Serum uric acid and metabolic syndrome in Taiwanese adults

A positive association between serum uric acid and metabolic syndrome has been reported, but little information is available about the association between serum uric acid and metabolic syndrome in Taiwanese adults. The purpose of this study was to investigate the association between serum uric acid levels and metabolic syndrome in Taiwanese adults. We performed a cross-sectional study of 2085 men and 1557 women. All of the participants underwent a health screening during the period from January 2005 to December 2005 at a health center of the Shin Kong Wu Ho-Su Memorial Hospital. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The results showed that hyperuricemia was significantly associated with increased risk for hypertriglyceridemia, low high-density lipoprotein cholesterol level, and high blood pressure in men and women. The risk of metabolic syndrome was significantly higher in the fourth quartile than in the first quartile of uric acid level in men (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.06-2.14) and women (OR, 2.33; 95% CI, 1.39-3.93). In addition, uric acid level was inversely associated with hyperglycemia in men. The ORs of hyperglycemia for the second, third, and fourth quartile of uric acid were 0.69 (95% CI, 0.46-1.03), 0.55 (95% CI, 0.37-0.83), and 0.45 (95% CI, 0.29-0.69), respectively, compared with the lowest quartile of uric acid. The results demonstrate that there is a positive association between serum uric acid levels and metabolic syndrome and an inverse association between uric acid and fasting plasma glucose in Taiwanese adults.     

Serum uric acid and its change with the risk of type 2 diabetes: A prospective study in China

ObjectiveTo assess the association of baseline uric acid levels and their changes from baseline to Year 1 with the risk of type 2 diabetes.Research design and methodsThis study cohort included 9471 subjects without a history of diabetes at baseline. The incident diabetes was diagnosed according to the American Diabetes Association standard.ResultsDuring a mean follow-up of 2.9 years, we identified 762 type 2 diabetes cases. Multivariate-adjusted hazard ratios (HRs) of diabetes across baseline tertiles of serum uric acid were 1.00, 1.15, and 1.32 (P for trend = 0.018), respectively. Participants with hyperuricemia compared with those without had a 1.20-fold (95% confidence interval [CI] 1.01−1.44) risk of diabetes. When uric acid was examined as a continuous variable, multivariable-adjusted HR of diabetes for each 1 mg/dL (60 μmol/L) increase in serum uric acid was 1.09 (95% CI 1.03−1.15). Compared with subjects with stable serum uric acid from baseline to Year 1 (±10%), those with uric acid gain ≥30% had a 30% (95% CI 1.01–1.79) increased risk of diabetes and those with uric acid loss ≥10% had a 21% (95% 0.62−0.99) decreased risk of diabetes. This positive association between baseline serum uric acid and diabetes risk was consistent among subjects younger and older than 45 years, non-obese and obese participants, and men.ConclusionsHigh level of baseline serum uric acid and serum uric acid gain from baseline to Year 1 are associated with an increased risk of type 2 diabetes among Chinese adults.     

Hyperuricemia and the echocardiographic measures of myocardial dysfunction

Few studies have investigated the association between hyperuricemia and subclinical myocardial dysfunction. The authors analyzed the relationship between serum uric acid and subclinical markers of heart failure in participants in the Framingham Offspring Cohort (N=2169, mean age 57.3 years, 55.4% women). Cardiac dysfunction was assessed through echocardiographic measurements of left ventricular (LV) mass and thickness, end-diastolic LV thickness, and LV fractional shortening at the sixth visit, approximately 24 years after study onset. Participants in the highest serum uric acid quartile (≥ 6.2 mg/dL serum uric acid) had a significantly greater frequency of echocardiographic abnormalities compared with those in the lowest quartile (<4.3 mg/dL). Those in the highest quartile had multivariable-adjusted odds ratios of 9.013 (95% confidence interval, 2.051-39.604) for abnormal LV ejection fraction and 4.584 (95% confidence interval, 1.951-10.768) for LV systolic dysfunction compared with those in the lowest quartile. Hyperuricemia in young adults can be a marker for subsequent heart failure.     

Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease.

It is a matter of controversy as to whether uric acid is an independent predictor of mortality in patients with coronary artery disease (CAD) or whether it represents only an indirect marker of adverse outcome by reflecting the association between uric acid and other cardiovascular risk factors. Therefore, we studied the influence of uric acid levels on mortality in patients with CAD. In 1,017 patients with angiographically proven CAD, classic risk factors and uric acid levels were determined at enrollment. A follow-up over a median of 2.2 years (maximum 3.1) was performed. Death from all causes was defined as an end point of the study. In CAD patients with uric acid levels <303 micromol/L (5.1 mg/dl) (lowest quartile) compared with those with uric acid levels >433 micromol/L (7.1 mg/dl) (highest quartile), the mortality rate increased from 3.4% to 17.1% (fivefold increase). After adjustment for age, both sexes demonstrated an increased risk for death with increasing uric acid levels (female patients: hazard ratio [HR] 1.30, 95% confidence intervals [CI] 1.14 to 1.49, p < or = 0.001; male patients: HR 1.39 [95% CI 1.21 to 1.59], p < or = 0.001). In multivariate Cox regression analysis performed with 12 variables that influence overall mortality-including diuretic use-elevated levels of uric acid demonstrated an independent, significant positive relation to overall mortality (HR 1.23 [95% CI 1.11 to 1.36], p <0.001) in patients with CAD. Thus, uric acid is an independent predictor of mortality in patients with CAD.     

Hyperuricemia and incidence of hypertension among men without metabolic syndrome

The aim of this project was to study the risk of developing hypertension over a 6-year follow-up in normotensive men with baseline hyperuricemia (serum uric acid >7.0 mg/dL) but without diabetes/glucose intolerance or metabolic syndrome. We analyzed the data on men without metabolic syndrome or hypertension at baseline from the Multiple Risk Factor Intervention Trial. These men (n=3073; age: 35 to 57 years) were followed for an average of 6 years by annual examinations. Follow-up blood pressure among those with baseline was consistently higher than among those with normal serum uric acid concentration. We used Cox regression models for adjustment for the effects of serum creatinine, body mass index, age, blood pressure, proteinuria, serum cholesterol and triglycerides, alcohol and tobacco use, risk factor interventions, and use of diuretics. In these models, normotensive men with baseline hyperuricemia had an 80% excess risk for incident hypertension (hazard ratio: 1.81; 95% CI: 1.59 to 2.07) compared with those who did not. Each unit increase in serum uric acid was associated with a 9% increase in the risk for incident hypertension (hazard ratio: 1.09; 95% CI: 1.02 to 1.17). We conclude that the hyperuricemia-hypertension risk relationship is present among normotensive middle-aged men without diabetes/glucose intolerance or metabolic syndrome.     

Hyperuricemia associated with high cardiac event rates in the elderly with chronic heart failure

OBJECTIVES: Congestive heart failure (CHF) is the major cause of death and hospitalization in the elderly population. Simple markers that can be measured anywhere at low cost are necessary to identify patients at high risk. Recent studies have reported that hyperuricemia is a prognostic marker for CHF. However, it is not yet known whether serum levels of uric acid may provide prognostic information in the elderly population. Therefore, this study tried to identify the clinical characteristics of elderly CHF patients (+/-70 years) in our institution and to evaluate whether uric acid levels can effectively estimate the prognosis for elderly CHF patients. METHODS AND RESULTS: Uric acid levels were analyzed in 247 CHF patients, and patients were followed up for 451 +/- 235 days (mean +/- SD). Elderly CHF patients aged > or =70 years (123 patients) had higher rate of hypertension, lower current smoking rate and higher uric acid levels than those aged < 70 years (124 patients). There were 72 cardiac events including cardiac deaths and readmissions for worsening CHF. Multivariate analysis with the Cox proportional hazard model showed that uric acid was the only independent predictor of cardiac events (hazard ratio 1.544, 95% confidence interval 1.215-2.582, p < 0.0001) in the elderly with CHF. The highest quartile of uric acid level was associated with the highest risk of cardiac events (a 4.45-fold compared to the lowest quartile). Kaplan-Meier analysis revealed that uric acid levels effectively risk stratified elderly CHF patients for cardiac events. CONCLUSIONS: These findings suggest that measurement of uric acid levels in elderly CHF patients may add valuable prognostic information to predict cardiac events.     

Serum γ-glutamyltransferase as an independent predictor for incident type 2 diabetes in middle-aged and older adults: Findings from the KoGES over 12 years of follow-up

Backgrounds and aimsLimited evidence is available on whether serum γ-glutamyltransferase (GGT) has value as a predictor of type 2 diabetes in East Asian populations. We investigated the causal relationship between serum GGT level and incident type 2 diabetes in Korean adults.Methods and resultsA total of 7739 nondiabetic adults aged 40–69 years from the Korean Genome and Epidemiology Study were studied. We divided the population into four groups according to sex-specific quartiles by serum GGT levels. Hazard ratios (HRs) with 95% Confidence intervals (CIs) for incident type 2 diabetes were prospectively analyzed using multivariate Cox proportional hazards regression models. A total of 1432 (18.5%) participants developed type 2 diabetes over 12 years of follow-up. The higher the serum GGT group quartile, the higher the cumulative type 2 diabetes incidence over 12 years with significance in both sexes (log-rank test P < 0.001). HRs (95% CIs) for incident type 2 diabetes for the highest quartile versus referent lowest quartile for serum GGT levels were 2.55 (1.86–3.51) for men and 1.90 (1.40–2.58) for women after adjusting for confounding variables.ConclusionsHigher serum GGT levels preceded and positively associated with incident type 2 diabetes among community-dwelling middle-aged and older Korean adults.     

肥胖与高尿酸血症的关系

目的探讨血清尿酸水平与中国人群肥胖的关系。方法入选960例无心血管病症状的普通社区人群,男751人,女209人,平均年龄41.27岁,所有研究对象进行了详细的问卷调查和体检。按照体重指数的四分位数,将研究对象分成4组,测量各组血清尿酸水平及高尿酸血症的发生情况。结果男性中,BMI从低到高的各组对象的血清尿酸水平分别为295.75±52.29umol/L,323.55±75.93umol/L,331.38±65.62umol/L,344.66±66.72umol/L,各组间差别都有显著性,随着BMI的升高,血清尿酸的水平呈线性增高。女性中,BMI从低到高的各组对象的血清尿酸水平分别为233.62±49.3umol/L,235.76±54.34umol/L,243.57±46.99umol/L,295.79±54.31umol/L,第4组显著高于其他3组。高尿酸血症的发生率逐步提高,分别为1.2%,3.8%,8.0%和13.5%,在校正了年龄、性别、吸烟状况、饮酒状况、血压、血脂、血糖等混杂因素后,BMI高的对象发生高尿酸血症的危险是BMI低的对象的5.38（1.50-19.37）倍,P=0.001。结论血清尿酸水平与肥胖显著相关。     

Elevated serum γ-glutamyltransferase predicts the development of impaired glucose metabolism in middle-aged and elderly Chinese

The aim of this article is to prospectively investigate the association of the liver enzyme γ-glutamyltransferase (GGT) with the development of diabetes and impaired glucose regulation (IGR) in a Chinese population. Seven hundred and sixty normoglycaemic subjects aged 40?years or older randomly selected from an urban community of Shanghai received a baseline investigation in May 2005. The participants were invited to receive a standard 75-g oral glucose tolerance test (OGTT) in November 2008. Incident diabetes and IGR were determined according to the 1999 WHO criteria. Serum GGT levels were significantly associated with incident diabetes or combined diabetes and IGR prospectively. After extensive adjustment, the diabetes risk was significantly increased with incrementing serum GGT quartiles (P value for trend?=?0.0027). As compared with the lowest quartile of GGT, the highest quartile had an adjusted hazard ratio of 1.30 (95% CI 1.03-1.65) for developing combined diabetes and IGR. Furthermore, a high serum GGT level at baseline was independently associated with an increase in the index of homeostasis model assessment of insulin resistance (HOMA-IR) at follow-up. Serum GGT concentration, even within its normal range, is a risk marker for developing impaired glucose metabolism in middle-aged and elderly Chinese.     

Serum uric acid is associated with microalbuminuria in prehypertension

Serum uric acid is associated with cardiovascular disease. However, the independent role of uric acid in the development of cardiovascular disease is uncertain. This study examined the cross-sectional association of serum uric acid level with microalbuminuria among 6771 subjects without diabetes or hypertension. Blood pressure was categorized as prehypertension (systolic blood pressure, 120 to 140 mm Hg or diastolic blood pressure, 80 to 90 mm Hg) and normotension (systolic blood pressure, <120 mm Hg and diastolic blood pressure, <80 mm Hg). Microalbuminuria was found in 4.0% of normotensive subjects (n=4819) and in 7.9% of prehypertensive subjects (n=1952). Prehypertensive subjects with microalbuminuria had higher uric acid level than those with normoalbuminuria (men, 387 [68] mmol/L versus 371 [69] mmol/L; P=0.017; women 286 [56] mmol/L versus 262 [54] mmol/L; P=0.006). However, the difference in serum uric acid level according to the presence or absence of microalbuminuria was not found in the normotensive group. Multiple logistic regression models showed that, in the prehypertensive group, after adjustment for other cardiovascular risk factors, the highest uric acid quartile entailed >2 times greater risk for microalbuminuria than the lowest quartile in both men (odds ratio, 2.12; 95% CI, 1.16 to 3.87) and women (odds ratio, 3.36; 95% CI, 1.17 to 9.69). In the normotensive group, serum uric acid quartile did not show the independent association with microalbuminuria. In conclusion, serum uric acid level was strongly associated with microalbuminuria in prehypertensive subjects.     

Wnt signaling antagonists are potential prognostic biomarkers for the progression of radiographic hip osteoarthritis in elderly Caucasian women

OBJECTIVE: To determine whether serum levels of 2 Wnt signaling antagonists, Frizzled-related protein (FRP) and Dkk-1, are associated with the development and progression of radiographic hip osteoarthritis (RHOA). METHODS: Pelvic radiographs were obtained a mean of 8.3 years apart in 5,928 Caucasian women >or=65 years of age who were enrolled in the Study of Osteoporotic Fractures. Random sampling of this cohort was performed, with approximately 180 subjects per group assigned to 2 nested case-control studies on RHOA incidence and progression. Baseline serum levels of FRP and Dkk-1 were measured by capture enzyme-linked immunosorbent assay. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression analyses with adjustment for potential covariates. RESULTS: There were no differences in serum levels of FRP and Dkk-1 between case subjects with incidence or progression of RHOA and their respective control subjects. There was a trend for higher baseline serum levels of FRP to be associated with a reduced risk of incident RHOA (age-adjusted OR 0.59 [95% CI 0.32-1.09], P = 0.09 for women in the highest quartile versus women in the lowest quartile). There was no association of serum levels of FRP with progression of RHOA. Serum levels of Dkk-1 did not correlate with incident RHOA. However, higher serum levels of Dkk-1 were associated with diminished risk of RHOA progression (age-adjusted OR 0.43 [95% CI 0.23-0.79], P = 0.007 for women in the highest quartile compared with women in the lowest quartile). CONCLUSION: Elevated circulating levels of Dkk-1 appeared to be associated with reduced progression of RHOA in elderly women, whereas the highest quartile of serum FRP levels tended to be associated with a modest reduction in risk of incident RHOA.     

The association between serum uric acid level and long-term incidence of hypertension: Population-based cohort study

Increasing experimental evidence, including recently developed animal models support a causal role for uric acid in the development of hypertension. However, it is not clear whether serum uric acid levels are independently associated with the long-term incidence of hypertension. We examined the association between serum uric acid levels and 10-year incidence of hypertension in a population-based cohort study based in Beaver Dam city and township, Wisconsin, US. We studied 2520 hypertension-free individuals (56.3% women, age: 43-84 years, 98% Caucasian) at the baseline examination (1988-1990). The main outcome of interest was hypertension (systolic blood pressure (BP) of 140 mm Hg or higher, diastolic BP 90 mm Hg or higher, or combination of self-reported high BP diagnosis and use of antihypertensive medications) incidence over 10 years among baseline normotensive individuals. Nine hundred and fifty-six individuals developed hypertension over a 10-year follow-up period. The relative risk (RR) (95% confidence intervals (CI)) of incident hypertension increased in a dose-dependent manner (P-trend < 0.05 in all models) with increasing uric acid quartiles. Multivariable RR (95% CI) comparing the highest quartile of serum uric acid (> or =390 micromol/l) to the lowest quartile (< or =260 micromol/l) was 1.65 (1.41-1.93). This association persisted in subgroup analyses by categories of smoking, alcohol intake, body mass index, baseline blood pressure and estimated glomerular filtration rate (GFR). In conclusion, increasing quartiles of serum uric acid was associated with 10-year incidence of hypertension independent of smoking, alcohol intake and baseline kidney function suggesting an independent positive association between serum uric acid levels and hypertension development among community-dwelling older adults.     

Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the Atherosclerosis Risk in Communities Study.

BACKGROUND: Experimental studies in animals and cross-sectional studies in humans have suggested that low serum magnesium levels might lead to type 2 diabetes; however, this association has not been examined prospectively. METHODS: We assessed the risk for type 2 diabetes associated with low serum magnesium level and low dietary magnesium intake in a cohort of nondiabetic middle-aged adults (N = 12,128) from the Atherosclerosis Risk in Communities Study during 6 years of follow-up. Fasting serum magnesium level, categorized into 6 levels, and dietary magnesium intake, categorized into quartiles, were measured at the baseline examination. Incident type 2 diabetes was defined by self-report of physician diagnosis, use of diabetic medication, fasting glucose level of at least 7.0 mmol/L (126 mg/dL), or nonfasting glucose level of at least 11.1 mmol/L (200 mg/dL). RESULTS: Among white participants, a graded inverse relationship between serum magnesium levels and incident type 2 diabetes was observed. From the highest to the lowest serum magnesium levels, there was an approximate 2-fold increase in incidence rate (11.1, 12.2, 13.6, 12.8, 15.8, and 22.8 per 1000 person-years; P = .001). This graded association remained significant after simultaneous adjustment for potential confounders, including diuretic use. Compared with individuals with serum magnesium levels of 0.95 mmol/L (1.90 mEq/L) or greater, the adjusted relative odds of incident type 2 diabetes rose progressively across the following lower magnesium categories: 1.13 (95% CI, 0.79-1.61), 1.20 (95% CI, 0.86-1.68), 1.11 (95% CI, 0.80-1.56), 1.24 (95% CI, 0.86-1.78), and 1.76 (95% CI, 1.18-2.61) (for trend, P = .01). In contrast, little or no association was observed in black participants. No association was detected between dietary magnesium intake and the risk for incident type 2 diabetes in black or white participants. CONCLUSIONS: Among white participants, low serum magnesium level is a strong, independent predictor of incident type 2 diabetes. That low dietary magnesium intake does not confer risk for type 2 diabetes implies that compartmentalization and renal handling of magnesium may be important in the relationship between low serum magnesium levels and the risk for type 2 diabetes.     

High serum uric acid level and low urine pH as predictors of metabolic syndrome: a retrospective cohort study in a Japanese urban population

The objective of this study was to evaluate whether hyperuricemia, acidic urine, or their combination predicts metabolic syndrome (MetS). In study 1, 69,094 subjects who received a general health checkup between 1985 and 2005 were included in a cross-sectional study of serum uric acid (SUA) and urine pH in relation to MetS. In study 2, the association of SUA and urine pH with MetS development over a 5-year period was evaluated in 5617 subjects with body mass index less than 25 kg/m(2) at the first examination. In study 1, higher SUA and lower urine pH were both positively correlated to MetS status (P < .001). The combination of high SUA and low urine pH was significantly associated with higher MetS prevalence compared with the combination of low SUA and high urine pH (odds ratio, 3.383; 95% confidence interval [CI], 3.034-3.784 in men; odds ratio, 4.000; 95% CI, 2.992-5.452 in women). In study 2, the top quartile of SUA levels was associated with higher MetS development compared with the bottom quartile during the 5-year period in men (hazard ratio [HR], 1.793; 95% CI, 1.084-2.966; P = .023). In women, the HR was 3.732 (95% CI, 0.391-35.62; P = .252) for the upper vs the lower half of SUA levels. For urine pH, the HR was 1.955 (95% CI, 1.089-3.509; P = .025) for the bottom vs the top quartile in men. A likelihood ratio test confirmed that high SUA and low urine pH act synergistically in the development of MetS. High SUA, low urine pH, and their combination are predictive risk factors for MetS development.     

中老年人血尿酸水平与非酒精性脂肪性肝病的相关性研究

目的:研究中老年人群血尿酸水平与非酒精性脂肪性肝病(NAFLD)的相关性。方法 :采取整群抽样方法,对上海市嘉定社区2 519名40岁以上常住居民进行问卷调查、体格检查,同时采血进行血尿酸、血糖、血脂、肝功能、肾功能检测,以及上腹部彩色多普勒超声检查。NAFLD的诊断依据高分辨率超声扫描结果。按照血尿酸水平四分位数将研究人群分为Q1、Q2、Q3、Q4四组,并对其各项代谢指标进行分析。结果:NAFLD组的血尿酸水平显著高于非NAFLD组[(319.6±92.3)比(272.8±88.8)μmol/L,P<0.05)。结论:上海城镇中老年人群NAFLD患病风险随着血尿酸水平升高而增加。     

Low serum micronutrient concentrations predict frailty among older women living in the community

BACKGROUND: Micronutrient deficiencies are common among older adults. We hypothesized that low serum micronutrient concentrations were predictive of frailty among older disabled women living in the community. METHODS: We studied 766 women, aged 65 and older, from the Women's Health and Aging Study I, a population-based study of moderately to severely disabled community-dwelling women in Baltimore, Maryland. Serum vitamins A, D, E, B(6), and B(12), carotenoids, folate, zinc, and selenium were measured at baseline. Frailty status was determined at baseline and during annual visits for 3 years of follow-up. RESULTS: At baseline, 250 women were frail and 516 women were not frail. Of 463 nonfrail women who had at least one follow-up visit, 205 (31.9%) became frail, with an overall incidence rate of 19.1 per 100 person-years. Compared with women in the upper three quartiles, women in the lowest quartile of serum carotenoids (hazard ratio [HR] 1.39; 95% confidence interval [CI], 1.01-1.92), alpha-tocopherol (HR 1.39; 95% CI, 1.02-1.92), and 25-hydroxyvitamin D (HR 1.34; 95% CI, 0.94-1.90) had an increased risk of becoming frail. The number of nutritional deficiencies (HR 1.10; 95% CI, 1.01-1.20) was associated with an increased risk of becoming frail, after adjusting for age, smoking status, and chronic pulmonary disease. Adjusting for potential confounders, we found that women in the lowest quartile of serum carotenoids had a higher risk of becoming frail (HR 1.54; 95% CI, 1.11-2.13). CONCLUSIONS: Low serum micronutrient concentrations are an independent risk factor for frailty among disabled older women, and the risk of frailty increases with the number of micronutrient deficiencies.     

Serum uric acid, diuretic treatment and risk of cardiovascular events in the Systolic Hypertension in the Elderly Program (SHEP)

OBJECTIVE: To assess longitudinally the association of serum uric acid and its change due to diuretic treatment with cardiovascular events in hypertensive patients. DESIGN: Cohort study in a randomized trial. SETTING: Cohort of hypertensive patients. PARTICIPANTS: A total of 4327 men and women, aged > or = 60 years, with isolated systolic hypertension, randomized to placebo or chlorthalidone, with the addition of atenolol or reserpine if needed, were observed for 5 years. MAIN OUTCOME MEASURES: Major cardiovascular events, coronary events, stroke and all-cause mortality. RESULTS: Cardiovascular event rates for quartiles of baseline serum uric acid were: I, 32.7 per 1000 person-years; II, 34.5 per 1000 person-years; III, 38.1 per 1000 person-years; and IV, 41.4 per 1000 person-years (P for trend = 0.02). The adjusted hazard ratio (HR), of cardiovascular events for the highest quartile of serum uric acid versus the lowest quartile was 1.32 (95% CI, 1.03-1.69). The benefit of active treatment was not affected by baseline serum uric acid. After randomization, an increase of serum uric acid < 0.06 mmol/l (median change) in the active treatment group was associated with a HR of 0.58 (0.37-0.92) for coronary events compared with those with a serum uric acid increase > or = 0.06 mmol/l. This difference was not explained by blood pressure effects. Those with a serum uric acid increase > or = 0.06 mmol/l in the active treatment group had a similar risk of coronary events as the placebo group. CONCLUSIONS: Serum uric acid independently predicts cardiovascular events in older persons with isolated systolic hypertension. Monitoring serum uric acid change during diuretic treatment may help to identify patients who will most benefit from treatment.     

Serum uric acid level and risk for peripheral arterial disease: analysis of data from the multiple risk factor intervention trial

Although several studies report an association between hyperuricemia and coronary artery disease, little is known about the effect of hyperuricemia and gout on the risk of peripheral arterial disease (PAD). Data on 283 incident clinical cases of PAD during a randomized controlled trial of multiple cardiovascular risk factor intervention are evaluated. The serum uric acid levels among these individuals are compared with those of individuals who did not develop PAD during the study period. Multivariate logistic regression analyses measure the risk of developing PAD associated with higher levels of serum uric acid after adjusting for the effect of traditional vascular risk factors. Age and smoking are independently associated with development of PAD, with odds ratios of 1.08 (95% confidence interval [CI], 1.06-1.09) and 3.83 (95% CI, 2.49-5.91) per year, respectively. Hyperuricemia (serum uric acid level, >7.0 mg/dL) is an independent risk factor, with an odds ratio of 1.23, but the confidence interval of the estimate is wide (95% CI, 0.98-1.54). In this multivariate model, a history of gout was associated with an odds ratio of 1.33 (95% CI, 1.07-1.66). Serum uric acid level is independently associated with a higher (but statistically nonsignificant) risk of PAD. A history of gouty arthritis is an independent and statistically significant predictor of incidence of PAD even after adjustment for the effect of underlying hyperuricemia.     

Serum uric acid is positively associated with pulmonary function in Korean health screening examinees

Objectives: To determine whether level of serum uric acid (SUA) is linked to pulmonary function in health screening examinees without overt medical conditions.

Methods: We performed a cross-sectional study on 69,928 Koreans that participated in an annual health check.

Results: Percent predicted forced vital capacity (FVC%) and forced expiratory volume in 1?s (FEV1%) were positively correlated with SUA in both genders (FVC%: r?=?.361; FEV1%: r?=?.314 in males and FVC%: r?=?.413; FEV1%: r?=?.382 in females, all p?p for trend <.001). Similarly, the adjusted OR of having hyperuricemia in females decreased significantly across FEV1% and FVC% quartile groups compared to the reference.

Conclusions: Hyperuricemia may have a positive effect on pulmonary function in middle aged healthy population.     

Distinct hyperuricemia trajectories are associated with different risks of incident diabetes: A prospective cohort study

Background and aimConflicting results suggest a link between serum uric acid and diabetes and previous studies ignored the effect of continuous exposure of serum uric acid on diabetes risk. This study aims to characterize hyperuricemia trajectories in middle-aged adults and to examine its potential impact on diabetes risk, considering the role of obesity, dyslipidemia, and hypertension.Methods and resultsThe cohort included 9192 participants who were free of diabetes before 2013. The hyperuricemia trajectories during 2009–2013 were identified by latent class growth models. Incident diabetes during 2014–2018 was used as the outcome. Modified Poisson regression models were used to assess the association of trajectories with diabetes. Furthermore, marginal structural models were used to estimate the mediating effects of the relationship between hyperuricemia trajectories and diabetes. We identified three discrete hyperuricemia trajectories: high-increasing (n = 5794), moderate-stable (n = 2049), and low-stable (n = 1349). During 5 years of follow-up, we documented 379 incident diabetes cases. Compared with the low-stable pattern, the high-increasing pattern had a higher risk of developing diabetes (RR, 1.42; 95% CI: 1.09–1.84). In addition, the percentages of total effect between the high-increasing hyperuricemia pattern and diabetes mediated by obesity, dyslipidemia, and hypertension were 24.41%, 18.26%, and 6.29%. However, the moderate-stable pattern was not associated with an increased risk of diabetes.ConclusionsThese results indicate that the high-increasing hyperuricemia trajectory is significantly associated with an increased risk of diabetes. Furthermore, obesity, dyslipidemia, and hypertension play mediating roles in the relationship between the high-increasing hyperuricemia pattern and increased diabetes risk.