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Kim IY, Ye BM, Kim MJ, Kim SR, Lee DW, Kim HJ, Rhee H, Song SH, Seong EY, Lee SB. Association between serum uric acid and left ventricular hypertrophy/left ventricular diastolic dysfunction in patients with chronic kidney disease. PLoS One 2021; 16:e0251333. [PMID: 33956863 PMCID: PMC8101764 DOI: 10.1371/journal.pone.0251333] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/25/2021] [Indexed: 01/19/2023] Open
Abstract
Background The level of serum uric acid (SUA) has been reported to be associated with left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD). However, this association remains unclear in patients with chronic kidney disease (CKD). Methods A total of 1025 patients with pre-dialysis CKD with preserved left ventricular systolic function were enrolled in this cross-sectional study. The LVH and LVDD were assessed using two-dimensional echocardiography and tissue Doppler imaging. The associations of LVH/LVDD with clinical and laboratory variables were investigated using univariable and multivariable logistic regression analyses. Results In a multivariable analysis, the SUA level was an independent predictor of LVH (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.31–1.50, P < 0.001). In addition, patient age, systolic blood pressure, intact parathyroid hormone levels, and left atrial volume index levels were independent predictors of LVH. The SUA level was also an independent predictor of LVDD (OR: 1.93, 95% CI: 1.53–2.43, P < 0.001). Furthermore, systolic blood pressure and left atrial volume index levels were an independent predictor of LVDD. Receiver-operating characteristic curve analysis showed that the best cutoff values of SUA levels for identifying LVH and LVDD were ≥ 7.5 mg/dL and ≥ 6.3 mg/dL, respectively. Conclusion The SUA level was an independent predictor of LVD and LVDD in patients with CKD, suggesting that SUA could be a biomarker for LVH and LVDD.
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Affiliation(s)
- Il Young Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Byung Min Ye
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Min Jeong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Seo Rin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Won Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyo Jin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Harin Rhee
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sang Heon Song
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eun Young Seong
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo Bong Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- * E-mail:
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Kuwabara M, Hisatome I, Niwa K, Hara S, Roncal-Jimenez CA, Bjornstad P, Nakagawa T, Andres-Hernando A, Sato Y, Jensen T, Garcia G, Rodriguez-Iturbe B, Ohno M, Lanaspa MA, Johnson RJ. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension: A 5-Year Japanese Cohort Study. Hypertension 2017; 71:78-86. [PMID: 29203632 DOI: 10.1161/hypertensionaha.117.10370] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/04/2017] [Accepted: 10/15/2017] [Indexed: 02/07/2023]
Abstract
Prehypertension frequently progresses to hypertension, a condition associated with high morbidity and mortality from cardiovascular diseases and stroke. However, the risk factors for developing hypertension from prehypertension remain poorly understood. We conducted a retrospective cohort study using the data from 3584 prehypertensive Japanese adults (52.1±11.0 years, 2081 men) found to be prehypertensive in 2004 and reexamined in 2009. We calculated the cumulative incidences of hypertension over 5 years, examined risk factors, and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid levels. The additional analysis evaluated whether serum uric acid (hyperuricemia) constituted an independent risk factor for developing hypertension. The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%. There were no significant differences between women and men (24.4% versus 26.0%; P=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2858; 30.7% versus 24.0%; P<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR, 1.023; P<0.001), female sex (OR, 1.595; P<0.001), higher body mass index (OR, 1.051; P<0.001), higher baseline systolic (OR, 1.072; P<0.001) and diastolic blood pressure (OR, 1.085; P<0.001), and higher serum uric acid (OR, 1.149; P<0.001). Increased serum uric acid is a strong risk marker for developing hypertension from prehypertension. Further studies are needed to determine whether treatment of hyperuricemia in prehypertensive subjects could impede the onset of hypertension.
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Affiliation(s)
- Masanari Kuwabara
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.).
| | - Ichiro Hisatome
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Koichiro Niwa
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Shigeko Hara
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Carlos A Roncal-Jimenez
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Petter Bjornstad
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Takahiko Nakagawa
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Ana Andres-Hernando
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Yuka Sato
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Thomas Jensen
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Gabriela Garcia
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Bernardo Rodriguez-Iturbe
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Minoru Ohno
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Miguel A Lanaspa
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | - Richard J Johnson
- From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., P.B., A.A.-H., Y.S., T.J., G.G., M.A.L., R.J.J.); Department of Cardiology (M.K., M.O.) and Health Management Center (S.H.), Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.); Department of Future Basic Medicine, Nara Medical University, Japan (T.N.); and Department of Nephrology, Hospital Universitario and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
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