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Nagore D, Murie-Fernández M, Núñez-Córdoba JM, Vives M. Association between pre-operative hyperuricemia and risk of in-hospital death in high-risk patients undergoing cardiac surgery: An international prospective 14-centre study. Eur J Anaesthesiol 2024; 41:450-452. [PMID: 38269411 DOI: 10.1097/eja.0000000000001956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- David Nagore
- From the Department of Anaesthesia & Perioperative Medicine, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián (DN), Department of Neurology, Clínica San Miguel, Pamplona (MM-F), Research Support Service, Central Clinical Trials Unit, Clínica Universidad de Navarra, Pamplona (JMN-C), Department of Anesthesiology & Critical Care Medicine, Clínica Universidad de Navarra, Pamplona, Spain (MV)
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Li S, Hou L, Zhu S, Sun W, Cao J, Yi Q, Zhao D, Song P. Associations of serum uric acid with hypertension status, stages, phenotypes and progressions among Chinese middle-aged and elderly. Nutr Metab Cardiovasc Dis 2024; 34:988-997. [PMID: 38176957 DOI: 10.1016/j.numecd.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/15/2023] [Accepted: 10/21/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND AIMS No consensus has been reached on the association between serum uric acid (SUA) and hypertension. This study aimed to investigate the associations between SUA and hypertension, including its status, stages, phenotypes and progressions, among middle-aged and older Chinese. METHODS AND RESULTS Data were obtained from the China Health and Retirement Longitudinal Study 2011-2015. Binary logistic regression was used to evaluate the association between SUA and hypertension status. Multinomial logistic regression was used to explore the associations of SUA with hypertension stages, phenotypes and hypertension status progressions. Models were adjusted for potential confounders and stratified by sex. A total of 7931 individuals aged ≥45 years were included, with 39.16 % of hypertension. Significant associations were found of SUA with stage2 and above hypertension (quartile 4 [Q4] vs quartile 1 [Q1]: odds ratio 1.78, 95 % confidence interval 1.31-2.42, P < 0.001), and systolic diastolic hypertension (SDH) (Q4 vs Q1: 1.53, 1.14-2.06, P = 0.005). In sex stratification, significant associations were found between SUA and stage2 and above hypertension and SDH only for men. Moreover, higher quartiles of baseline SUA showed increased risks of maintained hypertension from 2011 to 2015 (Q3 vs Q1: 1.23, 1.03-1.48, P = 0.024; Q4 vs Q1: 1.73, 1.43-2.10, P < 0.001). CONCLUSION Higher SUA was associated with hypertension and maintained hypertension among Chinese middle-aged and elderly. Sex-specific associations of SUA with hypertension stages and phenotypes were observed. Regular measurement of SUA in clinical practice may indicate hypertension and its progression, particularly among men.
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Affiliation(s)
- Shuting Li
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Leying Hou
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Siyu Zhu
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jin Cao
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dong Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Nardin M, Verdoia M, Nardin S, Cao D, Chiarito M, Kedhi E, Galasso G, Condorelli G, De Luca G. Vitamin D and Cardiovascular Diseases: From Physiology to Pathophysiology and Outcomes. Biomedicines 2024; 12:768. [PMID: 38672124 PMCID: PMC11048686 DOI: 10.3390/biomedicines12040768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Vitamin D is rightly recognized as an essential key factor in the regulation of calcium and phosphate homeostasis, affecting primary adequate bone mineralization. In the last decades, a more complex and wider role of vitamin D has been postulated and demonstrated. Cardiovascular diseases have been found to be strongly related to vitamin D levels, especially to its deficiency. Pre-clinical studies have suggested a direct role of vitamin D in the regulation of several pathophysiological pathways, such as endothelial dysfunction and platelet aggregation; moreover, observational data have confirmed the relationship with different conditions, including coronary artery disease, heart failure, and hypertension. Despite the significant evidence available so far, most clinical trials have failed to prove any positive impact of vitamin D supplements on cardiovascular outcomes. This discrepancy indicates the need for further information and knowledge about vitamin D metabolism and its effect on the cardiovascular system, in order to identify those patients who would benefit from vitamin D supplementation.
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Affiliation(s)
- Matteo Nardin
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Internal Medicine, Department of Medicine, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Monica Verdoia
- Division of Cardiology, Ospedale degli Infermi, ASL Biella, 13875 Biella, Italy
- Department of Translational Medicine, Eastern Piedmont University, 28100 Novara, Italy
| | - Simone Nardin
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Sciences, School of Medicine, University of Genova, 16126 Genova, Italy
| | - Davide Cao
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Department of Cardiology, Humanitas Gavazzeni Hospital, 24125 Bergamo, Italy
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Department of Cardiovascular Medicine, IRCCS-Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Elvin Kedhi
- McGill University Health Center, Montreal, QC H3G 1A4, Canada
- Department of Cardiology and Structural Heart Disease, University of Silesia, 40-032 Katowice, Poland
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Department of Cardiovascular Medicine, IRCCS-Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giuseppe De Luca
- Division of Cardiology, AOU “Policlinico G. Martino”, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
- Division of Cardiology, IRCCS Hospital Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
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4
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Pan G, Liu Y, Yu L, Yang R, Yang T, Wang Y, Su J, Li Z, Cheng Q, Gao S, Li L, Yu C. Relationship Between Serum Uric Acid and Carotid Plaque in Patients With Coronary Artery Disease by Sex and Blood Pressure Status. Angiology 2024; 75:274-280. [PMID: 36617727 DOI: 10.1177/00033197221150614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The purpose of this study was to explore the sex difference and effects of blood pressure (BP) on the relationship between serum uric acid (SUA) and carotid plaque in patients with coronary heart disease (CHD). This large multicenter retrospective study included 12099 patients with CHD (aged 35-75 years) between January 1, 2014 and September 30, 2020. Patients were divided into three groups according to systolic BP (SBP) and diastolic BP (DBP), and the SUA levels in males and females were converted into three groups. Logistic regression was used to analyze the influence of sex and BP on the relationship between SUA levels and carotid plaque in patients with CHD. In the model of male BP subgroups, using the BP of group A (normal with SBP <120 mmHg and DBP <80 mmHg) as a reference, SUA levels were significantly correlated with the occurrence of carotid plaque under different BP states (P < .001). In contrast, in the model of female BP subgroups, most of these correlations were not statistically significant. Our study showed that SUA levels were significantly associated with carotid plaque occurrence in males with CHD, which remained significant across different BP states.
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Affiliation(s)
- Guangwei Pan
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yijia Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lu Yu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongrong Yang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tong Yang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yang Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jinyu Su
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhu Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qi Cheng
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Sheng Gao
- Nankai Hospital of Tianjin, Tianjin, China
| | - Lin Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunquan Yu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Bolognesi A, Bortolotti M, Battelli MG, Polito L. Gender Influence on XOR Activities and Related Pathologies: A Narrative Review. Antioxidants (Basel) 2024; 13:211. [PMID: 38397809 PMCID: PMC10885918 DOI: 10.3390/antiox13020211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Taking into account the patient's gender is the first step towards more precise and egalitarian medicine. The gender-related divergences observed in purine catabolism and their pathological consequences are good examples of gender medicine differences. Uric acid is produced by the activity of xanthine oxidoreductase (XOR). The serum levels of both XOR activity and uric acid differ physiologically between the genders, being higher in men than in women. Their higher levels have been associated with gout and hypertension, as well as with vascular, cardiac, renal, and metabolic diseases. The present review analyzes the gender-related differences in these pathological conditions in relation to increases in the serum levels of XOR and/or uric acid and the opportunity for gender-driven pharmacological treatment.
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Affiliation(s)
| | | | - Maria Giulia Battelli
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (M.B.); (L.P.)
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Bellino M, Galasso G, Silverio A, Tedeschi M, Formisano C, Romei S, Esposito L, Cancro FP, Vassallo MG, Accarino G, Verdoia M, Di Muro FM, Vecchione C, De Luca G. Soluble PCSK9 Inhibition: Indications, Clinical Impact, New Molecular Insights and Practical Approach-Where Do We Stand? J Clin Med 2023; 12:jcm12082922. [PMID: 37109259 PMCID: PMC10146045 DOI: 10.3390/jcm12082922] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Current research on cardiovascular prevention predominantly focuses on risk-stratification and management of patients with coronary artery disease (CAD) to optimize their prognosis. Several basic, translational and clinical research efforts aim to determine the etiological mechanisms underlying CAD pathogenesis and to identify lifestyle-dependent metabolic risk factors or genetic and epigenetic parameters responsible for CAD occurrence and/or progression. A log-linear association between the absolute exposure of LDL cholesterol (LDL-C) and the risk of atherosclerotic cardio-vascular disease (ASCVD) was well documented over the year. LDL-C was identified as the principal enemy to fight against, and soluble proprotein convertase subtilisin kexin type 9 (PCSK9) was attributed the role of a powerful regulator of blood LDL-C levels. The two currently available antibodies (alirocumab and evolocumab) against PCSK9 are fully human engineered IgG that bind to soluble PCSK9 and avoid its interaction with the LDLR. As documented by modern and dedicated "game-changer" trials, antibodies against soluble PCSK9 reduce LDL-C levels by at least 60 percent when used alone and up to 85 percent when used in combination with high-intensity statins and/or other hypolipidemic therapies, including ezetimibe. Their clinical indications are well established, but new areas of use are advocated. Several clues suggest that regulation of PCSK9 represents a cornerstone of cardiovascular prevention, partly because of some pleiotropic effects attributed to these newly developed drugs. New mechanisms of PCSK9 regulation are being explored, and further efforts need to be put in place to reach patients with these new therapies. The aim of this manuscript is to perform a narrative review of the literature on soluble PCSK9 inhibitor drugs, with a focus on their indications and clinical impact.
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Affiliation(s)
- Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Michele Tedeschi
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Ciro Formisano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Stefano Romei
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Luca Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Francesco Paolo Cancro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Maria Giovanna Vassallo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Giulio Accarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
| | - Monica Verdoia
- Division of Cardiology, Ospedale Degli Infermi, ASL Biella, 13900 Biella, Italy
| | - Francesca Maria Di Muro
- Structural Interventional Cardiology, Department of Clinical and Experimental Medicine, Clinica Medica, Careggi University Hospital, 50139 Florence, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
- Vascular Physiopathology Unit, IRCCS Neuromed Mediterranean Neurological Institute, 86077 Pozzilli, Italy
| | - Giuseppe De Luca
- Division of Cardiology, AOU "Policlinico G. Martino", Department of Clinical and Experimental Medicine, University of Messina, 98166 Messina, Italy
- Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, 20161 Milan, Italy
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Li HY, Ji HY, Maimaitituersun G, Ma YT, Fu ZY. Correlation of elevated serum uric acid with coronary artery disease in Xinjiang, China: A retrospective case-control study. Medicine (Baltimore) 2023; 102:e33256. [PMID: 37000112 PMCID: PMC10063311 DOI: 10.1097/md.0000000000033256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
Elevated serum uric acid (SUA) levels are associated with coronary artery disease (CAD). However, whether this association is independent of traditional cardiovascular risk factors remains controversial. Our study aimed to determine the concentration of SUA in the presence and severity of CAD in multi-ethnic patients in Xinjiang, China. For this study, 412 consecutive patients with percutaneous coronary intervention (PCI) and 845 individuals with normal coronary angiograms were included in the study. CAD severity was evaluated using the Gensini score index. The SUA concentrations and the levels of various cardiometabolic risk factors were investigated. We assessed the relationship between SUA levels and other cardiometabolic risk factors. Logistic regression was used to evaluate risk factors for PCI patients. SUA levels were significantly elevated in PCI patients compared to those in control subjects (P < .01). With increased UA levels, we found that the risk factors for CAD increased. SUA concentration had a significant positive relationship with total cholesterol (P < .01), triglycerides (P < .01), low-density lipoprotein cholesterol (P < .01), and creatinine (P < .01) in both sexes. In the PCI group, there was no significant correlation between UA levels. SUA levels are not an independent risk factor for CAD. It can be concluded that in Xinjiang, China, SUA is related to multiple risk factors for CAD, but not related to the severity of CAD.
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Affiliation(s)
- Hua-Yin Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Xinjiang, China
| | - Hong-Yu Ji
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Xinjiang, China
| | - Gulinigaer Maimaitituersun
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Xinjiang, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Xinjiang, China
| | - Zhen-Yan Fu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Xinjiang, China
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Secondary Cardiovascular Prevention after Acute Coronary Syndrome: Emerging Risk Factors and Novel Therapeutic Targets. J Clin Med 2023; 12:jcm12062161. [PMID: 36983163 PMCID: PMC10056379 DOI: 10.3390/jcm12062161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The control of cardiovascular risk factors, the promotion of a healthy lifestyle, and antithrombotic therapy are the cornerstones of secondary prevention after acute coronary syndrome (ACS). However, many patients have recurrent ischemic events despite the optimal control of traditional modifiable risk factors and the use of tailored pharmacological therapy, including new-generation antiplatelet and lipid-lowering agents. This evidence emphasizes the importance of identifying novel risk factors and targets to optimize secondary preventive strategies. Lipoprotein(a) (Lp(a)) has emerged as an independent predictor of adverse events after ACS. New molecules such as anti-PCSK9 monoclonal antibodies, small interfering RNAs, and antisense oligonucleotides can reduce plasma Lp(a) levels and are associated with a long-term outcome benefit after the index event. The inflammatory stimulus and the inflammasome, pivotal elements in the development and progression of atherosclerosis, have been widely investigated in patients with coronary artery disease. More recently, randomized clinical trials including post-ACS patients treated with colchicine and monoclonal antibodies targeting cytokines yielded promising results in the reduction in major cardiovascular events after an ACS. Gut dysbiosis has also raised great interest for its potential pathophysiological role in cardiovascular disease. This evidence, albeit preliminary and needing confirmation by larger population-based studies, suggests the possibility of targeting the gut microbiome in particularly high-risk populations. The risk of recurrent ischemic events after ACS is related to the complex interaction between intrinsic predisposing factors and environmental triggers. The identification of novel risk factors and targets is fundamental to customizing patient clinical management with a precision medicine perspective.
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Mello FM, Bensenor IM, Santos IS, Bittencourt MS, Lotufo PA, Fuller R. Serum Uric Acid Levels and Subclinical Atherosclerosis: Results From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Curr Probl Cardiol 2023; 48:101525. [PMID: 36455798 DOI: 10.1016/j.cpcardiol.2022.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
High serum uric acid (sUA) has been associated with coronary artery calcium (CAC) and increased carotid intima-media thickness (cIMT) in people at high cardiovascular risk. However, association is unclear in apparently healthy individuals. Our study aims to evaluate association between sUA and subclinical atherosclerosis measures: CAC and increased cIMT, in apparently healthy adults enrolled in ELSA-Brasil. A total of 4096 participants without previous coronary artery disease, stroke, and use of urate-lowering drugs, underwent CAC and cIMT assessment. All analyses were stratified by sex. Serum uric acid categorized by quintiles was the exposure variable. Thorough cardiovascular risk factor evaluation was performed, and association between sUA quintiles and CAC and cIMT was analyzed by linear regression using ln(CAC + 1) and cIMT, both as continuous variables. Median age of the sample was 49.0 (44.0-56.0) years (women: 55.1%; 59.1% were white). Mean values of sUA were 6.5 ± 1.4 mg/dL for men, and 4.9 ± 1.2 mg/dL for women. The highest quintile (Q5) of sUA was independently associated with cIMT in women (beta-coefficient: 0.022; 95% CI: 0.007-0.036; P = 0.003) and men (beta-coefficient: 0.020; 95% CI: 0.002-0.038; P = 0.032). Regarding CAC, no association was found: men's Q5 (beta-coefficient: -0.142; 95% CI: -0.436 to 0.153; P = 0.347) and women's Q5 (beta-coefficient: 0.046; 95% CI: -0.152 to 0.245; P = 0.647). In this cohort, the highest sUA quintiles were independently associated with cIMT in both women and men. No association was found between sUA and the presence of CAC.
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Akashi N, Kuwabara M, Matoba T, Kohro T, Oba Y, Kabutoya T, Imai Y, Kario K, Kiyosue A, Mizuno Y, Nochioka K, Nakayama M, Iwai T, Nakao Y, Iwanaga Y, Miyamoto Y, Ishii M, Nakamura T, Tsujita K, Sato H, Fujita H, Nagai R. Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan. Front Cardiovasc Med 2023; 9:1062894. [PMID: 36704454 PMCID: PMC9871893 DOI: 10.3389/fcvm.2022.1062894] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background The causal relationship between hyperuricemia and cardiovascular diseases is still unknown. We hypothesized that hyperuricemic patients after percutaneous coronary intervention (PCI) had a higher risk of major adverse cardiovascular events (MACE). Methods This was a large-scale multicenter cohort study. We enrolled patients with chronic coronary syndrome (CCS) after PCI between April 2013 and March 2019 using the database from the Clinical Deep Data Accumulation System (CLIDAS), and compared the incidence of MACE, defined as a composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure, between hyperuricemia and non-hyperuricemia groups. Results In total, 9,936 patients underwent PCI during the study period. Of these, 5,138 patients with CCS after PCI were divided into two group (1,724 and 3,414 in the hyperuricemia and non-hyperuricemia groups, respectively). The hyperuricemia group had a higher prevalence of hypertension, atrial fibrillation, history of previous hospitalization for heart failure, and baseline creatinine, and a lower prevalence of diabetes than the non-hyperuricemia group, but the proportion of men and age were similar between the two groups. The incidence of MACE in the hyperuricemia group was significantly higher than that in the non-hyperuricemia group (13.1 vs. 6.4%, log-rank P < 0.001). Multivariable Cox regression analyses revealed that hyperuricemia was significantly associated with increased MACE [hazard ratio (HR), 1.52; 95% confidential interval (CI), 1.23-1.86] after multiple adjustments for age, sex, body mass index, estimated glomerular filtration rate, left main disease or three-vessel disease, hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction, and history of hospitalization for heart failure. Moreover, hyperuricemia was independently associated with increased hospitalization for heart failure (HR, 2.19; 95% CI, 1.69-2.83), but not cardiovascular death or myocardial infarction after multiple adjustments. Sensitive analyses by sex and diuretic use, B-type natriuretic peptide level, and left ventricular ejection fraction showed similar results. Conclusion CLIDAS revealed that hyperuricemia was associated with increased MACE in patients with CCS after PCI. Further clinical trials are needed whether treating hyperuricemia could reduce cardiovascular events or not.
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Affiliation(s)
- Naoyuki Akashi
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | | | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahide Kohro
- Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yusuke Oba
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yasushi Imai
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Arihiro Kiyosue
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Masaharu Nakayama
- Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takamasa Iwai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoko Nakao
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshitaka Iwanaga
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Taishi Nakamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Hideo Fujita
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan,*Correspondence: Hideo Fujita ✉
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11
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Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry. J Clin Med 2022; 11:jcm11226722. [PMID: 36431198 PMCID: PMC9698021 DOI: 10.3390/jcm11226722] [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: 08/07/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS−STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.
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12
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Mutual effect of homocysteine and uric acid on arterial stiffness and cardiovascular risk in the context of predictive, preventive, and personalized medicine. EPMA J 2022; 13:581-595. [PMID: 36505895 PMCID: PMC9727018 DOI: 10.1007/s13167-022-00298-x] [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: 07/14/2022] [Accepted: 08/26/2022] [Indexed: 12/15/2022]
Abstract
Background Arterial stiffness is a major risk factor and effective predictor of cardiovascular diseases and a common pathway of pathological vascular impairments. Homocysteine (Hcy) and uric acid (UA) own the shared metabolic pathways to affect vascular function. Serum uric acid (UA) has a great impact on arterial stiffness and cardiovascular risk, while the mutual effect with Hcy remains unknown yet. This study aimed to evaluate the mutual effect of serum Hcy and UA on arterial stiffness and 10-year cardiovascular risk in the general population. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that combined assessment of Hcy and UA provides a better tool for targeted prevention and personalized intervention of cardiovascular diseases via suppressing arterial stiffness. Methods This study consisted of 17,697 participants from Beijing Health Management Cohort, who underwent health examination between January 2012 and December 2019. Brachial-ankle pulse wave velocity (baPWV) was used as an index of arterial stiffness. Results Individuals with both high Hcy and UA had the highest baPWV, compared with those with low Hcy and low UA (β: 30.76, 95% CI: 18.36-43.16 in males; β: 53.53, 95% CI: 38.46-68.60 in females). In addition, these individuals owned the highest 10-year cardiovascular risk (OR: 1.49, 95% CI: 1.26-1.76 in males; OR: 7.61, 95% CI: 4.63-12.68 in females). Of note, males with high homocysteine and low uric acid were significantly associated with increased cardiovascular risk (OR: 1.30, 95% CI: 1.15-1.47), but not the high uric acid and low homocysteine group (OR: 1.02, 95% CI: 0.90-1.16). Conclusions This study found the significantly mutual effect of Hcy and UA on arterial stiffness and cardiovascular risk using a large population and suggested the clinical importance of combined evaluation and control of Hcy and UA for promoting cardiovascular health. The adverse effect of homocysteine on arteriosclerosis should be addressed beyond uric acid, especially for males. Monitoring of the level of both Hcy and UA provides a window opportunity for PPPM/3PM in the progression of arterial stiffness and prevention of CVD. Hcy provides a novel predictor beyond UA of cardiovascular health to identify individuals at high risk of arterial stiffness for the primary prevention and early treatment of CVD. In the progressive stage of arterial stiffness, active control of Hcy and UA levels from the aspects of dietary behavior and medication treatment is conducive to alleviating the level of arterial stiffness and reducing the risk of CVD. Further studies are needed to evaluate the clinical effect of Hcy and UA targeted intervention on arterial stiffness and cardiovascular health. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-022-00298-x.
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Pei Z, Lu W, Feng Y, Xu C, Hsueh AJW. Out of step societal and Darwinian adaptation during evolution is the cause of multiple women's health issues. Hum Reprod 2022; 37:1959-1969. [PMID: 35881063 DOI: 10.1093/humrep/deac156] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/18/2022] [Indexed: 11/15/2022] Open
Abstract
During human evolution, major changes in our societal conditions and environment took place without sufficient time for concomitant genetic alterations, leading to out of step adaptation and diseases in women. We first discuss recent societal adaptation mismatch (menstrual bleeding; increases in cancers of reproductive organs, endometriosis; mother's nursing; polycystic ovarian syndrome; transgenerational epigenetic modifications), followed by Darwinian out of step adaptation (labor difficulties; sex chromosomes, human diseases and sex disparity in genomic DNA). We discuss the evolutionary basis of menstrual bleeding, followed by recent increases in cancers of reproductive organs and endometriosis. The importance of breastfeeding by mothers is also emphasized. Earlier onset of menarche, decreased rates of childbirths and breastfeeding resulted in increased number of menstrual cycles in a lifetime, coupled with excess estrogen exposure and incessant ovulation, conditions that increased the susceptibility to mammary and uterine cancers as well as ovarian epithelial cancer and endometriosis. Shorter lactation duration in mothers also contributed to more menstrual cycles. We further discuss the evolutionary basis of the prevalent polycystic ovary syndrome. During the long-term Darwinian evolution, difficulties in childbirth evolved due to a narrowed pelvis, our upright walking and enlarged fetal brain sizes. Because there are 1.5% genomic DNA differences between woman and man, it is of significance to investigate sex-specific human physiology and diseases. In conclusion, understanding out of step adaptation during evolution could allow the prevention and better management of female reproductive dysfunction and diseases.
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Affiliation(s)
- Zhenle Pei
- Department of Genetics, Shanghai Ji Ai Genetics & IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,Department of Integrative Medicine and Neurobiology, Institute of Integrative Medicine of Fudan University, Institute of Brain Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Wenhan Lu
- Department of Integrative Medicine and Neurobiology, Institute of Integrative Medicine of Fudan University, Institute of Brain Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, Institute of Integrative Medicine of Fudan University, Institute of Brain Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Congjian Xu
- Department of Genetics, Shanghai Ji Ai Genetics & IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Aaron J W Hsueh
- Department of Integrative Medicine and Neurobiology, Institute of Integrative Medicine of Fudan University, Institute of Brain Science, School of Basic Medical Sciences, Fudan University, Shanghai, China.,Division of Reproductive and Stem Cell Biology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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14
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Gu F, Luo X, Jin X, Cai C, Zhao W. Association of Total Calcium With Serum Uric Acid Levels Among United States Adolescents Aged 12-19 Years: A Cross-Sectional Study. Front Med (Lausanne) 2022; 9:915371. [PMID: 35755048 PMCID: PMC9226332 DOI: 10.3389/fmed.2022.915371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/24/2022] [Indexed: 11/15/2022] Open
Abstract
Aims Evidence of a link between total calcium (CA) and serum uric acid (SUA) is absent in adolescents. Thus, this study aimed to determine the relationship between total CA levels and SUA levels in United States adolescents. Methods A cross-sectional study analyzed a sample composed of 8,309 United States adolescents aged 12–19 years from the National Health and Nutrition Examination Survey database (1999–2006 survey cycle). Multivariable linear regression analyses and multivariable logistic regression analyses were used to assess the correlation of total CA with SUA levels and hyperuricemia. Furthermore, the dose-response relationship of total CA and SUA levels was analyzed using smooth curve fitting (penalized spline method). Results According to multivariable linear regression analysis, every 1 mg/dL increase in total CA level is associated with a 0.33 mg/dL (β = 0.33, 95% CI: 0.27–0.40, p < 0.001) increase in SUA. Multivariable logistic regression analyses showed that every 0.1 mg/dL increase in total CA level is linked with an 8% increased risk of hyperuricemia (OR = 1.08, 95% CI: 1.06–1.10, p < 0.001). The analyses of smooth curve fitting revealed that total CA levels were linearly correlated with SUA levels (Pnon–linearity = 0.152). The results were highly stable in all subgroups. The interaction analysis results presented that race/ethnicity had an interactive role in associating total CA with SUA levels. Conclusions In United States adolescents, total CA levels were linearly and positively correlated with SUA levels.
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Affiliation(s)
- Fang Gu
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Xiaoming Luo
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Xiaoli Jin
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Changshou Cai
- Department of Neurosurgery, The Central Hospital of Haining, Haining, China
| | - Wenyan Zhao
- Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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15
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Zhang Y. Association between higher serum uric acid levels and plasma N-terminal pro-B-type natriuretic peptide concentrations in patients with coronary artery disease and without overt heart failure. Int J Cardiol 2022; 356:97. [DOI: 10.1016/j.ijcard.2022.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 01/29/2023]
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16
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Serum uric acid level is associated with an increase in systolic blood pressure over time in female subjects: Linear mixed-effects model analyses. Hypertens Res 2022; 45:344-353. [PMID: 34848887 DOI: 10.1038/s41440-021-00792-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/14/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023]
Abstract
Whether hyperuricemia is a true risk factor for elevated blood pressure (BP) is controversial, and the sex-specific effects of serum uric acid (SUA) on BP during a follow-up period remain unclear. We investigated whether the association of SUA level with systolic or diastolic BP during a 10-year period differs by sex in a Japanese general population of individuals who received annual health examinations (n = 28,990). After exclusion of subjects who had no BP or SUA data at baseline, a total of 22,994 subjects (male/female: 14,603/8391, age: 47 ± 11 years) were recruited. After adjustment for age; body mass index; BP; SUA level; use of drugs for hyperuricemia and hypertension; diagnosis of diabetes mellitus, dyslipidemia, and chronic kidney disease; family history of hypertension; habits of current smoking and alcohol consumption at baseline; the duration of the observation period; and the interaction between each covariate and the duration of the observation period indicated a significant association of SUA level with change in systolic or diastolic BP over time. There was a significant interaction between sex and SUA level for the change in systolic BP (P = 0.003) but not the change in diastolic BP (P = 0.081). The SUA level at baseline (per 1 mg/dL) was significantly associated with a change in systolic BP over time in females (estimate: 0.073 mmHg/year, P = 0.003) but not in males (estimate: 0.020 mmHg/year, P = 0.160). In conclusion, a high SUA level at baseline is significantly associated with an increase in systolic BP over time in female individuals but not in male individuals.
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De Luca L, Gulizia MM, Gabrielli D, Meessen J, Mattei L, D'Urbano M, Colivicchi F, Temporelli PL, Borghi C, Desideri G. Impact of serum uric acid levels on cardiovascular events and quality of life in patients with chronic coronary syndromes: Insights from a contemporary, prospective, nationwide registry. Nutr Metab Cardiovasc Dis 2022; 32:393-401. [PMID: 34893417 DOI: 10.1016/j.numecd.2021.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/05/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Hyperuricemia is a metabolic disorder that has been associated with adverse cardiovascular (CV) events. Using the data from a nationwide, prospective registry on patients with chronic coronary syndromes (CCS), we assessed the impact of serum uric acid (SUA) levels on quality of life (QoL) and major adverse CV events (MACE), a composite of CV death and hospitalization for myocardial infarction, heart failure (HF), angina or revascularization at 1-year. METHODS AND RESULTS Among the 5070 consecutive CCS patients enrolled in the registry, levels of SUA were available for 2394 (47.2%). Patients with SUA levels available at baseline were grouped as low tertile (n = 860; 4.3 [3.7-4.7] mg/dL), middle tertile (n = 739; 5.6 [5.3-5.9] mg/dL) and high tertile (n = 795; 7.1 [6.7-7.9] mg/dL). At 1 year, the incidence of MACE was 3.7%, 4.1% and 6.8% for low, middle and high tertiles, respectively (p = 0.005 for low vs high tertile). Patients in the high tertile of SUA had a significantly higher rate of CV mortality (1.4% vs 0.4%; p = 0.05) and hospital admission for HF (2.8% vs 1.6%; p = 0.03) compared to the low tertile. However, hyperuricemia did not result as an independent predictor of MACE at multivariable analysis [hazard ratio: 1.27; 95% confidence intervals: 0.81-2.00; p = 0.3]. CONCLUSIONS In this contemporary, large cohort of CCS, those in the high tertile of SUA had a greater burden of CV disease and worse QoL. However, SUA did not significantly influence the higher rate of CV mortality, hospitalization for HF and MACE observed in these patients during 1-year follow-up.
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Affiliation(s)
- Leonardo De Luca
- Department of Cardiosciences, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
| | | | - Domenico Gabrielli
- Department of Cardiosciences, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Jennifer Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Luisa Mattei
- Division of Cardiology, Ospedale Monfalcone-Gorizia, Italy
| | | | | | - Pier L Temporelli
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno, Novara, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Kong Y, Liu C, Zhang C, Wang W, Li Y, Qiu H, Wang G, Li D, Chen X, Lv Z, Zhou D, Wan L, Ai M, Chen J, Ran L, Kuang L. Association Between Serum Uric Acid Levels and Suicide Attempts in Adolescents and Young Adults with Major Depressive Disorder: A Retrospective Study. Neuropsychiatr Dis Treat 2022; 18:1469-1477. [PMID: 35899094 PMCID: PMC9310655 DOI: 10.2147/ndt.s368471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Uric acid (UA) is thought to exert neuroprotective roles. The purpose of this study was to examine the association of serum UA with suicide attempts (SA) in adolescents and young adults with major depressive disorder (MDD). PATIENTS AND METHODS We retrospectively recruited 533 participants with MDD aged 13 to 25 years, of which 168 had a history of SA in the past three months and 365 did not have a history of SA. Serum UA levels were measured using the uricase-peroxidase coupling method. In addition to overall serum UA level comparison in MDD individuals with and without SA, a stratified analysis by biological sex was carried out. RESULTS Compared to MDD individuals without a history of SA, serum UA levels were significantly lower in MDD individuals with SA (P < 0.001). Female MDD, but not male MDD individuals, with SA exhibited lower levels of UA than those without SA (P < 0.01). Importantly, serum UA remained significantly associated with SA in MDD individuals (OR = 0.996, 95% CI: 0.993~0.999, P < 0.01) when controlling for possible confounding variables. CONCLUSION This research identifies a relationship between serum UA levels and SA in adolescents and young adults with MDD. UA may represent a biological risk marker for SA, in particular for female MDD individuals.
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Affiliation(s)
- Yiting Kong
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Chuan Liu
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Chenyu Zhang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yalan Li
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Haitang Qiu
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Gaomao Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Daqi Li
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaorong Chen
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhen Lv
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Dongdong Zhou
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Liyang Wan
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Ming Ai
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jianmei Chen
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Liuyi Ran
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Li Kuang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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19
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Yang M, Cao S. Gender and Age-Specific Differences in the Association of Thyroid Function and Hyperuricemia in Chinese: A Cross-Sectional Study. Int J Endocrinol 2022; 2022:2168039. [PMID: 35846250 PMCID: PMC9277216 DOI: 10.1155/2022/2168039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 06/05/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We aimed to explore gender and age-specific influences on the association between thyroid function and hyperuricemia (HUA) in a large Chinese population. METHODS A total of 19,013 individuals (10,563 males and 8,450 females) were recruited. The association between HUA and thyroid function was analyzed by multivariate logistic regression, and the analyses were stratified by gender and age. Thyroid function subgroups were determined in 2 methods including thyroid status and thyroid-stimulating hormone (TSH) quartiles. RESULTS Overall prevalence of serum uric acid (SUA) and HUA was significantly higher in males, while TSH value and thyroid dysfunction were higher in females. Increasing trends of the TSH level in both genders as well as HUA prevalence in females were found positively along with aging. However, males showed a reduced trend in HUA risk negatively with aging. Our population showed that the risk of developing HUA in hyperthyroidism, normal euthyroidism, mild hypothyroidism, and overt hypothyroidism subgroups had adjusted ORs of 0.634, 1.229, 1.370, and 1.408, respectively, in males. Subjects in females showed a similar increased risk of HUA with ORs of 0.770, 1.198, 1.256, and 1.458, respectively. Similar tendency was observed in TSH quartiles; the above two models showed significantly higher risk of HUA in the high TSH group of males, but not of females. Aging was a significant risk factor for HUA, particularly in older females after adjusting for TSH. CONCLUSION The risk of HUA was positively associated with an elevation in TSH levels in both genders irrespective of age, indicating the protective effects of low TSH on HUA. Males with high TSH value were more vulnerable to suffer significant risk of HUA.
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Affiliation(s)
- Ming Yang
- VIP Department, General Medicine Department and Health Management Centre, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Da Hua Road, Dongcheng District, Beijing 100037, China
| | - Suyan Cao
- VIP Department, General Medicine Department and Health Management Centre, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Da Hua Road, Dongcheng District, Beijing 100037, China
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20
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Maloberti A, Biolcati M, Ruzzenenti G, Giani V, Leidi F, Monticelli M, Algeri M, Scarpellini S, Nava S, Soriano F, Oreglia J, Sacco A, Morici N, Oliva F, Piani F, Borghi C, Giannattasio C. The Role of Uric Acid in Acute and Chronic Coronary Syndromes. J Clin Med 2021; 10:jcm10204750. [PMID: 34682873 PMCID: PMC8540994 DOI: 10.3390/jcm10204750] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022] Open
Abstract
Uric acid (UA) is the final product of the catabolism of endogenous and exogenous purine nucleotides. While its association with articular gout and kidney disease has been known for a long time, new data have demonstrated that UA is also related to cardiovascular (CV) diseases. UA has been identified as a significant determinant of many different outcomes, such as all-cause and CV mortality, and also of CV events (mainly Acute Coronary Syndromes (ACS) and even strokes). Furthermore, UA has been related to the development of Heart Failure, and to a higher mortality in decompensated patients, as well as to the onset of atrial fibrillation. After a brief introduction on the general role of UA in CV disorders, this review will be focused on UA's relationship with CV outcomes, as well as on the specific features of patients with ACS and Chronic Coronary Syndrome. Finally, two issues which remain open will be discussed: the first is about the identification of a CV UA cut-off value, while the second concerns the possibility that the pharmacological reduction of UA is able to lower the incidence of CV events.
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Affiliation(s)
- Alessandro Maloberti
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
- Correspondence: ; Tel.: +39-026-444-2141; Fax: +39-026-444-2566
| | - Marco Biolcati
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Giacomo Ruzzenenti
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Valentina Giani
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Filippo Leidi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Massimiliano Monticelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Michela Algeri
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Sara Scarpellini
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Stefano Nava
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Francesco Soriano
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Jacopo Oreglia
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Alice Sacco
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Nuccia Morici
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Fabrizio Oliva
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Federica Piani
- School of Medicine and Surgery, University of Bologna—IRCCS Policlinico S. Orsola, 40138 Bologna, Italy; (F.P.); (C.B.)
| | - Claudio Borghi
- School of Medicine and Surgery, University of Bologna—IRCCS Policlinico S. Orsola, 40138 Bologna, Italy; (F.P.); (C.B.)
| | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
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Correlation between serum uric acid levels and carotid plaque neovascularisation assessed by contrast-enhanced ultrasound. Clin Radiol 2021; 76:942.e1-942.e6. [PMID: 34482988 DOI: 10.1016/j.crad.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/03/2021] [Indexed: 11/21/2022]
Abstract
AIM To investigate the potential impact of serum uric acid (SUA) levels on the grade of intraplaque neovascularisation (IPN) at contrast-enhanced ultrasound (CEUS). MATERIAL AND METHODS The study screened 212 patients with carotid atherosclerotic plaques using conventional ultrasound, and the patients then underwent CEUS. Based on the distribution of contrast medium microbubbles in the plaque, patients were split into three groups: 60 patients regarded as grade 0-1 (group A), 81 patients as grade 2 (group B), and 71 patients as grade 3 (group C), and SUA levels were measured on the second day after CEUS. RESULTS The frequencies of stroke were statistically different between the three groups (p<0.05). In grades 0, 1, 2, and 3, SUA levels ranged from 236.92 ± 72.75, 276.46 ± 67.31, 283.93 ± 53.85, and 384.49 ± 79.80 μmol/l, respectively. Spearman's analysis showed that the visual grade of IPN at CEUS correlated linearly with the SUA level (r=0.551, p<0.01). The difference in SUA levels between different sexes was statistically significant (p<0.05), and the differences in plaque echogenicity and diastolic blood pressure (DBP) between the three groups were also statistically significant (all p<0.05). CONCLUSIONS SUA levels correlate positively with the visual grade of IPN at CEUS, which may promote plaque vulnerability. The present results may further help to optimise therapy for vulnerable plaque and improve stroke risk stratification strategies.
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Ren W, Huang Q, Fan K, Hu J, Cheng Q, Xu M, Xu R, Liu Y, Wang L, Chen S, Zhang W, Zhu Z, Wu C, Xue L, Dai Y, Yan F, Huang G, He J. Uric acid played a role in the association between gender and deep vein thrombosis in patients with stroke. Nutr Metab Cardiovasc Dis 2021; 31:2700-2706. [PMID: 34218986 DOI: 10.1016/j.numecd.2021.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/07/2021] [Accepted: 05/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Gender-specific differences were found in serum uric acid (SUA) levels and the risk of isolated distal deep vein thrombosis (IDDVT). This study aimed to explore the association among gender, SUA, and IDDVT in stroke patients. METHODS AND RESULTS Finally, 3404 patients were recruited and divided into two groups: IDDVT (n = 1233) and Non-IDDVT (n = 2171) groups. Propensity score matching (PSM) was conducted to match the patients. Binary logistic regression was adopted to explore the association between SUA and IDDVT, with the SUA divided into quartiles. After PSM, 975 patients were included in each group. Non-IDDVT group had a larger proportion of male than IDDVT group (64.9% vs. 52.7%, p < 0.001). Moreover, males showed higher SUA levels than females (316.7 ± 102.1 vs. 261.8 ± 94.0 μmol/L, t = 12.1, p < 0.001). The highest quartile of SUA (≥346 μmol/L) showed a lower risk of IDDVT (OR = 0.629, p = 0.001), while the lowest quartile (≤225 μmol/L) showed a higher risk of IDDVT (OR = 1.361, p = 0.022). CONCLUSION In patients with stroke, SUA played a protective role in IDDVT. Females had a higher risk of IDDVT, which may be owing to the lower SUA levels than males. In clinical practice, more attention should be paid to the risk of IDDVT in females, especially those with lower SUA levels.
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Affiliation(s)
- Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Qiqi Huang
- Department of Cardiovascular, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Kaili Fan
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000, China
| | - Jingjie Hu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Qianqian Cheng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Minjie Xu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Ruoting Xu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yuntao Liu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Liping Wang
- Department of Ultrasound, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Siyan Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Wanli Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zhenguo Zhu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Chunxue Wu
- Department of Neurology, Wencheng County People's Hospital, Wenzhou, 325000, China
| | - Langlang Xue
- Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yanman Dai
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Feifan Yan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Guiqian Huang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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Sex-Specific Association of Uric Acid and Kidney Function Decline in Taiwan. J Pers Med 2021; 11:jpm11050415. [PMID: 34063419 PMCID: PMC8156506 DOI: 10.3390/jpm11050415] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
An elevated serum urate concentration is associated with kidney damage. Men’s uric acid levels are usually higher than women’s. However, postmenopausal women have a higher risk of gout than men, and comorbidities are also higher than in men. This study examined the sex differences in the relationship between hyperuricemia and renal progression in early chronic kidney disease (CKD) and non-CKD, and further examined the incidence of CKD in non-CKD populations among patients over 50 years of age. We analyzed 1856 women and 1852 men participating in the epidemiology and risk factors surveillance of the CKD database. Women showed a significantly higher risk of renal progression and CKD than men within the hyperuricemia group. After adjusting covariates, women, but not men resulted in an hazard ratio (HR) for developing renal progression (HR = 1.12; 95% CI 1.01–1.24 in women and HR = 1.03; 95% CI 0.93–1.13 in men) and CKD (HR = 1.11; 95% CI 1.01–1.22 in women and HR = 0.95; 95% CI 0.85–1.05 in men) for each 1 mg/dL increase in serum urate levels. The association between serum urate levels and renal progression was stronger in women. Given the prevalence and impact of kidney disease, factors that impede optimal renal function management in women and men must be identified to provide tailored treatment recommendations.
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Maloberti A, Bossi I, Tassistro E, Rebora P, Racioppi A, Nava S, Soriano F, Piccaluga E, Piccalò G, Oreglia J, Vallerio P, Pirola R, De Chiara B, Oliva F, Moreo A, Valsecchi MG, Giannattasio C. Uric acid in chronic coronary syndromes: Relationship with coronary artery disease severity and left ventricular diastolic parameter. Nutr Metab Cardiovasc Dis 2021; 31:1501-1508. [PMID: 33810962 DOI: 10.1016/j.numecd.2021.01.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Uric Acid (UA) has been related to the development of Cardio-Vascular (CV) events in patients affected by Chronic Coronary Syndromes (CCS). Among various hypothesis, two arise: UA may negatively act on coronary artery determining a higher degree of atherosclerotic disease, and/or on heart determining a higher prevalence of diastolic dysfunction. Both the above hypothesized effects are object of our investigation. METHODS AND RESULTS 231 patients who were admitted to the cardiological department of the Niguarda Hospital (Milan, Italy) for CCS from January 2017 to June 2018 were enrolled. Coronary atherosclerotic burden was evaluated from coronary angiography as the number and type of involved vessels, as well as with both Gensini and Syntax scores. All subjects underwent a complete echocardiogram. At unadjusted and adjusted/multivariable analysis, UA levels were not significantly associated with variables analysed from the coronary angiography (number and type of vessels involved, neither the Gensini and Syntax scores) as well as with echocardiographic parameters regarding systolic and diastolic function. CONCLUSIONS In conclusion, the main finding of our work is the absence of a role for UA in determining coronary arteries disease as well as LV diastolic dysfunction in CCS subjects. Taking together the results of previous studies with ours, we hypothesize that UA could act on heart (both on coronary arteries and on LV function) in an early phase of the disease, whereas while in the advanced stages other factors (previous myocardial infarction, previous myocardial revascularization and so on) may overshadow its effects.
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Affiliation(s)
- Alessandro Maloberti
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.
| | - Irene Bossi
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Elena Tassistro
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Paola Rebora
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Angelo Racioppi
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Stefano Nava
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Francesco Soriano
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Emanuela Piccaluga
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Giacomo Piccalò
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Jacopo Oreglia
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Paola Vallerio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Roberto Pirola
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Benedetta De Chiara
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Fabrizio Oliva
- Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Antonella Moreo
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Maria Grazia Valsecchi
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Giannattasio
- Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
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Gender differences with short-term vs 12 months dual antiplatelet therapy in patients with acute coronary syndrome treated with the COMBO dual therapy stent: 2-years follow-up results of the REDUCE trial. J Thromb Thrombolysis 2021; 52:797-807. [PMID: 33847862 DOI: 10.1007/s11239-021-02439-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Gender differences in the thrombotic and bleeding risk have been suggested to condition the benefits of antithrombotic therapies in Acute Coronary Syndrome (ACS) patients, and mainly among those undergoing percutaneous coronary interventions with drug eluting stents (DES). The impact of gender on the optimal duration of dual antiplatelet therapy (DAPT) in ACS patients is still unexplored and was, therefore, the aim of the present sub-study. METHODS REDUCE was a prospective, multicenter, randomized investigator-initiated study designed to enroll 1500 ACS patients after treatment with the COMBO Dual Stent Therapy, based on a noninferiority design. Patients were randomized in a 1:1 fashion to either 3 or 12 months of DAPT. Primary study endpoint was a composite of all-cause mortality, myocardial infarction, definite/probable stent thrombosis (ST), stroke, target-vessel revascularization (TVR) and bleedings (BARC II, III, V) at 12 months. Secondary endpoints were cardiovascular mortality and the individual components of the primary endpoint within 24 months. RESULTS From June 2014 to May 2016 300 women and 1196 men were included in the study. Among them, 43.7% of females and 51.9% of males were assigned to the 3 months DAPT treatment. Baseline characteristics were well matched between the two arms, with the exception of a lower rate of TIMI flow < 3 (p = 0.04), lower systolic blood pressure (p = 0.05) and use of spironolactone (p = 0.006) among women and a more advanced age (p = 0.05) among men receiving a short-term DAPT. At a mean follow-up of 525 (± 198) days, no difference in the primary endpoint was observed according to DAPT duration in both females [6.9% vs 5.9%, HR (95% CI) = 1.19 (0.48-2.9), p = 0.71] and males [8.2% vs 9%, HR (95% CI) = 0.92 (0.63-1.35), p = 0.67; p INT = 0.20]. Results were confirmed after correction for baseline differences [females: adjusted HR (95% CI) = 1.12 (0.45-2.78), p = 0.81; males: adjusted HR (95% CI) = 0.90 (0.61-1.32), p = 0.60]. Comparable rates of survival, thrombotic (MI, stent thrombosis, TVR, stroke) and bleeding events were observed with the two DAPT strategies, with no impact of gender. CONCLUSIONS The present study shows that among ACS patients randomized in the REDUCE trial, a 3 months DAPT strategy offers comparable results as compared to a standard 12 months DAPT at 2-years follow-up in both male and female gender.
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Association between vitamin D deficiency and serum Homocysteine levels and its relationship with coronary artery disease. J Thromb Thrombolysis 2021; 52:523-531. [PMID: 33538987 PMCID: PMC7859464 DOI: 10.1007/s11239-021-02391-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2021] [Indexed: 01/21/2023]
Abstract
Homocysteine (Hcy) elevation and vitamin D deficiency have emerged as potential markers of coronary artery disease (CAD). However, even tough hypovitaminosis D has been suggested to interfere with Hcy catabolism, no study has so far addressed the interaction of vitamin D and Hcy and their impact on CAD, that was the aim of present study. A cohort of consecutive patients undergoing coronary angiography in a single center were included and analyzed within the year 2019. Significant CAD was defined as at least 1 vessel stenosis > 50%, while severe CAD as left main and/or three-vessel disease. Hcy and vitamin D levels were assesssed at admission. We included 3150 patients undergoing coronary angiography at our centre, who were divided according to the quartiles values of vitamin D. Patients with lower levels of Vitamin D displayed a higher cardiovascular risk profile and a higher prevalence of CAD. We observed an inverse linear relationship between lower levels of vitamin D and higher Hcy (r = − 0.092, p < 0.001) and a higher prevalence of hyperhomocysteinemia in patients with lower quartiles values of vitamin D (p < 0.001). By forward conditional regression model, low vitamin D appeared as independent predictors of Homocysteine levels above the median (OR[95%CI] = 1.79[1.37–2.33], p < 0.001). In addition, patients with low vitamin D (below the median) and increased Hcy displayed a non-significantly higher rate of CAD (81% vs 77.7%, p = 0.13, adjusted OR[95%CI] = 1.16[0.88–1.54], p = 0.29) but a significant increase in the rate of severe left main/3-vessel CAD (37.4% vs 30.5%, p = 0.005, adjusted OR[95%CI] = 1.29[1.02–1.67], p = 0.04). Among patients with vitamin D levels above the median, Hcy levels did not impact on the prevalence and extent of CAD (77.7 vs 77.2%, p = 0.81, adjusted OR[95%CI] = 0.94[0.73–1.20], p = 0.60 for CAD and 31.8% vs 27.7%, p = 0.08, adjusted OR[95%CI] = 0.97[0.75–1.25], p = 0.81 for severe left main/3-vessel CAD). No significant interaction between Hcy and vitamin D with CAD or severe CAD was observed. The present study shows an independent inverse linear relationship between vitamin D and Hcy values. Moreover, the association of Hcy with the extent of CAD was significant only among patients with hypovitaminosis D, and not in the cohort of subjects with vitamin D levels above the median, suggesting that a normal vitamin D status can prevent the deleterious effects of hyperhomocysteinemia on coronary atherosclerosis, a hypothesis that certainly needs further confirmation in larger randomized trials.
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Jeong H, Moon JE, Jeon CH. Hyperuricemia is Associated With an Increased Prevalence of Metabolic Syndrome in a General Population and a Decreased Prevalence of Diabetes in Men. JOURNAL OF RHEUMATIC DISEASES 2020. [DOI: 10.4078/jrd.2020.27.4.247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hyemin Jeong
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Korea
| | - Ji Eun Moon
- Department of Biostatistics, Soonchunhyang University Hospital Bucheon, Bucheon, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Korea
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Hyperuricemia and Hypertension, Coronary Artery Disease, Kidney Disease: From Concept to Practice. Int J Mol Sci 2020; 21:ijms21114066. [PMID: 33561034 PMCID: PMC7312288 DOI: 10.3390/ijms21114066] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
Since the publication of the Framingham Heart Study, which suggested that uric acid should no longer be associated with coronary heart disease after additional adjustment for cardiovascular disease risk factors, the number of publications challenging this statement has dramatically increased. The aim of this paper was to review and discuss the most recent studies addressing the possible relation between sustained elevated serum uric acid levels and the onset or worsening of cardiovascular and renal diseases. Original studies involving American teenagers clearly showed that serum uric acid levels were directly correlated with systolic and diastolic pressures, which has been confirmed in adult cohorts revealing a 2.21-fold increased risk of hypertension. Several studies involving patients with coronary artery disease support a role for serum uric acid level as a marker and/or predictor for future cardiovascular mortality and long-term adverse events in patients with coronary artery disease. Retrospective analyses have shown an inverse relationship between serum uric acid levels and renal function, and even a mild hyperuricemia has been shown to be associated with chronic kidney disease in patients with type 2 diabetes. Interventional studies, although of small size, showed that uric acid (UA)-lowering therapies induced a reduction of blood pressure in teenagers and a protective effect on renal function. Taken together, these studies support a role for high serum uric acid levels (>6 mg/dL or 60 mg/L) in hypertension-associated morbidities and should bring awareness to physicians with regards to patients with chronic hyperuricemia.
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Liu Q, Liu C, Gao Y, Zhang X, Yi N, Cao J, Wang Y, Jiang Y, Tang Z. Gender-Specific Association between Serum Uric Acid and Incident Fundus Arteriosclerosis in Chinese Population: A Retrospective Cross-Sectional Study. Sci Rep 2020; 10:8595. [PMID: 32451435 PMCID: PMC7248060 DOI: 10.1038/s41598-020-65575-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/04/2020] [Indexed: 12/11/2022] Open
Abstract
Elevated levels of serum uric acid (SUA) were considered to be risk factors for cardiovascular disease, it has been found to be associated with increased arteriosclerosis. The aim of this study was to explore the gender specific relationship between SUA and fundus arteriosclerosis in a healthy population. In a retrospective cross-sectional study, 23474 individuals without diabetes and hypertension were included in the present study. SUA levels were cut to four groups as Q1 to Q4, according to the quartiles. The odds ratio and 95% confidence interval of different SUA levels were estimated by a binomial logistic regression model. A restrictive cubic spline method was used to estimate the dose-response relationship between SUA and fundus arteriosclerosis. Subgroup analysis was performed to find the gender-specific association between SUA and incident fundus arteriosclerosis. In males, after adjusting for confounding factors, the highest SUA level was significantly associated with the risk of incident fundus arteriosclerosis. The OR with 95%CI for Q4 was 1.44(1.18, 1.76), Q1 as a reference. Specially, for females, SUA level was not associated with the incidence of fundus arteriosclerosis. In conclusion, elevated levels of SUA were associated with the incidence of fundus arteriosclerosis in males, but not in females.
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Affiliation(s)
- Qianqian Liu
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China
| | - Chunxing Liu
- Department of Laboratory, Hua Dong Sanatorium, Wuxi, 214065, China
| | - Yonghui Gao
- Department of Laboratory, Hua Dong Sanatorium, Wuxi, 214065, China
| | - Xinyan Zhang
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30458, USA
| | - Nengjun Yi
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Jianping Cao
- School of Radiation Medicine and Protection and Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215006, China
| | - Yamin Wang
- Department of Basic Science, Changzhou Vocational Institute of Engineering, Changzhou, Jiangsu, 213164, China
| | - Yongbin Jiang
- Department of Health management center, Hua Dong Sanatorium, Wuxi, 214065, China.
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China. .,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China.
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Guo G, Huang Z, Wang S, Chen X. Sex differences in uric acid and NT-pro BNP assessments during coronary severity. Medicine (Baltimore) 2020; 99:e19653. [PMID: 32282714 PMCID: PMC7220359 DOI: 10.1097/md.0000000000019653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/09/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022] Open
Abstract
To investigate the correlation between uric acid (UA) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and coronary artery severity in acute coronary syndrome patients of different sexes.A total of 134 patients with acute coronary syndrome (ACS) were investigated. According to sex, there were 96 cases in male group and 38 cases in female group. According to the number of diseased vessels, the degree of coronary artery lesion was determined and divided into negative group (n = 21), single vessel lesion group (n = 43), double vessel lesion group (n = 38), and 3 vessel lesion group (n = 32).Univariate analysis showed that UA, NT-proBNP was correlated with the severity of ACS (P < .05). UA was an independent risk factor for the severity of coronary artery disease in female group (P < .05), but not in male group (P > .05). There was no significant correlation between NT-proBNP and severity of coronary artery disease in different sex (P > .05).UA was significantly correlated with the severity of coronary heart disease, especially in women, but not in men. The level of NT-proBNP was positively correlated with the severity of coronary artery, but no significant difference was found in different sexes.
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Uric acid-lymphocyte ratios and myocardial damage parameters in ST elevated myocardial infarction. JOURNAL OF CONTEMPORARY MEDICINE 2020. [DOI: 10.16899/jcm.565897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Serum Uric Acid is Associated with Renal Prognosis of Lupus Nephritis in Women but not in Men. J Clin Med 2020; 9:jcm9030773. [PMID: 32178386 PMCID: PMC7141287 DOI: 10.3390/jcm9030773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 02/04/2023] Open
Abstract
Lupus nephritis (LN) is a major complication of systemic lupus erythematosus. Early intervention in lupus nephritis improves prognosis. There is an association between hyperuricemia and lupus nephritis; nevertheless, the sex-specific role of uric acid in lupus nephritis remains unclear. We retrospectively analyzed 578 patients diagnosed with LN by renal biopsy. We determine the relationship of serum uric acid to progression of LN using Kaplan–Meier survival analyses and Cox proportional hazards models. The primary end point was LN progression defined as the initiation of dialysis or kidney transplantation. Men had higher mean serum uric acid levels than did women. Every 1 mg/dL increase in baseline uric acid level increased the risk of LN progression by 15.1%. The serum uric acid level was an independent risk factor for LN progression in women (hazard ratio [HR], 1.158; confidence interval [CI], 1.018–1.317; p = 0.028) but not in men (HR, 1.499; CI, 0.964–2.331; p = 0.072). Sensitivity analysis involving serum uric acid terciles generated consistent and robust results. Serum uric acid level was an independent risk factor for LN progression in women but not in men.
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Tani S, Matsuo R, Imatake K, Suzuki Y, Takahashi A, Yagi T, Matsumoto N, Okumura Y. The serum uric acid level in females may be a better indicator of metabolic syndrome and its components than in males in a Japanese population . J Cardiol 2020; 76:100-108. [PMID: 32107070 DOI: 10.1016/j.jjcc.2020.01.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Although the level of uric acid (UA) is higher in males, increased UA level in females was reported to be closely associated with prevalence of metabolic syndrome (Mets) leading to atherosclerotic cardiovascular disease (ASCVD). Few data exist regarding the gender diferences in relationship between the serum UA levels and cardo-metabolic risk in the Japanese population, which generally contains a lower proportion of obesity than Western populations. METHODS This cross-sectional study was designed to investigate, by gender, the association between the serum UA level and abdominal obesity, and thereby cardio-metabolic risk i.e. presence of Mets and its components using a sample of 8567 apparently healthy subjects females: n = 3334, males: n = 5233 at the Health Planning Center of Nihon University Hospital between September 2015 and August 2016. RESULTS Receiver operating characteristic analysis was performed to reveal the accuracy of serum UA level as a predictor of abdominal obesity based on the Japanese criteria of Mets (females vs. males: area under the curve, 0.751 vs 0.609). Furthermore, the serum UA level and proportion of abdominal obesity rose with increasing age in females; in males, however, these parameters did not change in parallel with age. Furthermore, the serum UA levels in females reflected a status of cardio-metabolic risk when compared with males in a multi-logistic regression analysis. It is particularly worth noting that in the above-mentioned multivariate logistic regression analysis, the odds ratio of hyperuricemia in females was generally 1.3-2.5 times higher than that in males. CONCLUSIONS Compared with males, increased serum UA level in females might be involved in abdominal obesity and cardio-metabolic risk, possibly leading to the development of ASCVD even in a Japanese population. This may be due to gender differences affecting the development of abdominal obesity and changes in the serum UA levels with age. CLINICAL TRIAL REGISTRATION UMIN (http://www.umin.ac.jp/) Study ID: UMIN000035901retrospectively registered 1 March 2018.
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Affiliation(s)
- Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan; Department of Cardiology, Nihon University Hospital, Tokyo, Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Rei Matsuo
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan; Department of Cardiology, Nihon University Hospital, Tokyo, Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Atsuhiko Takahashi
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
| | - Tsukasa Yagi
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females. J Clin Med 2020; 9:jcm9010176. [PMID: 31936416 PMCID: PMC7019531 DOI: 10.3390/jcm9010176] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/26/2019] [Accepted: 01/07/2020] [Indexed: 02/07/2023] Open
Abstract
Hyperuricemia is a potential risk factor for immunoglobulin A nephropathy (IgAN) progression but its sex-specific effects on IgAN progression remain unclear. This study aimed to determine the effect of serum uric acid on IgAN progression and whether its effect varied according to sex. A total of 4339 patients who diagnosed with IgAN by renal biopsy were retrospectively analyzed. We assessed the association of serum uric acid on IgAN progression using Kaplan–Meier survival analyses and Cox proportional hazards models. The study’s primary end point was IgAN progression that was defined as a 50% decline in the estimated glomerular filtration rate or the initiation of dialysis. On average, the serum uric acid levels were higher in the men than in the women. In the fully adjusted Cox proportional hazards model that considered all subjects, the risk of IgAN progression increased by about 25.6% for every 1 mg/dL increase in the baseline uric acid level. The serum uric acid level was an independent risk factor for IgAN progression in both sexes but its effect was more pronounced in the women (hazard ratio [HR], 1.383; confidence interval [CI],1.263 to 1.514; p < 0.001) than in the men (HR, 1.181; CI, 1.097 to 1.272; p < 0.001) (pinteraction < 0.001). A sensitivity analysis involving serum uric acid quartiles generated consistent and robust results. In conclusion, the serum uric acid level was an independent risk factor for IgAN progression and its effect was more pronounced among the women compared with that among the men.
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Association between serum uric acid levels and coronary artery disease in different age and gender: a cross-sectional study. Aging Clin Exp Res 2019; 31:1783-1790. [PMID: 30694512 DOI: 10.1007/s40520-019-01137-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/18/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The association between uric acid (UA) and coronary artery disease (CAD) was controversial. It was still unclear how the UA level changes with age and gender. AIMS To confirm the relationship between the change of UA with age and gender and CAD, especially in elderly people. METHODS 8285 individuals were investigated. The changes of UA and hyperuricemia in female and male with age were analyzed. The associations of UA, and hyperuricemia with CAD in different age and sex were assessed. RESULTS Individuals were stratified into four groups according to their age: ≤ 39 years; 40-59 years; 60-79 years, and ≥ 80 years. The level of UA and the proportion of hyperuricemia increased significantly with age in female (P < 0.001), but showed a downward trend in male (P < 0.001). After adjusting for confounding factors, hyperuricemia remained an independent risk factor for the incident of CAD in all women (P = 0.029). In ≥ 80 year groups of female, UA and hyperuricemia became independent risk factors for the incident of CAD in the univariate and multivariate logistic regression analyses (all P ≤ 0.001). DISCUSSION The level of UA showed significantly different changes with age in different gender. The relationship between UA and CAD showed differences in different age and sex. CONCLUSIONS There were significant correlations between UA, hyperuricemia, and CAD only in female, particularly in the ≥ 80 year elderly women, but not in men.
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Li Y, Zhao L, Yu D, Ding G. Associations between serum uric acid and depression among middle-aged and elderly participants in China. PSYCHOL HEALTH MED 2019; 24:1277-1286. [PMID: 31131632 DOI: 10.1080/13548506.2019.1622748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Few studies have investigated the sex-related associations between serum uric acid and depression. This study aimed to explore the associations between serum uric acid and depression stratified by sex among middle-aged and elderly Chinese participants. Using the baseline data of the China health and retirement longitudinal study (CHARLS), a total of 10,522 participants aged 45 years and older were included in the final analysis. Depression symptoms were measured with the 10-term Center for Epidemiologic Studies Depression Scale (CES-D). A multivariable logistic regression model was performed to examine the associations between serum uric acid levels and depression, and the results are presented using odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of depression was 38% among middle-aged and elderly participants in China. In men, participants in the highest serum uric acid quartile had a decreased prevalence of depression relative to those in the lowest quartile (OR: 0.57; 95% CI: 0.41-0.81) after adjustment for potential confounders. However, there was no significant association between serum uric acid and depression among women. Participants with hyperuricemia were had no higher prevalence of depression relative to participants with normal serum uric acid level. Negative association between uric acid and depression was found in men, but not in women.
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Affiliation(s)
- Yaru Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention , Beijing , China
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Raja S, Kumar A, Aahooja RD, Thakuria U, Ochani S, Shaukat F. Frequency of Hyperuricemia and its Risk Factors in the Adult Population. Cureus 2019; 11:e4198. [PMID: 31106098 PMCID: PMC6504021 DOI: 10.7759/cureus.4198] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction Hyperuricemia (HU) does not only predispose to gouty arthritis but also increases the risk of major cardiovascular events and chronic kidney disease and decreases the overall quality of life. Although the incidence of hyperuricemia is increasing in the Asian population, prevalence studies from healthy asymptomatic adults are still scarce. The aim of this study was to determine the frequency of HU in the general population of Karachi, Pakistan. Methods A cross-sectional study was conducted in various out-patient clinics across Karachi in January 2019. Serum uric acid (SUA) levels were recorded using UASure Blood Uric Acid Monitoring System. Age, gender, body mass index (BMI), the frequency of activity, the frequency of meat consumption, and the presence of hypertension were noted. For hypertensives, the use of thiazide diuretics was noted. Data were entered and analyzed using SPSS v. 22. Results This study was completed by 375 individuals including 208 (55.5%) men and 167 (44.5%) women. Their mean age was 48.78 ± 13.399 years and the mean SUA level was 5.92 ± 1.73 mg/dl. There were 83 (39.9%) men and 30 (17.9%) women with elevated SUA levels. The overall prevalence of HU was 30.1%. Patient characteristics including gender, hypertension, the use of diuretics frequency of meat consumption, sedentary lifestyle, and BMI showed statistical significance with mean SUA levels. Eta-squared indicated a weak effect of SUA with gender, age, and use of thiazide diuretics. A moderate effect was seen with hypertension, the frequency of meat consumption, sedentary lifestyle, and BMI. Conclusion Hyperuricemia is a health hazard and its incidence is high in Pakistan. Patients who have risk factors for elevated SUA levels must be monitored for hyperuricemia at regular intervals.
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Affiliation(s)
- Sooraj Raja
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Akshay Kumar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Ramesh D Aahooja
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Ujala Thakuria
- Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PAK
| | - Simran Ochani
- Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, PAK
| | - Faizan Shaukat
- Internal Medicine, Jinnah Postgraduate Medical Center, Karachi, PAK
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Haque T, Rahman S, Islam S, Molla NH, Ali N. Assessment of the relationship between serum uric acid and glucose levels in healthy, prediabetic and diabetic individuals. Diabetol Metab Syndr 2019; 11:49. [PMID: 31285758 PMCID: PMC6588943 DOI: 10.1186/s13098-019-0446-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In epidemiological studies, serum uric acid (SUA) has been shown to be associated with hypertension and cardiovascular disorders. However, limited studies have evaluated the relationship between SUA and glucose levels in healthy and diabetic individuals and their observed findings are inconsistent. This study aimed to examine the relationship between SUA and fasting blood glucose (FBG) levels among healthy, prediabetic and diabetic individuals in Bangladesh. METHODS In total, 310 blood samples were collected from 215 male and 95 female subjects and analyzed for FBG, SUA, and lipid levels. All participants were categorized into four quartiles based on SUA concentrations. Diabetes and prediabetes were defined as FBG level ≥ 126 mg/dL and 100-125 mg/dL, respectively. The association between SUA and diabetes was evaluated by multinomial logistic regression analysis. RESULTS The prediabetic and diabetic individuals had a lower mean level of SUA (338.2 ± 101.6 and 290.9 ± 98.2 µmol/L, respectively) compared to healthy (369.5 ± 110.9 µmol/L) individuals (p < 0.001). SUA was positively associated with BMI, TG and TC but negatively associated with FBG. The prevalence of diabetes was decreased with increasing concentration of SUA across the quartiles. In regression analysis, SUA levels were inversely associated with diabetes mellitus. CONCLUSIONS SUA levels were high in healthy individuals but declined in prediabetic and diabetic individuals with increasing FBG concentrations. A significant inverse association was observed between the levels of SUA and diabetes in Bangladeshi adults. Further studies are needed to examine the reliability of using SUA to predict diabetes.
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Affiliation(s)
- Tangigul Haque
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Sadaqur Rahman
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Shiful Islam
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Noyan Hossain Molla
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
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Baseline Serum Uric Acid Levels Are Associated with All-Cause Mortality in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention. DISEASE MARKERS 2018; 2018:9731374. [PMID: 30647801 PMCID: PMC6311730 DOI: 10.1155/2018/9731374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/01/2018] [Accepted: 10/15/2018] [Indexed: 12/22/2022]
Abstract
Background Whether serum uric acid (UA) is associated with all-cause mortality in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI) remains unclear. Methods We performed a retrospective cohort study of 2296 patients with ACS. Curve-fitting and Cox proportional-hazard regression models with a hazard ratio (HR) and 95% confidence interval (CI) were used. Results During a mean follow-up of 246.31 ± 49.16 days, 168 (7.32%) patients died from all causes. Patients were divided into two groups [the high-UA group (n = 566) and the low-UA group (n = 1730)] based on the serum UA threshold value (5.6 mg/dl) identified through curve fitting. Fifty-three (9.36%) patients died in the high-UA group, and 115 (6.65%) patients died in the low-UA group. The difference between groups was statistically significant (P = 0.031). Univariate analysis showed that the risk of all-cause mortality in the high-UA group was significantly greater than that in the low-UA group (HR = 1.45, 95% CI: 1.03 to 2.04). This difference persisted after adjustment for baseline characteristics, medical history, and medication history (HR = 1.42, 95% CI: 1.05 to 1.87). Conclusions Our study demonstrated that elevated serum UA (>5.6 mg/dl) is associated with all-cause mortality in ASC patients after PCI.
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Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, Cautela J, Thuny F, Barraud J, Mottola G, Rossi P, Fenouillet E, Ruf J, Guieu R, Paganelli F. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal 2018. [PMID: 29626320 DOI: 10.1007/s11302-018-96q4-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
The role of serum uric acid in coronary artery disease has been extensively investigated. It was suggested that serum uric acid level (SUA) is an independent predictor of endothelial dysfunction and related to coronary artery lesions. However, the relationship between SUA and severity of coronary atherosclerosis evaluated via endothelial dysfunction using peripheral arterial tone (PAT) and the reactive hyperhemia index (RHI) has not been investigated during a first episode of acute coronary syndrome (ACS). The aim of our study was to address this point. We prospectively enrolled 80 patients with a first episode of ACS in a single-center observational study. All patients underwent coronary angiography, evaluation of endothelial function via the RHI, and SUA measurement. The severity of the coronary artery lesion was assessed angiographically, and patients were classified in three groups based on the extent of disease and Gensini and SYNTAX scores. Endothelial function was considered abnormal if RHI < 1.67. We identified a linear correlation between SUA and RHI (R2 = 0.66 P < 0.001). In multivariable analyses, SUA remained associated with RHI, even after adjustment for traditional cardiovascular risk factors and renal function. SUA was associated with severity of coronary artery disease. SUA is associated with severity of coronary atherosclerosis in patients with asymptomatic hyperuricemia. This inexpensive, readily measured biological parameter may be useful to monitor ACS patients.
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Affiliation(s)
| | - Marion Marlinge
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Marine Alessandrini
- EA 3279 Public Health, Chronic Disease and Quality of Life-Research Unit, Aix-Marseille University, Marseille, France
| | - Marc Laine
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Julien Fromonot
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | | | - Franck Thuny
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Giovanna Mottola
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Pascal Rossi
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Emmanuel Fenouillet
- UMR MD2, Aix-Marseille University, Marseille, France
- Institut des Sciences Biologiques, CNRS, Paris, France
| | - Jean Ruf
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Régis Guieu
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.
- UMR MD2, Aix-Marseille University, Marseille, France.
- Faculté de Médecine Nord, Boulevard P. Dramard, F-13015, Marseille, France.
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Tanriverdi Z, Besli F, Gungoren F, Altiparmak İH, Yesilay AB. Determination of the optimal cut-off value of serum uric acid concentration in patients with acute coronary syndrome. Atherosclerosis 2018; 272:240. [DOI: 10.1016/j.atherosclerosis.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
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Porchia LM, Gonzalez-Mejia ME, Torres-Rasgado E, Ruiz-Vivanco G, Pérez-Fuentes R. Low serum uric acid concentration augments insulin effects on the prevalence of metabolic syndrome. Diabetes Metab Syndr 2018; 12:325-331. [PMID: 29292186 DOI: 10.1016/j.dsx.2017.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/19/2017] [Indexed: 01/07/2023]
Abstract
AIM Insulin and uric acid were shown affect the prevalence of Metabolic Syndrome (MetS), but no studies examine their interaction. Therefore, we conducted this study to determine their biological interaction in subjects from central Mexico. METHODS 433 subjects were enrolled for a cross-sectional study. MetS was defined according to the Harmonizing Definition. Hyperuricemia was defined as ≥7.0 mg/dL in males and ≥5.8 mg/dL in females. Hyperinsulinemia was defined as ≥11.0 μU/mL. Pearson correlation coefficient (r) was calculated to determine the association between uric acid or insulin and MetS. Logistic regression was used to determine the risk (odds ratio) of developing MetS. Biological interactions were determined by the PROCESS Macro and Anderson's method. RESULTS Insulin and uric acid levels were elevated in MetS positive group (p < .05) and correlated with the number of MetS components (r = 0.276 and r = 0.166, p < .001, respectively). The interaction between uric acid and insulin was associated with the number of MetS components (PROCESS Model 1, interaction coefficient = -0.009, 95%CI: -0.017 to -0.001, p = .036). Johnson-Neyman analysis suggests the interaction is lost when uric acid concentration increased >7.0 mg/dL. When the cohort was separated by hyperinsulinemia and hyperuricemia, there was a significant risk of developing MetS for subjects with hyperuricemia (odds ratio = 2.3; 95%CI: 1.1-4.8, p < .05), hyperinsulinemia (odds ratio = 3.1; 95%CI: 1.9-4.9, p < .05), or both (odds ratio = 7.4; 95%CI: 3.2-17.2, p < .05); however, there was no multiplicative or additive interaction. CONCLUSION Here, we show that uric acid and insulin augments the prevalence of MetS; however, no biological interaction was determined for hyperuricemia and hyperinsulinemia.
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Affiliation(s)
- Leonardo M Porchia
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, Delegación Puebla, Instituto Mexicano del Seguro Social, México. Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Puebla, México.
| | - M Elba Gonzalez-Mejia
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Puebla, Mexico.
| | - Enrique Torres-Rasgado
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Puebla, Mexico.
| | - Guadalupe Ruiz-Vivanco
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, Delegación Puebla, Instituto Mexicano del Seguro Social, México. Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Puebla, México; Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Puebla, Mexico; Posgrado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Carretera Federal Tlaxcala, Puebla. S/N; Km. 1.5 Tlaxcala, Tlaxcala, C.P. 90062, Mexico.
| | - Ricardo Pérez-Fuentes
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, Delegación Puebla, Instituto Mexicano del Seguro Social, México. Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Puebla, México; Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Puebla, Mexico.
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The prevalence of thyroid nodules in northwest China and its correlation with metabolic parameters and uric acid. Oncotarget 2018; 8:41555-41562. [PMID: 28107199 PMCID: PMC5522227 DOI: 10.18632/oncotarget.14720] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 01/03/2017] [Indexed: 11/25/2022] Open
Abstract
This study aimed to estimate the prevalence of thyroid nodules (TN) and investigate its correlation with metabolic parameters, especially uric acid (UA) in northwest Chinese population. We conducted a large cross-sectional survey with 67,781 residents (33,020 men, 34,761 women), aged from 18 to 86 years in Shanxi, China, from January 2012 to December 2014. A thyroid ultrasound examination was performed with number and size of nodules being recorded. Metabolic parameters including body mass index (BMI), blood pressure (BP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting glucose (FG), and uric acid (UA) were also examined. Our study revealed that approximately 30.7% of men and 39.9% of women in Northwest China had TN, about half of which were multi-nodularity and a quarter of their TN larger than 1 cm. The prevalence of TN increased with aging and increasing BMI, and metabolic disorders, which also related to the increased incident of multi-nodularity and larger TN. Serum UA appeared to be a protective factor for TN in men older than 30 years, but a risk factor in both men younger than 30 years and women older than 30 years. This phenomenon needs to be further investigated.
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Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, Cautela J, Thuny F, Barraud J, Mottola G, Rossi P, Fenouillet E, Ruf J, Guieu R, Paganelli F. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal 2018; 14:191-199. [PMID: 29626320 DOI: 10.1007/s11302-018-9604-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
The role of serum uric acid in coronary artery disease has been extensively investigated. It was suggested that serum uric acid level (SUA) is an independent predictor of endothelial dysfunction and related to coronary artery lesions. However, the relationship between SUA and severity of coronary atherosclerosis evaluated via endothelial dysfunction using peripheral arterial tone (PAT) and the reactive hyperhemia index (RHI) has not been investigated during a first episode of acute coronary syndrome (ACS). The aim of our study was to address this point. We prospectively enrolled 80 patients with a first episode of ACS in a single-center observational study. All patients underwent coronary angiography, evaluation of endothelial function via the RHI, and SUA measurement. The severity of the coronary artery lesion was assessed angiographically, and patients were classified in three groups based on the extent of disease and Gensini and SYNTAX scores. Endothelial function was considered abnormal if RHI < 1.67. We identified a linear correlation between SUA and RHI (R2 = 0.66 P < 0.001). In multivariable analyses, SUA remained associated with RHI, even after adjustment for traditional cardiovascular risk factors and renal function. SUA was associated with severity of coronary artery disease. SUA is associated with severity of coronary atherosclerosis in patients with asymptomatic hyperuricemia. This inexpensive, readily measured biological parameter may be useful to monitor ACS patients.
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Affiliation(s)
| | - Marion Marlinge
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | - Marine Alessandrini
- EA 3279 Public Health, Chronic Disease and Quality of Life-Research Unit, Aix-Marseille University, Marseille, France
| | - Marc Laine
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Julien Fromonot
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | | | - Franck Thuny
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Giovanna Mottola
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | - Pascal Rossi
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Emmanuel Fenouillet
- UMR MD2, Aix-Marseille University, Marseille, France.,Institut des Sciences Biologiques, CNRS, Paris, France
| | - Jean Ruf
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Régis Guieu
- Laboratory of Biochemistry, Hopital Timone, Marseille, France. .,UMR MD2, Aix-Marseille University, Marseille, France. .,Faculté de Médecine Nord, Boulevard P. Dramard, F-13015, Marseille, France.
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Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population. Sci Rep 2017; 7:5456. [PMID: 28710367 PMCID: PMC5511152 DOI: 10.1038/s41598-017-05751-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 06/14/2017] [Indexed: 12/31/2022] Open
Abstract
Hyperuricemia is common in China and the relevance of hyperuricemia and cardiovascular disease (CVD) risk has been highlighted, but to date there has been rarely nation-wide study in China. Here, we aim to estimate the current prevalence of hyperuricemia and evaluate the associations between hyperuricemia and cardiovascular risk factors (CRFs) clustering in a large sample of China adults including a plurality of ethnic minorities. Generally, a nationally representative sample of 22983 adults aged ≥18 years was recruited from 2007 to 2011. Questionnaire data and information on anthropometric characteristics, and laboratory measurements were collected. We define hyperuricemia as SUA ≥416 mmol/L for men and SUA ≥357 mmol/L for women. We found that the prevalence of hyperuricemia was 13.0% (18.5% in men and 8.0% in women). To our estimation, hyperuricemic subjects had higher prevalence rates of CRFs clustering than non-hyperuricemic subjects. Furthermore, there was a dose-response association between the number of CVD risk factors clustering and hyperuricemia. Our study revealed a high prevalence of hyperuricemia and CVD risk factors clustering among Chinese adults, and hyperuricemia was significantly associated with coexistence of more CVD risk factors. Therefore, guidance and effective lifestyle intervention are required to prevent hyperuricemia and CVD risk factors in China.
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Capuano V, Marchese F, Capuano R, Torre S, Iannone AG, Capuano E, Lamaida N, Sonderegger M, Capuano E. Hyperuricemia as an independent risk factor for major cardiovascular events: a 10-year cohort study from Southern Italy. J Cardiovasc Med (Hagerstown) 2017; 18:159-164. [PMID: 28129213 DOI: 10.2459/jcm.0000000000000347] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To date, whether hyperuricemia may represent a marker or an independent risk factor for cardiovascular disease remains unclear. This study aimed at assessing the role of hyperuricemia in the onset of major cardiovascular events (MACE). METHODS Baseline clinical data were collected through a 1998/1999 longitudinal survey as part of the larger Valle dell'Irno Prevenzione Project. Ten years later, MACE incidence was evaluated. RESULTS A total of 1175 patients (50% men, aged 25-74 years) completed the study. At least one MACE was reported by 135 patients, whose mean uric acid values were significantly higher compared with patients without events (6.0 ± 4.8 and 4.6 ± 4.0 mg/dl, respectively; P < 0.01). Patients with uric acid values of at least 6 mg/dl (prevalence of 14.6%) had significantly lower levels of high-density lipoprotein cholesterol and increased values of BMI, blood pressure (BP), cholesterol, triglycerides, white blood cells, complement component 3 (C3) and creatinine. After subgrouping patients in tertiles and considering the first one as reference [odds ratio (OR): 1], the OR (95% confidence interval) was 1.44 (0.7-2.9) in the second and 2.2 (1.3-3.5) in the third tertile, respectively. Confounder-adjusted stepwise linear regression revealed uric acid, age, creatinine, glucose and systolic BP as independent predictors of MACE. Diastolic BP and creatinine were independently correlated with uric acid in the entire population, diastolic BP only in men and BMI, creatinine, age and C3 in women. CONCLUSION Hyperuricemia was shown to be a strong independent risk factor for MACE and should be included in cardiovascular prevention strategies. Whether hypouricemic drugs can decrease cardiovascular disease risk warrants further studies.
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Affiliation(s)
- Vincenzo Capuano
- aUnità Operativa di Cardiologia ed UTIC - Ospedale "G.Fucito", Mercato S. Severino - Azienda Ospedaliera Universitaria di SalernobCanopo Centro Studi, Salerno, Italy
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47
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Choi HY, Kim SH, Choi AR, Kim SG, Kim H, Lee JE, Kim HJ, Park HC. Hyperuricemia and risk of increased arterial stiffness in healthy women based on health screening in Korean population. PLoS One 2017; 12:e0180406. [PMID: 28666027 PMCID: PMC5493403 DOI: 10.1371/journal.pone.0180406] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/15/2017] [Indexed: 12/20/2022] Open
Abstract
Hyperuricemia is a risk factor for cardiovascular disease and is associated with increased arterial stiffness in high-risk populations. However, given the possible sex-related differences in the prevalence of hyperuricemia, the association between elevated serum uric acid (SUA) level and increased arterial stiffness has yielded conflicting results. We investigated the relationship between SUA and arterial stiffness in asymptomatic healthy subjects who underwent a health examination. Subjects who underwent a comprehensive health examination were enrolled. After exclusion of extensive confounding factors, 2,704 healthy subjects with coronary calcium score < 100 were evaluated in the final analysis. All subjects underwent brachial—ankle pulse wave velocity (baPWV) to detect arterial stiffness. The SUA was divided into quartiles for its association with arterial stiffness and was analyzed separately for men and women. The mean SUA level was significantly lower in women than in men. The baPWV was significantly elevated in subjects with the highest quartile of SUA in women, but not in men. After adjusting for age, smoking, systolic blood pressure, body mass index, estimated glomerular filtration rate, fasting plasma glucose, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and coronary artery calcium score, the highest quartile of SUA in women was significantly associated with increased risk of high baPWV compared with the lowest quartile of SUA (OR = 1.7, p = 0.018), whereas in men, SUA level was not associated with high baPWV. Our study showed that elevated SUA is independently associated with increased baPWV in healthy Korean women, but not in men.
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Affiliation(s)
- Hoon Young Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Seok-hyung Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ah Ran Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Gyu Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunwook Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Jong Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- * E-mail: (HCP); (HJK)
| | - Hyeong Cheon Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
- * E-mail: (HCP); (HJK)
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48
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Verdoia M, Nardin M, Rolla R, Marino P, Bellomo G, Suryapranata H, De Luca G. Immature platelet fraction and the extent of coronary artery disease: A single centre study. Atherosclerosis 2017; 260:110-115. [DOI: 10.1016/j.atherosclerosis.2017.03.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 02/08/2023]
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Nagano S, Takahashi M, Miyai N, Oka M, Utsumi M, Shiba M, Mure K, Takeshita T, Arita M. Association of serum uric acid with subsequent arterial stiffness and renal function in normotensive subjects. Hypertens Res 2017; 40:620-624. [PMID: 28202946 DOI: 10.1038/hr.2017.10] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/12/2016] [Accepted: 12/15/2016] [Indexed: 02/07/2023]
Abstract
Serum uric acid (SUA) is correlated with an increased risk of not only gout but also cardiovascular diseases. The present study aimed to longitudinally evaluate the effects of SUA level on renal function and arterial stiffness in a population-based sample of normotensive subjects. The subjects completed a health checkup in 2002 at baseline and in 2011 or 2012 at the end of the follow-up period. A total of 407 normotensive subjects (171 men and 236 women) aged 26-66 years were enrolled in this study. We measured blood pressure (BP), brachial-ankle pulse wave velocity (baPWV), central BP, intima-media thickness, SUA level and estimated glomerular filtration rate (eGFR). We divided the subjects into four subgroups according to the SUA quartile at baseline and compared renal function and arterial stiffness after the follow-up. The cutoff values were 3.6, 4.4, 5.6 and 9.6 mg dl-1. The SUA levels associated with baPWV (Q1, 1324; Q2, 1457; Q3, 1442; Q4, 1489 cm s-1), systolic BP (SBP) (Q1, 110.9; Q2, 110.1; Q3, 112.8; Q4. 116.1 mm Hg) and eGFR (P for trend <0.001). There was a significant difference in the incidence of arterial stiffness in women. Multivariate regression analyses showed that after adjusting for potential confounders, including age, sex, body mass index, SBP and lipids, SUA was a significant determinant of baPWV (β=0.117; P<0.05) and eGFR (β=-0.335, P<0.001). The results of this study suggest that elevated SUA levels may be associated with a higher risk of increased arterial stiffness and reduced renal function in normotensive subjects.
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Affiliation(s)
- Shiori Nagano
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Maasa Takahashi
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Nobuyuki Miyai
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Mayumi Oka
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Miyoko Utsumi
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Mitsuru Shiba
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
| | - Kanae Mure
- Department of Public Health,Wakayama Medical University, Wakayama, Japan
| | - Tatsuya Takeshita
- Department of Public Health,Wakayama Medical University, Wakayama, Japan
| | - Mikio Arita
- Wakayama Medical University Graduate School of Health and Nursing Science, Wakayama, Japan
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Canepa M, Viazzi F, Strait JB, Ameri P, Pontremoli R, Brunelli C, Studenski S, Ferrucci L, Lakatta EG, AlGhatrif M. Longitudinal Association Between Serum Uric Acid and Arterial Stiffness: Results From the Baltimore Longitudinal Study of Aging. Hypertension 2016; 69:228-235. [PMID: 27956574 DOI: 10.1161/hypertensionaha.116.08114] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 07/30/2016] [Accepted: 11/17/2016] [Indexed: 02/07/2023]
Abstract
Serum uric acid (SUA) has long been associated with increased cardiovascular risk, with arterial stiffness proposed as a mediator. However, evidence on the association between SUA and arterial stiffness is limited to contradicting cross-sectional studies. In this analysis, we examined the longitudinal relationship between SUA and pulse wave velocity, a measure of arterial stiffness, in a community-dwelling population. We studied 446 women and 427 men participating in the BLSA (Baltimore Longitudinal Study of Aging), with 1409 and 1434 observations, respectively, over an average period of 6 years. At baseline, mean ages of women and men were 65±13 and 68±13 years; mean SUA, 4.6±1.1 and 5.7±1.3 mg/dL; mean pulse wave velocity, 8.1±1.7 and 8.6±1.9 m/s, respectively (P<0.0001). In gender-stratified models accounting for age, blood pressure, renal function, metabolic measures, and medications, there was a significant interaction between SUA and follow-up time in men (β=0.69; P=0.0002) but not in women. Men, but not women, in the highest gender-specific SUA tertile at baseline (SUA≥6.2 mg/dL in men and SUA≥4.9 mg/dL in women) had a greater rate of pulse wave velocity increase over time than those in the lowest tertiles (β=0.997; P=0.012). This gender difference was lost when the distribution of SUA in men and women was made comparable by excluding hyperuricemic men (SUA≥6.2 mg/dL). In conclusion, higher SUA was associated with greater increase in pulse wave velocity in men but not women; this association was lost when men with SUA≥6.2 mg/dL were not included, suggesting a threshold for SUA association with arterial stiffness, which is more frequently reached in men.
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