Association between uric acid and brachial-ankle pulse wave velocity: secondary analysis of data from a cross-sectional study

Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease

BACKGROUND

Although hyperuricemia and hypertension are significantly correlated, their temporal relationship and whether this relationship is associated with risk of cardiovascular disease (CVD) are largely unknown. This study aimed to examine temporal relationship between hyperuricemia and hypertension, and its association with future risk of CVD.

METHODS

This study included 60,285 participants from the Kailuan study. Measurement of serum uric acid (SUA), systolic and diastolic blood pressure (SBP and DBP) were obtained twice at 2006 (baseline) and 2010. Cross-lagged and mediation analysis were used to examine the temporal relationship between hyperuricemia and hypertension, and the association of this temporal relationship with CVD events risk after 2010.

RESULTS

After adjusting for covariates, the cross-lagged path coefficients (β1) from baseline SUA to follow-up SBP and DBP were significantly greatly than path coefficients (β2) from baseline SBP and DBP to follow-up SUA (β1=0.041 versus β2=0.003; Pdifference<0.0001 for SBP; β1=0.040 versus β2=0.000; Pdifference<0.0001 for DBP). The path coefficients from baseline SUA to follow-up SBP and DBP in group with incident CVD were significantly greatly than that in group without incident CVD (Pdifference of β1 in the two groups was 0.0018 for SBP and 0.0340 for DBP). Furthermore, SBP and DBP partially mediated the effect of SUA on incident CVD, the mediation effect was 57.64% for SBP and 46.27% for DBP. Similar mediated results were observed for stroke and myocardial infarction.

CONCLUSION

Increased SUA levels probably precede elevated BP, and BP partially mediates the pathway from SUA to incident CVD.

Association between serum uric acid and arterial stiffness in a large-aged 40-70 years old population

Arterial stiffness (AS), measured by arterial stiffness index (ASI), is a determinant in cardiovascular (CV) diseases. A high serum uric acid (SUA) level is a known risk factor for CV disease. The authors investigated the relationship between SUA and ASI in the middle-age UK Biobank population study. AS was defined as ASI > 10 m/s. A cross-sectional study was conducted from 126 663 participants. Participants were divided into four quartiles according to SUA levels and sex. Sex multivariate analyses were performed with adjustment for confounding factors. The average ASI for overall participants was 9.3 m/s (SD: 2.9); 9.9 m/s (SD: 2.8) for men and 8.7 m/s (SD: 2.9) for women (P < .001). Men presented higher SUA rate (351.3 mmol/L (SD:67.9)) than women (270.7 mmol/L (SD:64.4)), P < .001. In men multivariate analysis, SUA remained a determinant of AS, with an increase in the strength of the association between the quartiles, Q4 versus Q1, OR = 1.10 [1.05-1.16], P < .001, Q3 versus Q1, OR = 1.09 [1.04-1.14], P < .001 but not between Q2 and Q1 (P = .136). In women, SUA remained significant for AS, with an increase in the strength of the association between the quartiles, Q4 versus Q1, OR = 1.22 [1.15-1.30], P < .001, Q3 versus Q1, OR = 1.13 [1.07-1.19], P < .001 and no difference between Q2 and Q1 (P = .101). When applying continuous SUA values in the multivariate analysis, SUA remained significant (P < .001), with a Youden index value for men = 338.3 mmol/L and for women = 267.3 mmol/L. High SUA levels were associated with AS, suggesting that SUA could be used as a predictor of atherosclerosis.

Association between serum uric acid and depressive symptoms stratified by low-grade inflammation status

Despite increasing evidence for an association between circulating uric acid (UA) and depression, the directionality of this association remains unclear and is potentially moderated by low-grade inflammation. Thus, the present study aimed to investigate the cross-sectional association between serum UA concentration and depressive symptoms in Korean individuals with and without low-grade inflammation, as measured using serum high-specific C-reactive protein (hs-CRP) levels. The final study sample comprised 4188 participants, aged 19–79 years, from the Korea National Health and Nutrition Examination Study 2016. Data on serum uric acid (UA) concentrations, serum hs-CRP levels, Patient Health Questionnaire-9 (PHQ-9) scores, and relative covariates were retrieved. Negative binomial regression with adjustment for the complex sample design was used to analyze the associations. After adjusting for covariates, log-transformed serum UA concentrations and total PHQ-9 scores were positively associated (incidence rate ratio [IRR] = 1.34 [95% confidence interval [CI] = 1.09–1.66]) for participants without low-grade inflammation and inversely associated (IRR = 0.64 [95% CI = 0.45–0.92]) for participants with low-grade inflammation. In conclusion, the direction of the association between serum UA and depressive symptoms was the opposite in participants with and without low-grade inflammation. The study has the limitation of potential uncontrolled confounders.

Prediction of age and brachial-ankle pulse-wave velocity using ultra-wide-field pseudo-color images by deep learning

This study examined whether age and brachial-ankle pulse-wave velocity (baPWV) can be predicted with ultra-wide-field pseudo-color (UWPC) images using deep learning (DL). We examined 170 UWPC images of both eyes of 85 participants (40 men and 45 women, mean age: 57.5 ± 20.9 years). Three types of images were included (total, central, and peripheral) and analyzed by k-fold cross-validation (k = 5) using Visual Geometry Group-16. After bias was eliminated using the generalized linear mixed model, the standard regression coefficients (SRCs) between actual age and baPWV and predicted age and baPWV from the UWPC images by the neural network were calculated, and the prediction accuracies of the DL model for age and baPWV were examined. The SRC between actual age and predicted age by the neural network was 0.833 for all images, 0.818 for central images, and 0.649 for peripheral images (all P < 0.001) and between the actual baPWV and the predicted baPWV was 0.390 for total images, 0.419 for central images, and 0.312 for peripheral images (all P < 0.001). These results show the potential prediction capability of DL for age and vascular aging and could be useful for disease prevention and early treatment.

Factors Associated with Brachial-Ankle Pulse Wave Velocity in an Apparently Healthy Chinese Population

Purpose

To investigate the factors influencing brachial-ankle pulse wave velocity (baPWV) in an apparently healthy Chinese population, especially the associations between baPWV and indices of blood pressure (BP).

Methods

A total of 1123 participants with no history of hypertension were enrolled in this study, and the baPWV and BP of all four limbs were measured along with other covariates. Correlation analyses and multivariate linear regression models were used to identify factors associated with baPWV.

Results

A total of 1123 participants (male 43.3%, mean age: 58.4 ± 13.9 years) were included. The average baPWV was 14.87 ± 3.21 m/s, and no difference was found between the sexes. Age was positively correlated with baPWV (r = 0.65, p < 0.01), especially in females (r = 0.71 versus 0.56 in males). The correlation coefficient between age and baPWV increased markedly after the age of 65 years. In addition, the resting heart rate (RHR), waist-hip ratio, glomerular filtration rate, and plasma glucose level were significantly correlated with baPWV (r = 0.25, 0.22, -0.43, and 0.25, respectively; p < 0.01). BP parameters were highly positively correlated with baPWV, especially systolic BP (SBP) and pulse pressure (PP). Multivariate regression revealed that age, BP parameters, and RHR were independently correlated with baPWV (p < 0.01) after adjusting for confounding factors. The standardized coefficients of SBP were greater than those of PP, followed by diastolic BP (DBP).

Conclusion

BaPWV increased with age, especially after 65 years. Age, BP, and RHR were independent factors associated with baPWV. The effect of SBP on baPWV was more prominent than that of PP.

Gender-Specific Association between Serum Uric Acid and Incident Fundus Arteriosclerosis in Chinese Population: A Retrospective Cross-Sectional Study

Elevated levels of serum uric acid (SUA) were considered to be risk factors for cardiovascular disease, it has been found to be associated with increased arteriosclerosis. The aim of this study was to explore the gender specific relationship between SUA and fundus arteriosclerosis in a healthy population. In a retrospective cross-sectional study, 23474 individuals without diabetes and hypertension were included in the present study. SUA levels were cut to four groups as Q1 to Q4, according to the quartiles. The odds ratio and 95% confidence interval of different SUA levels were estimated by a binomial logistic regression model. A restrictive cubic spline method was used to estimate the dose-response relationship between SUA and fundus arteriosclerosis. Subgroup analysis was performed to find the gender-specific association between SUA and incident fundus arteriosclerosis. In males, after adjusting for confounding factors, the highest SUA level was significantly associated with the risk of incident fundus arteriosclerosis. The OR with 95%CI for Q4 was 1.44(1.18, 1.76), Q1 as a reference. Specially, for females, SUA level was not associated with the incidence of fundus arteriosclerosis. In conclusion, elevated levels of SUA were associated with the incidence of fundus arteriosclerosis in males, but not in females.