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Zhang XJ, Hou AJ, Luan B, Wang CF, Li JJ. Uric acid to albumin ratio as a novel predictor for coronary slow flow phenomenon in patients with chronic coronary syndrome and non-obstructive coronary arteries. BMC Cardiovasc Disord 2024; 24:358. [PMID: 39003493 PMCID: PMC11245809 DOI: 10.1186/s12872-024-04040-5] [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] [Received: 04/10/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND The plasma uric acid to albumin ratio (UAR) is considered as a novel indicator for Inflammation. However, the association between UAR and coronary slow flow phenomenon (CSFP) remains unclear. METHODS A total of 1328 individuals with chronic coronary syndrome (CCS) receiving coronary angiography (CAG) and found no obvious obstructive stenosis (< 40%) were included in this study. 79 individuals developed CSFP and were divided into CSFP group. The 1:2 age-matched patients with normal coronary blood flow were allocated to the control group (n = 158). The clinical characteristics, laboratory parameters including uric acid, albumin ratio, UAR and the angiographic characteristics were compared between the two groups. RESULTS Patients with CSFP had a higher level of uric acid (392.3 ± 85.3 vs. 273.8 ± 71.5, P < 0.001), UAR (10.7 ± 2.2 vs. 7.2 ± 1.9, P < 0.001), but a lower level of plasma albumin (36.9 ± 4.2 vs. 38.5 ± 3.6, P = 0.003). Moreover, UAR increased as the numbers of vessels involved in CSFP increased. The logistic regression analysis demonstrated that UAR was independent predictors for CSFP. The Receiver operating characteristic (ROC) curve analysis showed that when UAR was more than 7.9, the AUC was 0.883 (95% CI: 0.840-0.927, p < 0.001), with the sensitivity and specificity were 78.2% and 88.2% respectively. CONCLUSION Combined uric acid with plasma albumin, UAR could serve as an independent predictor for CSFP.
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Affiliation(s)
- Xiao-Jiao Zhang
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Ai-Jie Hou
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Bo Luan
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Cheng-Fu Wang
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Jia-Jin Li
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China.
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Wang Y, Ming J, Guo Z, Zhang W, Li X, Zhou S, Li X, Ma H. Association of serum uric acid with anemia in U.S. adults: a cross-sectional study using secondary data. BMC Cardiovasc Disord 2023; 23:291. [PMID: 37291524 PMCID: PMC10251553 DOI: 10.1186/s12872-023-03291-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND High serum uric acid (SUA) is a risk factor of cardiovascular disease (CVD). Abnormal SUA have been correlated with a significant increase in mortality. Anemia is an independent predictor of mortality and CVD. To date, no study has investigated the relationship between SUA and anemia. Here, we explored the correlation between SUA and anemia in the American population. METHODS The cross-sectional study involved 9205 US adults from NHANES (2011-2014). The relationship between SUA and anemia was explored using multivariate linear regression models. Two-piecewise linear regression model, generalized additive models (GAM) and smooth curve fitting were performed to explore the non-linear relationships between SUA and anemia. RESULTS We found a U-shaped non-linear relationship between SUA and anemia. The inflection point of the SUA concentration curve was 6.2 mg/dL. The ORs (95% CIs) for anemia on the left and right of the inflection point were 0.86 (0.78-0.95) and 1.33 (1.16-1.52), respectively. The 95% CI of inflection point was 5.9-6.5 mg/dL. The findings showed that both genders presented a U-shaped correlation. Safe ranges of SUA in men and women were 6-6.5 and 4.3-4.6 mg/dL, respectively. CONCLUSIONS Both high and low SUA levels were correlated with increased risk of anemia, and a U-shaped relationship was observed between SUA and anemia.
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Affiliation(s)
- Yingying Wang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Jingjing Ming
- Department of Emergency Trauma Surgery, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Zongyun Guo
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Wei Zhang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xiang Li
- Department of Nephrology, Affiliated Hospital of Jining Medical University, No.6 Jiankang Road, Jining, 272011, Shandong, China
| | - Shengguo Zhou
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xia Li
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
| | - Huijuan Ma
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
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Biter HI, Tosu AR. The Prognostic Significance of Uric Acid/Albumin Ratio in Patients with Aortic Stenosis Following Transcatheter Aortic Valve Implantation for Major Adverse Cardiac and Cerebral Events. Medicina (B Aires) 2023; 59:medicina59040686. [PMID: 37109644 PMCID: PMC10147064 DOI: 10.3390/medicina59040686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Background: The goal of this study was to examine if the uric acid/albumin ratio (UAR) could predict major adverse cardiac and cerebral events (MACCEs) such as stroke, readmission, and short-term all-cause death in aortic stenosis (AS) patients, after transcatheter aortic valve implantation (TAVI). Material and Methods: A total of 150 patients who had TAVI for AS between 2013 and 2022 were included in our study, retrospectively. Before the TAVI, each patient’s baseline uric acid/albumin was determined. The study’s major endpoint was MACCEs, which included stroke, re-hospitalization, and 12-month all-cause death. Results: The UAR was found to be higher in TAVI patients who developed MACCEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the UAR (HR: 95% CI; 2.478 (1.779–3.453) p < 0.01), was an independent predictor of MACCEs in AS patients after TAVI. The optimal value of the UAR for MACCEs in AS patients following TAVI was >1.68 with 88% sensitivity and 66% specificity (AUC (the area under the curve): 0.899, p < 0.01). We noted that the AUC of UAR in predicting MACCEs was significantly higher than the AUC of albumin (AUC: 0.823) and uric acid (AUC: 0.805, respectively). Conclusion: MACCEs in AS patients who received TAVI may be predicted by high pre-procedural uric acid/albumin levels. The uric acid/albumin ratio (UAR) can be used to determine MACCEs in such patients following TAVI because it is inexpensive and straightforward to calculate inflammatory parameters.
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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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Liu PY, Huang CM, Chen HH, Wang HS, Lin GM. Serum Uric Acid and Clinical Cardiovascular Diseases in Men and Women: A Perspective for the Drug Target and the Effect of Sex. Endocr Metab Immune Disord Drug Targets 2023; 23:1368-1370. [PMID: 37151167 DOI: 10.2174/1871530323666230505114734] [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: 01/02/2023] [Revised: 02/28/2023] [Accepted: 03/13/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Pang-Yen Liu
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chen-Ming Huang
- Department of Cardiovascular Surgery, Mennonite Christian Hospital, Hualien City, Taiwan
| | - Han-Hsing Chen
- Department of Cardiovascular Medicine, Mennonite Christian Hospital, Hualien City, Taiwan
| | - Hui-Shang Wang
- Department of Internal Medicine, Division of Cardiology, Hualien Tzu Chi Hospital, Hualien City, Taiwan
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan
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Maulana S, Nuraeni A, Aditya Nugraha B. The Potential of Prognostic Biomarkers of Uric Acid Levels in Coronary Heart Disease Among Aged Population: A Scoping Systematic Review of the Latest Cohort Evidence. J Multidiscip Healthc 2022; 15:161-173. [PMID: 35115780 PMCID: PMC8801359 DOI: 10.2147/jmdh.s340596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sidik Maulana
- Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Aan Nuraeni
- Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
- Correspondence: Aan Nuraeni, Department of Critical Care and Emergency, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia, Tel + 6285624217606, Fax +022-7795596, Email
| | - Bambang Aditya Nugraha
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
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7
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Cheng Z, Zheng T, Zhang D, Yang J, Hu X, Yin C, Ren X, Li J, Shi D, Li N, Zheng S, Wang M, Bai Y. High-level uric acid in asymptomatic hyperuricemia could be an isolated risk factor of cardio-cerebrovascular diseases: A prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:3415-3425. [PMID: 34663537 DOI: 10.1016/j.numecd.2021.08.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS Whether the asymptomatic hyperuricemia (AH) raise the cardiovascular disease risk with or without hyperuricemia-related comorbidities still remains contentious. Our study was aimed to quantitatively access the incidence risk of coronary heart disease (CHD) and stroke associated with AH. METHODS AND RESULTS In this prospective cohort study, multivariate-adjusted Cox regression models were applied to evaluate the risk of cardiovascular disease (CVD). Baseline serum uric acid beyond normouricemia (357 mmol/L) was quarterly stratified based on the distribution of healthy populations without CVD onset. 1062 CVD first-attack cases were collected among the 29,974 study population (age range: 18-91, mean age: 47.2 ± 13.9 years-old) with a mean follow-up duration of 5.78 ± 0.83 years. The AH showed overall non-association with the CVD incident. However, significantly increased adjusted hazard ratio (HR) of CVD with 95% confidence interval (CI) were observed when the fourth quartile compared with normouricemia stratum in the total cohort population (CHD: 1.42, 1.21-1.68; stroke: 1.27, 1.06-1.41), male (CHD: 1.26, 1.12-1.55), female (CHD: 1.34, 1.04-2.02; stroke: 2.06, 1.13-3.77) and aged over 50 years-old population. Meanwhile, the age-standardized incidence rate of CVD in the fourth quartile was 2-3 times higher than the normouricemia population. After excluded 14,464 baseline population with diabetes, dyslipidemia, and hypertension, consistent results were also observed in the AH population in absence of comorbidities (CHD: 1.51, 1.22-2.25; stroke: 1.68, 1.13-2.39). CONCLUSION Asymptomatic hyperuricemia patients exposed to a higher level of uric acid (>=428 mmol/L) could significantly increase the incidence risk of CHD and stroke, with or without hyperuricemia-related comorbidities.
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Affiliation(s)
- Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology of China, Shenzhen, Guangdong 518055, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02901, USA
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, Jinchang, Gansu, 737100, PR China
| | - Jingli Yang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Xiaobin Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Chun Yin
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, Jinchang, Gansu, 737100, PR China
| | - Xiaowei Ren
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Juansheng Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Dian Shi
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02901, USA; School of Basic Medical Science, Lanzhou University, Lanzhou, Gansu, 73000, PR China
| | - Na Li
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, Jinchang, Gansu, 737100, PR China
| | - Shan Zheng
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Minzhen Wang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, PR China.
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Çakmak EÖ, Bayam E, Çelik M, Kahyaoğlu M, Eren K, Imanov E, Karagöz A, İzgi İA. Uric Acid-to-Albumin Ratio: A Novel Marker for the Extent of Coronary Artery Disease in Patients with Non-ST-Elevated Myocardial Infarction. Pulse (Basel) 2021; 8:99-107. [PMID: 34307206 PMCID: PMC8280454 DOI: 10.1159/000514533] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/16/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE This research aimed to investigate the predictive value of the uric acid-to-serum albumin ratio (UAR) in establishing the severity and extent of coronary artery disease (CAD) with non-ST segment elevation myocardial infarction (NSTEMI) patients. METHODS A total of 402 patients (mean age 63.5 ± 11.6 years) were included in this retrospectively designed study. We compared Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Scores (SS) between low (≤22) and intermediate-high (>22) groups. The UAR, the neutrophil-to-lymphocyte ratio (NLR), and the C-reactive protein-to-albumin ratio (CAR) were evaluated and compared. RESULTS SS >22 were observed in 30.8% (n = 124) of the patients, and their UAR, NLR, and CAR were significantly higher. Three separate multivariate analysis models performed as the outcome of a reliable correlation between UAR, NLR, CAR, and consequently UAR (OR = 2.08; 95% CI 1.21-3.58; p = 0.008) and CAR (OR = 3.33; 95% CI 1.85-5.9; p < 0.001) reached significance but NLR (OR = 1.26; 95% CI 0.86-1.84; p = 0.20) clinically trended significance (not statistically). Model performance comparisons demonstrated that UAR is a better predictor regarding likelihood ratios (UAR, 60.95; NLR, 57.8; and CAR, 59.0). CONCLUSION As a novel inflammatory marker, UAR independently predicted better outcomes than CAR and might be used reliably in prediction of the extent of CAD in NSTEMI patients.
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Affiliation(s)
- Ender Özgün Çakmak
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Emrah Bayam
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Çelik
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Muzaffer Kahyaoğlu
- Department of Cardiology, Gaziantep Abdülkadir Yüksel State Hospital, Gaziantep, Turkey
| | - Kıvanç Eren
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Elmin Imanov
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagöz
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - İbrahim Akın İzgi
- Department of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
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Yu J, Sun H, Zhu J, Wei X, Shi H, Shen B, Ren L, He Y, Zhang R, Zhang M, Peng H. Asymptomatic Hyperuricemia and Metabolically Unhealthy Obesity: A Cross-Sectional Analysis in the Tianning Cohort. Diabetes Metab Syndr Obes 2021; 14:1367-1374. [PMID: 33790604 PMCID: PMC8006809 DOI: 10.2147/dmso.s301363] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The relationship between obesity and hyperuricemia has been demonstrated by many studies. However, whether or to what extent metabolic condition influents the association between obesity and hyperuricemia was not clear. Here, we aimed to examine the association between obese-metabolic phenotype and hyperuricemia in a large sample of Chinese adults. METHODS According to BMI and metabolic syndrome, obese-metabolic phenotype was defined as metabolically unhealthy obesity (MUO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically healthy non-obesity (MHNO)in the Tianning cohort (N=5072). We conducted a cross-sectional analysis between obese-metabolic phenotype and hyperuricemia, followed by a Mendelian Randomization analysis using GWAS summary data to confirm the causality between uric acid and BMI. RESULTS The average level of serum UA showed 41.87-higher μmol/L in participants with MHO (β=41.87, P<0.001) and 63.18-higher μmol/L in participants with MUO (β=63.18, P<0.001), compared to those with MHNO. Compared to participants with MHNO, those with MUO had the highest likelihood to have hyperuricemia (OR=4.56, P<0.001), followed by those with MHO (OR=3.32, P<0.001). Mendelian randomization analysis indicated that uric acid was more likely to be a consequence of BMI (β=0.059, P=6.54×10-154). CONCLUSION MUO, in comparison with MHO, was significantly associated with hyperuricemia in Chinese adults.
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Affiliation(s)
- Jia Yu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hongyan Sun
- Center for Disease Prevention and Control of Tianning District, Changzhou, People’s Republic of China
| | - Jinhua Zhu
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Xintong Wei
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hongfei Shi
- Center for Disease Prevention and Control of Tianning District, Changzhou, People’s Republic of China
| | - Bin Shen
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Liyun Ren
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Rongyan Zhang
- Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China
| | - Mingzhi Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, People’s Republic of China
- Correspondence: Hao Peng Department of Epidemiology, School of Public Health, Medical College of Soochow University, 199 Renai Road, Industrial Park, Suzhou, 215123, People’s Republic of ChinaTel +86 512 6588 0078Fax +86 512 6588 0052 Email
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10
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Lin YK, Liu PY, Fan CH, Tsai KZ, Lin YP, Lee JM, Lee JT, Lin GM. Metabolic biomarkers and long-term blood pressure variability in military young male adults. World J Clin Cases 2020; 8:2246-2254. [PMID: 32548155 PMCID: PMC7281053 DOI: 10.12998/wjcc.v8.i11.2246] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of cardiovascular risk factors, including central obesity, high blood pressure, elevated plasma glucose, reduced high-density lipoprotein and elevated triglyceride levels.
AIM To investigate the relationship between metabolic biomarkers and long-term blood pressure variability (BPV) in young males.
METHODS A cohort of 1112 healthy military males aged 18-40 years from the cardiorespiratory fitness and hospitalization events in armed forces study in eastern Taiwan was prospectively included. The following metabolic biomarkers were used: Waist circumference, serum uric acid (SUA), triglycerides, high density lipoprotein, triglycerides, and fasting glycose. BPV was assessed by average real variability (ARV) and standard deviation (SD) across 4 clinic visits during the study period (2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association after adjusting for age, body mass index, systolic and diastolic blood pressure (SBP and DBP), lipid profiles, physical activity, alcohol intake and tobacco smoking status.
RESULTS In the unadjusted model, waist circumference was significantly and positively correlated with ARVDBP and SDDBP [β (standard errors) = 0.16 (0.049) and 0.22 (0.065), respectively], as was SUA [β = 0.022 (0.009) and 0.038 (0.012), respectively]. High-density lipoprotein was negatively correlated with ARVSBP [β = −0.13 (0.063)]. There were no associations with the other metabolic biomarkers. In contrast, only SUA was significantly correlated with SDSBP and SDDBP [β = 0.019 (0.011) and 0.027 (0.010), respectively] in the adjusted model.
CONCLUSION Our findings showed that of traditional metabolic biomarkers, SUA had the strongest positive correlation with long-term systolic and diastolic BPV in young male adults, and the clinical relevance needs further investigation.
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Affiliation(s)
- Yu-Kai Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
- Departments of Neurology, Tri-Service General Hospital, and Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
| | - Pang-Yen Liu
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
| | - Chia-Hao Fan
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
| | - Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu-Chi General Hospital, New Taipei City 231, Taiwan
| | - Ju-Mi Lee
- Department of Preventive Medicine, Eulji College of Medicine, Daejeon 34824, South Korea
| | - Jiunn-Tay Lee
- Departments of Neurology, Tri-Service General Hospital, and Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
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11
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McComb M, Ramanathan M. Generalized Pharmacometric Modeling, a Novel Paradigm for Integrating Machine Learning Algorithms: A Case Study of Metabolomic Biomarkers. Clin Pharmacol Ther 2020; 107:1343-1351. [PMID: 31863460 DOI: 10.1002/cpt.1746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/03/2019] [Indexed: 12/27/2022]
Abstract
There is an unmet need for identifying innovative machine learning (ML) strategies to improve drug treatment regimens and therapeutic outcomes. We investigate Generalized Pharmacometric Modeling (GPM), a novel paradigm that integrates ML algorithms with pharmacokinetic and pharmacodynamic structural models, population covariate modeling, and "big data," and enables identification of patient-specific factors contributing to drug disposition. We hypothesize that GPM will enhance forecasting of drug outcomes in diverse populations. We assessed random forest regression in conjunction with Bayesian networks as the ML methods within GPM and used the National Health and Nutrition Examination Survey population-based study database. GPM was utilized to identify subject-specific factors associated with cholesterol dynamics. Our results demonstrate the utility of GPM to enhance pharmacometrics modeling and its potential for modeling drug outcomes in diverse populations.
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Affiliation(s)
- Mason McComb
- Department of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Department of Neurology, University at Buffalo, The State University of New York, Buffalo, New York, USA
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12
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Rahimi-Sakak F, Maroofi M, Rahmani J, Bellissimo N, Hekmatdoost A. Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants. BMC Cardiovasc Disord 2019; 19:218. [PMID: 31615412 PMCID: PMC6792332 DOI: 10.1186/s12872-019-1215-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/30/2019] [Indexed: 01/09/2023] Open
Abstract
Background Cardiovascular disease (CVD) is the leading cause of death worldwide. Some studies have suggested anassociation between serum uric acid levels and cardiovascular mortality; however, the results have not been summarized in a meta-analysis. Methods A comprehensive search of all related studies until April 2018was performed in MEDLINE/PubMed and Scopus databases DerSimonianand Laird random-effects models were used to combine hazard ratios (HRs) with 95% confidence intervals (CIs). Dose-response analysis was also carried out. Results Thirty-two studies containing forty-four arms with 1,134,073 participants reported association between uric acid and risk of CVD mortality were included in our analysis. Pooled results showed a significant positive association between uric acid levels and risk of CVD mortality (HR 1.45, 95% CI 1.33–1.58, I2 = 79%). Sub-group analysis showed this relationshipwasstronger in women compared to men. Moreover, there was a significant non-linear association between uric acid levels and the risk of CVD mortality (r = 0.0709, p = 0.001). Conclusion Our analysis indicates a positive dose-response association between SUA and CVD mortality risk.
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Affiliation(s)
- Fatemeh Rahimi-Sakak
- Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Maroofi
- Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamal Rahmani
- Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nick Bellissimo
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, ShahidBeheshti University of Medical Sciences, Tehran, Iran.
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13
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Lin JW, Tsai KZ, Chen KW, Su FY, Li YH, Lin YP, Han CL, Lin F, Lin YK, Hsieh CB, Lin GM. Sex-Specific Association Between Serum Uric Acid and Elevated Alanine Aminotransferase in a Military Cohort: The CHIEF Study. Endocr Metab Immune Disord Drug Targets 2019; 19:333-340. [PMID: 30499423 DOI: 10.2174/1871530319666181129163802] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 01/05/2023]
Abstract
AIM The study was conducted in order to examine the sex-specific association of serum uric acid (SUA) levels with elevated serum alanine aminotransferase (ALT) in a Taiwanese military cohort. METHODS We made a cross-sectional examination of the sex-specific relationship using 6728 men and 766 women, aged 18-50 years from a large military cohort in Taiwan. SUA levels within the reference range (<7.0 mg/dL for men and <5.7 mg/dL for women respectively) were divided into quartiles and SUA levels greater than the upper reference limits were defined as hyperuricemia. Elevated ALT levels were defined as ≥40 U/L. Multivariate logistic regression analysis was performed to determine the association between each SUA category and elevated ALT levels in men and women, respectively. RESULTS The prevalence of hyperuricemia and elevated ALT in men were 18.7% and 12.7%, respectively, and in women were 3.3% and 2.1%, respectively. As compared with the lowest SUA quartile, hyperuricemia was associated with elevated ALT in men (odds ratios (OR): 1.62, 95% confidence intervals (CI): 1.19-2.20) after controlling for age, service specialty, body mass index, metabolic syndrome components, current cigarette smoking, alcohol intake status, and weekly exercise times, but the associations for the other SUA quartiles were null. By contrast, the associations of hyperuricemia (OR: 0.81, 95% CI: 0.10-6.64) and the other SUA quartiles with elevated ALT were null in women. CONCLUSION Our findings suggest that the relationship between each SUA level and elevated ALT may differ by sex among military young adults. The mechanism for the sex difference requires further investigations.
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Affiliation(s)
- Jia-Wei Lin
- Department of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Zhe Tsai
- Division of Dentistry Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Kai-Wen Chen
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Fang-Ying Su
- Biotechnology R&D Center, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Yi-Hwei Li
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Buddhist Tzu Chi General Hospital, Taipei branch, New Taipei City, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Felicia Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Yu-Kai Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Bao Hsieh
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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14
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Hasic S, Kadic D, Kiseljakovic E, Jadric R, Spahic E. Serum Uric Acid Could Differentiate Acute Myocardial Infarction and Unstable Angina Pectoris in Hyperuricemic Acute Coronary Syndrome Patients. Med Arch 2018; 71:115-118. [PMID: 28790542 PMCID: PMC5511526 DOI: 10.5455/medarh.2017.71.115-118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction: Serum uric acid (SUA) is the final product of purine metabolism in humans. Aim: The present study aimed to identify a potential association between serum UA and cardiac troponin I (cTnI) levels and to find out whether uric acid could differentiate patients presenting with the acute myocardial infarction (AMI) and unstable angina pectoris (UAP) in hyperuricemic and normouricemic acute coronary syndrome (ACS) patients. Methods: Eighty ACS patients, aged 50-83 years, were enrolled in the study, 40 of them presenting with AMI and 40 with UAP. Frequency of patients with serum uric level over threshold for hyperuricemia was investigated and two groups of patients were formed such as hyperuricemic and normouricemic groups (A and B groups, respectively) independently of type of ACS. Those groups of patients were also subjected to cTnI measurement. Results: Levels of SUA are associated with the type of ACS in the hyperuricemic ACS patients (AMI versus UAP, 499(458-590), 425(400-447) mmol/L, p=0.007, respectively). Uric acid correlated significantly with cTnI, moderate positively in the group A (rho=0.358, p=0.038) and moderate negatively in the group B (r=-0.309, p=0.037) of ACS patients. Multiple logistic regression analysis revealed that cTnI and age were independently associated with the SUA levels in the group A of ACS patients. Conclusions: Serum uric acid differentiates AIM and UAP patients in hyperuricemic group of acute coronary syndrome. Therefore it can be used as nonspecific parameter for evaluation of the myocardial lesion extent only in hyperuricemic ACS patients. This is supported by finding that cTnI along with age predicts SUA level in hyperuricemic ACS patients.
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Affiliation(s)
- Sabaheta Hasic
- Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Damira Kadic
- Department of Laboratory Diagnostics, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
| | - Emina Kiseljakovic
- Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Radivoj Jadric
- Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Emina Spahic
- Primary Health Care Centre Zenica, Zenica, Bosnia and Herzegovina
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15
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Martínez-Ramírez M, Flores-Castillo C, Sánchez-Lozada LG, Bautista-Pérez R, Carreón-Torres E, Fragoso JM, Rodriguez-Pérez JM, García-Arroyo FE, López-Olmos V, Luna-Luna M, Vargas-Alarcón G, Franco M, Pérez-Méndez O. Hyperuricemia is Associated with Increased Apo AI Fractional Catabolic Rates and Dysfunctional HDL in New Zealand Rabbits. Lipids 2017; 52:999-1006. [PMID: 28940111 DOI: 10.1007/s11745-017-4301-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/14/2017] [Indexed: 12/16/2022]
Abstract
The potential cause-effect relationship between uric acid plasma concentrations and HDL functionality remains elusive. Therefore, this study aimed to explore the effect of oxonic acid (OA)-induced hyperuricemia on the HDL size distribution, lipid content of HDL subclasses, and apo AI turnover, as well as HDL functionality in New Zealand white rabbits. Experimental animals received OA 750 mg/kg/day by oral gavage during 21 days. The HDL-apo AI fractional catabolic rate (FCR) was determined by exogenous labeling with 125I, and HDL subclasses were determined by sequential ultracentrifugation and PAGE. Paraoxonase-1 activity (PON-1) and the effect of HDL on relaxation of aorta rings in vitro were determined as an indication of HDL functionality. Oxonic acid induced a sixfold increase of uricemia (0.84 ± 0.06 vs. 5.24 ± 0.12 mg/dL, P < 0.001), and significant decreases of triglycerides and phospholipids of HDL subclasses, whereas HDL size distribution and HDL-cholesterol remained unchanged. In addition, HDL-apo AI FCR was significantly higher in hyperuricemic rabbits than in the control group (0.03697 ± 0.0038 vs. 0.02605 ± 0.0017 h-1 respectively, P < 0.05). Such structural and metabolic changes were associated with lower levels of PON-1 activities and deleterious effects of HDL particles on endothelium-mediated vasodilation. In conclusion, hyperuricemia is associated with structural and metabolic modifications of HDL that result in impaired functionality of these lipoproteins. Our data strongly suggest that uric acid per se exerts deleterious effects on HDL that contribute to increase the risk of atherosclerosis.
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Affiliation(s)
- Miriam Martínez-Ramírez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - Cristóbal Flores-Castillo
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | | | - Rocío Bautista-Pérez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - Elizabeth Carreón-Torres
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - José Manuel Fragoso
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - José Manuel Rodriguez-Pérez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | | | - Victoria López-Olmos
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - María Luna-Luna
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico
| | - Martha Franco
- Nephrology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico
| | - Oscar Pérez-Méndez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, Mexico City, Mexico.
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16
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Seki S, Oki Y, Tsunoda S, Takemoto T, Koyama T, Yoshimura M. Impact of alcohol intake on the relationships of uric acid with blood pressure and cardiac hypertrophy in essential hypertension. J Cardiol 2016; 68:447-454. [DOI: 10.1016/j.jjcc.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/29/2015] [Accepted: 11/05/2015] [Indexed: 12/26/2022]
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17
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Kawabe M, Sato A, Aonuma K. Author's reply. J Cardiol 2016; 68:461-462. [PMID: 27026151 DOI: 10.1016/j.jjcc.2016.03.002] [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: 02/29/2016] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Masayuki Kawabe
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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18
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Wang R, Song Y, Yan Y, Ding Z. Elevated serum uric acid and risk of cardiovascular or all-cause mortality in people with suspected or definite coronary artery disease: A meta-analysis. Atherosclerosis 2016; 254:193-199. [PMID: 27755985 DOI: 10.1016/j.atherosclerosis.2016.10.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/15/2016] [Accepted: 10/04/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Serum uric acid (SUA) has been recognized as an independent risk factor for mortality in the general population. We performed this meta-analysis to determine whether elevated SUA levels are associated with greater risk of cardiovascular or all-cause mortality in people with suspected or definite coronary artery disease (CAD). METHODS The Pubmed and Embase databases were searched up to April 1, 2016 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in people with suspected or definite CAD. Pooled adjusted risk ratio (RR) and corresponding 95% confidence interval (CI) were calculated for the highest vs. the lowest SUA category or each 1 mg/ml SUA rise. RESULTS Nine studies enrolling 25,229 participants were included in the analyses. The highest vs. lowest SUA category was associated with greater risk of cardiovascular mortality (RR 2.09; 95% CI: 1.45-3.02) and all-cause mortality (RR 1.80; 95% CI: 1.39-2.34) after adjustment for potential confounders in a random effects model. Moreover, each 1 mg/ml SUA rise significantly increased by 12% cardiovascular mortality and by 20% all-cause mortality. CONCLUSIONS Elevated SUA levels are strongly and independently associated with greater risk of cardiovascular and all-cause mortality in people with suspected or definite CAD.
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Affiliation(s)
- Ruijuan Wang
- Department of Cardiology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei province, PR China.
| | - Youxin Song
- Department of Orthopedics, Affiliated Hospital of Chengde Medical College, Chengde, Hebei province, PR China
| | - Yaqi Yan
- Department of Cardiology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei province, PR China
| | - Zhenjiang Ding
- Department of Cardiology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei province, PR China
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19
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Sex differences in the association between serum uric acid and cardiac mortality in Asian patients with established coronary artery disease: A revisit of the ET-CHD registry in Taiwan, 1997-2003. J Cardiol 2016; 68:461. [PMID: 26970934 DOI: 10.1016/j.jjcc.2016.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 11/21/2022]
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20
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Aşkın L, Karakelleoğlu Ş, Değirmenci H, Demirelli S, Şimşek Z, Taş MH, Topçu S, Lazoğlu Z. Comparison of the effects of metoprolol or carvedilol on serum gamma-glutamyltransferase and uric acid levels among patients with acute coronary syndrome without ST segment elevation. Anatol J Cardiol 2015; 16:16-22. [PMID: 26467358 PMCID: PMC5336699 DOI: 10.5152/akd.2015.5708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objective: Serum gamma-glutamyltransferase (GGT) and uric acid levels measured in patients with acute coronary syndrome without ST segment elevation (NSTEMI) are important in diagnosis and in predicting the prognosis of the disease. There is a limited number of clinical studies investigating the effects of beta-blockers on GGT and uric acid levels in these patients. In our study, we aimed to investigate the effects of beta-blocker therapy on GGT and uric acid levels. Methods: We conducted a randomized, prospective clinical study. Hundred patients with NSTEMI were included in this study, and they were divided into two groups. Fifty patients were administered metoprolol succinate treatment (1 × 50 mg), whereas the remaining 50 patients were administered carvedilol treatment (2 × 12.5 mg). Thereafter, all of the patients underwent coronary angiography. Blood samples were taken at the time of admission, at the 1st month, and 3rd month to detect GGT and uric acid levels. Results: There was no statistically significant difference among the metoprolol or carvedilol groups in terms of the GGT levels measured at the baseline, 1st month, and 3rd month (p=0.904 and p=0.573, respectively). In addition, there was no statistically significant difference among the metoprolol or carvedilol groups in terms of uric acid levels measured at the baseline, 1st month, and 3rd month (p=0.601 and p=0.601, respectively). Conclusion: We found that GGT and uric acid levels did not show any change compared to the baseline values, with metoprolol and carvedilol treatment initiated in the early period in patients with NSTEMI.
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Affiliation(s)
- Lütfü Aşkın
- Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey.
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21
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Kleber ME, Delgado G, Grammer TB, Silbernagel G, Huang J, Krämer BK, Ritz E, März W. Uric Acid and Cardiovascular Events: A Mendelian Randomization Study. J Am Soc Nephrol 2015; 26:2831-8. [PMID: 25788527 DOI: 10.1681/asn.2014070660] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/24/2014] [Indexed: 01/05/2023] Open
Abstract
Obesity and diets rich in uric acid-raising components appear to account for the increased prevalence of hyperuricemia in Westernized populations. Prevalence rates of hypertension, diabetes mellitus, CKD, and cardiovascular disease are also increasing. We used Mendelian randomization to examine whether uric acid is an independent and causal cardiovascular risk factor. Serum uric acid was measured in 3315 patients of the Ludwigshafen Risk and Cardiovascular Health Study. We calculated a weighted genetic risk score (GRS) for uric acid concentration based on eight uric acid-regulating single nucleotide polymorphisms. Causal odds ratios and causal hazard ratios (HRs) were calculated using a two-stage regression estimate with the GRS as the instrumental variable to examine associations with cardiometabolic phenotypes (cross-sectional) and mortality (prospectively) by logistic regression and Cox regression, respectively. Our GRS was not consistently associated with any biochemical marker except for uric acid, arguing against pleiotropy. Uric acid was associated with a range of prevalent diseases, including coronary artery disease. Uric acid and the GRS were both associated with cardiovascular death and sudden cardiac death. In a multivariate model adjusted for factors including medication, causal HRs corresponding to each 1-mg/dl increase in genetically predicted uric acid concentration were significant for cardiovascular death (HR, 1.77; 95% confidence interval, 1.12 to 2.81) and sudden cardiac death (HR, 2.41; 95% confidence interval, 1.16 to 5.00). These results suggest that high uric acid is causally related to adverse cardiovascular outcomes, especially sudden cardiac death.
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Affiliation(s)
- Marcus E Kleber
- Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany;
| | - Graciela Delgado
- Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tanja B Grammer
- Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Günther Silbernagel
- Department of Angiology, Swiss Cardiovascular Center, Inselspital, University of Bern, Bern, Switzerland
| | - Jie Huang
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Bernhard K Krämer
- Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eberhard Ritz
- Division of Nephrology, Department of Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Winfried März
- Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; and Synlab Academy, Synlab Services GmbH, Mannheim, Germany
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Sugihara S, Hisatome I, Kuwabara M, Niwa K, Maharani N, Kato M, Ogino K, Hamada T, Ninomiya H, Higashi Y, Ichida K, Yamamoto K. Depletion of Uric Acid Due to SLC22A12 (URAT1) Loss-of-Function Mutation Causes Endothelial Dysfunction in Hypouricemia. Circ J 2015; 79:1125-32. [PMID: 25739858 DOI: 10.1253/circj.cj-14-1267] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Uric acid (UA) serves as an antioxidant in vascular endothelial cells. UA transporter 1 (URAT1) encoded by SLC22A12 is expressed in the kidney and vessels and its loss of function causes hypouricemia. The purpose of this study was to examine whether there is any endothelial dysfunction in patients with hypouricemia. METHODS AND RESULTS Twenty-six patients with hypouricemia (<2.5 mg/dl) and 13 healthy control subjects were enrolled. Endothelial function was evaluated using flow-mediated dilation (FMD). mRNA of UA transporters expressed in cultured human umbilical endothelial cells (HUVEC) was detected on RT-PCR. There was a positive correlation between FMD and serum UA in the hypouricemia group. URAT1 loss-of-function mutations were found in the genome of 21 of 26 patients with hypouricemia, and not in the other 5. In the hypouricemia groups, serum UA in homozygous and compound heterozygous patients was significantly lower than in other groups, suggesting that severity of URAT1 dysfunction may influence the severity of hypouricemia. Thirteen of 16 hypouricemia subjects with homozygous and compound heterozygote mutations had SUA <0.8 mg/dl and their FMD was lower than in other groups. HUVEC do not express mRNA of URAT1, suggesting the null role of URAT1 in endothelial function. CONCLUSIONS Depletion of UA due to SLC22A12/URAT1 loss-of-function mutations causes endothelial dysfunction in hypouricemia patients.
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Affiliation(s)
- Shinobu Sugihara
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics Faculty of Medicine, Tottori University
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Zhang Y, Xu RX, Li S, Zhu CG, Guo YL, Sun J, Li JJ. Lipoprotein subfractions partly mediate the association between serum uric acid and coronary artery disease. Clin Chim Acta 2014; 441:109-14. [PMID: 25549901 DOI: 10.1016/j.cca.2014.12.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 12/19/2014] [Accepted: 12/22/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Serum uric acid (SUA) has been established to be highly associated with coronary artery disease (CAD) susceptibility and lipid metabolism, but the underlying mechanisms are unclear. Recently, lipoprotein subfractions have been proposed to be more valuable in CAD risk evaluation. Hence, we sought to investigate whether the relationship between SUA and CAD is partly mediated by lipoprotein subfractions. METHODS A total of 401 consecutive subjects undergoing coronary angiography were enrolled. The baseline clinical data including the SUA level and lipid profiles were collected. The lipoprotein subfractions were determined using the Lipoprint system. RESULTS In the overall population, the upper SUA quintiles had significantly higher atherogenic lipid parameters and unbalanced lipoprotein subfractions especially higher small dense low-density lipoprotein-cholesterol (sdLDL-C) and lower large high-density lipoprotein-cholesterol (HDL-C) (p<0.05). The levels of SUA and lipoprotein subfractions were dramatically different between male and female. After adjusting for traditional risk factors including gender, multivariate linear regression analysis suggested that SUA was positively associated with sdLDL-C (β=0.113, p=0.013) but negatively related to large HDL-C level (β=-0.152, p=0.002). Given the significant association of the SUA level with lipoprotein subfractions and incident CAD (adjusted OR=1.312, 95% CI 1.069-1.609, p=0.009), we performed the mediation analyses and found that 8.7-10.5% of the effect of SUA on CAD susceptibility was mediated by the increased sdLDL-C or decreased large HDL-C level (p<0.05). CONCLUSIONS The SUA level was proved to be associated with lipoprotein subfractions including sdLDL-C (positive) and large HDL-C (negative), which partly mediated the association between SUA and CAD susceptibility.
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Affiliation(s)
- Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Jing Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China.
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Zhang JW, He LJ, Cao SJ, Yang Q, Yang SW, Zhou YJ. Association of serum uric acid and coronary artery disease in premenopausal women. PLoS One 2014; 9:e106130. [PMID: 25184207 PMCID: PMC4153543 DOI: 10.1371/journal.pone.0106130] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 08/02/2014] [Indexed: 02/07/2023] Open
Abstract
Objective To date, no study in the published literature has investigated the role of various serum uric acid (SUA) concentrations in the development of angiographically-proven coronary artery disease (CAD) in premenopausal women. Therefore, the aim of this study was to investigate the role SUA levels may play in the prevalence, severity, and prognosis of CAD in premenopausal women. Methods This cross-sectional retrospective study included 607 premenopausal women who had undergone coronary angiography. The CAD diagnosis was based upon stenosis affecting ≥50% of the luminal diameter. Association of the SUA levels with CAD prevalence, severity, and clinical outcomes were assessed by statistical analysis. Results In total, 369 (60.8%) of the patients were diagnosed with CAD. The CAD patients had significantly higher SUA levels than those without CAD (5.3±1.9 vs. 4.8±1.7 mg/dL, P = 0.001). The SUA levels were found to be significantly associated with CAD prevalence (P = 0.013). Patients with higher levels of SUA also showed increased rates of multivessel disease and composite end-points, such as major adverse cardiac events. Furthermore, multivariate analysis identified abnormally high levels of uric acid (hyperuricemia) as an independent risk factor for CAD (OR 1.51 (1.11–2.53), P<0.05). Conclusions The SUA levels are significantly associated with the prevalence of CAD. The SUA levels may be a predictor for incidence of major cardiovascular events in premenopausal women.
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Affiliation(s)
- Jian-wei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Ling-jie He
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shu-jun Cao
- Department of Cardiology, Beijing Daxing Hospital, Capital Medical University, Beijing, China
| | - Qing Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Shi-wei Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Yu-jie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
- * E-mail:
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Uysal OK, Duran M, Sahin DY, Elbasan Z, Kaya MG, Gur M, Cayli M. Uric Acid As a Cardiovascular Risk Factor Or Not? Angiology 2013; 65:234-5. [DOI: 10.1177/0003319713507770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Onur Kadir Uysal
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mustafa Duran
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Durmus Yildiray Sahin
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Zafer Elbasan
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Mustafa Gur
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Murat Cayli
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
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Li YH, Lin GM, Lai CP, Lin CL, Wang JH. β-Blocker use in angiographic coronary artery disease patients without myocardial infarction or heart failure: a report from the ET-CHD registry, 1997-2006. Int J Cardiol 2013; 168:4817-9. [PMID: 23871618 DOI: 10.1016/j.ijcard.2013.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Yi-Hwei Li
- Department of Public Health, Tzu-Chi University, Hualien, Taiwan.
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Seasonal variation in cardiac death of patients with angiographic coronary artery disease from the ET-CHD registry, 1997–2006. Int J Cardiol 2013; 168:3090-2. [DOI: 10.1016/j.ijcard.2013.04.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 04/06/2013] [Indexed: 11/17/2022]
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Li YH, Lin GM, Lin CL, Wang JH, Chen YJ, Han CL. Relation of serum uric acid and body mass index to mortality in high-risk patients with established coronary artery disease: a report from the ET-CHD registry, 1997-2006. J Cardiol 2013; 62:354-60. [PMID: 23838556 DOI: 10.1016/j.jjcc.2013.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/14/2013] [Accepted: 06/01/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hyperuricemia is associated with a higher risk of death in patients with coronary artery disease (CAD). In contrast, overweight or obesity was associated with survival benefits in this population. However, the relation of body mass index (BMI) and serum uric acid (SUA) to mortality has not been clarified in this population. METHODS We studied a cohort of 1202 patients with angiographic CAD from the ET-CHD registry during 1997-2003 in Taiwan. To evaluate the relation of BMI and SUA on mortality, the subjects were categorized into 4 groups by BMI >/= 25 kg/m(2) (overweight or obesity) or BMI<25 kg/m(2) (normal- or under-weight), and SUA levels higher or lower than the median of 6.6 mg/dl. At a median follow-up of 5.4 years, cardiac and all-cause deaths were the primary end points. RESULTS Multivariate analyses demonstrated that high SUA group had a significantly higher cardiac mortality [hazard ratio (HR): 1.79, 95% confidence interval (CI): 1.14-2.82, p=0.023] and overall mortality (HR: 1.68, 95% CI: 1.19-2.36, p=0.003) than low SUA group only in overweight or obese patients. Additionally, high BMI was associated with a significantly lower cardiac mortality (HR: 0.58, 95% CI: 0.38-0.99, p=0.023) and overall mortality (HR: 0.62, 95% CI: 0.41-0.82, p=0.003) than low BMI in patients with low SUA levels. Furthermore, normal-low weight and underweight patients (BMI<21 kg/m(2)) were found to have a higher risk of mortality regardless of SUA levels. CONCLUSIONS Among patients with established CAD, SUA may be a potent predictor to mortality in overweight or obese patients. Moreover, the obesity-mortality paradox phenomenon was mainly driven by higher mortality risk in underweight patients and lower mortality risk in overweight and obese patients with low SUA.
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Affiliation(s)
- Yi-Hwei Li
- Department of Public Health, Tzu-Chi University, Hualien, Taiwan.
| | - Gen-Min Lin
- Department of Public Health, Tzu-Chi University, Hualien, Taiwan; Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.
| | - Chin-Lon Lin
- Division of Cardiology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan
| | - Ji-Hung Wang
- Division of Cardiology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan
| | - Yu-Jung Chen
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan; Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Relation of estimated glomerular filtration rate and body mass index to mortality in non-dialysis patients with coronary artery disease: a report from the ET-CHD registry, 1997-2003. J Cardiol 2013; 62:144-50. [PMID: 23731921 DOI: 10.1016/j.jjcc.2013.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/16/2013] [Accepted: 03/27/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low estimated glomerular filtration rate (eGFR) and body mass index (BMI) have been known as poor prognostic factors in patients with coronary artery disease (CAD). Besides, high BMI was associated with higher survival rate in patients on dialysis as well. However, the relation of eGFR and BMI to mortality has not been clarified in non-dialysis CAD patients. METHODS We studied a cohort of 1243 non-dialysis patients with angiographic CAD from the ET-CHD registry during 1997-2003 in Taiwan. To evaluate the relation of eGFR and BMI to mortality, the subjects were categorized into 4 groups by BMI higher or lower than 25 kg/m2 and eGFR higher or lower than 60 mL/min/1.73 m2, a cut-off value for chronic kidney disease (CKD). At a mean follow-up of 5.4 years, cardiac and all-cause deaths were the primary end points. RESULTS In the high BMI group, CKD was a strong predictor of cardiac and overall mortality [hazard ratio (HR): 1.63 (95% CI: 1.05-2.53) and 2.17 (95% CI: 1.54-3.07), respectively]. Besides, CKD marginally elevated the mortality risk in the low BMI group. Among CKD patients, BMI was not associated with mortality except for a high death rate in patients with BMI lower than 21 kg/m2. In contrast, in non-CKD patients, high BMI group had a lower cardiac and overall mortality than the low BMI group [HR: 0.75 (95% CI: 0.48-1.16) and 0.55 (95% CI: 0.39-0.77), respectively]. CONCLUSIONS Among non-dialysis CAD patients in eastern Taiwan, lower eGFR was associated with worse prognosis regardless of BMI levels. Notably, in patients with high BMI, the relationship between CKD and mortality was extremely remarkable. Moreover, the obesity-mortality paradox phenomenon was not present in non-dialysis CKD patients.
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Gender differences in the impact of diabetes on mortality in patients with established coronary artery disease: a report from the eastern Taiwan integrated health care delivery system of Coronary Heart Disease (ET-CHD) registry, 1997-2006. J Cardiol 2013; 61:393-8. [PMID: 23499171 DOI: 10.1016/j.jjcc.2013.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/06/2013] [Accepted: 02/14/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The effect of type 2 diabetes mellitus (DM) on mortality was more pronounced in women than men with coronary artery disease (CAD) in the pre-stent era before 1996. However this relationship is controversial in the post-stent era. METHODS We studied a cohort of 1073 patients with angiographically defined CAD from the Eastern Taiwan integrated health care delivery system of Coronary Heart Disease (ET-CHD) registry during 1997-2003 in Tzu-Chi General Hospital, Hualien, Taiwan. To evaluate gender-specific DM effect on mortality, the subjects were divided into 4 groups: diabetic women (n=147), non-diabetic women (n=127), diabetic men (n=239), and non-diabetic men (n=560). At a mean follow-up of 5.4 years, cardiac and all-cause mortality were the primary end points. RESULTS Annual total mortality rates were 10.2%, 5.1%, 7.2%, and 4.8%; annual cardiac mortality rates were 8.2%, 3.0%, 4.3%, and 2.6% for diabetic women, non-diabetic women, diabetic men, and non-diabetic men, respectively. Multivariate Cox regression models, adjusted for possible confounders showed that gender-specific hazard ratios (HRs) of DM for total mortality were 2.02 (95% CI: 1.32-3.09), and 1.72 (95% CI: 1.32-2.25) for women and men, respectively. The HRs for total mortality associated with diabetes were not different between women and men (p=0.53). Similarly, adjusted gender-specific HRs of DM for cardiac mortality were 2.46 (95% CI: 1.45-4.19) for women, and 1.83 (95% CI: 1.28-2.62) for men, which were also not significantly different (p=0.36). CONCLUSIONS Among patients with CAD, the impact of DM on mortality was consistently higher in women than in men, but the differences across sexes were not statistically significant after 1996 in Taiwan.
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Lin GM, Li YH, Lin CL, Wang JH, Han CL. Relation of body mass index to mortality among Asian patients with obstructive coronary artery disease during a 10-year follow-up: a report from the ET-CHD registry. Int J Cardiol 2013; 168:616-20. [PMID: 23465238 DOI: 10.1016/j.ijcard.2013.01.204] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/18/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Gen-Min Lin
- Department of Public Health, Tzu-Chi University, Hualien, Taiwan; Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.
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