Association between serum uric acid and prehypertension among US adults

BACKGROUND: Experimental evidence supports a causal role of serum uric acid in hypertension development. Previous epidemiologic studies demonstrated an association between uric acid and hypertension; however, data from non-Caucasian ethnicities are limited. Currently there are few data available on the association between serum uric acid level and clinically relevant blood pressure (BP) categories earlier in the disease continuum, when hypertension prevention efforts may be applicable. We examined the association between serum uric acid and prehypertension in a nationally representative sample of US adults. METHODS: Cross-sectional study among 4,817 National Health and Nutrition Examination Survey 1999-2002 participants aged >or=18 years without hypertension. The main outcome of interest was the presence of prehypertension (systolic BP 120-139 mmHg or diastolic BP 80-89 mmHg) (n = 1913). RESULTS: Higher serum uric acid levels were positively associated with prehypertension, independent of smoking, body mass index (BMI), diabetes, kidney function and other confounders. The multivariable odds ratio (OR) [95% confidence intervals (CI)] comparing quartile 4 of uric acid (>356.9 micromol/l) to quartile 1 (<237.9 micromol/l) was 1.96 (1.38-2.79), P trend = 0.0016. This association persisted in separate analysis among men and women. The results were consistent in subgroup analyses by categories of race-ethnicity, education, age, smoking and BMI. In nonparametric models, the positive association between serum uric acid and prehypertension appeared to be present across the full range of uric acid, without any threshold effect. CONCLUSIONS: Higher serum uric acid levels are associated with prehypertension in a nationally representative sample of US adults, free of cardiovascular disease (CVD) and hypertension.     

血清尿酸浓度与冠心病的相关性分析

目的:探讨血清尿酸浓度与冠心病的关系及其在冠心病发病中的作用。方法:对我院2003年4月到2005年12月收治的256例拟诊冠心病的患者行冠状动脉造影,同时测定血清尿酸浓度及其它生化指标。采用单因素和多因素相关分析尿酸与冠心病之间关系。结果:单因素分析显示冠心病组血清尿酸浓度显著高于正常冠状动脉组[(351±85)μmol/L∶(305±75)μmmol/L,P<0.001];多因素分析显示:血清尿酸浓度与冠心病呈显著正相关(Wald=16.15,P<0.001)且为其独立危险因素(OR=1.011)。结论:血清尿酸浓度与冠心病发病存在密切关系,且可能是其独立危险因素之一。     

Changes in serum uric acid concentration after defined physical stress

The influence of two variants of strength training on serum level of uric acid was examined in four weightlifters. In a pilot study a remarkable increase was found in both after maximum strength orientated squats and after power-related strength training. The results were discussed in terms of different kinds of recruitment of motor units, the time structure of examined movements and the arthritis urica as a typical disturbance of the purine nucleotid metabolism.     

Absence of an independent association between serum uric acid and left ventricular mass in Caucasian hypertensive women and men

Background and aimExperimentally uric acid may induce cardiomyocyte growth and interstitial fibrosis of the heart. However, clinical studies exploring the relationship between serum uric acid (SUA) and left ventricular (LV) mass yielded conflicting results.The aim of our study was to evaluate the relationships between SUA and LV mass in a large group of Caucasian essential hypertensive subjects.Methods and resultsWe enrolled 534 hypertensive patients free of cardiovascular complications and without severe renal insufficiency. In all subjects routine blood chemistry, including SUA determination, echocardiographic examination and 24 h ambulatory blood pressure (BP) monitoring were obtained.In the overall population we observed no significant correlation of SUA with LV mass indexed for height^2.7 (LVMH^2.7) (r = 0.074). When the same relationship was analysed separately in men and women, we found a statistically significant correlation in female gender (r = 0.27; p < 0.001), but not in males (r = ?0.042; p = NS). When we grouped the study population in sex-specific tertiles of SUA, an increase in LVMH^2.7 was observed in the highest tertiles in women (44.5 ± 15.6 vs 47.5 ± 16 vs 55.9 ± 22.2 g/m^2.7; p < 0.001), but not in men.The association between SUA and LVMH^2.7 in women lost statistical significance in multiple regression analyses, after adjustment for age, 24 h systolic BP, body mass index, serum creatinine and other potential confounders.ConclusionsOur findings do not support an independent association between SUA and LV mass in Caucasian men and women with arterial hypertension.     

血清尿酸含量与冠心病的相关性研究

目的：研究血清尿酸（SUA）含量与冠状动脉病变程度的关系。方法：选择2006年10月~2008年10月在我科住院并行冠状动脉造影的患者205例。根据冠状动脉造影结果分为CHD组154例和非CHD组51例,比较两组间有关指标的差别。根据SUA水平CHD组又被分为高尿酸组（96例）和正常尿酸组（58例）两个亚组,分析SUA水平与冠脉病变程度的关系。根据CHD病变血管支数分为单支、双支、多支病变三个亚组,比较三亚组间SUA水平。结果：（1）CHD组患者的SUA水平明显高于非CHD组[（486.94±162.96）μmol/L∶（305.69±99.58）μmol/L,P〈0.05];（2）高尿酸血症的检出率为54.1%,其中CHD组的尿酸异常率为62.34%（96/154）,明显高于非CHD组的尿酸异常率[29.41%（15/51）,P〈0.05];（3）SUA水平与性别有关,与收缩压、甘油三酯（TG）呈正相关,与高密度脂蛋白（HDL）呈负相关,r分别为0.339,0.244,0.156,-0.102,P〈0.05;（4）单支、双支、多支病变三个亚组的SUA水平分别为（387.07±100.14）μmol/L,（474.43±133.62）μmol/L,（581.30±180.21）μmol/L。SUA水平随着冠脉病变血管支数的增加而明显升高,P均〈0.01。三亚组的冠脉狭窄积分分别为（6.93±4.48）分,（16.54±11.13）分,（33.67±17.85）分,两两比较有显著差异（P均〈0.01）;（5）Logistic回归分析显示,年龄、SUA、低HDL为CHD的危险因素,OR值分别为1.102,1.012,0.397。结论：（1）血尿酸水平与性别有关,与收缩压和甘油三酯呈正相关,与高密度脂蛋白呈负相关;（2）血尿酸水平随着冠状动脉病变程度的加重而逐渐增加,是反映冠心病严重程度的一种重要生化指标;（3）在冠心病的防治中,除控制传统危险因素外,对高尿酸血症也不容忽视。     

Prognostic significance of serum uric acid in women with gestational hypertension

Aim of our study was to ascertain, prospectively, whether serum uric acid is a suitable predictor of preeclampsia and/or the delivery of small-for-gestational-age infants in women with gestational hypertension. We screened 206 primiparas, with a singleton pregnancy, referred for recent onset of hypertension. At presentation, we measured serum uric acid, creatinine, blood glucose, hemoglobin and platelet level, and 24-hour proteinuria, as well as office and 24-hour blood pressures. We followed the women until 1 month after delivery and recorded pregnancy outcome. After logistic regression analysis, uric acid resulted a significant predictor of preeclampsia, with an unadjusted odds ratio of 9.1 (95% CI: 4.8 to 17.4; P<0.001); after adjustment for age, gestation week, hemoglobin and platelet levels, serum creatinine, office and 24-hour average systolic and diastolic blood pressures, it was 7.1 (95% CI: 3.2 to 15.7; P<0.001). Regarding the association between maternal serum uric acid and the chance of giving birth to a small-for-gestational-age infant, the unadjusted odds ratio was 1.7 (95% CI: 1.4 to 2.2; P<0.001), and it was 1.6 (95% CI: 1.1 to 2.4; P=0.02) after adjustment. Receiver operating characteristic analysis showed that serum uric acid, at a 309-μmol/L cutoff, predicted the development of preeclampsia (area under the curve: 0.955), with 87.7% sensitivity and 93.3% specificity, and the delivery of small-for-gestational-age infants (area under the curve: 0.784) with 83.7% sensitivity and 71.7% specificity. In conclusion, the results of our study show that serum uric acid is a reliable predictor of preeclampsia in women referred for gestational hypertension.     

冠心病患者血清胆红素及尿酸水平的变化

目的:探讨冠心病患者及正常对照组血清胆红素及尿酸水平的变化。方法:应用全自动生化分析仪测定40例冠心病组和38例正常对照组的血尿酸(UA),总胆红素(T-BTL)直接胆红素(D-BIL)含量并进行分析。结果: 冠心病患者血尿酸水平显著高于正常对照组,但血清总胆红素水平则显著低于正常对照组(P均<0.01);而两组直接胆红素水平无明显差异。结论:血清胆红素、尿酸水平对冠心病的诊断有一定临床价值。     

血尿酸与代谢综合征及其各组分的相关性研究

目的观察血尿酸水平与代谢综合征（MS）及其各组分的相关性。方法用尿酸酶一过氧化酶法随机检测江苏省城乡社区MS流行病学调查人群血尿酸（SUA）水平865份。结果研究对象的SUA水平与MS的危险因素呈显著相关，其中与腰围、SBP、DBP、TG、FPG、HOM-IR呈正相关，与HDL-C呈负相关。按SUA水平的四分位间距分组后，高血压的患病率分别为19．2％、28、8％、29．1％、43、0％，趋势检验P〈0.01；随着代谢异常数目的增加，SUA水平呈上升趋势。多元Logistic回归分析显示，在调整了年龄、性别、饮酒、吸烟、TC、LDL-C、C-RP，SUA水平的升高仍然使MS的患病危险增加，但进一步调整BMI后，其OR值失去统计学意义。结论SUA水平与高血压、IR及其他MS的危险因素密切相关，但sUA水平的升高可能不是MS患病危险增加的独立的影响因素。     

彩色多普勒超声对高尿酸血症患者四肢动脉病变的评价

目的应用彩色多普勒超声观察高尿酸血症患者四肢动脉结构和血流动力学的改变,探讨高尿酸血症与四肢动脉硬化的关系。方法对174例高尿酸血症患者和60名正常人的四肢动脉进行二维和彩色多普勒超声检查,观察四肢动脉血管形态,有无斑块,管腔狭窄或闭塞,测量舒张期内-中膜厚度（IMT）及其踝／肱动脉的收缩压比值指数（ABI）、趾／肱动脉的收缩压比值指数（TSPI）的改变。结果（1）高尿酸血症患者四肢动脉硬化斑块的发生率明显高于对照组（P〈0．05）;（2）平均IMT增厚明显高于对照组,ABI、TSPI比值指数明显小于对照组。结论高尿酸血症患者四肢动脉的IMT增厚,粥样硬化斑块发生率增加,彩色多普勒超声对高尿酸血症患者四肢血管的早期诊断、预防及治疗有重要的临床指导意义。     

Relation between serum uric acid and carotid intima-media thickness in healthy postmenopausal women

Abstract Objective: Serum uric acid (SUA) is associated with cardiovascular disease (CVD). However it is still disputed whether the relationship is mediated by other risk factors such as obesity, dyslipidaemia, hypertension and insulin resistance. We explored the association of the uric acid level with carotid intima-media thickness (IMT), a well known marker of CVD, in postmenopausal healthy women. Methods: We consecutively enrolled postmenopausal women undergoing a screening for health evaluation. After an accurate clinical examination, and a biochemical evaluation, the enrolled subjects underwent B mode ultrasonography to assess common carotid intima media thickness. Results: Among 234 women aged 45–70 years, the uric acid level is associated with carotid IMT independently of other prognostic factors (p=0.03). In particular, women in the highest tertiles of uric acid level have a greater IMT than women in the lowest tertile (p=0.007). Conclusions: Independently of other cardiovascular risk factors, SUA levels are associated with carotid IMT even in subjects without the metabolic syndrome. This confirms and expands the role of uric acid in the determinism of CVD. Prospective trials would be useful to evaluate interventions aimed at lowering the uric acid level.     

Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome.

BACKGROUND: Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined a Korean adult population with respect to the relationships between serum uric acid concentrations and hypertension, insulin resistance, and the risk factors of metabolic syndrome. METHODS AND RESULTS: A total of 53,477 subjects were divided into 4 groups according to serum uric acid quartiles. The incidence of hypertension in all subjects was higher in the first quartile than in the third plus fourth quartile (odds ratio (OR) 1.192, p < 0.001). Homeostasis model assessment index was found to be associated with serum uric acid concentration in all subjects (OR 1.193, p < 0.001), and the serum uric acid concentration was positively correlated with the risk factors of metabolic syndrome. In addition, the number of metabolic syndrome variables increased as serum uric acid concentration increased. CONCLUSIONS: Serum uric acid concentration was found to be independently correlated with hypertension, insulin resistance and the risk factors of metabolic syndrome. In addition, even those with a serum uric acid concentration in the normal range showed an increased risk of metabolic syndrome as serum uric acid concentration increased.     

Relation of serum uric acid with metabolic risk factors in asymptomatic middle-aged Brazilian men

This study in 352 asymptomatic middle-aged Brazilian men demonstrated that serum uric acid increases linearly with an increasing number (0 to >/=3) of metabolic risk factors (5.78 +/- 1.1, 6.14 +/- 1.0, 6.27 +/- 1.1, and 6.79 +/- 1.3, p <0.001). In patients who had >/=3 metabolic risk factors, there was a higher prevalence of serum uric acid in the highest quartile (7.2 to 10.3 mg/dl) than in the lowest quartile (2.6 to 5.4 mg/dl, 35% vs 12%, p <0.001). Mean serum levels of uric acid were higher in those who had an abnormal ratio of >/=3 for triglyceride to high-density lipoprotein (suggesting insulin resistance) than in those who had a normal ratio (6.6 +/- 1.2 vs 5.87 +/- 1 mg/dl, p <0.001).     

2型糖尿病患者血清尿酸水平与踝肱指数相关性的研究

目的探讨T2DM患者血清尿酸(SUA)水平与踝肱指数(ABI)的相关性。方法选取经住院确诊的T2DM患者873例,根据UA水平分为4组:Q1组(<240μmol/L)181例,Q2组(240～300μmol/L)162例,Q3组(301～360μmol/L)164例和Q4组(>360μmol/L)366例。根据ABI分为2组:无大血管病变组(ABI≥0.9)663例和大血管病变组(ABI<0.9)210例。结果 Q1～Q4组间年龄、病程、SBP、HbA1c、TC、TG、UAlb、SCr、肾小球滤过率(eGFR)和ABI差异均有统计学意义(P均<0.05)。SUA与病程、BMI、SBP、TG、UAlb、SCr、ABI间均呈正相关(P均<0.05),与HbA1c、eGFR呈负相关(P均<0.05)。与Q1组相比,Q2、Q3与Q4组(P=0.097,0.023,0.005)发生大血管病变的风险增加(趋势P=0.041),校正相关危险因素后,虽然OR逐渐减少,但趋势P<0.05。结论 T2DM患者SUA水平与ABI具有相关性,SUA高水平可能是T2DM患者发生大血管病变的危险因素。     

尿酸与代谢综合征及颈动脉粥样硬化的关系

目的研究尿酸与代谢综合征(MS)的关系,及其对颈动脉粥样硬化的影响,为动脉粥样硬化性心血管疾病的防治提供临床依据。方法MS诊断依据2005年国际糖尿病联盟的标准将2232例患者分为两组:MS组(1199例)和非MS组(1033例),在排除高尿酸血症前后,比较两组间年龄、尿酸、腰围、血压、血糖、血脂情况,应用彩色多普勒超声检测颈动脉内膜中层厚度(IMT)。结果MS组高尿酸血症检出率明显高于非MS组,排除高尿酸血症后,MS组与非MS组尿酸水平无明显差异(P>0.01),尿酸是MS的独立危险因素(OR=1.002,95%CI:1.001～1.004);MS组IMT明显高于非MS组(P<0.01);尿酸未进入IMT的回归方程。结论MS及高尿酸血症检出率呈同步升高;尿酸可能仅仅是MS,但不是颈动脉粥样硬化的独立危险因素。     

老年男性血清尿酸水平与局部肌肉含量相关性的研究

摘要: 目的 探讨老年男性局部肌肉含量与血清尿酸水平之间的关系,为临床肌少症的预防及治疗提供新的观点和依据。方法 选取2019年至2021年在本院治疗的60岁以上男性患者资料,根据纳入标准和排除标准共纳入350例,按照尿酸水平分组分为Q1、Q2、Q3、Q4组,四分位切点分别为≤320、320-360、361-419、≥420 umol/L,对4组间髋部肌肉、脊柱肌肉占比、血脂等进行比较分析,校正年龄、血脂等混杂因素后,采用偏相关分析分析血清尿酸水平与局部肌肉的相关性。结果 随着尿酸水平的的升高,四组髋部肌肉含量无明显差异。脊柱肌肉方面,Q4组明显低于Q1组。在Q4组,髋部肌肉含量与尿酸水平呈明显负相关（r=-0.239,P=0.006）。脊柱肌肉含量在4组均未表现与尿酸水平有明显的相关性。结论 对于60岁以上的老年男性,高尿酸血症可导致局部肌肉含量,尤其是髋部肌肉含量的减少。为帮助维持骨骼肌质量以及髋部肌肉含量,建议维持理想的尿酸水平,将尿酸水平控制在420mmol/L以下。