Serum Uric Acid Concentration Research Articles

Type 3 innate lymphoid cells as an indicator of renal dysfunction and serum uric acid in hyperuricemia.

Type 3 innate lymphoid cells (ILC3s) are a newly identified group of innate immune cells that participate in the progression of several metabolic diseases by secreting interleukin (IL)-17 and IL-22. These cytokines are associated with hyperuricemia (HUA) severity and development; however, the relationship between ILC3s and HUA remains unclear. To determine the characteristics of circulating ILC3s in patients with HUA. Type 3 innate lymphoid cells and their subsets were detected using flow cytometry in peripheral blood mononuclear cells (PBMCs) of 80 HUA patients and 30 healthy controls (HC). Plasma levels of IL-17A and IL-22 were measured with enzyme-linked immunosorbent assay (ELISA). Clinical data of enrolled subjects were collected from electronic medical records. In patients with HUA, the frequency of circulating ILC3s was elevated and positively correlated with levels of serum uric acid and serum creatinine (Scr). Although there was no significant difference in the plasma concentration of IL-17A between the patients with HUA and healthy controls, positive correlations between plasma IL-17A and the concentration of serum uric acid and frequency of circulating ILC3s were observed in the patients with HUA. In patients with HUA, positive correlations were detected between circulating ILC3 levels, plasma IL-17A and serum uric acid. Therefore, ILC3s and IL-17A may be useful indicators of disease severity, and are potential new therapeutic targets in HUA.

The Good, the Bad and the New about Uric Acid in Cancer.

Simple SummaryThe concentration of uric acid in blood is sex-, age- and diet-dependent and is maintained close to its maximal solubility, indicating that it plays some important role. Indeed, it has been demonstrated that, at physiological concentrations, uric acid is a powerful antioxidant and is a scavenger of singlet oxygen and radicals. At high intracellular concentration, uric acid has been demonstrated to act as a pro-oxidant molecule. Recently, uric acid has been reported to affect the properties of several proteins involved in metabolic regulation and signaling, and the relationship between uric acid and cancer has been extensively investigated. In this review, we present the most recent results on the positive and negative effects played by uric acid in cancer and some new findings and hypotheses about the implication of this metabolite in the pathogenesis of several diseases such as metabolic syndrome, diabetes, and inflammation, thus favoring the development of cancer.Uric acid is the final product of purine catabolism in man and apes. The serum concentration of uric acid is sex-, age- and diet-dependent and is maintained close to its maximal solubility, indicating that it plays some important role. Indeed, it has been demonstrated that, at physiological concentrations, uric acid is a powerful antioxidant, while at high intracellular concentrations, it is a pro-oxidant molecule. In this review, we describe the possible causes of uric acid accumulation or depletion and some of the metabolic and regulatory pathways it may impact. Particular attention has been given to fructose, which, because of the complex correlation between carbohydrate and nucleotide metabolism, causes uric acid accumulation. We also present recent results on the positive and negative effects played by uric acid in cancer and some new findings and hypotheses about the implication of this metabolite in a variety of signaling pathways, which can play a role in the pathogenesis of diseases such as metabolic syndrome, diabetes, and inflammation, thus favoring the development of cancer. The loss of uricase in Homo sapiens and great apes, although exposing these species to the potentially adverse effects of uric acid, appears to be associated with evolutionary advantages.

Association between Serum Uric Acid and Hypertension in a Large Cross-Section Study in a Chinese Population.

Background: The association of serum uric acid (SUA) with hypertension has been well established in Caucasian populations. However, its association with hypertension in Chinese remained to be clarified. Methods: Consecutive patients, homogeneous in Chinese Han ethnicity, aged ≥18 years, abstracted from the database, admitted from 1 January 2010 to 31 December 2013, were included for potential analysis. The patients were grouped according to the presence or absence of hypertension. Unconditional logistic regression was performed to estimate the association between SUA and hypertension. Its possible interactions with risk factors on hypertension were also explored. Results: A total of 9587 patients were finally analyzed in the current study, where 5692 were with hypertension and 3895 were without hypertension. Per 100 μmol/L higher SUA concentration was associated with multivariable-adjusted odds ratios (95% CI) of 1.25 (1.08–1.22) in males, 1.10 (1.01–1.20) in females, and 1.19 (1.13–1.24) in total. On a categorical scale, when compared with the first quintile, the multivariable-adjusted odds ratios (95% CI) were 1.40 (1.20–1.64) for the 2nd quintile, 1.48 (1.27–1.74) for the 3rd quintile, 1.55 (1.32–1.82) for the 4th quintile, and 1.92 (1.63–2.26) for the 5th quintile, with a p for trend < 0.01. Conclusions: SUA is associated with hypertension in a dose-response manner among the Chinese hospitalized population. Management of SUA could help to the prevention and control of hypertension.

Acute effect of empagliflozin on serum uric acid – a subanalysis of the EMPAG-HF trial (effects of empagliflozin on diuresis and renal function in patients with acute decompensated heart failure)

Abstract Background Elevated levels of uric acid (UA) have been associated with worsening of outcomes in cardiovascular and renal disease and may lead to gout. Patients with acute decompensated heart failure (ADHF) may develop hyperuricemia under intensified diuretic treatment. In this setting, the effect of empagliflozin on serum uric acid remains unknown. Aim/Purpose The aim of this subanalysis in patients with ADHF was to assess how additive treatment with empagliflozin influences the concentration of serum uric acid and potential related outcomes. Methods In the single-center, prospective, double-blind, placebo-controlled EMPAG-HF trial, patients with ADHF were screened and randomized within 12 hours following hospital admission to receive either empagliflozin 25 mg or placebo in addition to standard medical treatment over five days. Sixtypatients (mean age 74,7±9,9, 39% female) were enrolled and randomized 1:1 irrespective of left ventricular ejection fraction or the presence of diabetes. UA in serum was determined daily and renal handling of UA was evaluated by fractional excretion of UA (FEUA). Two-way mixed ANOVA and Wilcoxon rank-sum test were used for statistical analyses. Results The empagliflozin group comprised 30 patients and the placebo group comprised 29 patients. There were no differences in baseline patient characteristics including LVEF, NT-proBNP, eGFR, HbA1c. In the placebo group, UA increased from baseline 487.86±32.21 μmol/l to 500.38±28.37 μmol/l at day (d) 2 (p=0.045), 512.36±29.43 μmol/l at d3 (p=0.018), and 518.46±31.14 μmol/l at d4 (p=0.021). By contrast, in the empagliflozin group, UA tended to decrease compared to baseline and was significantly lower compared to placebo at d3 (436.08±23.94 vs. 512.36±29.43 μmol/l, p=0.049), d4 (423.20±24.12 vs. 518.46±31.14 μmol/l, p=0.018), and d5 (423.17±24.75 vs. 508.62±31.08 μmol/l, p=0.037). Serum UA returned to baseline levels in both groups 30 days after cessation of empagliflozin. The reduction of UA in the empagliflozin group was associated with a significant enhancement in FEUA (5.49±0.81% vs. 9.38±1.07%, p=0.004). Conclusion Our data suggest that the additive treatment with empagliflozin in patients with acute decompensated heart failure lowers the levels of serum uric acid compared to loop diuretics alone. This effect may be attributed to an improved renal elimination of UA and a better preservation of kidney function. It remains to be clarified whether this uricosuric effect of empagliflozin also contributes to its prognostic benefits in heart failure. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Department of Internal Medicine I, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany) Boehringer Ingelheim Inc.

Maternal serum uric acid, creatinine and blood urea levels in the prediction of pre-eclampsia among pregnant women attending ANC and delivery services at Bahir Dar city public hospitals, northwest Ethiopia: A case-control study

BackgroundPre-eclampsia (PE) is a metabolic disorder that adversely affects the lives of mother and their infants. Even though, several studies have been conducted on PE, no effective diagnostic and therapeutic agents were developed so far. Hence, this study was designed to evaluate serum uric acid, blood urea and creatinine levels in the prediction of PE. MethodsA hospital-based case-control study was conducted among pregnant women. A simple random sampling technique was applied to select study participants. The socio-demographic and clinical data were collected using an interview-administered questionnaire. Serum samples were used to determine the maternal uric acid, urea and creatinine levels via an automated chemistry analyzer. Independent sample t-test, Pearson correlation test and receiver operating characteristic (ROC) curve analysis were performed to check the association and diagnostic accuracy of variables to PE. ResultsThe mean ages (in years) of the case and control groups were 27.98 ± 5.64 and 27.33 ± 4.45, respectively. The mean serum uric acid and blood urea levels were significantly higher in pre-eclamptic women than in normotensive pregnant women (6.27 ± 0.20 vs 4.43 ± 0.15, and 8.50 ± 3.99 vs 5.67 ± 2.19), respectively but the serum creatinine level is non-significantly increased in cases as compared to controls (0.70 ± 0.05 vs 0.50 ± 0.01). The areas under the ROC curve of serum uric acid, creatinine and blood urea levels were 0.785, 0.735 and 0.764 (sensitivity: 69%, 60.7%, 67.9%; specificity: 73.8%, 75%, 71.4%) with the cutoff points of ≥5.25 mg/dL, ≥0.565 mg/dL and ≥6.5 mg/dL, respectively. ConclusionIn this study, we observed a significantly higher concentration of serum uric acid and blood urea values in pre-eclampsia as compared with normotensive pregnant women. Therefore, this suggested that serum uric acid; blood urea and creatinine values can be associated with PE. Moreover, serum uric acid, blood urea and creatinine levels could be carefully utilized as a diagnostic marker for PE, but their inclusion in routine diagnostic test to PE requires large-scale multi-center prospective studies that corroborate our findings.

Xanthine oxidase inhibition for cardiovascular disease prevention

In the metabolic process of purine degradation into uric acid, activated xanthine oxidase produces oxygen species and causes a pro-inflammatory vascular state, resulting in an increased risk of cardiovascular disease.1 Elevated serum uric acid concentrations and gout have also been recognised as independent residual risk factors for cardiovascular disease,2 contributing to the hypothesis that xanthine oxidase inhibition can prevent the development of cardiovascular disease.

Real clinical experience after one year of treatment with tolvaptan in patients with autosomal dominant polycystic kidney disease.

BackgroundTolvaptan (TV) is the first vasopressin-receptor antagonist approved for the treatment of autosomal dominant polycystic kidney disease (ADPKD). No publications report TV experience in real clinical practice during the first year of treatment.MethodsA prospective study of an initial cohort of 220 rapidly progressing patients treated with TV for 12 months. The tolerability of TV, the evolution of the estimated glomerular filtration rate (eGFR), analytical parameters, and blood pressure were analyzed.ResultsA total of 163 patients (78.2%) received TV for 1 year. The main causes of treatment withdrawal were the aquaretic effects (11%), eGFR deterioration (5%), and hepatic toxicity (2.3%). eGFR decreased significantly after 1 month of treatment without further changes. The decrease in eGFR in the first month was higher in patients with an initially higher eGFR. The eGFR drop during the first year of treatment with TV was lower than that reported by patients in the 2 years prior to TV treatment (–1.7 ± 7.6 vs. –4.4 ± 4.8 mL/min, p = 0.003). Serum sodium and uric acid concentrations increased, and morning urinary osmolality decreased in the first month, with no further changes. Blood pressure decreased significantly without changes in antihypertensive medication.ConclusionTV treatment is well tolerated by most patients. Liver toxicity is very rare and self-limited. TV reduces eGFR in the first month without showing further changes during the first year of treatment. Patients with a higher starting eGFR will suffer a greater initial drop, with a longer recovery. We suggest using the eGFR observed after a month of treatment as the reference for future comparisons and calculating the rate of eGFR decline in patients undergoing TV treatment.

The Association of Serum Uric Acid Level, Gout, and Alzheimer's Disease: A Bidirectional Mendelian Randomization Study.

The relationship between serum uric acid (UA) and Alzheimer's disease (AD) risk still remained ambiguous despite extensive attempts. Via the two-sample Mendelian randomization (MR) design, we aimed to examine the bidirectional causal relationships of serum UA, gout, and the risk of AD. Genetic variants of UA, gout, and AD were extracted from published genome-wide association summary statistics. The inverse-variance weighted (IVW, the primary method), and several sensitivity methods (MR-Egger, weighted median, and weighted mode) were used to calculate the effect estimates. Egger regression, MR-PRESSO and leave-one-SNP-out analysis were performed to identify potential violations. Genetic proxies for serum UA concentration [odds ratio (ORIVW) = 1.09, 95% confidence interval (CI) = 1.01-1.19, p = 0.031] were related with an increased risk of AD using 25 single nucleotide polymorphisms (SNPs). This causal effect was confirmed by sensitivity analyses including MR-Egger (1.22, 1.06-1.42, p = 0.014), weighted median (1.18, 1.05-1.33, p = 0.006), and weighted mode (1.20, 1.07-1.35, p = 0.005) methods. No evidence of notable directional pleiotropy and heterogeneity were identified (p &gt; 0.05). Three SNPs (rs2078267, rs2231142, and rs11722228) significantly drove the observed causal effects. Supportive causal effect of genetically determined gout on AD risk was demonstrated using two SNPs (ORIVW = 1.05, 95% CI = 1.00-1.11, p = 0.057). No reverse causal effects of AD on serum UA levels and gout risk were found. The findings revealed a causal relationship between elevated serum UA level and AD risk. However, further research is still warranted to investigate whether serum UA could be a reliable biomarker and therapeutic target for AD.

Correlation of serum uric acid levels with type II diabetic patients

Aim: To correlate diabetes patients' blood uric acid levels with their duration of diabetes. Materials and methods: This study was conducted on 100 diabetic patients(30-50 years).diabetic patients with no history of any other systemic complications and metabolic disorders like obesity and gout . Each diabetic patient was subjected to detailed general examination. A biochemical investigation for fasting serum uric acid levels estimated. Results: A positive correlation present between SUA and duration of type 2 diabetes is statistically significant. As the duration of diabetes increases than there is an increase in the serum uric acid concentration in type 2 diabetes patients (r = +0.630,p&lt;0.001). Conclusion: Drugs that reduce the serum uric acid level may become effective in preventing the development and prognosis of insulin resistance, a major factor in type 2 diabetes. The significant positive correlation between serum uric acid and the duration of type 2 diabetes suggests the uric acid acts as an independent biochemical marker for type 2 diabetes prognosis.

Cluster Analysis to Distinguish Patients Most Likely to Benefit from Outpatient Cardiac Rehabilitation-A Prospective, Multicenter Study.

Offering cardiac rehabilitation to people who can benefit most could improve the outcomes in the context of limited availability. We used cluster analysis to distinguish three patient groups based on clinical and laboratory variables and then compared the outcomes of 6-month outpatient cardiac rehabilitation between these groups. The outcomes included blood pressure, blood lipids, fasting blood glucose, and uric acid concertation in serum. Group 1 consisted primarily of men with obesity, increased blood pressure, favourable lipid profiles and increased fasting glucose. Group 2 consisted of men or women with normal weight, normal blood pressure, favourable lipid profiles, and normal fasting glucose. Group 3 consisted primarily of women with overweight, normal blood pressure, unfavourable lipid profiles, and normal fasting glucose. After 6 months of cardiac rehabilitation, blood lipids improved in group 3, whereas blood pressure improved in groups 1 and 3, but the outcomes did not change significantly in group 2. We did not see any effect of cardiac rehabilitation on fasting blood glucose and serum uric acid concentration in any group. Concentrations of glucose and uric acid did not change significantly in any group. In conclusion, an adequate selection of patients should maximise the benefits of cardiac rehabilitation.

Serum Uric Acid to Serum Creatinine Ratio and Risk of Stroke Recurrence in Young Adults with Ischemic Stroke.

Background and AimSerum uric acid to serum creatinine ratio (SUA/SCr) is associated with metabolic and cardiovascular diseases. We aimed to investigate the association between SUA/SCr and stroke recurrence among young adults with ischemic stroke.MethodsA total of 428 young patients with ischemic stroke were included in the present study. SUA/SCr was calculated from the concentration of serum uric acid and creatine (uric acid/creatine). Cox proportional regression models were performed to evaluate the association between SUA/SCr and stroke recurrence. Kaplan–Meier curves were used to compare recurrence rates in different quantiles of SUA/SCr.ResultsDuring a median follow-up of 3.14 years, 51 (10.7%) patients had stroke recurrence. Multivariable analyses indicated that SUA/SCr was associated with stroke recurrence after being adjusted for potential confounders (quantile four versus quantile one: hazard ratio: 3.420; 95% confidence interval: 1.426–8.200; P = 0.006). Kaplan–Meier curves revealed that patients with a high concentration of SUA/SCr had an increased stroke recurrence risk. The time-dependent receiver operating characteristic curve showed that the area under the curve for SUA/SCr was above 0.7 during follow-up. Restricted cubic spline presented an increasing trend for the link between SUA/SCr and stroke recurrence among young adults.ConclusionSUA/SCr was positively associated with the risk of stroke recurrence among young adults with ischemic stroke. Further prospective studies are warranted to assess the causality between SUA/SCr and the development of stroke recurrence among young adults.

Validation of age- and sex-dependent association of uric acid and incident hypertension in rural areas

BackgroundA previous study based on urban areas suggested the age- and sex-dependent association of uric acid (UA) and incident hypertension. We aimed to investigate whether this association is valid even in rural areas with different lifestyle.MethodsData from the cardiovascular disease association study, a prospective cohort study based on rural residents, was analyzed. A total of 4,592 subjects (mean age, 60.1 ± 9.5 years; men, 37.7%) without hypertension were included. We first investigated whether UA was a risk factor for incident hypertension using Cox regression, and then compared the relative risk by stratification according to age and sex.ResultsDuring the follow-up period (mean, 2.0 years), 579 subjects (12.6%) were newly diagnosed with hypertension. The risk factors for incident hypertension were age (Hazard ratios [HR] for ≥ 65, 1.26), systolic blood pressure (HR per 1 mmHg increase, 1.07), and serum UA concentration (HR per 1 mmHg increase, 1.10). The risk of UA-related incident hypertension was higher in the non-elderly than in the elderly for both men and women (HR, 1.74 for non-elderly men; 1.88 for non-elderly women; 1.66 for elderly men; 1.10 for elderly women). Even after adjusting for multiple confounders, the risk of UA-related incident hypertension was significantly higher in non-elderly women (HR, 1.59; P < 0.05).ConclusionsAge- and sex-dependent association of UA with incident hypertension suggested in cohort study based on urban areas was consistently found in rural areas as well. In particular, non-elderly women were at a higher risk for UA-related incident hypertension.

Prevalence of hyperuricemia in patients with severe obesity and the relationship between serum uric acid and severe obesity: A decade retrospective cross-section study in Chinese adults.

ObjectiveUndoubtedly, the relationship between serum uric acid (SUA) and obesity is less data for Chinese patients with obesity. This study aimed to examine the prevalence of hyperuricemia (HUA) and the association between SUA and patients with obesity.MethodsAll participants were categorized as overweight, obesity I, obesity II, and obesity III. In addition, based on SUA concentration, the participants were stratified into four quartiles. The authors used descriptive analysis, independent t-test, ANOVA, correlation analysis, and multiple linear regression models to verify the SUA level and obesity among Chinese adults.ResultsOverall, the estimated prevalence of HUA was 69.8%. In the BMI categories, the prevalence of HUA was 5.1% in overweight, 15.2% in obesity I, 16.9% in obesity II, and 32.5% in obesity III. Correlation analysis shows that SUA is strongly correlated with BMI, waist circumference (WC), and hip circumference (HC). Multiple linear regression analysis shows that high density–lipoprotein cholesterol (HDL-C) is a protective predictor of serum uric acid levels in patients with obesity. Compared with the overweight, obesity I, obesity II, and obesity III were more likely to have higher levels in the SUA levels.ConclusionWe mainly showed that the serum uric acid levels in Chinese patients with severe obesity declined slightly as age increased.

Effects of Renal Function on Urinary Excretion and Serum Concentration of Uric Acid in Patients Treated with Febuxostat for Chronic Kidney Disease.

Febuxostat is recommended for lowering serum uric acid (sUA) concentration in chronic kidney disease (CKD) patients with hyperuricemia. However, it remains uncertain how febuxostat affects associations between several laboratory variables related to glomerular filtration and renal tubular reabsorption of uric acid. We retrospectively analyzed the records of 148 patients with CKD and hyperuricemia: 122 were treated with febuxostat, and 26 were not. Clinical and laboratory variables were used to calculate estimated glomerular filtration rate (eGFR), fractional excretion of uric acid (FEUA), and estimated 24-h urinary excretion of uric acid (eEUA). We examined correlations of those variables and compared patients who did and did not receive febuxostat. eGFR and FEUA were significantly inversely regardless of febuxostat-treatment status. eGFR was significantly inversely correlated with sUA in patients who received febuxostat, but not in those who did not. Similarly, there was a significant positive correlation between FEUA and eEUA only in patients treated with febuxostat. FEUA increased as eGFR decreased in our patients. Febuxostat changed correlation patterns for clinical and laboratory variables. Additional administration of uricosuric agents might help further lower sUA by increasing FEUA and eEUA in patients treated with febuxostat.

Effects of dietary inclusion of Bambara groundnut and sweet orange peels on streptozotocin/HFD type-2 induced diabetes mellitus complications and related biochemical parameters.

The effects of dietary inclusion of Bambara groundnut and sweet orange peels composite bread on low-dose streptozotocin and high-fat diet (HFD)-induced type-2 diabetes mellitus (T2D) complications was evaluated in the present study. Male experimental rats-induced T2D were administered with acarbose (standard) and fed with Bambara groundnut and sweet orange peels composite bread for a period of 14 days while monitoring their blood glucose levels. More so, the activities of angiotensin-I-converting enzyme (ACE), serum aspartate aminotransferase, alkaline phosphatase, and alanine aminotransferase activities, as well as nitric oxide (NO), reactive oxygen species (ROS), albumin, total bilirubin, creatinine, urea, and uric acid serum concentrations were assayed for. Diabetic untreated rats showed disorders in ACE, AST, ALT, and ALP activities, and NO, ROS, glucose, albumin, bilirubin, creatinine, urea, uric acid levels, as well as lipid profiles. Interestingly, these disorders were significantly ameliorated in composite bread diet-fed rats in comparison to the diabetic untreated rats. Meanwhile, the presence of polyphenols in the Bambara groundnut and sweet orange peels composite bread diet could have aided the amelioration of these metabolic disorders after the 14th day of administration. Finally, it was proposed that the ability of Bambara groundnut-wheat and sweet orange peel composite bread to treat T2D and its complications makes it a more successful therapy than medications that just target one of the diseased states. PRACTICAL APPLICATIONS: Diabetes mellitus is a global and chronic disease that presently affects 536.6 million people alongside 1.5 million deaths directly attributed to it yearly. Several drug and medicinal agents have been employed for the management of diabetes but those drugs are mostly limited to the management of diabetes while the associated complications are most untreated, while drugs that can manage diabetes and its related complications mostly come at high prices. Therefore, there is an urgent need to evaluate legumes, such as Bambara groundnut, with proven therapeutic potential in the management of diabetes and its complications. However, the Bambara groundnut takes a long period to prepare for a meal, therefore including it in a ready-to-eat product will not only improve its acceptability but also add to economic improvement. Furthermore, adding a waste product, sweet orange peels, will both add flavor and source of additional antioxidant attributes.

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.

Bilirubin as a new antioxidant in melasma.

Oxidative stress and its role in the pathogenesis of cutaneous diseases have been widely investigated. However, there are few studies that have solely assessed the contribution of intracellular antioxidants in the etiopathology of melasma. Furthermore, there are convincing reports about antioxidant properties of bilirubin (Bil) and uric acid (UA) in some skin disorders but not melasma. This study aimed to determine serum levels of two major extracellular antioxidants (Bil and UA) levels in patients with melasma and their correlation with the severity and extent of the disease. In this case-control study, the serum levels of bilirubin and uric acid of 50 melasma patients were compared with 50 healthy controls. Moreover, the correlation of serum concentrations of these antioxidants with the extent and severity of the disease were assessed. The serum concentration of Bil was significantly higher in the case group (p < 0.05). Furthermore, serum Bil level had a positive correlation with the extent of the melasma (correlation coefficient, +0.3; p < 0.05). No significant difference was found between the serum concentrations of UA between the study and control group. Neither Bil nor UA had a significant correlation with the severity of the disease. Oxidative stress may play a major role in the etiopathology of melasma and bilirubin, as an antioxidant, could be involved in the process of oxidative stress.

Genetic Basis of the Epidemiological Features and Clinical Significance of Renal Hypouricemia.

A genetic defect in urate transporter 1 (URAT1) is the major cause of renal hypouricemia (RHUC). Although RHUC is detected using a serum uric acid (UA) concentration <2.0 mg/dL, the relationship between the genetic state of URAT1 and serum UA concentration is not clear. Homozygosity and compound heterozygosity with respect to mutant URAT1 alleles are associated with a serum UA concentration of <1.0 mg/dL and are present at a prevalence of ~0.1% in Japan. In heterozygous individuals, the prevalence of a serum UA of 1.1–2.0 mg/dL is much higher in women than in men. The frequency of mutant URAT1 alleles is as high as 3% in the general Japanese population. The expansion of a specific mutant URAT1 allele derived from a single mutant gene that occurred in ancient times is reflected in modern Japan at a high frequency. Similar findings were reported in Roma populations in Europe. These phenomena are thought to reflect the ancient migration history of each ethnic group (founder effects). Exercise-induced acute kidney injury (EI-AKI) is mostly observed in individuals with homozygous/compound heterozygous URAT1 mutation, and laboratory experiments suggested that a high UA load on the renal tubules is a plausible mechanism for EI-AKI.

Urate Transporter ABCG2 Function and Asymptomatic Hyperuricemia: A Retrospective Cohort Study of CKD Progression

Treatment of asymptomatic hyperuricemia is not commonly implemented. However, it is unclear whether urate deposition that begins during asymptomatic hyperuricemia can induce nephropathy. Dysfunction of ATP-binding cassette subfamily G member 2 (ABCG2), a urate efflux transporter, leads to elevated serum uric acid concentration (SUA). We investigated the association between asymptomatic hyperuricemia and decreased estimated glomerular filtration rate (eGFR), and the impact of ABCG2 on this relationship. Retrospective cohort study. 1,885 Japanese adults undergoing routine health care follow-up between 2007 and 2017 who had eGFR≥60 mL/min/1.73 m2, of which 311 had asymptomatic hyperuricemia (SUA >7.0 mg/dL). Study participants were classified into 3 categories of estimated ABCG2 function (full, 75%, and≤50% function). Baseline SUA and estimated ABCG2 function. Change in eGFR over time. Linear mixed-effect models were used to analyze the relationship between asymptomatic hyperuricemia, ABCG2 function, and eGFR decline. Asymptomatic hyperuricemia was negligibly associated with eGFR decline overall. However, among those with eGFR 60-89 mL/min/1.73 m2 and≤50% ABCG2 function, eGFR decline was associated with asymptomatic hyperuricemia (P= 0.03). ABCG2 was not associated with eGFR reductions when the SUA was<6.0 mg/dL. Among participants with SUA≥6.0 mg/dL and eGFR 60-89 mL/min/1.73 m2,≤50% ABCG2 function was associated with approximately 1.2-fold faster eGFR decline compared with fully functional ABCG2 (P= 0.02). Among the participants with SUA≥6.0 mg/dL and eGFR 60-89 mL/min/1.73 m2, the adjusted eGFR slopes (given as mean ± standard error of the mean, in mL/min/1.73 m2 per year) were-0.946 ± 0.049,-1.040 ± 0.046, and-1.148 ± 0.069 for full, 75%, and≤50% ABCG2 function, respectively. Lack of measurement of urinary urate and uremic toxins that are known to be transported by ABCG2, and no independent validation cohort. Asymptomatic hyperuricemia was not associated with eGFR decline, except when in the presence of≤50% ABCG2 function. The urate transporter ABCG2 is a protein that regulates serum urate concentrations; when dysfunctional, it can lead to elevated serum concentrations of this compound (ie, hyperuricemia). Although persistent hyperuricemia induces gout and kidney injury, the effects on organs during the asymptomatic phase have yet to be established. Therefore, to clarify the relationship between ABCG2, asymptomatic hyperuricemia, and kidney function, we conducted a retrospective cohort study of 1,885 healthy participants, including 311 participants with asymptomatic hyperuricemia. We found that the coexistence of asymptomatic hyperuricemia and severe ABCG2 dysfunction was associated with the age-dependent decline in kidney function. We concluded that asymptomatic hyperuricemia represents a risk factor for chronic kidney disease, at least in individuals with highly dysfunctional ABCG2. This new finding highlights the potential importance of ABCG2 in the pathogenesis of hyperuricemia-induced kidney injury.

Effect and Potential Mechanism of Lactobacillus plantarum Q7 on Hyperuricemia in vitro and in vivo

Hyperuricemia (HUA) is a disorder of purine metabolism resulting in abnormally elevated serum uric acid (UA) concentration. It is believed that there is an association between gut microbiota and HUA, and probiotics have the potential palliative effect. However, the underlying mechanism of probiotics in ameliorating HUA remains unclear. The purpose of this study was to investigate the effect and mechanism of Lactobacillus plantarum Q7 on HUA in Balb/c mice. The results showed that L. plantarum Q7 had an excellent capability to affect UA metabolism, which could degrade nucleotides by 99.97%, nucleosides by 99.15%, purine by 87.35%, and UA by 81.30%. It was observed that L. plantarum Q7 could downregulate serum UA, blood urea nitrogen (BUN), creatinine (Cr), and xanthine oxidase (XOD) by 47.24%, 14.59%, 54.59%, and 40.80%, respectively. Oral administration of L. plantarum Q7 could restore the liver, kidney, and intestinal injury induced by HUA and the expression of metabolic enzymes and transporters to normal level. 16S rRNA sequencing analysis showed that L. plantarum Q7 treatment could restore the imbalance of species diversity, richness, and community evenness compared with the model group. The ratio of Bacteroidetes to Firmicutes was recovered nearly to the normal level by L. plantarum Q7 intervention. The dominant microorganisms of L. plantarum Q7 group contained more anti-inflammatory bacteria than those of the model group. These findings indicated that L. plantarum Q7 might regulate UA metabolism and repair the liver and kidney injury by reshaping the gut microbiota and could be used as a potential probiotic strain to ameliorate HUA.