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Ibrahim WN, Shi Z, Abdallah AM, Abu-Madi MA. Sex distinctive patterns in the association between serum bicarbonate and uric acid levels among healthy adults. Qatar biobank data. Front Med (Lausanne) 2023; 10:1021217. [PMID: 37332752 PMCID: PMC10272753 DOI: 10.3389/fmed.2023.1021217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Background Uric acid is the final product of purine metabolism and is a potent plasma antioxidant but with pro-inflammatory effects. At high levels, it may increase the risk of developing multiple chronic diseases, such as gout, atherosclerosis, hypertension, and renal diseases. The aim of this study was to assess the sex-specific association between serum bicarbonate and uric acid levels among healthy adults. Methodology This retrospective cross-sectional study included 2,989 healthy Qatari adults (36.4 ± 11.1 years) from the Qatar Biobank database. Serum uric acid and bicarbonate levels were estimated alongside other serological markers. Participants free from chronic diseases were divided into four quartiles based on serum bicarbonate levels. The sex-specific relationship between serum bicarbonate and uric acid levels was assessed through univariate and multivariate analyses. Results In men, low serum uric acid levels were significantly associated with higher quartiles of serum bicarbonate levels after adjusting for age. The association remained significant after further adjustment for BMI, smoking, and renal function. The subgroup analysis using the restricted cubic spline method confirmed a significant dose-response association between the variation coefficients of uric acid by serum bicarbonate level in men with adjustments for age, BMI, smoking, and renal function. In women, no significant association was found between quartiles of serum bicarbonate and uric acid levels following the same adjustments. However, using the restricted cubic spline method, a significant bidirectional relation was demonstrated between serum bicarbonate and the variation coefficients of uric acid that were positive for serum bicarbonate levels below 25 mEq/L and negative at higher levels. Conclusion Serum bicarbonate levels are linearly associated with reduced serum uric acid levels among healthy adult men, which may be a potential protective factor against hyperuricemia-related complications. Further research is needed to determine the underlying mechanisms.
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Affiliation(s)
- Wisam Nabeel Ibrahim
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Atiyeh M. Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Dong Y, Wang Z, Wang S, Chang R, Liu Y, Wang R, Chen H, Liu S, Qian C, Cai Y, Hu F. Gender-Specific and U-Shaped Relationship Between Serum Uric Acid and All-Cause Mortality Among Chinese Older Adults: A National Population-Based Longitudinal Study. Int J Public Health 2023; 68:1605934. [PMID: 37206093 PMCID: PMC10188991 DOI: 10.3389/ijph.2023.1605934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/19/2023] [Indexed: 05/21/2023] Open
Abstract
Objectives: This study aimed to prospectively investigate gender-specific relationship between hyperuricemia and all-cause mortality among Chinese older adults. Methods: The study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018, a prospective nationwide cohort of older adults in China. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for all-cause mortality. Restricted cubic splines (RCS) were conducted to explore the dose-response relationship between SUA levels and all-cause mortality. Results: For older women, compared to the participants in the third quartile of SUA level, those in the highest quartile of SUA was associated with significantly higher risk of all-cause mortality in the fully adjusted model (HR: 1.41, 95% CI: 1.03-1.92). No significant associations between SUA levels and all-cause mortality were observed in older men. The present study further found a U-shaped non-linear relationship between SUA levels and all-cause mortality in both sexes of older population (P for non-linear <0.05). Conclusions: This study provided prospective epidemiological evidence for the predictive role of SUA on all-cause mortality among the Chinese aging population over 10 years of follow-up, while revealing considerable gender-related differences.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Community Healthcare, Hospital Development Institute Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqiang Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suping Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Changlin Qian
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Changlin Qian, ; Yong Cai, ; Fan Hu,
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Community Healthcare, Hospital Development Institute Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Changlin Qian, ; Yong Cai, ; Fan Hu,
| | - Fan Hu
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Community Healthcare, Hospital Development Institute Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Changlin Qian, ; Yong Cai, ; Fan Hu,
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3
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Xuan Y, Zhang W, Wang Y, Wang B, Xia F, Zhang K, Li Q, Wang N, Lu Y. Association Between Uric Acid to HDL Cholesterol Ratio and Diabetic Complications in Men and Postmenopausal Women. Diabetes Metab Syndr Obes 2023; 16:167-177. [PMID: 36760595 PMCID: PMC9869791 DOI: 10.2147/dmso.s387726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
AIM Previous studies have implicated the uric acid to high-density lipoprotein cholesterol (HDL-C) ratio (UHR) was associated with type 2 diabetes. However, the association between UHR and diabetes-related vascular damages is still unclear. METHODS The total of 4551 patients with type 2 diabetes from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai study (METAL study) were enrolled. UHR was calculated as uric acid to HDL-C ratio. Cardiovascular disease (CVD) was defined as previously diagnosed with stroke, coronary heart disease, or peripheral arterial disease. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate ≤60 mL/min/1.73 m2 and/or urinary albumin to creatinine ratio ≥30 mg/g. Fundus image was examined by trained individuals and degree of diabetic retinopathy (DR) was evaluated. RESULTS UHR was positively correlated with CVD (OR = 1.28, 95% CI: 1.02-1.61) and CKD (OR = 1.78, 95% CI: 1.39-2.27) after adjusting for all confounders. No association was found between UHR and DR. In stratified analyses, UHR was predominantly correlated with CVD in diabetic patients with age older than 65 (OR = 1.41, 95% CI: 1.08-1.85), female (OR = 1.43, 95% CI: 1.06-1.94) and BMI≥24kg/m2 (OR = 1.57, 95% CI: 1.17-2.11). A 1-SD increment of UHR was also positively associated with CVD (OR 1.26, 95% CI 1.03, 1.15) and CKD (OR 1.28, 95% CI 1.20,1.39). UHR was positively associated with CKD in all subgroups analysis. No significant interaction effect was observed between UHR and all subgroup variables in CVD and CKD risk. CONCLUSION Our study reported a positive association between the UHR and diabetic-related vascular complications in men and postmenopausal women. The relationship between the UHR and DR seems to be uncertain and requires further investigation. And no significant interaction effect was observed between the UHR and all subgroup variables in CVD and CKD risk.
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Affiliation(s)
- Yan Xuan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Endocrinology, Luwan Branch, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200020, People’s Republic of China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Qing Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Correspondence: Yingli Lu, Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, People’s Republic of China, Tel +86-13636352507, Fax +86-21-63136856, Email
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Lubis A, Siregar MFG, Syahputra MI. Correlation between Vitamin D and Uric Acid in Menopausal Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background : Vitamin D deficiency and hyperuricemia are global health problems in post-menopausal women in which parathyroid hormone increases hyperuricemia incidence.
Aim : This research purpose to determine correlation between vitamin D and uric acid levels in postmenopausal women
Methods: This research is an observational analytic study with a cross-sectional study design conducted at University of North Sumatra Hospital and Network Hospital in Medan for 12 months on 40 postmenopausal women who met inclusion and exclusion criteria. The data will be analyzed descriptively to determine variables frequency distribution. Previously, normality test of numerical data is carried out. If the data is normally distributed, Pearson correlation test will be carried out, and if the data is not normally distributed, then Spearman correlation test will be used.
Results : Mean vitamin D of the sample was 23.11 ng/mL with a standard deviation 4.43 and median value 23.5 ng/mL. while the mean uric acid was 7.52 mg/dL with a standard deviation 0.92 and median value 7.45 mg/dL. There is an inverse relationship between uric acid levels and Vitamin D, as evidenced by Pearson test correlation coefficient of -0.541 with p value = 0.001.
Conclusion : There is an inverse correlation between Vitamin D and uric acid levels.
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Vallée A. Association between serum uric acid and arterial stiffness in a large-aged 40-70 years old population. J Clin Hypertens (Greenwich) 2022; 24:885-897. [PMID: 35748644 PMCID: PMC9278596 DOI: 10.1111/jch.14527] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 12/24/2022]
Abstract
Arterial stiffness (AS), measured by arterial stiffness index (ASI), is a determinant in cardiovascular (CV) diseases. A high serum uric acid (SUA) level is a known risk factor for CV disease. The authors investigated the relationship between SUA and ASI in the middle-age UK Biobank population study. AS was defined as ASI > 10 m/s. A cross-sectional study was conducted from 126 663 participants. Participants were divided into four quartiles according to SUA levels and sex. Sex multivariate analyses were performed with adjustment for confounding factors. The average ASI for overall participants was 9.3 m/s (SD: 2.9); 9.9 m/s (SD: 2.8) for men and 8.7 m/s (SD: 2.9) for women (P < .001). Men presented higher SUA rate (351.3 mmol/L (SD:67.9)) than women (270.7 mmol/L (SD:64.4)), P < .001. In men multivariate analysis, SUA remained a determinant of AS, with an increase in the strength of the association between the quartiles, Q4 versus Q1, OR = 1.10 [1.05-1.16], P < .001, Q3 versus Q1, OR = 1.09 [1.04-1.14], P < .001 but not between Q2 and Q1 (P = .136). In women, SUA remained significant for AS, with an increase in the strength of the association between the quartiles, Q4 versus Q1, OR = 1.22 [1.15-1.30], P < .001, Q3 versus Q1, OR = 1.13 [1.07-1.19], P < .001 and no difference between Q2 and Q1 (P = .101). When applying continuous SUA values in the multivariate analysis, SUA remained significant (P < .001), with a Youden index value for men = 338.3 mmol/L and for women = 267.3 mmol/L. High SUA levels were associated with AS, suggesting that SUA could be used as a predictor of atherosclerosis.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch hospital, Suresnes, France
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6
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Močnik M, Golob Jančič S, Filipič M, Marčun Varda N. The Role of Urate in Cardiovascular Risk in Adolescents and Young Adults With Hypertension, Assessed by Pulse Wave Velocity. Front Cardiovasc Med 2022; 9:867428. [PMID: 35498002 PMCID: PMC9053644 DOI: 10.3389/fcvm.2022.867428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Urate is increasingly recognized as a cardiovascular risk factor. It has been associated with hypertension, metabolic syndrome, obesity, chronic kidney disease and diabetes. Its prognostic role is less clear. The aim of our study was to evaluate the association between serum urate and pulse wave velocity, a measure of arterial stiffness in hypertensive adolescents and young adults. Methods 269 adolescents and young adults with hypertension were included in the study. From all, anthropometric, blood pressure, pulse wave velocity and serum urate measurements were made. Variables were compared between sex, participants with or without obesity and with or without elevated urate. Results In multiple regression analysis for urate as dependent variable gender and diastolic pressure were found to be statistically significant. The difference between urate levels were found between boys and girls (p < 0.001), obese and non-obese (p < 0.001); however, pulse wave velocity did not differ between hyper- and eu-uricemic group (p = 0.162). Conclusion Associations between urate, gender, diastolic blood pressure and obesity were confirmed, however, no significant associations between pulse wave velocity and urate were detected.
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Abstract
Circulation of urate levels is determined by the balance between urate production and excretion, homeostasis regulated by the function of urate transporters in key epithelial tissues and cell types. Our understanding of these physiological processes and identification of the genes encoding the urate transporters has advanced significantly, leading to a greater ability to predict risk for urate-associated diseases and identify new therapeutics that directly target urate transport. Here, we review the identified urate transporters and their organization and function in the renal tubule, the intestinal enterocytes, and other important cell types to provide a fuller understanding of the complicated process of urate homeostasis and its role in human diseases. Furthermore, we review the genetic tools that provide an unbiased catalyst for transporter identification as well as discuss the role of transporters in determining the observed significant gender differences in urate-associated disease risk.
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Affiliation(s)
| | - Owen M Woodward
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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8
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Chen J. Serum uric acid level and all-cause and cardiovascular mortality in Chinese elderly: A community-based cohort study in Shanghai. Nutr Metab Cardiovasc Dis 2021; 31:3367-3376. [PMID: 34629247 DOI: 10.1016/j.numecd.2021.08.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 07/29/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS The association between serum uric acid (SUA) and the all-cause and cardiovascular diseases (CVD) mortality remains controversial, but few studies based on the community population in Shanghai have been reported. We aimed to evaluate the association of SUA level with all-cause and CVD mortality in Chinese elderly based on a community-based cohort study in Shanghai of China. METHODS AND RESULTS A total of 12,071 eligible participants were included, with a cumulative follow-up period of 46,063.65 person-years and a median of 4.67 years. The time-dependent Cox regression model indicated that when SUA level was classified into quartile groups, no significant association was observed between SUA level and all-cause death in both men and women and between SUA level and CVD mortality in men. However, the HR (95%CI) between SUA groups and CVD death in women was 3.75 (1.49-9.43) for quartile 1, 3.66 (1.53-8.76) for quartile 2, and 2.98 (1.33-6.69) for quartile 4, respectively, when compared with the quartile 3 SUA level. A significant non-linear association was observed between SUA level and CVD death in elderly women. An increased risk of CVD death was observed among women with SUA level less than 4.30 mg/dL at the baseline, and a lower risk, among women with SUA level of 4.30-4.72 mg/dL at the baseline. CONCLUSION The non-linear association between SUA level and CVD mortality in elderly women suggests a potential benefit of controlling SUA level at4.30-4.72 mg/dL in elderly Chinese women.
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Affiliation(s)
- Jianfeng Chen
- Pudong New Aera Gaodong Community Health Service Center, Shanghai, China; Fudan University School of Public Health, Shanghai, China; Qingpu District Center for Disease Control and Prevention, Shanghai, China.
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9
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Gender Difference in the Relationships between Inflammatory Markers, Serum Uric Acid and Framingham Risk Score. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137103. [PMID: 34281041 PMCID: PMC8297121 DOI: 10.3390/ijerph18137103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022]
Abstract
The purpose of the present study was to explore the role of gender in the relation of high-sensitivity C-reactive protein (hsCRP), white blood cell (WBC) count, and serum uric acid (UA) to the risk of future cardiovascular disease (CVD) events. In total, 404 workers were recruited to obtain the measurements of serum markers for CVD risk. Demographic data, nutrition, exercise, smoking, and alcohol consumption were assessed through a questionnaire. The Framingham Risk Score (FRS) was adopted to estimate the risk of future CVD events. Multiple linear regression models were used to determine CVD risk markers in relation to the FRS by gender. The hsCRP was not significantly correlated with the FRS for all workers after adjusting for covariates, including demographic data and health-related lifestyle. WBC count was positively correlated with FRS for all workers, but WBC count did not show an interaction with gender with respect to the FRS. Serum UA showed an interaction with gender on the FRS, and UA positively correlated with the FRS in males though not in females. With respect to CVD prevention, the WBC count can be used to monitor the risk for all workers. Due to a gender difference shown in the relationship between serum UA and the FRS, serum UA can be a monitor of the risk of future CVD events in male workers only.
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Matsubayashi M, Sakaguchi YM, Sahara Y, Nanaura H, Kikuchi S, Asghari A, Bui L, Kobashigawa S, Nakanishi M, Nagata R, Matsui TK, Kashino G, Hasegawa M, Takasawa S, Eriguchi M, Tsuruya K, Nagamori S, Sugie K, Nakagawa T, Takasato M, Umetani M, Mori E. 27-Hydroxycholesterol regulates human SLC22A12 gene expression through estrogen receptor action. FASEB J 2020; 35:e21262. [PMID: 33368618 PMCID: PMC7771643 DOI: 10.1096/fj.202002077r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
The excretion and reabsorption of uric acid both to and from urine are tightly regulated by uric acid transporters. Metabolic syndrome conditions, such as obesity, hypercholesterolemia, and insulin resistance, are believed to regulate the expression of uric acid transporters and decrease the excretion of uric acid. However, the mechanisms driving cholesterol impacts on uric acid transporters have been unknown. Here, we show that cholesterol metabolite 27‐hydroxycholesterol (27HC) upregulates the uric acid reabsorption transporter URAT1 encoded by SLC22A12 via estrogen receptors (ER). Transcriptional motif analysis showed that the SLC22A12 gene promoter has more estrogen response elements (EREs) than other uric acid reabsorption transporters such as SLC22A11 and SLC22A13, and 27HC‐activated SLC22A12 gene promoter via ER through EREs. Furthermore, 27HC increased SLC22A12 gene expression in human kidney organoids. Our results suggest that in hypercholesterolemic conditions, elevated levels of 27HC derived from cholesterol induce URAT1/SLC22A12 expression to increase uric acid reabsorption, and thereby, could increase serum uric acid levels.
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Affiliation(s)
| | | | - Yoshiki Sahara
- RIKEN Center for Biosystems Dynamics Research, Kobe, Japan.,Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Hitoki Nanaura
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan.,Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Sotaro Kikuchi
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan
| | - Arvand Asghari
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
| | - Linh Bui
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
| | - Shinko Kobashigawa
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan
| | - Mari Nakanishi
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan
| | - Riko Nagata
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan
| | - Takeshi K Matsui
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan.,Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Genro Kashino
- Radioisotope Research Center, Nara Medical University, Kashihara, Japan
| | - Masatoshi Hasegawa
- Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, Kashihara, Japan
| | | | - Kazuhiko Tsuruya
- Department of Nephrology, Nara Medical University, Kashihara, Japan
| | - Shushi Nagamori
- Department of Collaborative Research, Nara Medical University, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Takahiko Nakagawa
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan
| | - Minoru Takasato
- RIKEN Center for Biosystems Dynamics Research, Kobe, Japan.,Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Michihisa Umetani
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA.,HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Eiichiro Mori
- Department of Future Basic Medicine, Nara Medical University, Nara, Japan.,V-iCliniX Laboratory, Nara Medical University, Kashihara, Japan
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Yuan Q, Karmacharya U, Liu F, Chen BD, Ma X, Ma YT. Uric acid and its correlation with hypertension in postmenopausal women: A multi-ethnic study (Observational study). Clin Exp Hypertens 2020; 42:559-564. [PMID: 32163303 DOI: 10.1080/10641963.2020.1739697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We investigate the association of uric acid with hypertension among Han, Uygur, and Kazakh populations in the Xinjiang Province of Western China. Our study aims to evaluate the relationships of serum uric acid (SUA) with hypertension in the Chinese population according to the menopausal status. Medical data of 1684 Han, 1895 Uygur, and 294 Kazakh people was examined. The prevalence of hypertension was calculated by the quartiles of SUA. Correlation between hypertension-related risk factors calculated and compared between men and women. SUA was higher in men than in women. The level was significantly higher in postmenopausal than premenopausal women (4.40 ± 1.75 v.s 4.06 ± 1.63 mg/dl, P < .01). Logistic regression analysis showed Body mass index (BMI) [OR = 1.08, P < .01]; and eGFR<60 vs.≥60 [OR = 1.22, P = .04] were independent risk factors for hypertension in women. Age and diabetes were independent risk factors for the participants with hypertension [OR = 1.04, P < .01] and [OR = 2.24, P < .01]. High quartile SUA group has increased the risk for hypertension in postmenopausal women [OR = 1.34, P = .048]. We found that postmenopausal women have high SUA compared to premenopausal women. The high SUA quartiles uric acid may be an independent risk for hypertension in postmenopausal women.
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Affiliation(s)
- Qinghua Yuan
- Department of Cardiology, The Seventh Affiliated Hospital of Sun Yat-sen University , Shenzhen, Guangdong, China
| | - Ujit Karmacharya
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University , Urumqi, Xinjiang, China
| | - Fen Liu
- Department of Cardiology, Xinjiang Key Laboratory of Cardiovascular Disease Research , Urumqi, P.R. China
| | - Bang-Dang Chen
- Department of Cardiology, Xinjiang Key Laboratory of Cardiovascular Disease Research , Urumqi, P.R. China
| | - Xiang Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University , Urumqi, Xinjiang, China.,Department of Cardiology, Xinjiang Key Laboratory of Cardiovascular Disease Research , Urumqi, P.R. China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University , Urumqi, Xinjiang, China.,Department of Cardiology, Xinjiang Key Laboratory of Cardiovascular Disease Research , Urumqi, P.R. China
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12
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Sex Differences in Urate Handling. Int J Mol Sci 2020; 21:ijms21124269. [PMID: 32560040 PMCID: PMC7349092 DOI: 10.3390/ijms21124269] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023] Open
Abstract
Hyperuricemia, or elevated serum urate, causes urate kidney stones and gout and also increases the incidence of many other conditions including renal disease, cardiovascular disease, and metabolic syndrome. As we gain mechanistic insight into how urate contributes to human disease, a clear sex difference has emerged in the physiological regulation of urate homeostasis. This review summarizes our current understanding of urate as a disease risk factor and how being of the female sex appears protective. Further, we review the mechanisms of renal handling of urate and the significant contributions from powerful genome-wide association studies of serum urate. We also explore the role of sex in the regulation of specific renal urate transporters and the power of new animal models of hyperuricemia to inform on the role of sex and hyperuricemia in disease pathogenesis. Finally, we advocate the use of sex differences in urate handling as a potent tool in gaining a further understanding of physiological regulation of urate homeostasis and for presenting new avenues for treating the constellation of urate related pathologies.
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Kwon CH, Lee SH, Lee JY, Ryu S, Sung KC. Uric Acid and Risk of Atrial Fibrillation in the Korean General Population. Circ J 2018; 82:2728-2735. [DOI: 10.1253/circj.cj-18-0748] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Chang Hee Kwon
- Division of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine
| | - Sung Ho Lee
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Jong-Young Lee
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Sungkyunkwan University School of Medicine
| | - Ki-Chul Sung
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
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Juraschek SP, White K, Tang O, Yeh HC, Cooper LA, Miller ER. Effects of a Dietary Approach to Stop Hypertension (DASH) Diet Intervention on Serum Uric Acid in African Americans With Hypertension. Arthritis Care Res (Hoboken) 2018; 70:1509-1516. [PMID: 29342506 DOI: 10.1002/acr.23515] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/09/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine whether partial replacement of a diet typical of the average American diet with Dietary Approaches to Stop Hypertension (DASH)-related foods in the home environment lowers the serum uric acid (UA) level in individuals with hypertension. METHODS We conducted an ancillary study of a randomized trial of African American adults with controlled hypertension from an urban clinic. Participants were assigned to either a control group or an intervention (DASH-Plus) group. DASH-Plus participants received coach-directed dietary advice, assistance with purchasing DASH-related foods ($30/week), and home delivery of food via a community supermarket. Participants in the control group received a DASH diet brochure and a debit card account ($30/week) to purchase foods. Serum UA levels were measured at baseline and after 8 weeks. RESULTS Of the original 123 randomized participants, 117 had available serum UA measurements. Seventy percent of the participants were women, the mean ± SD age was 59 ± 9.5 years, and the mean ± SD serum UA level was 6.4 ± 1.7 mg/dl. The DASH-Plus diet did not reduce serum UA levels compared with the control diet (difference in difference -0.01 mg/dl [95% confidence interval -0.39, 0.38]). However, there was a significant trend toward a greater reduction in the serum UA level in participants with higher baseline serum UA levels (P for trend = 0.008). Baseline changes in the serum UA level were inversely associated with changes in systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.001), and urinary sodium excretion (P = 0.05). CONCLUSION Overall, in African American individuals, partial replacement of a typical diet with DASH foods did not lower serum UA levels compared with a control diet. However, there was a significant trend toward a greater reduction in serum UA levels in subjects with higher baseline serum UA levels. Furthermore, changes in serum UA levels were associated with known correlates, suggesting heterogeneity of effects in the treatment and control arms. Future pragmatic studies of consumption of the DASH diet to lower serum UA levels should optimize replacement strategies and enroll individuals with hyperuricemia or gout.
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Affiliation(s)
- Stephen P Juraschek
- Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Karen White
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Olive Tang
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hsin-Chieh Yeh
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa A Cooper
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Edgar R Miller
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, and Johns Hopkins University School of Medicine, Baltimore, Maryland
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Li Y, Fan X, Li C, Zhi X, Peng L, Han H, Sun B. The relationships among hyperuricemia, body mass index and impaired renal function in type 2 diabetic patients. Endocr J 2018; 65:281-290. [PMID: 29237999 DOI: 10.1507/endocrj.ej17-0266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chronic kidney disease (CKD) is a common chronic microvascular complication and the major cause of death in diabetic patients. This study was conceived to explore the possible mechanisms of how hyperuricemia and obesity contribute to renal function impairment in type 2 diabetic (T2DM) patients. A cross-sectional study in 609 participants recruited from a T2DM population in North China was conducted. The multiplicative interaction between body mass index (BMI) and uric acid (UA) level was assessed using an interaction term in a logistic regression analysis. Our results indicate that male T2DM patients having higher BMI (OR 1.711, p = 0.038), blood urine nitrogen (BUN) (OR 1.100, p = 0.034), and 24-hour urinary micro-albumin levels (OR 1.004, p = 0.021) were much more likely to have high UA. Whereas, for female T2DM patients, the OR of BMI, BUN, and triglyceride were 1.169 (p = 0.001), 1.337 (p = 0.000), and 1.359 (p = 0.006), respectively. In this study population, obesity and elevated UA work together to increase the risk of renal injury. In vitro experiments indicate that reactive oxygen species (ROS) production increased with UA treatment in human renal glomerular endothelial cells (HRGECs), while endothelial nitric oxide synthase (eNOS) production level dropped. UA also increased monocyte chemotactic protein-1 (MCP-1) expression and nuclear factor kappa B (NF-κB) activation. Taken together, our results indicate that high concentrations of UA lead to endothelial dysfunction through the activation of the inflammatory response and induction of oxidative stress, even in non-obese T2DM patients.
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Affiliation(s)
- Yongmei Li
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Department of Pathogenic Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xing Fan
- Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Chunjun Li
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xinyue Zhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liyuan Peng
- Department of Physiology and Pathophysiology, Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Medical University, Tianjin, China
| | - Hongling Han
- Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Bei Sun
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Department of Physiology and Pathophysiology, Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Medical University, Tianjin, China
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Effect of Salt Intake on Plasma and Urinary Uric Acid Levels in Chinese Adults: An Interventional Trial. Sci Rep 2018; 8:1434. [PMID: 29362390 PMCID: PMC5780523 DOI: 10.1038/s41598-018-20048-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/08/2018] [Indexed: 01/30/2023] Open
Abstract
Uric acid (UA) has been proposed as an important risk factor for cardiovascular and renal morbidity. We conducted an interventional trial to assess effects of altered salt intake on plasma and urine UA levels and the relationship between UA levels and salt sensitivity in humans. Ninety subjects (18–65 years old) were sequentially maintained on a normal diet for 3 days at baseline, a low-salt diet for 7 days (3.0 g/day, NaCl), and a high-salt diet for an additional 7 days (18.0 g/day of NaCl). Plasma UA levels significantly increased from baseline to low-salt diet and decreased from low-salt to high-salt diet. By contrast, daily urinary levels of UA significantly decreased from baseline to low-salt diet and increased from low-salt to high-salt diet. The 24 h urinary sodium excretions showed inverse correlation with plasma UA and positive correlation with urinary UA excretions. Additionally, salt-sensitive subjects presented significantly higher plasma UA changes in comparison to salt-resistant subjects, and a negative correlation was observed between degree of salt sensitivity and plasma UA difference. The present study indicates that variations in dietary salt intake affect plasma and urine UA levels, and plasma UA may be involved in pathophysiological process of salt sensitivity.
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Techatraisak K, Kongkaew T. The association of hyperuricemia and metabolic syndrome in Thai postmenopausal women. Climacteric 2017; 20:552-557. [DOI: 10.1080/13697137.2017.1369513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- K. Techatraisak
- Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - T. Kongkaew
- Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Juraschek SP, Gelber AC, Choi HK, Appel LJ, Miller ER. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid. Arthritis Rheumatol 2017; 68:3002-3009. [PMID: 27523583 DOI: 10.1002/art.39813] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 07/07/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Randomized trial data guiding dietary recommendations to lower serum uric acid (UA), the etiologic precursor of gout, are scarce. We undertook this study to examine the effects of the Dietary Approaches to Stop Hypertension (DASH) diet (a well-established diet that lowers blood pressure) and levels of sodium intake on serum UA. METHODS We conducted an ancillary study of a randomized, crossover feeding trial in 103 adults with prehypertension or stage I hypertension. Participants were randomly assigned to receive either the DASH diet or a control diet (typical of the average American diet) and were further fed low, medium, and high levels of sodium for 30 days, each in random order. Body weight was kept constant. Serum UA levels were measured at baseline and following each feeding period. RESULTS Trial participants were 55% women and 75% black with a mean ± SD age of 51.5 ± 9.7 years and a mean ± SD serum UA level of 5.0 ± 1.3 mg/dl. The DASH diet reduced serum UA (-0.35 mg/dl [95% confidence interval (95% CI) -0.65, -0.05], P = 0.02), with a higher effect (-1.29 mg/dl [95% CI -2.50, -0.08]) among participants (n = 8) with a baseline serum UA level of ≥7 mg/dl. Increasing sodium intake from the low level decreased serum UA during the medium sodium intake period (-0.3 mg/dl [95% CI -0.5, -0.2], P < 0.001) and during the high sodium intake period (-0.4 mg/dl [95% CI -0.6, -0.3], P < 0.001). CONCLUSION The DASH diet lowered serum UA, and this effect was greater among participants with hyperuricemia. Moreover, we found that higher sodium intake decreased serum UA, which enhances our knowledge of urate pathophysiology and risk factors for hyperuricemia.
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Affiliation(s)
| | | | - Hyon K Choi
- Harvard Medical School and Massachusetts General Hospital, Boston
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Juraschek SP, Choi HK, Tang O, Appel LJ, Miller ER. Opposing effects of sodium intake on uric acid and blood pressure and their causal implication. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2016; 10:939-946.e2. [PMID: 27938853 PMCID: PMC5161245 DOI: 10.1016/j.jash.2016.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 12/20/2022]
Abstract
Reducing uric acid is hypothesized to lower blood pressure, although evidence is inconsistent. In this ancillary of the DASH-Sodium trial, we examined whether sodium-induced changes in serum uric acid (SUA) were associated with changes in blood pressure. One hundred and three adults with prestage or stage 1 hypertension were randomly assigned to receive either the DASH diet or a control diet (typical of the average American diet) and were fed each of the three sodium levels (low, medium, and high) for 30 days in random order. Body weight was kept constant. SUA was measured at baseline and following each feeding period. Participants were 55% women and 75% black. Mean age was 52 (SD, 10) years, and mean SUA at baseline was 5.0 (SD, 1.3) mg/dL. Increasing sodium intake from low to high reduced SUA (-0.4 mg/dL; P < .001) but increased systolic (4.3 mm Hg; P < .001) and diastolic blood pressure (2.3 mm Hg; P < .001). Furthermore, changes in SUA were independent of changes in systolic (P = .15) and diastolic (P = .63) blood pressure, regardless of baseline blood pressure, baseline SUA, and randomized diet, as well as sodium sensitivity. Although both SUA and blood pressure were influenced by sodium, a common environmental factor, their effects were in opposite directions and were unrelated to each other. These findings do not support a consistent causal relationship between SUA and BP.
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Affiliation(s)
- Stephen P Juraschek
- The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University School of Medicine, Baltimore MD.
| | - Hyon K Choi
- Gout and Crystal Arthropathy Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Olive Tang
- The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University School of Medicine, Baltimore MD
| | - Lawrence J Appel
- The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University School of Medicine, Baltimore MD
| | - Edgar R Miller
- The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University School of Medicine, Baltimore MD
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Serum Uric Acid Level Predicts Progression of IgA Nephropathy in Females but Not in Males. PLoS One 2016; 11:e0160828. [PMID: 27560997 PMCID: PMC4999279 DOI: 10.1371/journal.pone.0160828] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/26/2016] [Indexed: 12/15/2022] Open
Abstract
Background Immunoglobulin A nephropathy (IgAN) is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN. Study Design Multicenter retrospective cohort study. Setting & Participants 935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital. were included in this study. Predictor Uric acid levels at renal biopsy. Outcomes The outcome of interest was the time from the kidney biopsy to the time when a 50% increase in the baseline serum creatinine level was observed, which was defined as "progression". Measurements The baseline characteristics according to the kidney biopsy at the time of diagnosis were collected from the medical records, and included age, gender, body mass index, hypertension, diabetes (use of antidiabetic drugs), serum levels of creatinine, urinary protein, smoking status, RAAS blockers and steroid therapy. Results An elevated serum uric acid level was an independent risk factor for progression in female patients (per 1.0 mg/dL, multivariate-adjusted incident rate ratio 1.33 [95% confidence interval 1.07, 1.64], P = 0.008) but not in male patients (1.02 [0.81, 1.29], P = 0.855). To control a confounding effect of renal function on an association between serum uric acid level and progression in female patients, age- and serum creatinine-matched and propensity score-matched analyses were performed, and these results also supported the effect by uric acid on kidney disease progression independent of basal kidney function. Limitations A cohort analyzed retorospectively. Conclusions This study revealed that an elevated uric acid level was an independent risk factor for ESKD in female IgAN patients. Therefore, uric acid might be a treatable target in female IgAN patients.
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Kawasoe S, Kubozono T, Yoshifuku S, Ojima S, Oketani N, Miyata M, Miyahara H, Maenohara S, Ohishi M. Uric Acid Level and Prevalence of Atrial Fibrillation in a Japanese General Population of 285,882. Circ J 2016; 80:2453-2459. [DOI: 10.1253/circj.cj-16-0766] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shin Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | | | - Satoko Ojima
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Naoya Oketani
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masaaki Miyata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | | | | | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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Abstract
Cardiovascular disease (CVD) is the most common cause of death and disability worldwide. Therefore, great importance has been placed on the discovery of novel risk factors and metabolic pathways relevant in the prevention and management of CVD. Such research is ongoing and may continue to lead to better risk stratification of individuals and/or the development of new intervention targets and treatment options. This review highlights emerging biomarkers related to lipid metabolism, glycemia, inflammation, and cardiac damage, some of which show promising associations with CVD risk and provide further understanding of the underlying pathophysiology. However, their measurement methodology and assays will require validation and standardization, and it will take time to accumulate evidence of their role in CVD in various population settings in order to fully assess their clinical utility. Several of the novel biomarkers represent intriguing, potentially game-changing targets for therapy.
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Affiliation(s)
- Leah E Cahill
- Department of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, B3H 1V7, Canada.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Monica L Bertoia
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Sarah A Aroner
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, 1309 Beacon Street, 2nd Floor, Brookline, Boston, MA, USA.
| | - Majken K Jensen
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
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Wu CY, Hu HY, Chou YJ, Huang N, Chou YC, Lee MS, Li CP. High Serum Uric Acid Levels Are Associated with All-Cause and Cardiovascular, but Not Cancer, Mortality in Elderly Adults. J Am Geriatr Soc 2015; 63:1829-36. [PMID: 26277576 DOI: 10.1111/jgs.13607] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To estimate the all-cause, cardiovascular, and cancer mortality risks associated with serum uric acid levels in elderly adults. DESIGN Cohort study. SETTING The Annual Geriatric Health Examination Program database from 2006 to 2010. PATICIPANTS Community-dwelling Taipei citizens aged 65 and older (N = 77,541). MEASUREMENTS Stratified according to sex, serum uric acid levels were analyzed in quartiles and as normal versus high categories. Mortality was determined by matching cohort identifications with national death files. RESULTS Men had significantly higher uric acid levels than women (P < .001), and mean levels increased with age (P < .001). Serum uric acid levels (normal vs high) were an independent risk factor for all-cause and cardiovascular mortality in men and women, with the strongest association found for cardiovascular mortality. The association between serum uric acid levels and cardiovascular mortality was independent of other cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidemia, and glomerular filtration rate levels. When levels were analyzed as quartiles, men with levels in the second quartile had the lowest hazard ratios for all-cause and cardiovascular mortality. CONCLUSION High serum uric acid levels are associated with greater risk of all-cause and cardiovascular mortality but not cancer mortality in elderly adults. Further studies are warranted to investigate the prognostic implications and potential utility in the monitoring of therapy.
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Affiliation(s)
- Chen-Yi Wu
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Dermatology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Public Health, National Yang Ming University, Taipei, Taiwan
| | - Nicole Huang
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan
| | - Yi-Chang Chou
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Public Health, National Yang Ming University, Taipei, Taiwan.,Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Meng-Sui Lee
- Department of Dermatology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan.,National Yang Ming University School of Medicine, Taipei, Taiwan
| | - Chung-Pin Li
- National Yang Ming University School of Medicine, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Juraschek SP, Tunstall-Pedoe H, Woodward M. Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study. Atherosclerosis 2014; 233:623-629. [PMID: 24534458 DOI: 10.1016/j.atherosclerosis.2014.01.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 12/25/2013] [Accepted: 01/10/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Elevated uric acid is a prevalent condition with controversial health consequences. Observational studies disagree with regard to the relationship of uric acid with mortality, and with factors modifying this relationship. OBJECTIVE We examined the association of serum uric acid with mortality in 15,083 participants in the Scottish Heart Health Extended Cohort (SHHEC) Study. METHODS Serum uric acid was measured at study enrollment. Death was ascertained using both the Scottish death register and record linkage. RESULTS During a median follow-up of 23 years, there were 3980 deaths. In Cox proportional hazards models with sexes combined, those in the highest fifth of uric acid had significantly greater mortality (HR 1.18, 95% CI: 1.06, 1.31) compared with the second fifth, after adjustment for traditional cardiovascular risk factors. This relationship was modified by sex (P-interaction=0.002) with adjusted HRs of 1.69 (95% CI: 1.40, 2.04) and 0.99 (95% CI: 0.86, 1.14) in women and men, respectively. Compared with the second fifth, the highest fifth of uric acid was most associated with kidney-related death (HR: 2.08, 95% CI: 1.31, 3.32). CONCLUSION Elevated uric acid is associated with earlier mortality, especially in women. Future studies should evaluate mechanisms for these interactions and explore the strong association with renal-related mortality.
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Affiliation(s)
- Stephen P Juraschek
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Australia
| | - Hugh Tunstall-Pedoe
- Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Australia
| | - Mark Woodward
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Australia; The George Institute for Global Health, Australia.
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