Association of uric acid and carotid artery disease in patients with ischemic stroke

Prevalence of Monosodium Urate (MSU) Deposits in Cadavers Detected by Dual-Energy Computed Tomography (DECT)

Background: Dual-energy computed tomography (DECT) allows direct visualization of monosodium urate (MSU) deposits in joints and soft tissues. Purpose: To describe the distribution of MSU deposits in cadavers using DECT in the head, body trunk, and feet. Materials and Methods: A total of 49 cadavers (41 embalmed and 8 fresh cadavers; 20 male, 29 female; mean age, 79.5 years; SD ± 11.3; range 52–95) of unknown clinical history underwent DECT to assess MSU deposits in the head, body trunk, and feet. Lens, thoracic aorta, and foot tendon dissections of fresh cadavers were used to verify MSU deposits by polarizing light microscopy. Results: 33/41 embalmed cadavers (80.5%) showed MSU deposits within the thoracic aorta. 11/41 cadavers (26.8%) showed MSU deposits within the metatarsophalangeal (MTP) joints and 46.3% of cadavers demonstrated MSU deposits within foot tendons, larger than and equal to 5 mm. No MSU deposits were detected in the cranium/intracerebral vessels, or the coronary arteries. Microscopy used as a gold standard could verify the presence of MSU deposits within the lens, thoracic aorta, or foot tendons in eight fresh cadavers. Conclusions: Microscopy confirmed the presence of MSU deposits in fresh cadavers within the lens, thoracic aorta, and foot tendons, whereas no MSU deposits could be detected in cranium/intracerebral vessels or coronary arteries. DECT may offer great potential as a screening tool to detect MSU deposits and measure the total uric acid burden in the body. The clinical impact of this cadaver study in terms of assessment of MSU burden should be further proven.

Carotid Artery Pathology in Inflammatory Diseases

There is considerable evidence that patients with inflammatory conditions are at higher risk of developing cardiovascular (CV) disease including carotid artery stenosis. CV disease accounts for 35-50% of the excess mortality in patients with inflammatory diseases such as rheumatoid arthritis, with cerebrovascular disease being the second leading cause of death. We review current evidence regarding the association of inflammatory conditions and specifically carotid artery disease. Clinical epidemiological observations suggest that mechanisms other than classic risk factors may promote accelerated atherogenesis in rheumatoid and other inflammatory arthritis and carotid artery disease is increased in individuals with these conditions. Additional studies to better understand the underlying mechanisms and targeted strategies to mitigate such risk are indicated. For now, lifestyle modifications, aggressive treatment of risk factors and lipid lowering therapy in appropriate individuals is indicated.

Colchicine Use and Risks of Stroke Recurrence in Acute Non-Cardiogenic Ischemic Stroke Patients: A Population-Based Cohort Study

Background: The objective is to study whether the cardiovascular protective effects of colchicines could be applied to non-cardiogenic ischemic stroke (IS) patients. Patients and Methods: Non-cardiogenic IS patients were identified from the National Health Insurance Research Database. Eligible patients were divided into chronic and non-chronic use categories based on their long-term status of colchicine use. The non-chronic use category was subdivided into (1) non-user and (2) new user groups while the chronic use category was divided into (3) former user and (4) long-term user groups according to the patient's recent status of colchicine use. Inverse probability of treatment weights for propensity scores was used to balance the baseline characteristics. The primary outcome was recurrent IS, which was compared within the non-chronic use and chronic use categories. Results: In the non-chronic use category, the number of patients was 355,498 and 912 in the non-user and new user groups, respectively. In the chronic use category, the number of patients was 4737 and 4354 in the former user and long-term user groups, respectively. In the non-chronic use category, patients in the new user group had a marginally lower risk of recurrent IS at 6-months (subdistribution hazard ratio [SHR], 0.95; 95% confidence interval [CI], 0.94-0.97) and 2-years (SHR, 0.92; 95% CI, 0.91-0.93) follow up. In the chronic use category, patients in the long-term user group also had a marginally lower risk of recurrent IS at 6-months (SHR, 0.87; 95% CI, 0.86-0.88) and 2-years (SHR, 0.87; 95% CI, 0.86-0.88) follow up. The effect of colchicine on the reduced risk of recurrent IS was more favorable in patients who also used statins. Conclusions: Recent colchicine use in acute non-cardiogenic IS patients is associated with marginal fewer incidences of recurrent IS. Patients with concurrent statin use may have more profound protective effects.

Serum Uric Acid Concentration in Patients with Cerebrovascular Disease (Ischemic Stroke and Vascular Dementia)

Introduction:

Significance of serum uric acid (UA) in cerebrovascular disease still remains controversial. UA is most abundant natural antioxidant in human plasma. Its antioxidant properties might protect against free radical damage, thereby reducing the risk of oxidative stress-related cognitive impairment and dementia.

Aim:

In our investigation, we determine the level of UA in 100 male patients diagnosed with the first ischemic brain stroke (blood samples were collected during the acute phase and post-acute phase), 100 male patients diagnosed with vascular dementia and 100 male healthy volunteers (control group).

Methods:

UA was determined using DIMENSION LxR automatic analyzer. Measurement of UA concentration was based on an enzymatic method (range 208-428 μmol/L).

Results:

The prevalence of hyperuricemia among ischemic stroke and vascular dementia patients was 30% and 8%, respectively. Serum UA concentration was higher 7 and 14 days after the stroke compared to the acute phase (24-48 hours after hospitalization) and these concentrations were significantly higher than those measured in the control group. UA levels measured at 24-48 hours after the first symptoms of ischemic stroke were strongly correlated with those measured after 7 days of treatment (r = 0.79, p = 0.001) or after 14 days (r = 0.839, p = 0.0049). No significant differences were found between ischemic stroke and vascular dementia groups.

Conclusion:

UA concentrations were higher in ischemic stroke and vascular dementia groups than in controls. UA increase may reflect vascular atherosclerosis and tissue hypoxia. UA monitoring in patients with cerebrovascular disease is essential, because UA is more harmful than protective.

Meta-analysis of the correlation between serum uric acid level and carotid intima-media thickness

Objective

Recently, increasing epidemiological evidence has shown that there is a correlation between serum uric acid level (SUA) and carotid intima-media thickness (CIMT). This paper explored the relationship between them through meta-analysis.

Methods

PubMed, Cochrane Library, EMBASE, Web of Science and Google Scholar were searched to obtain literature. The keywords used to retrieve the literature were carotid intima thickness, intima-media thickness, carotid atherosclerosis, carotid stenosis, carotid artery, uric acid, blood uric acid, and hyperuricaemia. The retrieval time was from the establishment of the database through July 2020. Stata15.0 and RevMan5.3 software were used for statistical analysis. The standardized mean difference (SMD) and 95% confidence interval (95% CI) were calculated by a random effect model to estimate the correlation. Publication bias was assessed using the Begg and Egger tests. The stability of these results was evaluated using sensitivity analyses.

Results

Fifteen studies were included with a total sample size of 11382, including 7597 participants in the high uric acid group and 3785 in the control group, on the basis of the inclusion and exclusion criteria. According to the evaluation of the JBI scale, the literature was of high quality. The average age ranged from 42 to 74. Meta-analysis showed that CIMT in the high uric acid group was significantly higher than that in the control group (SMD = 0.53, 95% CI: [0.38, 0.68]), and the difference was significant (z = 6.98, P < 0.00001). The heterogeneity among the 15 articles was obvious (I² = 89%, P < 0.00001). Subgroup analysis by disease status illustrated a positive relationship between SUA and CIMT in healthy people and people with diseases. SUA was shown to be positively correlated with CIMT in people aged 45–60 years and ≥60 years by subgroup analysis by age. SUA was also found to be positively correlated with CIMT in a population with BMI>24 kg/m² by subgroup analysis by BMI. In addition, subgroup analysis of other risk factors for CIMT, including TC, SBP, DBP, triglycerides, and LDL-C, all showed a positive correlation between SUA and CIMT.

Conclusions

There is a significant correlation between serum uric acid level and carotid intima-media thickness, and a high concentration of serum uric acid is related to carotid artery intima-media thickness.

The association between serum uric acid levels and ischemic stroke in essential hypertension patients

Objectives: The association between serum uric acid (SUA) and ischemic stroke is still inconsistent across population. This study aimed to examine the association between SUA and ischemic stroke in essential hypertension patients. Methods: This retrospective study recruited participants from September 2011 to December 2012, in the Liao-bu community, Guangdong Province, China, and followed them until 31 December 2016. Participants were divided into quartiles based on SUA concentrations. Hazard ratio (HR) and confidence intervals (CIs) was estimated from Cox proportional hazards models, and propensity score analysis, Kaplan-Meier survival curves and receiver operating characteristic (ROC) curve were performed to evaluate the relationship between SUA and the risk of ischemic stroke. Results: A total of 5473 eligible hypertensive subjects were enrolled in this study, 2666 (48.71%) of them were males with an average age of 62.02 ± 13.76 years. A total of 155 (2.83%) ischemic stroke occurred after the mean follow-up period of 4.5 years. After adjusting for potential confounders, comparing with the lowest quartiles of SUA, multivariable HR (95%CI) for ischemic stroke for participants with SUA at the second, third and fourth quartiles were 1.13 (95%CI: 1.10, 1.81), 1.39 (95%CI: 1.18, 1.89), and 1.64 (95%CI: 1.19, 1.95), respectively (P < 0.0001 for trend). Elevated SUA was positively associated with ischemic stroke (HR = 1.41, 95%CI: 1.16, 1.84; P < 0.01) and the propensity scores analysis (HR = 1.45, 95%CI: 1.17, 1.90; P < 0.01) showed the similar results. Gender subgroup analysis showed SUA was an independent risk of ischemic stroke in female (HR = 1.35, 95%CI: 1.11, 1.81, P = 0.002) and male (HR = 1.53, 95%CI: 1.14, 1.92, P < 0.001). ROC curve demonstrated that SUA yielded an AUC of 0.7476 (95%CI: 0.7098, 0.7855, P < 0.001) for predictive of ischemic stroke. Conclusions: SUA was an independent risk factor for ischemic stroke, and also have a good predictive value ischemic stroke among hypertensive patients in Chinese community.

Serum Uric Acid Levels and Risk of Intracranial Atherosclerotic Stenosis: A Cross-Sectional Study

Elevated serum uric acid (SUA) has been reported to be associated with an increased risk of cardiovascular diseases, but the role of SUA in intracranial atherosclerosis remains unclear. To investigate the association between SUA and intracranial atherosclerotic stenosis (ICAS), we evaluated 1522 subjects (305 with ICAS, 1217 without ICAS) with magnetic resonance angiography (MRA). Subjects were classified into ten groups according to the deciles of the SUA level. The rate of ICAS reached a minimum in the seventh decile (6.0-6.3 mg/dL; reference group). After adjusting for confounding factors, multivariate logistic regression analysis demonstrated that both low SUA level (≤ 3.8 mg/dL; OR, 2.34; 95% CI, 1.29-4.39; p = 0.006) and high SUA level (≥ 7.8 mg/dL; OR, 2.10; 95% CI, 1.15-3.92; p = 0.017) conferred greater risk for ICAS. In multivariable analysis with a quadratic model which used SUA as a continuous variable, a U-shaped association between SUA and the rate of ICAS was confirmed (α > 0; p < 0.001). The estimated SUA level associated with the lowest rate of ICAS was 6.2 mg/dL. In conclusion, our findings suggest a U-shaped association between ICAS and SUA.

Lack of association between serum homocysteine level and middle cerebral artery stenosis

OBJECTIVES

Lowering homocysteine (HCY) has beneficial effects on vascular events in primary prevention but not in secondary prevention. Research on serum HCY level and middle cerebral artery (MCA) stenosis is lacking. The purpose of the study was to determine the association between these factors and provide more evidence for the prevention of ischemic stroke.

METHODS

A total of 412 patients (35-93 years old) in the Neurology Department were recruited. Data of clinical and biochemical vascular risk factors were collected. MCA stenosis, including M1, M2, and M3, was determined by brain magnetic resonance angiography (MRA) and classified into stenosis or no stenosis. The differences and associations were analyzed by relevant statistical methods.

RESULTS

There was no significant difference (p = 0.325) in HCY levels between the MCA stenosis and no stenosis groups at baseline. Logistic regression analysis demonstrated that there was no significant association between HCY levels and MCA stenosis (p = 0.447). After the two groups were matched for age and sex, there was still no difference (p = 0.540 for males and 0.061 for females) or association (p = 0.709 for males and 0.098 for females). In addition, we found that ischemic stroke was more prevalent in the MCA stenosis group and uric acid was higher in males with MCA stenosis.

CONCLUSIONS

The study indicates a lack of association between serum HCY level and MCA stenosis, which may partially explain the negative results of secondary prevention clinical trials focused on lowering serum HCY level. Future studies on HCY reduction should focus more on primary prevention of ischemic stroke.

Association between carotid plaque and Parkinson's disease

Background

Epidemiological studies show that patients with Parkinson's disease (PD) are prone to have a reduced incidence of ischemic cerebrovascular disease. Previous studies show the correlation between PD and the lipids serum levels. The PD,s patients are found with a reduced serum level of triglyceride and low-density lipoprotein cholesterol (LDL-C); thus, the level of serum uric acid (UA) is closely related to the occurrence and development of PD. Patients with low serum UA levels have a higher chance of developing PD than the ones who do not. However, the relationship between carotid plaques and PD is still unknown.

Methods

Our study was based on 68 patients with PD (known as the PD group) and 81 people without PD (known as the control group). Patients in the PD group were of the same age and gender. Both groups were recorded and analyzed for UA, LDL-C, and carotid plaques or intima-media thickness (IMT). The PD group was then divided into three subgroups: the stable plaque group, the unstable plaque group, and the non-plaque group.

Results

In the present study, the PD group showed a significantly lower level of UA and LDL-C than the control group (P<0.01); somehow there were no statistically significant differences in the IMT and plaque incidence between the two groups (P>0.05). There were also no significant differences (P>0.05) in both the LDL-C and UA levels in all subgroups, but there was a close relation in both age and duration of disease to IMT. According to the Hoehn and Yahr staging scale, serum levels of LDL-C were inversely correlated in PD patients, while UA was related to the duration of the disease.

Conclusions

Our study suggested that there were no differences in carotid artery arteriosclerosis plaque and IMT, but the PD progress was indeed correlated with IMT. Meanwhile, LDL-C and UA had different priorities in H&Y and disease progression.

Association of uric acid with stenosis of intracranial and extracranial arteries in elderly patients with cerebral infarction

BACKGROUND

To determine whether uric acid (UA) and intracranial and extracranial atherosclerosis stenosis of elderly patients suffering from ischaemic stroke are inter-related.

METHODS

Elderly patients with ischaemic stroke underwent computed tomography angiography (CTA) were enrolled between October 2015 and December 2017. We collected clinical assessment, image data, and laboratory tests, and divided patients into four groups: (1) intracranial stenosis atherosclerosis (ICAS) group, (2) combined intracranial and extracranial atherosclerosis stenosis (COAS) group, (3) extracranial carotid stenosis atherosclerosis (ECAS) group, and (4) non-cerebral stenosis atherosclerosis (NCAS) group. We used univariate and multiple logistic regression analyses to explore potential predictors.

RESULTS

We included 408 patients in this study, then divided them into elder group (n = 196) and young- and middle-aged group (n = 212). In old stroke patients, 72 cases (36.73%) were classified as the ICAS group, 45 cases (22.96%) as the COAS group, 21 cases (10.71%) as the ECAS group, and 58 cases (29.59%) as the NCAS group. The level of UA was comparatively higher (p = 0.033) in ICAS than in NCAS. Compared with the group which had only one stenosis artery, UA was substantially increased in patients with more than one stenosis intracranial artery (p < 0.001). With a multivariable analysis, UA was an independent predictor for intracranial stenosis of elderly patients (OR = 1.003, p = 0.042), but the relationship between extracranial artery stenosis and uric acid was negative.

CONCLUSIONS

Hyperuricaemia is a risk factor of intracranial artery stenosis rather than of ECAS in elderly patients with cerebral infarction.

Relationship between oxidative stress and inflammation in hyperuricemia: Analysis based on asymptomatic young patients with primary hyperuricemia

The average age of hyperuricemia patients has gradually decreased, but young patients with primary hyperuricemia often do not exhibit clinical symptoms and have not received sufficient attention. However, a lack of symptoms with primary hyperuricemia does not mean that high serum uric acid (UA) levels cannot lead to pathological effects, such as oxidative stress and inflammation, and the specific damage is still unclear. We aimed to determine the relationship between oxidative stress and inflammation to explore the possible role of pathological damage in asymptomatic young patients with primary hyperuricemia.A total of 333 participants were enrolled in our study: 158 asymptomatic young patients with primary hyperuricemia and 175 healthy persons from a health check-up population. Malondialdehyde (MDA), superoxide dismutase (SOD), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and general biochemical markers were measured.We found no differences in biochemical markers (fasting glucose, TG, TC, LDL-C, HDL-C, SCr, BUN, AST, and ALT) between the patients and healthy persons. Subsequent analyses of oxidative stress and inflammation revealed that the serum levels of MDA, IL-6, and TNF-α in the patients were significantly higher than those in the healthy control group (P < .001), and the SOD activity was significantly lower (P < .001). As the UA levels increased, MDA increased significantly and SOD decreased significantly; likewise, IL-6 and TNF-α increased significantly as the UA level increased. MDA showed a significant positive correlation with IL-6 (r = 0.367, P < .001) and TNF-α (r = 0.319, P < .001), and SOD was negatively correlated with IL-6 (r = -0.241, P < .01) and TNF-α (r = -0.308, P < .001). Multivariable logistic regression analysis showed that UA (OR: 2.379, 95% CI: 1.698-3.286, P < .001; OR: 3.261, 95% CI: 1.729-3.857, P < .001; for IL-6 and TNF-α, respectively) and MDA (OR: 1.836, 95% CI: 1.283-2.517, P < .01; OR: 2.532, 95% CI: 1.693-3.102, P < .001; for IL-6 and TNF-α, respectively) were risk factors for high IL-6 and TNF-α and that SOD (OR: 0.517, 95% CI: 0.428-0.763, P < .01; OR: 0.603, 95% CI: 0.415-0.699, P < .001; for IL-6 and TNF-α, respectively) was a protective factor.In our study, some abnormal pathological effects were found in asymptomatic young patients with hyperuricemia, suggesting that in young hyperuricemia patients, oxidative stress, inflammation and the inflammatory response may be related to the oxidative stress induced by UA. Therefore, we should pay more attention to the pathological damage caused by these alterations.

Association between serum uric acid and carotid disease in patients with atherosclerotic acute ischemic stroke

Aim

The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease.

Methods

Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis.

Results

A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 −1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005).

Conclusion

Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.

Serum uric acid concentrations and risk of intracerebral hemorrhage: A systematic review and meta-analysis

BACKGROUND AND AIMS

The relationship between serum uric acid (UA) and the risk of intracerebral hemorrhage (ICH) remains controversial. The aim of our systematic review and meta-analysis was to ascertain the association between serum UA concentrations and the risk of ICH.

METHODS

We systematically searched databases of Embase, Pubmed, Web of Science and Cochrane Library up to December 30, 2017, and additional papers were identified through a manual search. Mean difference (MD) for serum UA levels with 95% confidence intervals (CI) was calculated. Six studies, including 345 ICH patients, 574 ischemic stroke patients and 535 healthy controls, were identified for meta-analysis.

RESULTS

Our results revealed no statistically significant differences in the comparison of UA between ICH and healthy controls (95% CI = -9.04-15.61); UA levels in patients with ischemic stroke were significantly higher than those in healthy controls (95% CI = 3.91-56.32); further subgroup analysis of age showed higher UA levels in ICH patients over 65 years than healthy controls (age≥65: 95% CI = 1.44-35.96). Subgroup of ethnicity (Asians: CI = -9.06-21.00; Caucasians: 95% CI = -68.43-8.43), gender (Men: 95% CI = -56.08-4.73; Women: 95% CI = -27.19-35.91) and sample size (large samples: 95% CI = -20.54-41.05; small samples: 95% CI = -25.41-13.78) with respect to UA levels between ICH and healthy controls did not change these results.

CONCLUSIONS

This meta-analysis showed that serum UA levels did not increase the risk of ICH probably because of the dual roles of UA, i.e. pro-oxidant and antioxidant, in the progression of atherosclerosis. However, serum UA may be a potential risk factor for ICH in the elderly. There were no race-specific differences in UA levels between Asians and Caucasians as well as gender-related differences between men and women in the risk of ICH.

The modality of dialysis does not influence atheromatous vascular disease progression or cardiovascular outcomes in dialysis patients without previous cardiovascular disease

BACKGROUND

There is limited and inconclusive information regarding the influence of the modality of renal replacement therapy on the atherosclerotic burden of patients on dialysis. The aim of this study was to compare the prevalence of asymptomatic atheromatous carotid disease, as also its rate of progression and cardiovascular outcomes, in two matched populations of patients treated with hemodialysis (HD) and peritoneal dialysis (PD).

METHODS

Following a prospective, observational and multicenter design, we compared 237 PD and 237 HD patients without previous cardiovascular disease, included in the NEFRONA study, and matched for age, sex, diabetes and time on dialysis. Carotid ultrasound study was performed at baseline and after two years of follow-up in 6 carotid territories. Atheromatous vascular disease (AVD) progression was defined as any increase in the number of territories with plaques after 2 years. Fatal and non fatal cardiovascular events were also recorded during 36-month of follow-up.

MAIN RESULTS

At baseline, PD patients presented a worse general cardiovascular risk profile than HD patients. On the contrary, some markers of prevalent atherosclerotic disease (common carotid intima-media thickness and ankle-brachial index) were more favorable in PD patients. During follow-up, we observed no differences either in the rate of progression of atheromatous vascular disease (OR 1.78, 95% CI 0.80-4.06, p = 0.161) or in the incidence of cardiovascular events (OR 1.51, 95% CI 0.85-2.66, p = 0.159), according to the modality of dialysis.

CONCLUSION

Dialysis modality did not impact on atherosclerotic carotid disease progression or cardiovascular outcomes, in two groups of patients treated with PD or HD.

Association between serum uric acid level and renal arteriolar hyalinization in individuals without chronic kidney disease

BACKGROUND AND AIMS

Recent studies have reported an association between serum uric acid (SUA) and renal arteriolar changes in patients with chronic kidney disease (CKD). However, the association in individuals without CKD remains unclear. In this study, we investigated the relationship between SUA and renal arteriolar lesions in individuals without CKD from our living kidney donor cohort.

METHODS

Between January 2006 and May 2016, 393 living kidney donors underwent "time-zero" biopsy at Kyushu University Hospital. Patients were divided into sex-specific quartiles of SUA before donation: Q1, Q2, Q3, and Q4 (male: <5.2,5.2-5.8,5.9-6.4, and ≥6.5 mg/dL, female: <3.8,3.8-4.3,4.4-5.0, and ≥5.1 mg/dL). Renal arteriolar hyalinization and wall thickening were assessed using a semiquantitative grading system. Predictive performance was compared between models with and without SUA by calculating the net reclassification improvement (NRI).

RESULTS

In total, 158 (40.2%) patients had arteriolar hyalinization, and 148 (37.6%) had wall thickening. High SUA was significantly associated with arteriolar hyalinization in multivariable logistic analysis (odds ratio [OR] per 1-mg/dL increase in SUA, 1.24; 95% confidence interval [CI], 1.00-1.53; p = 0.048. OR for Q4 vs. Q2, 2.22; 95% CI, 1.17-4.21; p = 0.01). We found no association between SUA and wall thickening. When SUA was incorporated into a predictive model with conventional atherosclerotic factors, the NRI was 0.21 (p = 0.04).

CONCLUSIONS

High SUA was an independent risk factor for arteriolar hyalinization in individuals without CKD. SUA provided additional predictive value beyond conventional atherosclerotic factors in predicting arteriolar hyalinization.

Prevalence of calcified carotid artery atheromas on panoramic images of older men with gout: a descriptive retrospective study

OBJECTIVES

Given the enhanced risk of ischaemic stroke resulting from the direct effects of hyperuricaemia on vascular plaque formation seen among older males with gout, we sought to determine the prevalence of calcified carotid artery atheromas (CCAAs) on their panoramic images (PIs).

METHODS

Medical record librarians identified all male patients over 45 years, who had a diagnosis of gout and a PI incidentally obtained between 2000 and 2015. The prevalence rate of CCAA on technically appropriate images was determined, as were these patients' atherogenic risk profiles including: age, body mass index, hypertension and dyslipidaemia. Comparisons of atherogenic risk factors were made between this cohort and those without CCAA.

RESULTS

Of the 531 patients with gout, 163 patients were adjudicated to be CCAA+ (the panoramic image demonstrates a calcified carotid artery atheroma). Logistic regression analysis demonstrated that a comorbid diagnosis of diabetes mellitus or dyslipidaemia, or advancing age was determinant in differentiating patients who were CCAA+ vs those who were CCAA- (the panoramic image does not demonstrate a calcified carotid artery atheroma).

CONCLUSIONS

CCAAs often herald an ischaemic stroke and may be seen on the PIs of patients with gout, especially those with increased age, dyslipidaemia or diabetes. Thus, dentists must be uniquely vigilant in detecting these lesions when evaluating the images of all patients with gout, especially those with additional positive risk factors.

Uric acid is associated with vascular dementia in Chinese population

OBJECTIVE

Mounting evidence suggests that oxidative stress is involved in the pathogenesis of vascular dementia (VD). Uric acid (UA) has long been implicated as a critical cause of cardiovascular disease. Nevertheless, UA was also expected to play an important role in antioxidant and neuroprotection recently. We hypothesized that UA may have a protective role against VD. The aim of this study was to investigate the link between serum UA and cognitive dysfunction in VD.

MATERIALS AND METHODS

There were altogether 127 VD subjects and 81 nondemented controls enrolled in our study. Serum UA, demographic, and clinical characteristics were recorded at baseline, and all participants underwent Mini-Mental State Examination (MMSE) at the beginning of the trial.

RESULTS

The VD group showed lower MMSE scores and serum UA levels than nondemented controls and there was significant statistical difference between the two groups (p < .05). Demographic and clinical characteristics such as age, gender, education, body mass index (BMI), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), blood urea nitrogen (BUN), and serum creatinine (Scr) did not differ dramatically between groups (p > .05). In VD subjects, there was a positive correlation between serum UA and MMSE scores (r = .32, p < .05), and this correlation was independent of demographic and clinical characteristics (β = .272, p < .05).

CONCLUSIONS

VD subjects have dramatically lower serum UA levels in comparison to nondemented controls. Lower serum UA levels are linked to cognitive dysfunction and could serve as a potential predictor for VD.

The Relation of Moderate Alcohol Consumption to Hyperuricemia in a Rural General Population

Background: although alcohol abuse is known to increase serum uric acid, the relation between moderate drinking and uric acid have remained poorly understood. We performed this study to evaluate whether different alcohol consumption level has different effects on the risk of hyperuricemia based on a rural general population. Method: multi-stage cluster sampling method was used to select a representative sample of individuals aged 35 years or older. Participants were asked to provide information about their alcohol consumption. Data regarding the demographic and lifestyle characteristics and the blood biochemical indexes of these participants were collected by well-trained personnel. Results: in total, 11,039 participants aged 35 years or older were included (4997 men and 6042 women). The prevalence of hyperuricemia in the different male alcohol consumption groups was 11.9% in non-drinkers, 12.6% in moderate drinkers, and 16.3% in heavy drinkers (p < 0.001). In females, the rates were 6.3% in non-drinkers, 8.1% in moderate drinkers, and 6.6% for heavy drinkers (p = 0.818). In males, multivariate logistic regression analyses shows heavy drinkers had an approximately 1.7-fold higher risk of hyperuricemia (OR: 1.657, 95% CI: 1.368 to 2.007, p < 0.001) than non-drinkers; moderate drinkers did not experience a significant increase in risk (OR: 1.232, 95% CI: 0.951 to 1.596, p = 0.114)). Multivariate logistic regression analyses of females showed that, compared with non-drinkers, neither moderate nor heavy drinkers had a significantly increased risk of hyperuricemia (OR: 1.565, 95% CI: 0.521 to 4.695, p = 0.425 for heavy drinkers; OR: 0.897, 95% CI: 0.117 to 6.855, p = 0.916 for moderate drinkers). Conclusions: heavy alcohol consumption increased the risk of hyperuricemia for males but not for females. Among both males and females, moderate alcohol consumption did not increase the risk of hyperuricemia.

Association of uric acid with traditional inflammatory factors in stroke

Uric acid (UA) plays an important role in the oxidant stress that causes inflammation. We assessed the association between UA and neutrophil ratio, white blood cell (WBC) count and blood lipid in 524 patients admitted with stroke. Stroke patients with a neutrophil ratio >70% displayed significantly lower UA levels than those with a neutrophil ratio ≤70% (p < 0.05). According to UA quartiles, neutrophil ratio, WBC count, and high-density lipoprotein cholesterol in the UA grade 1 group (≤214.10 μmol/L) were significantly increased over those in other UA grade groups. The results of stepwise regression analysis found that UA levels were inversely associated with neutrophil ratios (B ± SE = -1.11 ± 0.35), high-density lipoprotein cholesterol (B ± SE = -46.18 ± 14.17), total cholesterol (B ± SE = 9.82 ± 3.66), blood urea nitrogen (B ± SE = 6.30 ± 1.73), and creatinine (B ± SE = 0.63 ± 0.10). There is a correlationship between lower serum uric acid with neutrophil ratios in inflammation associated with stroke and the reasons need to be investigated further.

Uric acid relates to dopamine transporter availability in Parkinson's disease

BACKGROUND

Diagnosing Parkinson's disease (PD) and tracking its progression may require the combination of reliable biomarkers. Among them, both serum uric acid (UA) and dopamine transporter (DaT) binding deserve more investigations.

AIMS OF THE STUDY

We aimed to investigate the relationship between serum UA levels and DaT availability in newly diagnosed, drug-naïve PD patients, by means of semiquantitative [(123) I]FP-CIT-SPECT.

METHODS

We recruited 52 newly diagnosed, drug-naïve PD patients, and performed serum UA dosage and [(123) I]FP-CIT-SPECT.

RESULTS

Pearson's correlation analysis showed that UA levels were significantly higher in patients with higher averaged, ipsilateral and contralateral DaT binding in caudate, putamen, and striatum.

CONCLUSIONS

We showed, for the first time, by regional semiquantitative analysis of DaT binding in PD patients that UA levels significantly correlates with the severity of dopaminergic impairment in caudate, putamen, and striatum. This study broadens our knowledge on the importance of UA as a biomarker of PD.