sixty patients were studied with age range from 18 to less than 40 years. The mean age in group A was 33.566± 4.19 years while 34.100± 3.46 years in group B. Mean Gestational age was 33.500±4.22 weeks in group A and 34.200±4.71 weeks in group B, while mean serum uric acid level was 7.416±1.04 in group A and 4.202±0.61 in group B. Intrauterine growth restriction was seen 93.3% in group A as compare to 60% in group B (P=0.002)(RRR=55.5%) while Low birth weight was 70% in group A and 10% in group B (P=0.000). Conclusion: The pregnancies with pre-eclampsia and raised serum uric acid levels result in adverse fetal outcome. Significant increased number of IUGR and LBW fetuses were observed in babies born to pre-eclamptic mothers with raised serum uric acid levels in comparison with babies born to normo-uricemic pre eclamptic mothers. Keywords: Pre-eclampsia, serum uric acid, fetal outcome

Association Between Serum Uric Acid Levels and Traditional Cardiovascular Risk Factors in Xiamen Residents of China: A Real-World Study.

BackgroundSerum uric acid (SUA) levels was associated with cardiovascular diseases and cardiovascular events. However, the relationship between SUA levels and traditional cardiovascular risk factors has not been well-established among Xiamen residents. Our study aimed to estimate the relationship between SUA levels and cardiovascular risk factors among Xiamen residents using real-world data.MethodsParticipants were enrolled from eight community health service centers in Xiamen, China. Participants were divided into four groups according to quartiles of the SUA levels. The history of diseases, the use of medications and the levels of laboratory parameters were collected. The China-PAR equation was used to evaluate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk.ResultsA total of 1,322 participants were enrolled. About 568 (43.0%) were men and 754 (57.0%) were women. The prevalences of hypertension, elderly, current smokers, and obesity were higher in the quartile 4 (Q4) group than the quartile 1 (Q1) group (all p < 0.001). Multivariable logistic regression analysis showed the OR for hypertension was 2.671 (95% CI 1.777–4.015, p < 0.001) in the Q4 group compared with that in the Q1 group. Further logistic regression showed the OR for hypertension was 3.254 (95% CI 1.756–6.031, p < 0.001) in men and 2.314 (95% CI 1.354–3.955, p = 0.002) in women in the Q4 group compared with that in the Q1 group, respectively. In addition, the percentage of participants with low 10-year ASCVD risk calculated by China-PAR was higher in the Q1 group than that in the Q4 group (55.86 vs. 31.82%, p < 0.001). The percentage of participants with high 10-year ASCVD risk was lower in the Q1 group compared with the Q4 group (15.32 vs. 25.45%, p < 0.001). Multiple linear logistic regression showed the 10-year China-PAR ASCVD risk scores was positively correlated with SUA after adjusting for various factors (β = 0.135, p = 0.001).ConclusionSerum uric acid was associated with several cardiovascular risk factors in Xiamen residents. The percentage of high 10-year ASDVD risk was higher in participants with hyperuricemia. Participants with hyperuricemia may experience cardiovascular benefit from uric acid-lowering therapy.

Clinical and Angiographic Characteristics of Coronary Artery Ectasia and Its Correlation with High-Sensitivity C-Reactive Protein and Serum Uric Acid

Introduction: The most plausible factor for coronary artery ectasia (CAE), a subset of coronary artery disease (CAD), is extensive inflammation. High-sensitivity C-reactive protein (hs-CRP) and serum uric acid (sUA) are well known markers of inflammation. Most of the previous studies (done in the Western population and of Middle East Asia) evaluated their role individually as a marker of inflammation in CAD. We aimed to investigate the possible association of isolated CAE with inflammation as assessed by the hs-CRP and sUA levels and check whether the inflammatory hypothesis holds good in the south Asian population. Materials and Methods: Patients admitted for coronary angiography with age ≥30 years were evaluated. Patients with both CAE and CAD were excluded. A total of 60 patients were studied. Patients with isolated CAE (30) were compared with an equal number of patients with obstructive CAD (30) and their clinical profile was studied. The hs-CRP, sUA, and novel inflammatory markers such as neutrophil–lymphocyte ratio (NLR), mean platelet volume (MPV), and red cell distribution width (RDW) were compared between the groups. Results: Of the 60 patients studied, males were 56% in the isolated CAE group and 50% in the obstructive CAD group. The hs-CRP (2.39 ± 0.41 vs. 1.41 ± 0.29, P &lt; 0.001) and sUA levels (6.46 ± 0.58 vs. 5.36 ± 0.40, P &lt; 0.001) were significantly elevated in the isolated CAE group compared to the obstructive CAD group. Among the novel inflammatory markers, the NLR (3.98 ± 0.42 vs. 2.91 ± 0.30, P &lt; 0.001) and RDW (12.69 ± 0.27 vs. 12.13 ± 0.48, P &lt; 0.001) were significantly higher in the CAE group compared to obstructive CAD group, whereas the MPV did not have a statistically significant difference (9.5 ± 0.98 vs. 9.6 ± 1.08, P = 0.525). Conclusion: The inflammatory etiology of CAE was supported by an elevated hs-CRP, sUA, and other novel inflammatory markers compared to the atherosclerotic obstructive CAD group.

Clinical Risk Factors for Thoracic Ossification of the Ligamentum Flavum: A Cross-Sectional Study Based on Spinal Thoracic Three-Dimensional Computerized Tomography.

BackgroundInconsistent results of the clinical risk factors associated with thoracic ossification of the ligamentum flavum (TOLF) have been reported in limited previous studies.PurposeThis retrospective study aimed to investigate the potential risk factors for TOLF by a retrospective cross-sectional study, which may provide valuable experience for further clinical and pathophysiological research.MethodsA total of 2247 asymptomatic participants, who underwent spinal thoracic three-dimensional computerized tomography (3D-CT) scans at our institution from January 2016 to December 2019, were enrolled in this study according to the screening criteria. Demographic information such as age, sex, height, weight, body mass index (BMI), smoking and drinking history, diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) were recorded. Laboratory results included serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), uric acid (UA), creatinine (Cr), calcium, and phosphorus. Participants were divided into TOLF group and non-TOLF group in accordance with the thoracic 3D-CT manifestation.ResultsTOLF was observed in 153 (6.81%) asymptomatic participants. Comparison of demographic data and laboratory examinations between the two groups showed that participants in the TOLF group were older, had a higher BMI, as well as higher levels of DBP. In addition, there was no significant difference in sex, drinking, tobacco use, SBP, TC, TG, PP, and levels of LDL-C, HDL-C, sUA, sCr, calcium, and phosphorus between the two groups. Furthermore, dichotomous logistic regression analyses revealed that age (OR = 1.018, p = 0.041) and BMI (OR = 1.090, p < 0.001) were risk factors for TOLF.ConclusionOur study reveals that age and BMI are clinical risk factors for the development of TOLF, while age cannot be identified as an independent risk factor for female in subgroup analysis.

Is Renoprotection Real for Patients with Hyperuricemia?

Number of patients with progressive chronic kidney disease (CKD) is increasing all over the world. One of the risk factors for CKD development and progression is increased serum uric acid (sUA) level. Possibly, control of hyperurcemia with urate lowering therapy drugs can slow the decline in kidney function. The objective: to determine efficacy and safety of allopurinol and febuxostat in treatment of patients with CKD and hyperurcemia to reduce the sUA level and analyze its influence on glomerular filtration rate (GFR). Materials and methods. The study included 45 CKD patients (stages 3b-5) without other severe/decompensated diseases and contraindications to the allopurinol/febuxostat. All patients underwent a comprehensive clinical and laboratory examination, and were divided into the study groups: Group I (28 patients, 61.3±3.2 y.o., CKD3b-12, CKD4-10, on hemodialysis-6 patients) received febuxostat, Group II (24 patients, 60.7Ѓ}4.1 y.o., CKD3b-9, CKD4-10, on hemodialysis – 5 patients) took allopurinol. Results. Achievement of the target level of sUA was significantly often registered in Group I: after 1 month – in 45.5% (in group II – in 15.9%, p&lt;0.001); after 3 months – in 67.5% (in group II – 21.2% p&lt;0.01); after 6 months, these figures were 90% and 37.1%, respectively (p&lt;0.01). sUA level &lt;300 μmol/l was accompanied by significant positive GFR changes in group I patients; in group II there was a gradual progression of GFR deterioration in 31.8% of patients. Conclusions. In patients with pre-dialysis stages of CKD febuxostat demonstrates renoprotective abilities. Use of febuxostat in patients with CKD stage 3b-4 and in patients on hemodialysis is safe and more effective for target sUA level achievement than the use of allopurinol.

Hyperuricemia is associated with all-cause mortality among males and females: Findings from a study on Japanese community-dwelling individuals

BackgroundSerum uric acid (SUA) is a key determinant of cardiovascular diseases (CVDs). Studies have also shown that SUA independently impacts age-related health outcomes, although their findings differ between males and females. Furthermore, predictive data on all-cause mortality remain limited, particularly for the Japanese population. Thus, this study examined the association between SUA and survival prognosis among males and females based on a follow-up period of 7 or 19 years. MethodsThe study was based on 1,573 male (63 ± 14 years) and 1,980 female (65 ± 12 years) participants who participated in a Nomura Cohort Study in 2002 (Cohort 1) and 2014 (Cohort 2), and continued throughout the follow-up period. A basic resident register was referenced to derive the adjusted relative risk estimates for all-cause mortality. Finally, a Cox proportional hazards model analysis was conducted and was adjusted for possible confounders to estimate hazard ratios (HRs). 95% confidence intervals (CIs) were computed separately for male and female participants. ResultsOf the total 3,553 participants, 905 (25.5%) were deceased. Of these, 473 were male (30.1% of all males) and 432 were female (21.8% of all females). Hyperuricemia was defined in males with SUA levels of 8.5 mg/dL or higher, and in females with SUA levels of 7.5 mg/dL or higher, and was associated with a significantly increased HR for all-cause mortality (males: 1.67; 95% CI: 1.06–2.63; females: 2.17; 95% CI: 1.20–3.94). The data were further stratified based on age (< 65 years or ≥ 65 years), body mass index (BMI) (< 25.0 kg/m2 or ≥ 25.0 kg/m2), History of cardiovascular disease, estimated glomerular filtration rate (< 60 mL/min/1.73 m2 or ≥ 60 mL/min/1.73 m2), and presence of SUA-lowering medication. All stratified groups demonstrated a similar trend. The hyperuricemia group in particular reported a significant increase in HR. On the other hand, a U-shaped increase in HR was observed in those with BMI greater than 25 kg/m2 and SUA-lowering medication, but interaction effect was not significant. ConclusionsHyperuricemia is a key risk indicator for all-cause mortality in male and female community-dwelling individuals in Japan.

Comparative efficacy and safety of topiroxostat at different dosages in hyperuricemic patients with or without gout: A network meta-analysis of randomized controlled trials.

We aimed to assess the relative efficacy and safety of topiroxostat at different dosages in hyperuricemic patients with or without gout. A Bayesian network meta-analysis was performed to combine direct and indirect evidence from randomized controlled trials (RCTs) for evaluating the efficacy and safety of topiroxostat at different dosages, allopurinol 200mg, and placebo in hyperuricemic patients with or without gout. Five RCTs, including 733 patients, fulfilled the inclusion criteria. The number of patients who had achieved a target serum uric acid (sUA) level was significantly higher in the topiroxostat 200mg group than in the placebo group (odds ratio, 1,023; 95% credible interval, 157.7-26,260). Similarly, the number of patients who had achieved the target sUA level was significantly higher with topiroxostat at other dosages and allopurinol than with placebo. The ranking probability based on the surface under the cumulative ranking curve indicated that topiroxostat 200mg was more likely to achieve the best target sUA level, followed by topiroxostat 80mg, allopurinol 200mg, topiroxostat 120mg, topiroxostat 160mg, topiroxostat 60mg, topiroxostat 40mg, and placebo. The frequency of adverse events (AEs) in the placebo group was lower than that in the topiroxostat 40mg, topiroxostat 60mg, and topiroxostat 200mg groups. Topiroxostat 200mg was the most effective treatment option for hyperuricemic patients with or without gout, with an increased risk of AEs.

A Retrospective Study of the Relationship Between the Triglyceride Glucose Index and Myocardial Revascularization for New-Onset Acute Coronary Syndromes.

BackgroundThis study explored the relationship between the TyG index/serum uric acid (SUA) panel and myocardial revascularization (MRT) for new-onset acute coronary syndromes (ACS).MethodsBetween January 2011 and July 2020, 13,271 new-onset ACS patients were enrolled. The logistic regression models and the odds ratios (ORs) were used to quantify the risk of TyG index/SUA and MRT. Then, interaction analyses of TyG index and SUA on MRT were applied.ResultsElevated TyG index was positively associated higher risks of MRT. However, SUA levels were negatively associated with MRT. Compared with those in the lowest quartile, the risk of MRT increased gradually among patients in Q1 of the SUA category (OR = 1.03, 1.11, and 1.28 for Q2, Q3, and Q4 of TyG index, respectively), Q2 of the SUA category (OR = 1.41, 1.68, and 2.18 for Q2, Q3, and Q4 of TyG index, respectively), Q3 of the SUA category (OR = 1.05, 1.45, and 1.45 for Q2, Q3, and Q4 of TyG index, respectively), and Q4 of the SUA category (OR = 1.20, 1.29, and 1.46 for Q2, Q3, and Q4 of TyG index, respectively). This pattern was observed in both male and female, as well as patients without type 2 diabetes mellitus.ConclusionPatients with a higher TyG index have a higher proportion of MRT in new-onset ACS. This result also applies to patients with different levels of SUA during new-onset ACS.

Impaired Sensitivity to Thyroid Hormones Is Associated with Hyperuricemia, Obesity, and Cardiovascular Disease Risk in Subjects with Subclinical Hypothyroidism.

Background: Subclinical hypothyroidism (SCH) is associated with an increased risk of metabolic disorders and cardiovascular events. There is a delicate interplay between thyroid hormones and thyrotropin (TSH) and metabolic homeostasis. However, the association between thyroid hormone sensitivity and metabolic indices has not been elucidated in SCH. Methods: We enrolled 11,109 participants with SCH. All participants had a TSH level >4.2 mIU/L and normal free thyroxine (fT4; 12.0-22.0 pmol/L). Metabolic indices (body mass index [BMI], blood pressure, serum lipid, serum uric acid [sUA], plasma glucose and glycosylated hemoglobin [HbA1C]) were measured. The thyroid hormone sensitivity indices that include thyroid feedback quantile-based index (TFQI), TSH index (TSHI), and thyrotroph thyroxine resistance index (TT4RI) were calculated based on fT4 and TSH. Higher TFQI quartiles indicated lower thyroid hormone sensitivity. The relationship between thyroid hormone sensitivity indices and metabolic indices and cardiovascular disease (CVD) risk were calculated. Results: Participants with decreased central sensitivity to thyroid hormone had lower BMI and higher sUA levels. The odds ratio of the fourth versus the first quartile of TFQI was 0.85 [confidence interval, CI: 0.73-0.96] for obesity, 1.64 [CI: 1.37-1.92] for hyperuricemia (HUA), and 12.22 [CI: 5.32-28.07] for 10-year risk distribution for CVD >20%. Further adjustment for BMI when analyzing HbA1C, HUA, and CVD risk generated similar results. TSHI and TT4RI also yielded similar results. Conclusions: Impaired sensitivity to thyroid hormone in SCH is associated with higher risk of HUA and CVD and lower risk of obesity. These findings are potentially useful for understanding the interaction between thyroid hormone sensitivity and metabolic diseases in SCH.

Characterizing and Evaluating Diurnal Salivary Uric Acid Across Pregnancy Among Healthy Women.

Uric acid levels during pregnancy have been examined as a potential indicator of risk for gestational diabetes mellites, hypertension, and related adverse birth outcomes. However, evidence supporting the utility of serum uric acid levels in predicting poor maternal and fetal health has been mixed. The lack of consistent findings may be due to limitations inherent in serum-based biomeasure evaluations, such as minimal repeated assessments and variability in the timing of these assessments. To address these gaps, we examined repeated measurements of diurnal salivary uric acid (sUA) levels in a sample of 44 healthy women across early-mid and late pregnancy. We assessed potential covariates and confounds of sUA levels and diurnal trajectories, as well as associations between maternal weight gain and blood pressure during pregnancy and sUA concentrations. Using multilevel linear models, we found sUA increased across pregnancy and displayed a robust diurnal pattern with the highest concentrations at waking, a steep decline in the early morning, and decreasing levels across the day. Maternal pre-pregnancy BMI, age, prior-night sleep duration, and fetal sex were associated with sUA levels and/or diurnal slopes. Maternal blood pressure and gestational weight gain also showed significant associations with sUA levels across pregnancy. Our results expand upon those found with serum UA measurements. Further, they demonstrate the feasibility of using at-home, minimally-invasive saliva sampling procedures to track UA levels across pregnancy with potential applications for the long-term monitoring of maternal cardiometabolic risk.

A study on association of serum uric acid and blood pressure in hypertensives at a tertiary care centre

Hypertension(HTN) is the most common and significant cardiovascular disease because of its prevalence and severity of the damage to the mankind globally. Hyperuricemia, a condition of increased levels of Serum Uric acid (UA) has been proposed to have an association with hypertension in various studies. In certain studies, serum uric acid levels has been found to be an independent predictor for developing hypertension. On the basis of the above observations, we have proposed to the present study to compare the relationship between serum UA and hypertension in a single cohort with adjustment of all possible confounding factors.A total of 245 subjects were enrolled in this study during a regular routine health checkup. All subjects were informed about the study aims Individuals having a known history of gout and cardiac or severe renal diseases and patients who are already under medication for anti-hyperuricemic were excluded from the study. General information like Name, Age, Sex, Occupation, Address along with history of any drug intake and anthropometric indices - body weight (BW), body height (BH), hip circumference (HC), waist circumference (WC), and lifestyle information have been obtained. The data has been arranged in tables with mean ± SD for further analysis. The data is analyzed using IBM SPSS version 23. The difference between the groups for baseline variables was done by independent sample t-test (two-tailed). Pearson’s correlation coefficient test was performed to assess the interrelationships between baseline variables and SUA concentrations. The differences for the variables among the groups was determined by using One-way ANOVA.Of the 245 subjects, mean age of the participants was 42.4 ± 8.4 years (range 18–70 years). There was no significant difference in the mean levels of Height, Weight and BMI between the two groups. Mean levels of WC, HC were significantly different between two group (p &amp;#60; 0.05) subjects. The mean levels of SBP and DBP were also significantly more in the hypertensive subjects (p &amp;#60; 0.001). In Pearson’s correlation coefficient test, SUA levels were significantly related with SBP and DBP. In this study, we have observed comparatively a stronger relationship for SUA concentration with hypertension and prehypertension in the participants. The extended mechanism for the effect of SUA on hypertension is yet to be elucidated. There are some hypotheses partly explain the association between SUA and high blood pressure. One of the possible mechanism might be uric acid deposition on the blood vessels walls activates the renin-angiotensin system, suppress the liberate of carbon monoxide, enhance inflammation, and leads to vasoconstriction on later stage, which consequently leads to hyperplasia and incidence of hypertension. Another possibility involving oxidative stress and endothelial dysfunction associated with high SUA levels may contribute to high blood pressure.