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Huang X, Hu L, Tao S, Xue T, Hou C, Li J. Relationship between uric acid to high-density cholesterol ratio (UHR) and circulating α-klotho: evidence from NHANES 2007-2016. Lipids Health Dis 2024; 23:244. [PMID: 39123222 PMCID: PMC11312937 DOI: 10.1186/s12944-024-02234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE To investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) and circulating α-klotho levels in U.S. adults. METHODS A cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Circulating α-klotho was defined as the dependent variable and UHR was defined as the independent variable. Multivariable linear regression was performed to assess the relationship between the independent and dependent variables. The nonlinear relationship and effect size between UHR and α-klotho were evaluated using smooth curve fitting and threshold effect analysis. Subgroup analysis and sensitivity analysis were conducted to determine the stability of the results. The diagnostic performance of UHR and α-klotho in common elderly diseases was compared using ROC (Receiver Operating Characteristic) analysis. RESULTS Among 12,849 participants, there was a negative relationship between the UHR and circulating α-klotho. In the fully adjusted overall model, each unit increase in UHR was associated with a decrease of 4.1 pg/mL in α-klotho. The threshold effect analysis showed that before the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 15.0 pg/mL in α-klotho; beyond the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 2.8 pg/mL in α-klotho. Subgroup analyses and sensitivity analysis indicated that the relationship between UHR and α-klotho remained stable across most populations. The ROC diagnostic test indicated that the evaluative efficacy of UHR in diagnosing age-related diseases was comparable to that of α-klotho. CONCLUSION This study revealed that the UHR was associated with the circulating α-klotho concentration, with a negative association observed in most cases. This finding suggested that the UHR might be a promising indicator for evaluating circulating α-klotho levels.
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Affiliation(s)
- Xuanchun Huang
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Lanshuo Hu
- Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Shiyi Tao
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Tiantian Xue
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Chengzhi Hou
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
| | - Jun Li
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
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Yang R, Ding N, Qin J, Peng H. The relationship between uric acid and bone mineral density in the intermediate stage of CKD 1-3. BMC Nephrol 2024; 25:219. [PMID: 38982346 PMCID: PMC11234712 DOI: 10.1186/s12882-024-03650-7] [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: 05/20/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Some studies have suggested that uric acid has antioxidant properties that can prevent bone loss, but the relationship between uric acid and bone mineral density is controversial. The aim of this study was to investigate the relationship between UA and BMD in patients with CKD stage 1-3. METHODS We extracted 13,047 participants from the NHANES database, including 7342 male subjects and 5705 female subjects. Weighted multiple linear regression analysis was used to investigate the correlation between UA and BMD in patients with CKD stages 1-3. RESULTS In patients with CKD stage 1-3, UA was significantly correlated with BMD. In the male group, UA was positively associated with BMD (β, 7.94 [95%CI, 4.95, 10.94]). In the female group, there was a negative relationship between them (β, -5.33 [95%CI, -8.77, -1.89]). The relationship between UA and BMD in male group showed an inverted U-shaped curve, and UA was positively correlated before 6.1 mg/dl and negatively correlated after 6.1 mg/dl. The relationship was basically negative in the female group. CONCLUSIONS For the patients with CKD stage 1-3, the relationship between UA and BMD showed an inverted U-shaped curve in the males, while the relationship was largely negative in the females.
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Affiliation(s)
- Ruiling Yang
- Department of Nephrology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
| | - Jiao Qin
- Department of Nephrology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
| | - Hongchun Peng
- Department of Orthopedics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
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Demiray A, Afsar B, Covic A, Kuwabara M, Ferro CJ, Lanaspa MA, Johnson RJ, Kanbay M. The Role of Uric Acid in the Acute Myocardial Infarction: A Narrative Review. Angiology 2021; 73:9-17. [PMID: 33902350 DOI: 10.1177/00033197211012546] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increased serum uric acid (SUA) levels have been associated with various pathologic processes such as increased oxidative stress, inflammation, and endothelial dysfunction. Thus, it is not surprising that increased SUA is associated with various adverse outcomes including cardiovascular (CV) diseases. Recent epidemiological evidence suggests that increased SUA may be related to acute myocardial infarction (AMI). Accumulating data also showed that elevated UA has pathophysiological role in the development of AMI. However, there are also studies showing that SUA is not related to the risk of AMI. In this narrative review, we summarized the recent literature data regarding SUA and AMI after providing some background information for the association between UA and coronary artery disease. Future studies will show whether decreasing SUA levels is beneficial for outcomes related to AMI and the optimum SUA levels for best outcomes in CV diseases.
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Affiliation(s)
- Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Masanari Kuwabara
- Intensive Care Unit and Department of Cardiology, Toranomon Hospital, Tokyo, Japan
| | - Charles J Ferro
- Department of Renal Medicine, University Hospitals Birmingham, Edgbaston, Birmingham, the United Kingdom
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
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Jing M, Zhao S, Rogiewicz A, Slominski BA, House JD. Effects of phytase supplementation on growth performance, plasma biochemistry, bone mineralisation and phosphorus utilisation in pre-lay pullets fed various levels of phosphorus. ANIMAL PRODUCTION SCIENCE 2021. [DOI: 10.1071/an20265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context
Reducing the environmental impact of animal production is becoming a really hot topic, especially with raised concerns over excessive flows of nitrogen and phosphorus (P) to the environment.
Aims
The present study was conducted to determine the effects of phytase supplementation on growth, plasma biochemistry, bone mineralisation and P utilisation of pre-lay pullets fed varying levels of non-phytate P.
Methods
A total of 240 Lohmann pullet chicks were randomly allocated to one of six dietary treatments with eight replicate cages (5 birds per cage) per treatment. Six treatments included three phytase-free diets and three diets supplemented with 1000 U/kg phytase; the non-phytate P levels were 2.75–2.50–2.25, 3.75–3.50–3.25 and 4.75–4.50–4.25 g/kg in the former, and 1.75–1.50–1.25, 2.75–2.50–2.25 and 3.75–3.50–3.25 g/kg in the latter, for the age of 0–4, 4–8 and 8–16 weeks respectively.
Key results
No significant differences were found for growth performance, plasma biochemistry (calcium, P, alkaline phosphatase and albumin) and bone mineralisation among dietary treatments, but P retention (%) was different (P < 0.001). Analysis of planned contrasts showed that phytase supplementation increased phytate P retention (P < 0.001), and improving the utilisation of phytate P tended most efficiently under low P conditions. Total P retention rate was reduced slightly by phytase supplementation (P < 0.05).
Conclusions
The results indicated that dietary non-phytate P level could possibly be reduced to 1.75, 1.50 and 1.25 g/kg for 0–4, 4–8 and 8–16 weeks of age respectively after phytase supplementation, without compromising pullet growth and performance during the pre-laying period.
Implications
The results of this study will contribute to decreasing P excretion by poultry and reducing the potential environmental impact with land application of manure.
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Isnuwardana R, Bijukchhe S, Thadanipon K, Ingsathit A, Thakkinstian A. Association Between Vitamin D and Uric Acid in Adults: A Systematic Review and Meta-Analysis. Horm Metab Res 2020; 52:732-741. [PMID: 33049785 PMCID: PMC7556437 DOI: 10.1055/a-1240-5850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Association between vitamin D and uric acid is complex and might be bidirectional. Our study aimed to determine the bidirectional association between vitamin D and uric acid in adults. Using MEDLINE via PubMed and Scopus, we systematically searched for observational or interventional studies in adults, which assessed the association between serum vitamin D and serum uric acid, extracted the data, and conducted analysis by direct and network meta-analysis. The present review included 32 studies, of which 21 had vitamin D as outcome and 11 had uric acid as outcome. Meta-analysis showed a significant pooled beta coefficient of serum uric acid level on serum 25(OH)D level from 3 studies of 0.512 (95% confidence interval: 0.199, 0.825) and a significant pooled odds ratio between vitamin D deficiency and hyperuricemia of 1.496 (1.141, 1.963). The pooled mean difference of serum 25(OH)D between groups with hyperuricemia and normouricemia was non-significant at 0.138 (-0.430, 0.707) ng/ml, and the pooled mean difference of serum uric acid between categories of 25(OH)D were also non-significant at 0.072 (-0.153, 0.298) mg/dl between deficiency and normal, 0.038 (-0.216, 0.292) mg/dl between insufficiency and normal, and 0.034 (-0.216, 0.283) mg/dl between deficiency and insufficiency. In conclusion, increasing serum uric acid might be associated with increasing 25(OH)D level, while vitamin D deficiency is associated with hyperuricemia. These reverse relationships should be further evaluated in a longitudinal study.
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Affiliation(s)
- Ronny Isnuwardana
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sanjeev Bijukchhe
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence Kunlawat Thadanipon Department of Clinical Epidemiology and BiostatisticsFaculty of Medicine Ramathibodi HospitalMahidol University, 270 Rama VI RoadRatchathewi10400 BangkokThailand+ 66 2 201 1284+66 2 201 1284
| | - Atiporn Ingsathit
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Fayed A, El Nokeety MM, Heikal AA, Sadek KM, Hammad H, Abdulazim DO, Salem MM, Sharaf El Din UA. Urine albumin and serum uric acid are important determinants of serum 25 hydroxyvitamin D level in pre-dialysis chronic kidney disease patients. Ren Fail 2019; 41:540-546. [PMID: 31234687 PMCID: PMC6598477 DOI: 10.1080/0886022x.2018.1563552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Low serum 25 hydroxyvitamin D (25 OH D) is common among chronic kidney disease (CKD) patients. This cross-sectional study is looking for the different factors associated with serum 25 OH D among pre-dialysis CKD. 1624 adult stage 3–5 CKD patients were studied beside 200 normal control subjects. All candidates were tested for body mass index (BMI), estimated glomerular filtration rate (eGFR), calcium (Ca), phosphorus (P), parathormone (PTH), 25 OH D, albumin, and uric acid (UA), and urine albumin/creatinine ratio (ACR). Multivariate linear regression analysis was done to determine predictors of 25 OH D. 98.6% of CKD patients have inadequate level of 25 OH D vs 48% of normal subjects. Serum 25 OH D was significantly lower in CKD patients (mean ± S.D = 16.54 ± 5.8 vs 37.79 ± 3.58 ng/mL for CKD vs control group respectively, p < .001). Serum level of 25 OH D has significant positive correlation with Ca (r = 0.337, p < .001), and significant negative correlation with P, PTH, UA, and ACR (r = −0.440, −0. 679, −0.724, and −0.781respectively, p < .001 in all). The independent predictors of 25 OH D were Ca, P, UA, PTH, and ACR (R square = 0.7, β = −0.087, −0.226, −0.313, −0.253, and −0.33 respectively, p < .001 in all). In conclusion, pre-dialysis CKD patients frequently suffer low 25 OH D. Among the different abnormalities related to CKD, urine albumin excretion rate and UA are the most important predictors of 25 OH D in these patients.
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Affiliation(s)
- Ahmed Fayed
- a Nephrology Unit, Internal Medicine Department , School of Medicine, Cairo University , Manial , Egypt
| | - Mahmoud M El Nokeety
- a Nephrology Unit, Internal Medicine Department , School of Medicine, Cairo University , Manial , Egypt
| | - Ahmed A Heikal
- b Internal Medicine Department, School of Medicine , Cairo University , Manial , Egypt
| | - Khaled M Sadek
- a Nephrology Unit, Internal Medicine Department , School of Medicine, Cairo University , Manial , Egypt
| | - Hany Hammad
- a Nephrology Unit, Internal Medicine Department , School of Medicine, Cairo University , Manial , Egypt
| | - Dina O Abdulazim
- c Rheumatology and Rehabilitation Department, School of Medicine , Cairo University , Manial , Egypt
| | - Mona M Salem
- d Endocrinology Unit, Internal Medicine Department, School of Medicine , Cairo University , Manial , Egypt
| | - Usama A Sharaf El Din
- a Nephrology Unit, Internal Medicine Department , School of Medicine, Cairo University , Manial , Egypt
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Afsar B, Sag AA, Oztosun C, Kuwabara M, Cozzolino M, Covic A, Kanbay M. The role of uric acid in mineral bone disorders in chronic kidney disease. J Nephrol 2019; 32:709-717. [DOI: 10.1007/s40620-019-00615-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/24/2019] [Indexed: 01/28/2023]
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Andrews ES, Perrenoud L, Nowak KL, You Z, Pasch A, Chonchol M, Kendrick J, Jalal D. Examining the effects of uric acid-lowering on markers vascular of calcification and CKD-MBD; A post-hoc analysis of a randomized clinical trial. PLoS One 2018; 13:e0205831. [PMID: 30356327 PMCID: PMC6200237 DOI: 10.1371/journal.pone.0205831] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/01/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a systemic disorder that leads to vascular calcification and accelerated atherosclerosis. Uric acid has been shown to associate with vascular calcification and with carotid intima-media thickness (CIMT) and to suppress the 1 α-hydroxylase enzyme leading to lower 1,25-dihydroxyvitamin D (1,25(OH)2D) and higher intact parathyroid hormone (iPTH) levels. We hypothesized that lowering serum uric acid would reduce CIMT, calcification propensity, and circulating markers of CKD-MBD in CKD. METHODS This is a post-hoc analysis of a randomized, double-blind study of 80 patients with stage 3 CKD and hyperuricemia who received allopurinol or placebo for 12 weeks. CIMT and T50 were measured as markers of vascular disease and serum calcification propensity, respectively. The following markers of CKD-MBD were measured: serum calcium, phosphorus, vitamin D metabolites, iPTH, and fibroblast growth factor-23 (FGF-23). Expression of extra-renal 1α-hydroxylase was evaluated in endothelial cells of study participants. FINDINGS Allopurinol successfully lowered serum uric acid levels compared to placebo with an estimate of -3.3 mg/dL (95% C.I. -4.1,-2.5; p < 0.0001). After 12 weeks, however, we found no significant change in CIMT or serum T50. There was not a significant change in vitamin D metabolites, iPTH, FGF-23, or the expression of endothelial 1α-hydroxylase. CONCLUSION These data suggest that factors other than uric acid may play a more important role in the regulation of CKD- MBD including vascular calcification and vitamin D metabolism in patients with CKD.
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Affiliation(s)
- Emily S. Andrews
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Loni Perrenoud
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Kristen L. Nowak
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Zhiying You
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Andreas Pasch
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Jessica Kendrick
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Diana Jalal
- Nephrology Division, The University of Iowa, Iowa City, IA, United States of America
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Ala-Mutka EM, Rimpelä JM, Fyhrquist F, Kontula KK, Hiltunen TP. Effect of hydrochlorothiazide on serum uric acid concentration: a genome-wide association study. Pharmacogenomics 2018; 19:517-527. [PMID: 29580174 DOI: 10.2217/pgs-2017-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To recognize genetic associations of hydrochlorothiazide-induced change in serum uric acid (SUA) concentration. PATIENTS & METHODS We conducted a genome-wide association study on hydrochlorothiazide-induced change in SUA in 214 Finnish men from the GENRES study. Replication analyses were performed in 465 Finns from the LIFE study. RESULTS In GENRES, we identified 31 loci associated with hydrochlorothiazide-induced change in SUA at p < 5 × 10-5. rs1002976 near VEGFC associated with the change in GENRES and in LIFE. rs950569 near BRINP3 associated with the change in SUA in GENRES and LIFE. The analysis of previously reported SNPs and candidate genes provided some proof for PADI4 and ABCC4. CONCLUSION We report genetic markers that may predict the increase in SUA concentration during thiazide treatment.
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Affiliation(s)
- Eero M Ala-Mutka
- Department of Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni M Rimpelä
- Department of Medicine, University of Helsinki, Helsinki, Finland.,Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Frej Fyhrquist
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Kimmo K Kontula
- Department of Medicine, University of Helsinki, Helsinki, Finland.,Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Timo P Hiltunen
- Department of Medicine, University of Helsinki, Helsinki, Finland.,Department of Medicine, Helsinki University Hospital, Helsinki, Finland
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