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Agabiti Rosei C, Paini A, Buso G, Maloberti A, Giannattasio C, Salvetti M, Casiglia E, Tikhonoff V, Angeli F, Barbagallo CM, Bombelli M, Cappelli F, Cianci R, Ciccarelli M, Cicero AFG, Cirillo M, Cirillo P, Dell’Oro R, D’Elia L, Desideri G, Ferri C, Galletti F, Gesualdo L, Grassi G, Iaccarino G, Lippa L, Mallamaci F, Masi S, Masulli M, Mazza A, Mengozzi A, Nazzaro P, Palatini P, Parati G, Pontremoli R, Quarti-Trevano F, Rattazzi M, Reboldi G, Rivasi G, Russo E, Tocci G, Ungar A, Verdecchia P, Viazzi F, Volpe M, Virdis A, Muiesan ML, Borghi C. Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study. Metabolites 2024; 14:323. [PMID: 38921458 PMCID: PMC11205863 DOI: 10.3390/metabo14060323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study with carotid ultrasound and without previous cardiovascular diseases (CVD) (n = 6209), followed over 20 years, were included in the analysis. Hypertriglyceridemia (hTG) was defined as TG ≥ 150 mg/dL. Higher levels of SUA (hSUA) were defined as ≥5.6 mg/dL in men and 5.1 mg/dL in women. A carotid plaque was identified in 1742 subjects (28%). SUA and TG predicted carotid plaque (HR 1.09 [1.04-1.27], p < 0.001 and HR 1.25 [1.09-1.45], p < 0.001) in the whole population, independently of age, sex, diabetes, systolic blood pressure, HDL and LDL cholesterol and treatment. Four different groups were identified (normal SUA and TG, hSUA and normal TG, normal SUA and hTG, hSUA and hTG). The prevalence of plaque was progressively greater in subjects with normal SUA and TG (23%), hSUA and normal TG (31%), normal SUA and hTG (34%), and hSUA and hTG (38%) (Chi-square, 0.0001). Logistic regression analysis showed that hSUA and normal TG [HR 1.159 (1.002 to 1.341); p = 0.001], normal SUA and hTG [HR 1.305 (1.057 to 1.611); p = 0.001], and the combination of hUA and hTG [HR 1.539 (1.274 to 1.859); p = 0.001] were associated with a higher risk of plaque. Our findings demonstrate that SUA is independently associated with the presence of carotid plaque and suggest that the combination of hyperuricemia and hypertriglyceridemia is a stronger determinant of carotid plaque than hSUA or hTG taken as single risk factors. The association between SUA and CVD events may be explained in part by a direct association of UA with carotid plaques.
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Affiliation(s)
- Claudia Agabiti Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.A.R.); (A.P.); (G.B.); (M.S.)
| | - Anna Paini
- Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.A.R.); (A.P.); (G.B.); (M.S.)
| | - Giacomo Buso
- Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.A.R.); (A.P.); (G.B.); (M.S.)
| | - Alessandro Maloberti
- Cardiology IV, “A.De Gasperi’s” Department, Niguarda Ca’ Granda Hospital, 20162 Milan, Italy; (A.M.); (C.G.)
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Cristina Giannattasio
- Cardiology IV, “A.De Gasperi’s” Department, Niguarda Ca’ Granda Hospital, 20162 Milan, Italy; (A.M.); (C.G.)
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.A.R.); (A.P.); (G.B.); (M.S.)
| | - Edoardo Casiglia
- Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy; (E.C.); (P.P.)
| | | | - Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
- Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico Tradate, 21100 Varese, Italy
| | - Carlo Maria Barbagallo
- Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy;
| | - Michele Bombelli
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (M.B.); (R.D.); (G.G.); (F.Q.-T.)
| | - Federica Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.C.); (S.M.); (A.M.); (A.V.)
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | - Michele Ciccarelli
- Department of Advanced Biomedical Sciences, “Federico II” University of Naples, 80133 Naples, Italy; (M.C.); (G.I.)
| | - Arrigo Francesco Giuseppe Cicero
- Department Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (A.F.G.C.); (C.B.)
- Heart-Chest-Vascular Department, IRCCS AOU of Bologna, 40126 Bologna, Italy
| | - Massimo Cirillo
- Department of Public Health, “Federico II” University of Naples, 80133 Naples, Italy;
| | - Pietro Cirillo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy; (P.C.); (L.G.)
| | - Raffaella Dell’Oro
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (M.B.); (R.D.); (G.G.); (F.Q.-T.)
| | - Lanfranco D’Elia
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80133 Naples, Italy; (L.D.); (F.G.); (M.M.)
| | - Giovambattista Desideri
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences Sapienza, University of Rome, 00161 Rome, Italy;
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80133 Naples, Italy; (L.D.); (F.G.); (M.M.)
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy; (P.C.); (L.G.)
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (M.B.); (R.D.); (G.G.); (F.Q.-T.)
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, “Federico II” University of Naples, 80133 Naples, Italy; (M.C.); (G.I.)
| | - Luciano Lippa
- Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy;
| | - Francesca Mallamaci
- CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy;
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.C.); (S.M.); (A.M.); (A.V.)
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80133 Naples, Italy; (L.D.); (F.G.); (M.M.)
| | - Alberto Mazza
- Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, Italy;
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.C.); (S.M.); (A.M.); (A.V.)
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, 8952 Schlieren, Switzerland
- Sant’Anna School of Advanced Studies, Research University, 56127 Pisa, Italy
| | - Pietro Nazzaro
- Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, Italy;
| | - Paolo Palatini
- Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy; (E.C.); (P.P.)
| | - Gianfranco Parati
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Auxologico Italiano, Department of Cardiology, Institute San Luca Hospital, Piazzale Brescia, 20149 Milan, Italy;
- Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Roberto Pontremoli
- Department of Internal Medicine, University of Genoa, IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy; (R.P.); (E.R.); (F.V.)
| | - Fosca Quarti-Trevano
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (M.B.); (R.D.); (G.G.); (F.Q.-T.)
| | - Marcello Rattazzi
- Department of Medicine—DIMED, University of Padova, Medicina Interna 1° Ca’ Foncello University Hospital, 31100 Treviso, Italy;
| | - Gianpaolo Reboldi
- Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy;
| | - Giulia Rivasi
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy; (G.R.); (A.U.)
| | - Elisa Russo
- Department of Internal Medicine, University of Genoa, IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy; (R.P.); (E.R.); (F.V.)
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy; (G.T.); (M.V.)
| | - Andrea Ungar
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy; (G.R.); (A.U.)
| | | | - Francesca Viazzi
- Department of Internal Medicine, University of Genoa, IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy; (R.P.); (E.R.); (F.V.)
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy; (G.T.); (M.V.)
- IRCCS San.Raffaele, Via della Pisana, 00163, Rome, Italy
| | - Agostino Virdis
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.C.); (S.M.); (A.M.); (A.V.)
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.A.R.); (A.P.); (G.B.); (M.S.)
| | - Claudio Borghi
- Department Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (A.F.G.C.); (C.B.)
- Heart-Chest-Vascular Department, IRCCS AOU of Bologna, 40126 Bologna, Italy
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Shahid R, Hussain M, Ghori MU, Bilal A, Awan FR. Association of hyperuricemia with metabolic syndrome and its components in an adult population of Faisalabad, Pakistan. Nutr Metab Cardiovasc Dis 2024; 34:1554-1558. [PMID: 38664128 DOI: 10.1016/j.numecd.2024.03.017] [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: 09/05/2023] [Revised: 01/10/2024] [Accepted: 03/01/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND AND AIMS The rising prevalence of metabolic syndrome (MetS) is a matter of serious concern worldwide. Hyperuricemia has been observed as an independent risk factor in the development of MetS and each of its individual components in different populations. This study aims to determine the association of hyperuricemia with MetS and its individual components in a Pakistani cohort. METHODS AND RESULTS A cross-sectional study was performed in a public sector hospital in Faisalabad, Pakistan. Total 204 participants were studied along with their anthropometric measurements and blood sample analysis for clinically important parameters. MetS was defined according to the NCEP-criteria. Independent sample t-test, Binomial logistic regression and Linear regression analyses were used to determine the association between hyperuricemia and metabolic syndrome. The prevalence of MetS and hyperuricemia in our study was 42.6% and 31.9% respectively. As compared to the normo-uricemic group, the hyperuricemic group had a significantly higher systolic blood pressure, BMI and lower HDL-C level (p < 0.05). After adjusting for age, gender, BMI and LDL-C, hyperuricemia was observed to increase the risk of MetS, increased systolic blood pressure and reduce HDL-C respectively by 1.34, 1.23 and 1.20 folds respectively. CONCLUSION In this study, a significant association between hyperuricemia and metabolic syndrome, systolic hypertension, blood glucose and decreased HDL-C was observed.
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Affiliation(s)
- Rameen Shahid
- Department of Paediatrics, District Head Quarters Hospital, Punjab Medical College, Faisalabad Medical University, Faisalabad, Pakistan
| | - Misbah Hussain
- Diabetes and Cardio-Metabolic Disorders Lab, Human Molecular Genetics and Metabolic Disorders Group, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan; Department of Biotechnology, University of Sargodha, Sargodha, Pakistan; NIBGE College, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Muhammad Umer Ghori
- Department of Bioinformatics and Biotechnology, Allama Iqbal Road, Government College University, Faisalabad, 38000, Pakistan
| | - Ahmed Bilal
- Department of Medicine, Allied Hospital, Punjab Medical College, Faisalabad Medical University, Faisalabad, Pakistan
| | - Fazli Rabbi Awan
- Diabetes and Cardio-Metabolic Disorders Lab, Human Molecular Genetics and Metabolic Disorders Group, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan; NIBGE College, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan.
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Deng F, Jia F, Sun Y, Zhang L, Han J, Li D, Yang Q, Hou R, Jiang W. Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome. BMC Cardiovasc Disord 2024; 24:155. [PMID: 38481127 PMCID: PMC10935860 DOI: 10.1186/s12872-024-03824-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Hyperuricemia and low level of high-density lipoprotein cholesterol (HDL-C) are both risk factors for coronary artery disease (CAD). The uric acid to HDL-C ratio (UHR) has recently been identified as a new inflammatory and metabolic biomarker. However, the relationship between the UHR and coronary culprit plaques has not been fully investigated in patients with acute coronary syndrome (ACS). METHODS A total of 346 patients with ACS were enrolled in this study. Culprit lesion characteristics were assessed by optical coherence tomography (OCT). Logistic regression and linear correlation analyses were performed to assess the association between the UHR and culprit plaques. The predictive value of the UHR was investigated by receiver operating characteristic (ROC) curve analysis. RESULTS The percentages of typical culprit plaques, including ruptures, erosions and thrombi, were greater in the high-UHR subgroup than those in the low-UHR subgroup. A positive relationship was also found between the UHR and diameter stenosis (r = 0.160, P = 0.003) and between the UHR and area stenosis (r = 0.145, P = 0.007). The UHR was found to be independently associated with plaque rupture, erosion and thrombus. Furthermore, ROC analysis suggested that the UHR had a better predictive value than low-density lipoprotein cholesterol. CONCLUSIONS An elevated UHR level was independently related to the occurrence rate of culprit plaques. The UHR is a simple and easily acquired parameter for detecting culprit plaques in patients with ACS.
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Affiliation(s)
- Fuxue Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Fang Jia
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Yang Sun
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Lisha Zhang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jie Han
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Danni Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Qiang Yang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Rongrong Hou
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Wei Jiang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
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Liang H, Zhang J, Yu H, Ding L, Liu F, Wang J. Incidence density of hyperuricemia and association between metabolism-related predisposing risk factors and serum urate in Chinese adults: a cohort study. Front Endocrinol (Lausanne) 2023; 14:1253470. [PMID: 38130398 PMCID: PMC10733531 DOI: 10.3389/fendo.2023.1253470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
Background Evidence regarding the association between metabolism-related indicators and serum urate (SU) is limited. We aimed to obtain the incidence density of hyperuricemia and to explore the association between metabolism-related predisposing risk factors and SU. Methods A total of 48,979 Chinese adults from the Beijing Physical Examination Center were included in the study. The partial least squares path model was used to explore the relationship between SU and metabolism-related risk factors. The generalized additive model was used for smooth curve fitting, showing the sex-specific associations of SU at follow-up with baseline fasting blood glucose (FBG) concentrations and age. Results The incidence density of hyperuricemia was 78/1000 person-years. Baseline SU, age, sex, obesity, FBG, and lipid metabolism were significantly associated with SU at follow-up (all P values <0.05). Non-linear relationships were found between the baseline FBG concentrations and SU at follow-up, while U-shaped associations were observed between baseline age and SU at follow-up. Conclusions The SU concentration is associated with several metabolism-related risk factors such as obesity and FBG. Recognition of these associations will aid in a deeper understanding of the multifaceted nature of SU regulation.
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Affiliation(s)
- Hailun Liang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Jijuan Zhang
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hancheng Yu
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lijie Ding
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Feng Liu
- Department of Health Management, Beijing Physical Examination Center, Beijing, China
| | - Jun Wang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
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Crawley WT, Jungels CG, Stenmark KR, Fini MA. U-shaped association of uric acid to overall-cause mortality and its impact on clinical management of hyperuricemia. Redox Biol 2022; 51:102271. [PMID: 35228125 PMCID: PMC8889273 DOI: 10.1016/j.redox.2022.102271] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
Serum uric acid (SUA) is significantly elevated in obesity, gout, type 2 diabetes mellitus, and the metabolic syndrome and appears to contribute to the renal, cardiovascular and pulmonary comorbidities that are associated with these disorders. Most previous studies have focused on the pathophysiologic effects of high levels of uric acid (hyperuricemia). More recently, research has also shifted to the impact of hypouricemia, with multiple studies showing the potentially damaging effects that can be caused by abnormally low levels of SUA. Along with these observations, recent inconclusive data from human studies evaluating the treatment of hyperuricemia with xanthine oxidoreductase (XOR) inhibitors have added to the debate about the causal role of UA in human disease processes. SUA, which is largely derived from hepatic degradation of purines, appears to exert both systemic pro-inflammatory effects that contribute to disease and protective antioxidant properties. XOR, which catalyzes the terminal two steps of purine degradation, is the major source of both reactive oxygen species (O2.-, H2O2) and UA. This review will summarize the evidence that both elevated and low SUA may be risk factors for renal, cardiovascular and pulmonary comorbidities. It will also discuss the mechanisms through which modulation of either XOR activity or SUA may contribute to vascular redox hemostasis. We will address future research studies to better account for the differential effects of high versus low SUA in the hope that this will identify new evidence-based approaches for the management of hyperuricemia.
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Li W, Wang Y, Ouyang S, Li M, Liu R, Zhang Y, Liu X, Li T, Liu S. Association Between Serum Uric Acid Level and Carotid Atherosclerosis and Metabolic Syndrome in Patients With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne) 2022; 13:890305. [PMID: 35769075 PMCID: PMC9234212 DOI: 10.3389/fendo.2022.890305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/04/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Serum uric acid (SUA) is associated with many cardiovascular risk factors, such as metabolic syndrome (MetS) and subclinical atherosclerosis. However, the relationship of SUA with carotid atherosclerosis remains controversial. We aimed to investigate whether elevated SUA levels are associated with a high risk of carotid atherosclerosis and MetS in patients with type 2 diabetes mellitus (T2DM). METHODS This cross-sectional study was performed with a sample of 1,947 hospitalized patients with T2DM. Carotid intima-media thickness and carotid artery plaques were measured via Doppler ultrasound. RESULTS Uric acid levels were negatively associated with HbA1C, eGFR, and HDL-C (all P < 0.001) and positively associated with WBC, BMI, ACR, creatinine, total cholesterol, triglycerides, LDL-C, systolic blood pressure, and diastolic blood pressure (all P < 0.001). After adjusting for multiple potential confounders, the risks were substantially higher for MetS in the highest quartile of SUA levels (odds ratio: 2.91, 95% confidence interval: 1.54-5.51, P = 0.003 for trend) than in the lowest quartile of SUA levels. Furthermore, a significant increase was observed in the prevalence of overweight/obesity, hypertension, and dyslipidemia across the SUA quartiles independent of confounders. However, no significant association was found between SUA quartile with the presence of carotid atherosclerosis. CONCLUSIONS In patients with T2DM, SUA levels were closely associated with MetS and its components but not with carotid atherosclerosis.
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Affiliation(s)
- Wei Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Li, ; Shengyun Liu,
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shengrong Ouyang
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing, China
| | - Mengdi Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuqi Zhang
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaojun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tianfang Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shengyun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Li, ; Shengyun Liu,
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Wang A, Tian X, Wu S, Zuo Y, Chen S, Mo D, Luo Y, Wang Y. Metabolic Factors Mediate the Association Between Serum Uric Acid to Serum Creatinine Ratio and Cardiovascular Disease. J Am Heart Assoc 2021; 10:e023054. [PMID: 34779219 PMCID: PMC9075399 DOI: 10.1161/jaha.121.023054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background The serum uric acid/serum creatinine ratio (SUA/SCr), which represents renal function‐normalized SUA, is associated with diverse adverse outcomes. The aim of this study was to investigate the association between SUA/SCr and cardiovascular disease (CVD), and determine whether and to what extent this association is mediated by cardiometabolic factors. Methods and Results This prospective study enrolled 96 378 participants from the Kailuan study without stroke and myocardial infarction at baseline (2006). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Mediation analyses were conducted to separately explore the mediating effects of cardiometabolic factors on the association between SUA/SCr and CVD. During median follow up of 11.01 years, 6315 (6.55%) individuals developed incident CVD. After adjustment for potential confounders, the highest quartile of SUA/SCr was associated with the highest risk of CVD (HR, 1.15; 95% CI, 1.07–1.23), stroke (HR, 1.16; 95% CI, 1.07–1.26), ischemic stroke (HR, 1.12; 95% CI, 1.02–1.22), and hemorrhagic stroke (HR, 1.36; 95% CI, 1.11–1.65), but not with myocardial infarction (HR, 1.07; 95% CI, 0.92–1.25). The association was consistent across different degrees of kidney function and glucose tolerance statuses. Additionally, the association between high SUA/SCr and CVD was partially mediated by triglycerides (30.74%), body mass index (BMI) (19.52%), total cholesterol (15.06%), hs‐CRP (high‐sensitivity C‐reactive protein) (13.06%), diastolic blood pressure (11.75%), and blood glucose (−16.38%). Conclusions SUA/SCr and CVD were positively associated. Furthermore, this association was partially mediated through blood lipids, BMI, blood pressure, hs‐CRP, and blood glucose.
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Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases Advanced Innovation Center for Human Brain Protection Beijing Tiantan HospitalCapital Medical University Beijing China.,Department of Neurology Beijing Tiantan HospitalCapital Medical University Beijing China
| | - Xue Tian
- Department of Epidemiology and Health Statistics School of Public Health Capital Medical University Beijing China.,Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Shouling Wu
- Department of Cardiology Kailuan Hospital North China University of Science and Technology Tangshan China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics School of Public Health Capital Medical University Beijing China.,Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Shuohua Chen
- Department of Cardiology Kailuan Hospital North China University of Science and Technology Tangshan China
| | - Dapeng Mo
- Department of Neurological Intervention Beijing Tiantan HospitalCapital Medical University Beijing China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics School of Public Health Capital Medical University Beijing China.,Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases Advanced Innovation Center for Human Brain Protection Beijing Tiantan HospitalCapital Medical University Beijing China.,Department of Neurology Beijing Tiantan HospitalCapital Medical University Beijing China
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8
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Pang S, Jiang Q, Sun P, Li Y, Zhu Y, Liu J, Ye X, Chen T, Zhao F, Yang W. Hyperuricemia prevalence and its association with metabolic disorders: a multicenter retrospective real-world study in China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1550. [PMID: 34790756 PMCID: PMC8576711 DOI: 10.21037/atm-21-5052] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022]
Abstract
Background The prevalence of hyperuricemia (HUA) and gout continues to increase in China. Research suggests that HUA may be related to many diseases other than gout. However, further population research is required to investigate the association between HUA and metabolic syndromes. This study sought to investigate the prevalence of HUA in an average population in China, and the association between serum uric acid (UA) levels and related metabolic disorders. Methods This multicenter retrospective real-world study examined the hospital information system data of 4 tertiary hospitals in 3 provinces in China. The data of patients aged between 18 and 80 years, who had attended at least 1 medical appointment at which their UA level was recorded, were analyzed to evaluate associations between UA levels and metabolic disorders. Results Among the 374,506 enrolled subjects (49.7% male; mean age 51.5 years old), the overall prevalence of HUA and gout were 14.8% and 0.5%, respectively. The prevalence was higher among males than females (17.6% vs. 12.0%, 0.8% vs. 0.1%; both P<0.001). Groups exhibiting higher UA levels had increased adjusted odds ratios for dyslipidemia and chronic kidney disease (CKD) in both sexes. Changes in UA levels from the baseline were negatively correlated with changes in the estimated glomerular filtration rate and hemoglobin A1c among both sexes (all P<0.001), and were positively correlated with changes in total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) (all P<0.05) among males, and changes in TC, TG, LDL-C and glucose (all P<0.001) among females. Conclusions HUA is associated with dyslipidemia and CKD both cross-sectionally and longitudinally. Similar phenomena were observed in both sexes.
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Affiliation(s)
- Shuguang Pang
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qiang Jiang
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Pei Sun
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yi Li
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Yanhua Zhu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Jin Liu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Xiaoran Ye
- Shanghai Palan DataRx Co., Ltd., Shanghai, China
| | - Ting Chen
- Shanghai Palan DataRx Co., Ltd., Shanghai, China
| | - Fei Zhao
- Shandong Health Medical Big Data Co., Ltd., Jinan, China
| | - Wenjun Yang
- Department of Endocrinology, The Affiliated Hospital of Shandong University of TCM, Jinan, China
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9
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Yu Y, Lan T, Wang D, Fang W, Tao Y, Li M, Huang X, Zhou W, Wang T, Zhu L, Bao H, Cheng X. The association of lipid ratios with hyperuricemia in a rural Chinese hypertensive population. Lipids Health Dis 2021; 20:121. [PMID: 34587966 PMCID: PMC8482679 DOI: 10.1186/s12944-021-01556-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/14/2021] [Indexed: 01/23/2023] Open
Abstract
Background Current studies support lipid ratios [the total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio; the triglyceride (TG)/HDL-C ratio; the low-density lipoprotein cholesterol (LDL -C)/HDL-C ratio; and non-HDL-C] as reliable indicators of cardiovascular disease, stroke, and diabetes. However, whether lipid ratios could serve as markers for hyperuricemia (HUA) remains unclear due to limited research. This study aimed to explore the association between lipid ratios and HUA in hypertensive patients. Methods The data from 14,227 Chinese hypertensive individuals in the study were analyzed. Multiple logistic regression analysis and smooth curve fitting models examined the relationship between lipid ratios and HUA. Results The results showed positive associations between the lipid ratios and HUA (all P < 0.001). Furthermore, lipid ratios were converted from continuous variables to tertiles. Compared to the lowest tertile, the fully adjusted ORs (95 % CI) of the TC/HDL-C ratio, the TG/HDL-C ratio, the LDL-C/HDL-C ratio, and non-HDL-C in the highest tertile were 1.79 (1.62, 1.99), 2.09 (1.88, 2.32), 1.67 (1.51, 1.86), and 1.93 (1.74, 2.13), respectively (all P < 0.001). Conclusions The study suggested that high lipid ratios (TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C) are associated with HUA in a Chinese hypertensive population. This study’s findings further expand the scope of the application of lipid ratios. These novel and essential results suggest that lipid ratio profiles might be potential and valuable markers for HUA. Trial registration No. ChiCTR1800017274. Registered July 20, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01556-z.
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Affiliation(s)
- Yu Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tian Lan
- Department of Health Care Management, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Dandan Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wangsheng Fang
- Wuyuan County Health Committee, Wuyuan of Jiangxi, Nanchang, China
| | - Yu Tao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Minghui Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang of Jiangxi, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang of Jiangxi, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang of Jiangxi, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang of Jiangxi, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang of Jiangxi, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
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10
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Katsiki N, Dimitriadis GD, Mikhailidis DP. Serum Uric Acid and Diabetes: From Pathophysiology to Cardiovascular Disease. Curr Pharm Des 2021; 27:1941-1951. [PMID: 33397230 DOI: 10.2174/1381612827666210104124320] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022]
Abstract
Hyperuricemia, has been traditionally related to nephrolithiasis and gout. However, it has also been associated with the development of type 2 diabetes mellitus (T2DM) and cardiometabolic and cardiovascular diseases. Pathophysiologically, elevated serum uric acid (SUA) levels may be associated with abnormal lipid and glucose metabolism. In this narrative review, we consider the associations between hyperuricemia, hyperglycemia, atherosclerosis and thrombosis. Furthermore, we comment on the available evidence linking elevated SUA levels with the incidence and outcomes of coronary heart disease, stroke, peripheral artery disease and non-alcoholic fatty liver in subjects with T2DM. The effects of antidiabetic drugs (e.g. metformin, pioglitazone, sulfonylureas, dipeptidyl peptidase 4 inhibitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors and insulin) on SUA concentrations are also reviewed.
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Affiliation(s)
- Niki Katsiki
- First Department of Internal Medicine, Diabetes Center, Division of Endocrinology and Metabolism, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital campus, University College London Medical School, University College London (UCL), London NW3 2QG, United Kingdom
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11
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Sasso FC, Pafundi PC, Simeon V, De Nicola L, Chiodini P, Galiero R, Rinaldi L, Nevola R, Salvatore T, Sardu C, Marfella R, Adinolfi LE, Minutolo R. Efficacy and durability of multifactorial intervention on mortality and MACEs: a randomized clinical trial in type-2 diabetic kidney disease. Cardiovasc Diabetol 2021; 20:145. [PMID: 34271948 PMCID: PMC8285851 DOI: 10.1186/s12933-021-01343-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Multiple modifiable risk factors for late complications in patients with diabetic kidney disease (DKD), including hyperglycemia, hypertension and dyslipidemia, increase the risk of a poor outcome. DKD is associated with a very high cardiovascular risk, which requires simultaneous treatment of these risk factors by implementing an intensified multifactorial treatment approach. However, the efficacy of a multifactorial intervention on major fatal/non-fatal cardiovascular events (MACEs) in DKD patients has been poorly investigated. METHODS Nephropathy in Diabetes type 2 (NID-2) study is a multicentre, cluster-randomized, open-label clinical trial enrolling 395 DKD patients with albuminuria, diabetic retinopathy (DR) and negative history of CV events in 14 Italian diabetology clinics. Centres were randomly assigned to either Standard-of-Care (SoC) (n = 188) or multifactorial intensive therapy (MT, n = 207) of main cardiovascular risk factors (blood pressure < 130/80 mmHg, glycated haemoglobin < 7%, LDL, HDL and total cholesterol < 100 mg/dL, > 40/50 mg/dL for men/women and < 175 mg/dL, respectively). Primary endpoint was MACEs occurrence by end of follow-up phase. Secondary endpoints included single components of primary endpoint and all-cause death. RESULTS At the end of intervention period (median 3.84 and 3.40 years in MT and SoC group, respectively), targets achievement was significantly higher in MT. During 13.0 years (IQR 12.4-13.3) of follow-up, 262 MACEs were recorded (116 in MT vs. 146 in SoC). The adjusted Cox shared-frailty model demonstrated 53% lower risk of MACEs in MT arm (adjusted HR 0.47, 95%CI 0.30-0.74, P = 0.001). Similarly, all-cause death risk was 47% lower (adjusted HR 0.53, 95%CI 0.29-0.93, P = 0.027). CONCLUSION MT induces a remarkable benefit on the risk of MACEs and mortality in high-risk DKD patients. Clinical Trial Registration ClinicalTrials.gov number, NCT00535925. https://clinicaltrials.gov/ct2/show/NCT00535925.
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Affiliation(s)
- Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy.
| | - Pia Clara Pafundi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Vittorio Simeon
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Luca De Nicola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Riccardo Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Teresa Salvatore
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138, Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Roberto Minutolo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
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12
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Zong Q, Ma G, Wang T. Uric acid lowering improves insulin sensitivity and lowers blood pressure: a meta-analysis of randomized parallel-controlled clinical trials. Afr Health Sci 2021; 21:82-95. [PMID: 34394285 PMCID: PMC8356612 DOI: 10.4314/ahs.v21i1.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives This meta-analysis aimed to investigate whether uric acid lowering treatment can improve β-cell function and insulin sensitivity. Methods PubMed, Cochrane Library, EMBASE and China Biology Medicine were searched up to March 1, 2020. Randomized controlled clinical trials of urate lowering therapy in hyperuricemia patients were included in meta-analysis. Effect size was estimated as mean difference with 95% confidence interval (CI). Results Our search yielded 7 eligible trials with 503 participants. This meta-analysis showed that uric acid-lowering therapy decreased fasting insulin -1.43 µIU/ml (weighted mean differences (WMD, 95% CI -2.78 to -0.09), homeostasis model assessment of insulin resistance -0.65 (WMD, 95% CI -1.05 to -0.24), systolic blood pressure -2.45 mm Hg (WMD, 95%CI -4.57 to -0.33) and diastolic blood pressure -3.41 mm Hg (WMD, 95%CI -3.87 to -2.95). However, the treatment had no significant effect on fasting plasma glucose (WMD -0.19 mmol/L, 95%CI -0.42 to 0.05), homeostasis model assessment of β-cell function index (WMD -0.02, 95%CI -0.28 to 0.24), total cholesterol (WMD 0.18 mg/dl; 95%CI, -1.39 to 1.75) and triglyceride (WMD 3.15 mg/dl, 95% CI -9.83 to 16.14). Conclusion Uric acid-lowering therapies might improve insulin sensitivity and lower blood pressure, but had no significant effect on HOMA-β and serum lipids.
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Affiliation(s)
- Qunchuan Zong
- Division of Orthopedic Surgery, the Affiliated Hospital of Qinghai University, 810001, Xining, Qinghai Province, China
| | - Guanyi Ma
- Division of Orthopedic Surgery, the Affiliated Hospital of Qinghai University, 810001, Xining, Qinghai Province, China
| | - Tao Wang
- Division of Orthopedic Surgery, the Affiliated Hospital of Qinghai University, 810001, Xining, Qinghai Province, China
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13
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Ma M, Wang L, Huang W, Zhong X, Li L, Wang H, Peng B, Mao M. Meta-analysis of the correlation between serum uric acid level and carotid intima-media thickness. PLoS One 2021; 16:e0246416. [PMID: 33571245 PMCID: PMC7877574 DOI: 10.1371/journal.pone.0246416] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Mingzhu Ma
- School of Public Health and Management, Chongqing Medical University; Research Center for Medicine and Social Development, Chongqing, China
| | - Liangxu Wang
- School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Wenjing Huang
- School of Public Health and Management, Chongqing Medical University; Research Center for Medicine and Social Development, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University; Research Center for Medicine and Social Development, Chongqing, China
| | - Longfei Li
- School of Public Health and Management, Chongqing Medical University; Research Center for Medicine and Social Development, Chongqing, China
| | - Huan Wang
- Department of Development planning, Chongqing Medical University, Chongqing, China
| | - Bin Peng
- School of Public Health and Management, Chongqing Medical University; Research Center for Medicine and Social Development, Chongqing, China
| | - Min Mao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- * E-mail:
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14
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Ephraim RKD, Awuku YA, Numekevor P, Botchway F, Adoba P, Dadzie EK, Abrefa CA, Abaka-Yawson A. Serum Uric acid is a better indicator of kidney impairment than serum uric acid to creatine ratio ; a cross sectional study of type 2 diabetes mellitus patients. J Diabetes Metab Disord 2021; 20:313-320. [PMID: 34178839 DOI: 10.1007/s40200-021-00746-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/18/2021] [Indexed: 11/27/2022]
Abstract
Background Type 2 diabetes mellitus (T2DM) patients are likely to develop kidney disease. The need to identify more accessible and cheaper diagnostic biomarkers cannot be overemphasized. This study investigated the ability of serum uric and uric acid to creatinine ratio in assessing the kidney function of T2DM patients and determined the relationship between serum uric acid to creatinine ratio and estimated glomerular filtration rate (eGFR). Methods One hundred and fifty-five (155) consented T2DM patients were recruited from the diabetes clinic of the Cape Coast Teaching hospital. Anthropometric variables and blood pressure were measured. Serum uric acid (SUA), serum creatinine and urine protein were estimated using standard protocols. Uric acid to creatinine ratio (UA:CR), eGFR were then calculated. Results From the receiver operator characteristic (ROC) curve obtained, serum uric acid was found to be a better predictor of impaired renal function than UA:CR at p = 0.0001. The uric acid levels of participants in the fourth quartile of each category was found to be significant at p = 0.010 and can be used as indicators of kidney function in these participants. According to the odds ratio, the UA:CR will not be suitable to be used as an indicator of kidney function in any of the participants because their odds ratios were all less than 1. A total of 29(18.7 %) participants were found to have CKD with their eGFR falling below 60 ml/mins per 1.73 m2. A significant positive relationship was found between serum uric acid and the staging of CKD according to eGFR whiles a negative relationship was found with UA:CR and CKD (p < 0.0001). Conclusions Serum uric acid is a better indicator of renal impairment (eGFR < 60 ml/mins per 1.73 m2) than UA:CR in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Yaw A Awuku
- Department of Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Prince Numekevor
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Felix Botchway
- Department of Chemical Pathology, University of Ghana, Accra, Ghana
| | - Prince Adoba
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Emmanuel K Dadzie
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Chris A Abrefa
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Albert Abaka-Yawson
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
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15
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Maloberti A, Qualliu E, Occhi L, Sun J, Grasso E, Tognola C, Tavecchia G, Cartella I, Milani M, Vallerio P, Signorini S, Brambilla P, Casati M, Bombelli M, Grassi G, Giannattasio C. Hyperuricemia prevalence in healthy subjects and its relationship with cardiovascular target organ damage. Nutr Metab Cardiovasc Dis 2021; 31:178-185. [PMID: 32994122 DOI: 10.1016/j.numecd.2020.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/06/2020] [Accepted: 08/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM Heterogeneous results have been obtained in the relationship between Uric Acid (UA) and Target Organ Damage (TOD). In the present study we sought to assess the prevalence of hyperuricemia in healthy subjects as well as the role of UA in determining TOD. We evaluated vascular, cardiac and renal TODs in the whole population as well as sub-grouped by gender. METHODS AND RESULTS As many as 379 blood donors participated at the present analysis. TOD was evaluated as Pulse Wave Velocity (PWV), Left Ventricular Mass Index (LVMI) and carotid Intima-Media Thickness (IMT). Hyperuricemia was defined with the classic cut-off (>7.0 in men and >6.0 mg/dL in women) but also with a most recently defined one (5.6 mg/dL for both sex). Hyperuricemia was present in 6.3% of the whole population (7.3% males, 2.8% females) considering the classic cut-off, while, with the recently identified one, it was present in 28.2% of the whole population (37.3% males, 4.7% females). Despite all the evaluated TODs significantly correlated with UA, linear multivariate regression analysis showed that none of them, except for GFR, displayed UA as a significant covariate. Similar figures were found also when both correlation and linear regression analyses were repeated in the two genders separately. CONCLUSIONS Hyperuricemia is an important problem also in healthy subjects and its prevalence could further increase if lower cut-off will be used. In this specific population UA is significantly associated with renal impairment while this was not the case for cardiac and vascular damage.
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Affiliation(s)
- Alessandro Maloberti
- Cardiology IV, "A. De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy; University of Milano-Bicocca, Milan, Italy.
| | | | - Lucia Occhi
- Cardiology IV, "A. De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy; University of Milano-Bicocca, Milan, Italy
| | - Jinwei Sun
- University of Milano-Bicocca, Milan, Italy
| | | | | | | | | | | | | | | | | | - Marco Casati
- Laboratory Medicine, San Gerardo Hospital, ASST Monza, Italy
| | - Michele Bombelli
- University of Milano-Bicocca, Milan, Italy; Clinica Medica, University of Milano-Bicocca, Monza, Italy
| | - Guido Grassi
- University of Milano-Bicocca, Milan, Italy; Clinica Medica, University of Milano-Bicocca, Monza, Italy
| | - Cristina Giannattasio
- Cardiology IV, "A. De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy; University of Milano-Bicocca, Milan, Italy
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16
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Han Y, Zhang Y, Cao Y, Yin Y, Han X, Di H, Chu X, Zeng X. Exploration of the association between serum uric acid and testosterone in adult males: NHANES 2011-2016. Transl Androl Urol 2021; 10:272-282. [PMID: 33532316 PMCID: PMC7844527 DOI: 10.21037/tau-20-1114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Previous studies have suggested that the possible relationship between serum uric acid (SUA) and testosterone. However, the results of previous studies are controversial and there is limited evidence examining the relationship between SUA and testosterone in a general US population of men. The objective of this study is to explore the correlation of SUA and testosterone among adult males from the US. Methods Data from the National Health and Nutrition Examination Survey 2011–2016 were used, including a total of 7,796 male participants aged 18 years or older and excluding those lacking serum testosterone and uric acid data. Clinical characteristics of the participants among different SUA groups and testosterone groups are compared. Univariate and multivariate linear regression analyses were applied to evaluate the association between SUA and testosterone. Results We found an inverse association between SUA and testosterone after fully adjusted the potential confounding factors in general US adult males. In the multivariate linear regression analysis, we found that increasing age (estimate testosterone percent difference: −0.20% per year, P<0.01), uric acid (estimate testosterone percent difference: −4.40% per md/dL, P<0.01) and BMI (estimate testosterone percent difference: −2.86% per kg/m2, P<0.01) were associated with declining serum testosterone. This association remained significant in sensitivity analysis, while in the stratified analysis, above association was not significant in men with diabetes or aged 65 and over. Conclusions SUA levels might be negatively associated with serum testosterone in adult males.
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Affiliation(s)
- Yingdong Han
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yun Zhang
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Cao
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Yin
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinxin Han
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Di
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaotian Chu
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuejun Zeng
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Liu F, Chen S, Zhao W, Chen M, Ke J, Zhang Z, Lu J, Li L. Urine Uric Acid Excretion Levels are Positively Associated with Obesity and Abdominal Obesity in Type 2 Diabetes Patients without Chronic Kidney Disease. Diabetes Metab Syndr Obes 2021; 14:4691-4703. [PMID: 34880638 PMCID: PMC8646115 DOI: 10.2147/dmso.s335558] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE We aimed to investigate whether urine uric acid excretion (UUAE) levels are associated with obesity and abdominal obesity in patients with type 2 diabetes (T2D). METHODS There were 2785 type 2 diabetic patients in this cross-sectional study. Obesity was defined as BMI ≥ 25 kg/m2, and abdominal obesity was defined as waist circumference (WC) ≥90 cm for men and WC ≥ 80 cm for women based on World Health Organization (WHO) recommendations for Asians. Chronic kidney disease (CKD) was defined as the estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and/or urinary albumin excretion (UAE) ≥300 mg/24h. 24-h UUAE was determined enzymatically using a single 24-hour urine collection. All the subjects were stratified into quartiles based on UUAE levels. Both obesity and abdominal obesity were compared among the UUAE quartile groups, respectively. Furthermore, the associations of UUAE with obesity and abdominal obesity were analyzed in both CKD and non-CKD patients, respectively. RESULTS There was an obvious increased trend in both obesity prevalence (36.2%, 41.5%, 46.3%, and 63.4%, respectively, p < 0.001 for trend) and abdominal obesity prevalence (58.1%, 61.2%, 64.7%, and 75.8%, respectively, p < 0.001 for trend) in patients with T2D across the UUAE quartiles after controlling for age, sex and diabetes duration. Multiple logistic regression analyses revealed independent associations between UUAE quartiles and obesity (p < 0.001) and abdominal obesity (p < 0.001) in all patients. However, UUAE was significantly associated with obesity and abdominal obesity only in the T2D patients without CKD (p < 0.001 in model 1, model 2, model 3 and model 4, respectively). CONCLUSION Increased UUAE levels were significantly associated with the presence of obesity, especially abdominal obesity in T2D patients without CKD.
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Affiliation(s)
- Fengjing Liu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Si Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Weijing Zhao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Mingyun Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Jiangfeng Ke
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Zhihui Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Junxi Lu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
| | - Lianxi Li
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, People’s Republic of China
- Correspondence: Lianxi Li Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, People’s Republic of ChinaTel +86 21 64369181x58337 Email
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18
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Zhang YY, Qiu HB, Tian JW. Association Between Vitamin D and Hyperuricemia Among Adults in the United States. Front Nutr 2020; 7:592777. [PMID: 33330592 PMCID: PMC7714933 DOI: 10.3389/fnut.2020.592777] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Serum uric acid can act as a risk factor for cardiovascular disease (CVD) and as antioxidant defense. Vitamin D deficiency can activate the parathyroid to induce the release of parathyroid hormone, which was thought to increase serum uric acid level, and low vitamin D status may also be associated with risk of CVD. No known studies have explored the association between serum 25(OH) D, vitamin D intake, and HU for the American population. Methods: We extracted 15,723 US adults aged 20–85 years from the National Health and Nutrition Examination Survey (NHANES) in 2007–2014. All dietary intakes were evaluated through 24-h dietary recalls. Multivariable logistic regression analysis was performed to examine the associations after adjustment for confounders. Results: Compared to the lowest quintile (Q1), for males, adjusted odds ratios (ORs) of HU in Q2 to Q4 of serum 25(OH) D levels were 0.78 (95% CI, 0.65–0.93), 0.97 (0.81–1.16), and 0.72 (0.60–0.88); ORs in Q2–Q5 of total vitamin D intake were 0.83 (0.69–0.98), 0.69 (0.58–0.83), 0.66 (0.55–0.79), and 0.59 (0.48–0.71), respectively. In females, OR was 0.80 (0.66–0.97) of serum 25(OH) D for Q3, and ORs in Q5 of total vitamin D intake were 0.80 (0.65–0.98). Conclusions: Our findings indicated that the serum 25(OH) D intakes of dietary vitamin D, supplemental vitamin D, and total vitamin D were inversely associated with HU in males. In females, a lower risk of HU with higher serum 25(OH) D, dietary vitamin D, and total vitamin D intake was found, but with no association between supplemental vitamin D intake and the risk of HU.
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Affiliation(s)
- Yi-Ying Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Hong-Bin Qiu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Jin-Wei Tian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
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19
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Jayachandran M, Qu S. Harnessing hyperuricemia to atherosclerosis and understanding its mechanistic dependence. Med Res Rev 2020; 41:616-629. [PMID: 33084092 DOI: 10.1002/med.21742] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/12/2020] [Accepted: 10/04/2020] [Indexed: 12/13/2022]
Abstract
Atherosclerosis is regarded as the disease of the arterial vasculature. The main characteristics of atherosclerosis are the abnormal accumulation of lipids, increased inflammatory cells, matrix deposits, and proliferation of smooth muscle cells. Diabetes mellitus, obesity, and hyperlipidemia are the most studied risk factors of atherosclerosis. One least studied risk factor is the uric acid (UA), a high UA in circulation is interlinked with many pathological processes. Several epidemiological studies suggest elevated UA levels as an essential biomarker in the forecast of several cardiovascular diseases. Available evidence claims that UA upholds the atherosclerosis process via disturbing lipid metabolism, reducing the nitric oxide synthesis in endothelial cells, promoting the proliferation of vascular smooth muscle cells, and overwhelms inflammation. In endothelial dysfunction and coronary artery lesions, UA is considered as an independent predictor. The updated studies on the involvement of hyperuricemia in atherosclerosis prove that treatment with xanthine oxidase (XO) inhibitors not just benefits the treatment of hyperuricemia but also reduces the burden of atherosclerosis to a greater extent. In this review, we highlight how the hyperuricemia affects vascular integrity, causes atherosclerosis, and the mechanism of action of XO inhibitors on atherosclerosis.
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Affiliation(s)
- Muthukumaran Jayachandran
- Department of Endocrinology and Metabolism, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Shen Qu
- Department of Endocrinology and Metabolism, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
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20
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Cho YS, Bae JH, Moon SH, Hyun SH, Choi JY, Kim BT, Lee KH. Serum uric acid in asymptomatic adults is weakly associated with carotid artery FDG uptake but not intima-media thickness. J Nucl Cardiol 2020; 27:1537-1546. [PMID: 30155781 DOI: 10.1007/s12350-018-1424-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study investigated the association of serum uric acid (UA) with carotid fluoro-2-deoxyglucose (FDG) uptake as a marker of inflammatory atherosclerosis. METHODS AND RESULTS In this cross-sectional retrospective study of 970 otherwise healthy adults, subjects in the greater serum UA quartiles had higher triglyceride (P < .001), lower high-density lipoprotein cholesterol (P < .05), and lower estimated GFR (P < .001). Mean and maximum Target-to-background ratios (TBRs) of carotid FDG uptake measured by positron emission tomography were significantly increased across greater serum UA quartiles (1.35 and 1.57 for Q1, 1.38 and 1.60 for Q2, 1.39 and 1.62 for Q3, and 1.39 and 1.61 for Q4; P = .001 and < .001). Carotid intima-media thickness was not different. Serum UA showed weak but significant correlations with estimated GFR (P < .001), and with mean (P < .001) and maximum carotid TBR (P = .004). Serum UA correlated with mean TBR in male (P = .008) and female subjects (P = .011), in high (≥ 70; P = .015) and low estimated GFR (< 70; P = .035), and in normotensive (P = .001) but not in hypertensive subjects. CONCLUSIONS Elevated serum UA in asymptomatic adults is associated with increased carotid FDG uptake, which suggests a potential role of UA in carotid inflammatory atherosclerosis.
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Affiliation(s)
- Young Seok Cho
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Ji Hoon Bae
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Seung Hyup Hyun
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Byung-Tae Kim
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
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21
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Yu X, Bian B, Huang J, Yao W, Wu X, Huang J, Wang J, Yang Q, Ning X. Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China. Postgrad Med 2020; 132:544-550. [PMID: 32297560 DOI: 10.1080/00325481.2020.1757266] [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: 10/24/2022]
Abstract
Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. Results: A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.
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Affiliation(s)
- Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Bo Bian
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jinyong Huang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Wei Yao
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Xianming Wu
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jingjing Huang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute , Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute , Tianjin, China
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22
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Rafiullah M, Siddiqui K, Al-Rubeaan K. Association between serum uric acid levels and metabolic markers in patients with type 2 diabetes from a community with high diabetes prevalence. Int J Clin Pract 2020; 74:e13466. [PMID: 31854061 DOI: 10.1111/ijcp.13466] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The importance of uric acid has been increasingly appreciated because of its association with the development of diabetes mellitus and related diseases. OBJECTIVE This study was undertaken to evaluate the association of serum uric acid (SUA) level with different clinical and biochemical parameters in patients with type 2 diabetes from Saudi Arabia. METHODS Clinical and biochemical data from the patients were obtained and assessed in a cross-sectional design. Relationships between SUA level and various clinical and biochemical parameters were analysed. RESULTS SUA level was positively associated with increased incidence of cardiovascular diseases (CVD) in patients with abnormal eGFR (<90 mL/min/1.73 m2 ). HbA1c was found to be inversely associated with hyperuricemia in patients with normal eGFR level (≥90 mL/min/1.73 m2 ). Incidence of metabolic syndrome did not show any relationship with SUA level. However, the incidence of hypertension, a component of metabolic syndrome, was significantly higher among patients with hyperuricemia. Waist circumference and serum triglycerides were higher, whereas serum high-density lipoprotein level was lower in patients with higher SUA level. Patients with hyperuricemia had higher incidence of CVDs than those of the normouricemic group. CONCLUSION SUA level was positively associated with incidence of cardiovascular diseases CVD in patients with abnormal eGFR. HbA1c correlated significantly with SUA level in patients with normal eGFR. Incidence of metabolic syndrome did not show any association with SUA level. Incidence of hypertension, waist circumference and serum triglycerides were significantly higher and serum high-density lipoprotein level was lower in patients with higher SUA level.
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Affiliation(s)
- Mohamed Rafiullah
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Siddiqui
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Rubeaan
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Yu Y, Huang X, Li M, Ding C, Hu L, Zhong X, Zhou W, Wang T, Zhu L, Bao H, Cheng X. Is There a Nonlinear Relationship between Serum Uric Acid and Lipids in a Hypertensive Population with eGFR ≥30 ml/min/1.73 m 2? Findings from the China Hypertension Registry Study. Int J Endocrinol 2020; 2020:9725979. [PMID: 33014048 PMCID: PMC7519986 DOI: 10.1155/2020/9725979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/12/2020] [Accepted: 09/07/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence regarding the nonlinear relationship between serum uric acid (SUA) and blood lipids in Chinese population with hypertension is limited. Therefore, the present study aimed to investigate whether there is a nonlinear association between SUA and lipids in Chinese hypertensive population with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m2. METHODS A total of 13,355 hypertensive participants with eGFR ≥30 ml/min/1.73 m2 were selected from the Chinese Hypertension Registry Study. Multivariate linear regression was used to examine the linear relationship between SUA and lipids. Smooth curve fitting (penalized spline method) and threshold saturation effects were used to analyze the nonlinear association between SUA and lipids. RESULTS In the fully adjusted model, the results showed a positive correlation between SUA and TG (β = 0.15; 95% CI: 0.14, 0.16) and LDL-C (β = 0.06; 95% CI: 0.05, 0.07), respectively. However, the relationship between SUA and HDL-C was nonlinear. The inflection point of SUA was 7.24 mg/dL. On the left side of the inflection point (<7.24 mg/dL), SUA was negatively associated with HDL-C (β = -0.02; 95% CI -0.02, -0.01). On the right side of the inflection point (≥7.24 mg/dL), SUA was not related to HDL-C (β = 0.01; 95% CI -0.01, 0.02). CONCLUSION After adjusting for all covariates, SUA was positively associated with TG and LDL-C. The relationship between SUA and HDL-C was nonlinear. The negative correlation between SUA and HDL-C only existed when the SUA was less than 7.24 mg/dL in a hypertensive population with eGFR ≥30 ml/min/1.73 m2.
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Affiliation(s)
- Yu Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Minghui Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Congcong Ding
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Zhong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Singh K, Kumar P, Joshi A, Shivhare DK, Mahto SK, Singh A, Aneja A, Lamba BMS. Study of association of serum uric acid with albuminuria and carotid atherosclerosis in type 2 diabetes mellitus patients. J Family Med Prim Care 2019; 8:4027-4031. [PMID: 31879654 PMCID: PMC6924255 DOI: 10.4103/jfmpc.jfmpc_777_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction: Type 2 diabetes mellitus is a heterogeneous group of metabolic disorders of disturbance of carbohydrate, fat, and protein metabolism causing macrovascular (like coronary artery disease) and microvascular (kidney damage) complications. Microalbuminuria is the first manifestation of injury to glomerular filtration barrier and carotid intima-media thickness (IMT) of common carotid artery serves as an excellent marker for early lesion of atherosclerosis. Method: A cross-sectional observational study was carried out over a period of 1.5 years in PGIMER, DR. RML Hospital, New Delhi. Patients with type 2 diabetes mellitus, aged between 35 and 60 years, were investigated for uric acid (UA), urine albumin levels, and common carotid IMT during this period. Patients on drugs that affect serum UA level, patients with acute illness, patients with serum creatinine >1.5 mg/dL, or with coronary artery disease were excluded from study. Result: Prevalence of hyperuricemia was found to be high (46%) in type 2 diabetic patients. It was also higher in females (73.7%) than males (25.8%). There was positive correlation between serum UA concentrations with logarithm of urine albumin excretion (P < 0.023) and carotid intima-media thickness (IMT) (P < 0.027). Plaque index also showed a positive correlation with UA (P < 0.019). However, there was no positive correlation with UA and other variable such as age, duration of diabetes, systolic blood pressure, diastolic blood pressure, HbA1c, lipid profiles, urea, and creatinine. Conclusion: Serum UA concentration thus serves as an early marker of renal dysfunction and cardiovascular diseases in type 2 diabetic patients.
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Affiliation(s)
- Kuldeep Singh
- Department of Medicine, PGIMER and DR. RML Hospital, New Delhi, India
| | - Pardeep Kumar
- Department of Medicine, PGIMER and DR. RML Hospital, New Delhi, India
| | - Arun Joshi
- Department of Nephrology, Army Research and Referral Hospital, New Delhi, India
| | | | | | - Akanskha Singh
- Department of Medicine, PGIMER and DR. RML Hospital, New Delhi, India
| | - Ankita Aneja
- Department of Medicine, PGIMER and DR. RML Hospital, New Delhi, India
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Xie M, Xie D, Yang Y, Zhang Y, Li K, Zhou B, Yang Z, Ding X, Li H. Association of high-sensitivity C-reactive protein in middle-aged and elderly Chinese people with hyperuricaemia and risk of coronary heart disease: a cross-sectional study. BMJ Open 2019; 9:e028351. [PMID: 31630099 PMCID: PMC6803153 DOI: 10.1136/bmjopen-2018-028351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Patients with hyperuricaemia are at relatively high risk of developing coronary heart disease (CHD). The purpose of this study was to examine the relationship between high-sensitivity C-reactive protein (hs-CRP) and CHD risk in a middle-aged and elderly population with hyperuricaemia. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS This study was conducted in a health examination centre of China. Participants were diagnosed with hyperuricaemia based on uric acid concentrations. Specifically, males with a uric acid concentration ≥416 μmol/L were included, as well as females with a concentration ≥360 μmol/L. MAIN OUTCOME MEASURES 10-year CHD risk for each individual was evaluated using Framingham risk score based on the Adult Treatment Panel III charts. RESULTS A total of 517 patients with hyperuricaemia (438 males and 79 females) aged from 40 to 85 years old were included in the present study. 193 (37.3%) patients were defined with relatively high 10-year CHD risk. Compared with the lowest quintile, the crude ORs of relatively high 10-year CHD risks were 1.43 (95% CI 0.78 to 2.63, p=0.245), 2.05 (95% CI 1.14 to 3.67, p=0.016), 2.77 (95% CI 1.54 to 4.98, p=0.001), 2.12 (95% CI 1.18 to 3.80, p=0.012) in the second, third, fourth and fifth quintiles of serum hs-CRP level, respectively (p for trend=0.057). The multivariable-adjusted ORs of relatively high 10-year CHD risk were 1.40 (95% CI 0.75 to 2.61, p=0.291) in the second, 2.05 (95% CI 1.13 to 3.72, p=0.019) in the third, 2.69 (95% CI 1.47 to 4.89, p=0.001) in the fourth and 2.10 (95% CI 1.15 to 3.84, p=0.016) in the fifth quintile of serum hs-CRP level when compared with the lowest quintile (p for trend=0.068). CONCLUSION This study showed that ORs of relatively high 10-year CHD risk were raised in patients with hyperuricaemia with higher serum hs-CRP level; however, there was a not significant but borderline trend association and that more research is needed.
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Affiliation(s)
- Mingsheng Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Dongxing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Ye Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Kun Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Bin Zhou
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zidan Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiang Ding
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Song M, Li N, Yao Y, Wang K, Yang J, Cui Q, Geng B, Chen J, Wang Y, Cheng W, Zhou Y. Longitudinal association between serum uric acid levels and multiterritorial atherosclerosis. J Cell Mol Med 2019; 23:4970-4979. [PMID: 31240862 PMCID: PMC6652300 DOI: 10.1111/jcmm.14337] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 03/12/2019] [Accepted: 03/29/2019] [Indexed: 01/19/2023] Open
Abstract
Multiterritorial atherosclerosis has dramatically increased annual risk of adverse cardiovascular events than atherosclerotic disease with single-artery affected. Serum uric acid (SUA) is an important predictor of stroke and atherosclerosis; however, which is supported by few direct evidence based on cohort studies. A prospective cohort study including 2644 North Chinese adults aged ≥40 years was performed in 2010-2012 to investigate the association between SUA and multiterritorial vascular stenosis. Hyperuricaemia was defined as SUA levels >6 and >7 mg/dL for males and females, respectively. All participants underwent twice transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS) and peripheral arterial disease (PAD) was determined by ankle-brachial index (ABI) on January 2010 and January 2012 based on regular health check-ups. The cumulative incidence of vascular stenosis was significantly higher in subjects with hyperuricaemia than in those without hyperuricaemia (54.1% vs. 34.7%, P < 0.001). The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new on-set vascular stenosis due to hyperuricaemia and a 1-mg/dL change in SUA level were 1.75 (1.32-2.31) and 1.29 (1.21-1.38), respectively. Furthermore, in the gender-stratified analysis, the association between SUA levels and ICAS was statistically significant in males (OR: 2.02; 95% CI: 1.18-3.46), but not females (OR: 0.85, 95% CI: 0.41-1.76, P for interaction: 0.026).
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Affiliation(s)
- Meiyue Song
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Na Li
- Department of Health Care, China-Japan Friendship Hospital, Ministry of Health, Beijing, China
| | - Yan Yao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Kaile Wang
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Qinghua Cui
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Jianxin Chen
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wenli Cheng
- Department of Hypertension, Beijing Anzhen Hospital and Capital Medical University, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Cao Z, Cheng Y, Li S, Yang H, Sun L, Gao Y, Yu P, Li W, Wang Y. Mediation of the effect of serum uric acid on the risk of developing hypertension: a population-based cohort study. J Transl Med 2019; 17:202. [PMID: 31215428 PMCID: PMC6582569 DOI: 10.1186/s12967-019-1953-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/13/2019] [Indexed: 12/15/2022] Open
Abstract
Background Serum uric acid (SUA) had been associated with incident hypertension, but it is uncertain whether and to what extent the effect of SUA is mediated by other metabolic factors. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS) during 2011 to 2015 was employed for this study. A total of 7639 participants aged between 35 and 96 years without hypertension was included. Cox proportional hazards model was used to investigate the association between elevated SUA and hypertension. A mediation model was used to separately explore mediating effects (MEs) of metabolic factors on the association between SUA and incident hypertension. Results During a median 4.0 years of follow-up, 2348 individuals were diagnosed with hypertension. After adjustment for metabolic confounders, participants with the highest SUA quartile had a hazard ratio of 1.16 (1.02–1.33) compared with the lowest category for incident hypertension. The association between SUA and incident hypertension were partially mediated by waist circumference (WC; ME = 0.034), body mass index (BMI; ME = 0.016), triglycerides (TG; ME = 0.024), total cholesterol (TC; ME = 0.009), high density lipoprotein cholesterol (HDL-C; ME = 0.009), fasting plasma glucose (FPG; ME = 0.005), and glycated hemoglobin (HbA1c; ME = − 0.002). Additionally, proportional mediation was 32.7% by WC and 15.4% by BMI for obesity indicators; 23.1% by TG, 8.7% by TC, and 8.7% by HDL-C for blood lipid; and 4.8% by FPG and − 1.9% by HbA1c for blood glucose. Conclusions The positive association between elevated SUA concentration and hypertension was reconfirmed in a Chinese population. Obesity indicators, blood lipids, and blood glucose may play important mediating roles in the pathways.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yangyang Cheng
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Shu Li
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Hongxi Yang
- Department of Biostatistics, School of Public Health, Yale University, New Haven, USA
| | - Li Sun
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Pei Yu
- Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Weidong Li
- Research Center of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.
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Tao M, Pi X, Ma X, Shi Y, Zhang Y, Gu H, Chi Y, Zhuang S, Liu N. Relationship between serum uric acid and clustering of cardiovascular disease risk factors and renal disorders among Shanghai population: a multicentre and cross-sectional study. BMJ Open 2019; 9:e025453. [PMID: 30826766 PMCID: PMC6429858 DOI: 10.1136/bmjopen-2018-025453] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/29/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To estimate the current prevalence of cardiovascular disease risk factors (CRFs) and renal disorders across serum uric acid (SUA) quartiles, and evaluate the relationships between SUA and CRFs and renal diseases in Shanghai population. STUDY DESIGN Observational, cross-sectional study. SETTING Data were obtained from the physical check-up of local residents at three hospitals in Shanghai. PARTICIPANTS Residents were invited to take part in a physical check-up and provided informed consent. Exclusion criteria were diseases that resemble cancer, hepatic disease, and other coexisting illnesses including autoimmune kidney diseases and renal artery stenosis, individuals treated with xanthine oxidase inhibitors, and those with incomplete information. There are 26 768 individuals in our study. PRIMARY AND SECONDARY OUTCOME MEASURES Hyperuricaemia was defined as SUA ≥7 mg/dL in men and ≥6 mg/dL in women or taking xanthine oxidase inhibitors. Subjects were divided into gender-specific quartiles. We estimate the prevalence of CRFs and renal disorders across SUA quartiles. The relationships between SUA and CRFs and renal disorders in both genders were evaluated using logistic regression analysis. RESULTS There was a significant increase in the prevalence of major CRFs and renal diseases across SUA quartiles in a separate analysis among men and women (all p trend <0.001). After multiple adjustment, hyperuricaemia positively correlated with obesity (male OR=3.165, p<0.001; female OR=3.776, p<0.001), hypertension (male OR=1.341, p<0.001; female OR=1.289, p=0.006), dyslipidaemia (male OR=2.490, p<0.001; female OR=3.614, p<0.001), chronic kidney disease (male OR=7.081, p<0.001; female OR=11.571, p<0.001) and nephrolithiasis (male OR=1.469, p<0.001; female OR=1.242, p=0.041), but negatively correlated with diabetes mellitus (male OR=0.206, p<0.001; female OR=0.524, p<0.001). There was a stronger association between hyperuricaemia and clustered CRFs as well as chronic kidney disease in women than in men. CONCLUSIONS In Shanghai population, concomitant with the elevated level of SUA, the prevalence of CRFs and renal diseases was rising. Hyperuricaemia was significantly associated with CRFs and renal disorders, especially in women.
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Affiliation(s)
- Min Tao
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoling Pi
- Department of Internal Medicine, Pudong New District Gongli Hospital, Shanghai, China
| | - Xiaoyan Ma
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Nephrology, Baoshan Branch of First People’s Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yingfeng Shi
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuzhen Zhang
- Key Laboratory of Arrhythmias of the Ministry of Education of China, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hongwei Gu
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongbin Chi
- Department of Medical Laboratory, Pudong New District Gongli Hospital, Shanghai, China
| | - Shougang Zhuang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Medicine, Department of Medicine, Rhode Island Hospital and Brown University School of Medicine, Providence, Rhode Island, USA
| | - Na Liu
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Khoshdel AR, Eshtiaghi R. Assessment of Arterial Stiffness in Metabolic Syndrome Related to Insulin Resistance in Apparently Healthy Men. Metab Syndr Relat Disord 2019; 17:90-96. [PMID: 30620239 DOI: 10.1089/met.2018.0090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Assessment of subclinical atherosclerosis in metabolic syndrome is one of the global health targets' priorities. This study aimed to evaluate the subclinical atherosclerosis in metabolic syndrome related to insulin resistance in healthy and physically active men. METHODS A consecutive group of 68 healthy men, 30-55 years of age, was studied. Anthropometric parameters, proinflammatory factors, and insulin level were measured, and pulse wave analysis (PWA) was performed by applanation tonometry and then processed with dedicated software (SphygmoCor®). The metabolic syndrome was defined according to International Diabetes Federation (IDF) and metabolic health as ≤1 component of metabolic syndrome according to the Joint Interim Statement criteria. RESULTS The odds ratio of insulin resistance for metabolic syndrome was 5.16 (95% confidence interval: 1.44-18.5), P = 0.008. In PWA, metabolically healthy subjects had lower aortic systolic and diastolic, and cardiac end-systolic pressures (103.5 ± 9.9 vs. 108.8 ± 11.0), P = 0.03, (76.2 ± 8.8 vs. 80.6 ± 7.8), P = 0.04, and (96.5 ± 9.2 vs. 101 ± 10.1), P = 0.05, respectively. Furthermore, metabolic syndrome was accompanied by higher ejection duration% (38.8 ± 3.5 vs. 36.9 ± 2.8), P = 0.04, and lower subendocardial viability ratio (SEVR) (139.8 ± 17.7 vs. 150.9 ± 17.6), P = 0.05. Insulin resistance was associated with higher cardiac end-systolic pressure (103.0 ± 6.9 vs. 96.7 ± 10.4), P = 0.015. CONCLUSION Metabolic risk factors had incremental correlations with central arterial pressures and cardiac end-systolic pressure. Furthermore, the composite of metabolic syndrome components imposed additional load on cardiac muscle by higher cardiac ejection duration and impairment in perfusion with lower Buckberg SEVR. Likewise, insulin resistance could be an early marker of arterial stiffness in healthy and active young to middle-age men.
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Affiliation(s)
- Ali Reza Khoshdel
- 1 Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- 2 Department of Nephrology, John Hunter Hospital, University of Newcastle, New South Wales, Australia
| | - Radina Eshtiaghi
- 3 Division of Metabolic Diseases, Epidemiology Research Center, AJA University of Medical Science, Tehran, Iran
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Bizuayehu Wube T, Mohammed Nuru M, Tesfaye Anbese A. A Comparative Prevalence Of Metabolic Syndrome Among Type 2 Diabetes Mellitus Patients In Hawassa University Comprehensive Specialized Hospital Using Four Different Diagnostic Criteria. Diabetes Metab Syndr Obes 2019; 12:1877-1887. [PMID: 31571962 PMCID: PMC6756827 DOI: 10.2147/dmso.s221429] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recognition of MetS in type two diabetic patients is important in starting the appropriate preventive and therapeutic measures. The commonly used definitions of MetS have similarities and discrepancies. Different definitions defined metabolic syndrome differently. IDF, WHO, NCEP-ATP III, and the harmonized definitions were used frequently to determine the prevalence of metabolic syndrome. OBJECTIVES This study was aimed to investigate the prevalence of MetS and its associated factors among patients with type 2 Diabetes Mellitus using four definitions and to identify the concordance and the difference of these four definitions. METHODS A cross-sectional study was conducted from February 28 to May 30/2017 at Hawassa university comprehensive specialized hospital. The study involved 314 study participants selected by simple random sampling technique. Logistic regression was used to determine associated factors of metabolic syndrome, and kappa statistics was used to determine the concordance between different definitions of metabolic syndrome. In any cases, a p-value of <0.05 was considered to be statistically significant. RESULT The prevalence of metabolic syndrome according to IDF, WHO, harmonized, and NCEP-ATP III diagnostic criteria was 59.9%, 31.2%, 65.6%, and 70.1%, respectively. Our study found the maximum agreement between IDF and NCEP criteria (K=0.54, P<0.001) and IDF and Harmonized(K=0.65, P<0.001). Uric acid level was associated factor of metabolic syndrome by all the four definitions, and total cholesterol was associated factors by the three definitions. CONCLUSION The prevalence of metabolic syndrome varies based on the definition used and the highest prevalence of MetS was observed with NCEP-ATP III and the different types of criteria do not always diagnose the same group of individuals.
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Affiliation(s)
- Temesgen Bizuayehu Wube
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Correspondence: Temesgen Bizuayehu Wube School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, P.O. Box:1560, Hawassa, EthiopiaTel +251 916604551 Email
| | | | - Adane Tesfaye Anbese
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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Changes in Sex Hormones After Laparoscopic Sleeve Gastrectomy in Chinese Obese Men: a 12-Month Follow-Up. Obes Surg 2018; 29:869-877. [DOI: 10.1007/s11695-018-3611-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Hao Z, Huang X, Shao H, Tian F. Effects of dapagliflozin on serum uric acid levels in hospitalized type 2 diabetic patients with inadequate glycemic control: a randomized controlled trial. Ther Clin Risk Manag 2018; 14:2407-2413. [PMID: 30587997 PMCID: PMC6294165 DOI: 10.2147/tcrm.s186347] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Raised serum uric acid (SUA) level is commonly observed in patients with type 2 diabetes mellitus (T2DM) and is associated with increased morbidity and mortality. Sodium-glucose cotransporter 2 inhibitor, a novel oral diabetic drug, might exert a potential hypouricemic effect. We evaluated the effects of dapagliflozin on SUA levels in hospitalized T2DM patients with inadequate glycemic control. Methods In this randomized controlled trial, 59 T2DM hospitalized patients with inadequate glycemic control were assigned to the dapagliflozin 10 mg group (n=29) or the control group (n=30). The primary outcome was changes in SUA levels from the baseline to good glycemic control. Additional outcomes included correlations between baseline SUA levels, urinary parameters, and the changes in SUA levels. This trial is registered in the Chinese Clinical Trial Registry (number ChiCTR1800015830). Results Compared to baseline level, SUA levels had significantly decreased in both groups (P<0.001 for the dapagliflozin group and P=0.013 for the control group). Mean changes from baseline in SUA levels for dapagliflozin vs the control group were 68.03 vs 25.90 μmol/L (P=0.0406). Adjusted mean SUA levels were lower in the dapagliflozin group (273.28 vs 307.57 μmol/L; P=0.0089). In T2DM patients treated with dapagliflozin, the decrease in SUA levels was positively correlated with baseline SUA levels (P<0.0001) but not correlated with changes in 24-hour urine volume, 24-hour urine glucose, or 24-hour urinary uric acid. Conclusion Dapagliflozin could improve glycemic control and lower SUA levels in hospitalized patients with uncontrolled T2DM. Longer-time trials are required to further demonstrate the hypouricemic effect of dapagliflozin and explore the potential underlying mechanisms.
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Affiliation(s)
- Zhaohu Hao
- Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, Tianjin, China, ,
| | - Xiao Huang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Hailin Shao
- Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, Tianjin, China, ,
| | - Fengshi Tian
- Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, Tianjin, China, , .,Department of Cardiology, Tianjin 4th Central Hospital, The 4th Central Hospital Affiliated to Nankai University, The 4th Center Clinical College of Tianjin Medical University, Tianjin, China,
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Metabolic syndrome and cardiometabolic risk factors among indigenous Malaysians. Public Health 2018; 176:106-113. [PMID: 30509859 DOI: 10.1016/j.puhe.2018.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/26/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study was undertaken to investigate the occurrence of metabolic syndrome (MetS) and cardiovascular disease (CVD) risk in Orang Asli (OA), the indigenous people of Peninsular Malaysia. OA consist of Negrito, Proto-Malay, and Senoi groups who collectively comprise only 0.76% of the population of Peninsular Malaysia. Owing to the challenges in accessing their remote villages, these groups are often excluded in larger government health surveys. Although tropical diseases were scourges in the past, with rapid national development, many OA communities have been gradually urbanized. We believe an epidemiological transition is occurring and non-communicable diseases are on the rise. STUDY DESIGN A retrospective cross-sectional study. METHODS Indigenous Malaysians (n = 629) from three major groups (Negrito, Proto-Malay, and Senoi) were recruited, after ethics approval and informed consent. Body mass index (BMI), body weight, height, waist circumference, and systolic and diastolic blood pressure were measured, and participants were examined for acanthosis nigricans. Venous blood samples were used for measurements of fasting blood sugar, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Insulin resistance was estimated using a surrogate measurement TG/HDL-C. The ratios of TC to HDL-C, and of LDL-C to HDL-C were determined. MetS was accessed according to the Joint Interim Statement of the IDF Tsak Force on Epidemiology and Prevention. RESULTS MetS affected 29.57% of the OA population investigated and was significantly more prevalent (P < 0.05) in women than in men (35.25% vs 21.95%, P < 0.001). MetS prevalence was the highest among the Proto-Malays (39.56%), followed by Negritos (26.35%) and Senois (11.26%). The most prevalent risk factor among the Negritos with MetS was low HDL-C (95.35%), whereas central obesity was the most common risk factor among the Proto-Malays (82.91%). In contrast, hypertension was the commonest risk factor among the Senois with MetS (94.44%). Elevated TG/HDL-C ratios resulted in the highest risk for MetS among the OA population (relative risk [RR] = 7.01, 95% confidence interval [CI] = 3.58-13.72). The risk was almost four-fold among those with high TG (RR = 3.89, 95% CI = 3.08-4.91) and three-fold among those with BMI obesity (RR = 3.37, 95% CI = 2.61-4.36) and central obesity (RR = 2.99, 95% CI = 2.48-3.61). CONCLUSIONS This may well be the first comprehensive report about MetS in OA indigenous communities in Malaysia. We have shown that rapidly urbanized OA communities had significant prevalence of MetS and associated cardiometabolic risk factors. Major contributory factors may include changes from previous hunter-gatherer lifestyles and subsistence diets to more urbanized lifestyles and easier access to high calorie foods.
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Peng YF, Su XH, Han MM, Zhu XY, Li L. Serum uric acid and high-risk pregnancy: an intriguing correlation in advanced pregnant women. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:451. [PMID: 30603639 DOI: 10.21037/atm.2018.11.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of our study is to explore the relationship between serum uric acid (UA) and high-risk pregnancy (HRP) in advanced pregnant women. METHODS The study included 226 advanced pregnant women (≥35 years), and the HRP score were assessed according to China HRP score standards. RESULTS All data were separated into the three groups according to HRP score, we observed significant increases of serum UA concentrations between the three groups (207.51±42.45; 226.65±45.42 and 228.27±49.70 µmol/L, P=0.017). Notably, serum UA concentrations were found to be positive correlated with HRP score (r=0.165, P=0.013) in advanced pregnant women. Serum UA was independent correlated with HRP score (beta =0.164, P=0.009) in multiple linear regression analysis. CONCLUSIONS We conclude that serum UA is correlated with HRP score, and increased serum UA levels may herald HRP in advanced pregnant women.
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Affiliation(s)
- You-Fan Peng
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiang-Hui Su
- Department of Endocrinology, The First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832003, China
| | - Man-Man Han
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiang-Yun Zhu
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Ling Li
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
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Venishetty S, Bhat R, Rajagopal KV. Serum Uric Acid Levels in Type 2 Diabetes Mellitus: Is There a Linear Relationship with Severity of Carotid Atherosclerosis? Indian J Endocrinol Metab 2018; 22:678-682. [PMID: 30294580 PMCID: PMC6166567 DOI: 10.4103/ijem.ijem_641_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIMS The aim of this study was to correlate serum uric acid (SUA) levels and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (DM). SETTINGS AND DESIGN This study was a cross-sectional observational study on 103 diabetic patients conducted from September 2015 to May 2017. SUBJECTS AND METHODS We screened 103 patients with type 2 DM between the ages of 30-65 years. SUA levels and the CIMT were measured. The patients were divided into quartiles based on uric acid level. The CIMT of the quartiles is compared and analyzed. STATISTICAL ANALYSIS USED Chi-squared test, Analysis of Variance, and Pearson's correlation. RESULTS Uric acid levels were positively associated with CIMT (P = 0.001). The association remained significant after further adjustment for potential confounders. Strong correlation was found among them as depicted by correlation coefficient (r = 0.779). CONCLUSIONS Carotid atherosclerosis as measured by IMT is associated with SUA levels in patients with type 2 DM.
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Affiliation(s)
| | - Rama Bhat
- Department of Medicine, Kasturba Hospital, Manipal, Karnataka, India
| | - K. V. Rajagopal
- Department of Radiodiagnosis, Kasturba Hospital, Manipal, Karnataka, India
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Su L, Wang C, Zheng C, Wei H, Song X. A meta-analysis of public microarray data identifies biological regulatory networks in Parkinson's disease. BMC Med Genomics 2018; 11:40. [PMID: 29653596 PMCID: PMC5899355 DOI: 10.1186/s12920-018-0357-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a long-term degenerative disease that is caused by environmental and genetic factors. The networks of genes and their regulators that control the progression and development of PD require further elucidation. METHODS We examine common differentially expressed genes (DEGs) from several PD blood and substantia nigra (SN) microarray datasets by meta-analysis. Further we screen the PD-specific genes from common DEGs using GCBI. Next, we used a series of bioinformatics software to analyze the miRNAs, lncRNAs and SNPs associated with the common PD-specific genes, and then identify the mTF-miRNA-gene-gTF network. RESULT Our results identified 36 common DEGs in PD blood studies and 17 common DEGs in PD SN studies, and five of the genes were previously known to be associated with PD. Further study of the regulatory miRNAs associated with the common PD-specific genes revealed 14 PD-specific miRNAs in our study. Analysis of the mTF-miRNA-gene-gTF network about PD-specific genes revealed two feed-forward loops: one involving the SPRK2 gene, hsa-miR-19a-3p and SPI1, and the second involving the SPRK2 gene, hsa-miR-17-3p and SPI. The long non-coding RNA (lncRNA)-mediated regulatory network identified lncRNAs associated with PD-specific genes and PD-specific miRNAs. Moreover, single nucleotide polymorphism (SNP) analysis of the PD-specific genes identified two significant SNPs, and SNP analysis of the neurodegenerative disease-specific genes identified seven significant SNPs. Most of these SNPs are present in the 3'-untranslated region of genes and are controlled by several miRNAs. CONCLUSION Our study identified a total of 53 common DEGs in PD patients compared with healthy controls in blood and brain datasets and five of these genes were previously linked with PD. Regulatory network analysis identified PD-specific miRNAs, associated long non-coding RNA and feed-forward loops, which contribute to our understanding of the mechanisms underlying PD. The SNPs identified in our study can determine whether a genetic variant is associated with PD. Overall, these findings will help guide our study of the complex molecular mechanism of PD.
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Affiliation(s)
- Lining Su
- Department of Biology of Basic Medical Science College, Hebei North University, Zhangjiakou, 075000, Hebei, China
| | - Chunjie Wang
- Department of Basic Medicine, Zhangjiakou University, Zhangjiakou, 75000, Hebei, China
| | - Chenqing Zheng
- Shenzhen RealOmics (Biotech) Co., Ltd, Shenzhen, 518081, Guangdong, China
| | - Huiping Wei
- Department of Biology of Basic Medical Science College, Hebei North University, Zhangjiakou, 075000, Hebei, China.
| | - Xiaoqing Song
- Department of Biology of Basic Medical Science College, Hebei North University, Zhangjiakou, 075000, Hebei, China
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Kawamoto R, Ninomiya D, Kasai Y, Senzaki K, Kusunoki T, Ohtsuka N, Kumagi T. Interaction between gender and uric acid on hemoglobin A1c in community-dwelling persons. J Endocrinol Invest 2018; 41:421-429. [PMID: 28948573 DOI: 10.1007/s40618-017-0760-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 08/28/2017] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Higher glycated hemoglobin (Hb) (HbA1c) is significantly associated with an increased risk of cardiovascular disease (CVD). Serum uric acid (SUA) levels are associated with glucose intolerance and type 2 diabetes. Whether gender-specific differences regarding the relationship between SUA levels and HbA1c exist is unknown. AIM We recruited 1636 (men, 696 aged of 70 ± 10 years; women, 940 aged of 70 ± 9 years) participants and enrolled in the study during their annual health examination from a single community. We investigated the association between SUA levels and HbA1c within each gender. RESULTS Multiple linear regression analysis showed that in men, SUA (β = -0.091, p = 0.014) with prevalence of antidiabetic medication (β = 0.428, p < 0.001) and eGFR (β = 0.112, p = 0.016) were significantly and negatively associated with HbA1c, and in women, SUA (β = 0.101, p = 0.002) with prevalence of antidiabetic medication (β = 0.458, p < 0.001) were significantly and positively associated with HbA1c. Moreover, the interaction between gender and SUA (β = 0.445, p < 0.001) as well as gender (β = -0.465, p < 0.001), prevalence of antidiabetic medication (β = 0.444, p < 0.001), eGFRCKDEPI (β = 0.074, p = 0.014), and SUA (β = -0.356, p < 0.001) was a significant and independent determinant of HbA1c. A significant interactive effect of gender and SUA on determinants of HbA1c was noted in patients not on antidiabetic medications, regardless of age, HbA1c, and renal function. CONCLUSIONS The interaction between gender and SUA was associated with HbA1c independent of other metabolic factors in community-dwelling persons.
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Affiliation(s)
- R Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Tōon, Ehime, 791-0295, Japan.
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo, Ehime, 797-1212, Japan.
| | - D Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Tōon, Ehime, 791-0295, Japan
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo, Ehime, 797-1212, Japan
| | - Y Kasai
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo, Ehime, 797-1212, Japan
| | - K Senzaki
- Department of Community Medicine, Ehime University Graduate School of Medicine, Tōon, Ehime, 791-0295, Japan
| | - T Kusunoki
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo, Ehime, 797-1212, Japan
| | - N Ohtsuka
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo, Ehime, 797-1212, Japan
| | - T Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Tōon, Ehime, 791-0295, Japan
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Feng L, Hua C, Sun H, Qin LY, Niu PP, Guo ZN, Yang Y. Association between Serum Uric Acid Level and Carotid Atherosclerosis in Chinese Individuals Aged 75 Years or Older: A Hospital-Based Case-Control Study. J Nutr Health Aging 2018; 22:508-512. [PMID: 29582890 DOI: 10.1007/s12603-017-0984-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To investigate the association between serum uric acid level and the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older. DESIGN Case-control study. SETTING In a teaching hospital. PARTICIPANTS Five hundred and sixty-four elderlies (75 years or above) who underwent general health screening in our hospital were enrolled. MEASUREMENTS The detailed carotid ultrasound results, physical examination information, medical history, and laboratory test results including serum uric acid level were recorded, these data were used to analyze the relationship between serum uric acid level and carotid atherosclerosis. Then, subjects who underwent the second carotid ultrasound 1.5-2 years later were further identified to analyzed the relationship between serum uric acid and the progression of carotid atherosclerosis. RESULTS A total of 564 subjects were included, carotid plaque was found in 482 (85.5%) individuals. Logistic regression showed that subjects with elevated serum uric acid (expressed per 1 standard deviation change) had significantly higher incidence of carotid plaque (odds ratio, 1.37; 95% confidence interval, 1.07-1.75; P= 0.012) after controlling for other factors. A total of 236 subjects underwent the follow-up carotid ultrasound. Linear regression showed that serum uric acid level (expressed per 1 standard deviation change; 1 standard deviation = 95.5 μmol/L) was significantly associated with percentage of change of plaque score (P = 0.008). Multivariable linear regression showed that 1 standard deviation increase in serum uric acid levels was expected to increase 0.448% of plaque score (P = 0.023). CONCLUSION The elevated serum uric acid level may be independently and significantly associated with the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older.
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Affiliation(s)
- L Feng
- Yi Yang, M.D, PhD. Department of Neurology, the First Hospital of Jilin University. Xinmin Street 71#, 130021, Changchun, China. Tel: +86-18186870008; Fax: +86-431-88782378; E-mail:
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Fanning N, Merriman TR, Dalbeth N, Stamp LK. An association of smoking with serum urate and gout: A health paradox. Semin Arthritis Rheum 2017; 47:825-842. [PMID: 29398126 DOI: 10.1016/j.semarthrit.2017.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/01/2017] [Accepted: 11/16/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The potential effect of cigarette smoking on levels of serum urate and risk of gout has been considered by a large number of studies, either as the primary variable of interest or as a covariate. METHODS Here we systematically review the published evidence relating to the relationship of smoking with serum urate, hyperuricaemia, and gout. RESULTS Many studies have reported that smoking reduces serum urate, however, the evidence has not been conclusive with other studies pointing to the opposite or no effect. It has also been suggested that smoking reduces the risk of gout, although there is some evidence to contradict this finding. CONCLUSION A consensus has yet to be reached as to the effect of smoking on serum urate levels and the risk of gout.
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Affiliation(s)
- Niamh Fanning
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand.
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
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Borràs Sans M, Pérez-Fontán M, Martinez-Alonso M, Bajo A, Betriu À, Valdivielso JM, Fernández E. The modality of dialysis does not influence atheromatous vascular disease progression or cardiovascular outcomes in dialysis patients without previous cardiovascular disease. PLoS One 2017; 12:e0186921. [PMID: 29095847 PMCID: PMC5667854 DOI: 10.1371/journal.pone.0186921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 10/10/2017] [Indexed: 01/04/2023] Open
Abstract
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.
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Affiliation(s)
- Mercè Borràs Sans
- Department of Nephrology, University Hospital Arnau de Vilanova de Lleida, Lleida,Spain
- UDETMA Unitat de Detecció de Malalties Aterotrombòtiques, Lleida, Spain
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | | | - Montserrat Martinez-Alonso
- UDETMA Unitat de Detecció de Malalties Aterotrombòtiques, Lleida, Spain
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - Auxiliadora Bajo
- Department of Nephrology, University Hospital La Paz, REDinREN del ISCIII, Madrid, Spain
| | - Àngels Betriu
- UDETMA Unitat de Detecció de Malalties Aterotrombòtiques, Lleida, Spain
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - José M. Valdivielso
- UDETMA Unitat de Detecció de Malalties Aterotrombòtiques, Lleida, Spain
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - Elvira Fernández
- Department of Nephrology, University Hospital Arnau de Vilanova de Lleida, Lleida,Spain
- UDETMA Unitat de Detecció de Malalties Aterotrombòtiques, Lleida, Spain
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
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Lamacchia O, Fontana A, Pacilli A, Copetti M, Fariello S, Garofolo M, Penno G, Trischitta V, De Cosmo S, Cignarelli M. On the non-linear association between serum uric acid levels and all-cause mortality rate in patients with type 2 diabetes mellitus. Atherosclerosis 2017; 260:20-26. [PMID: 28334637 DOI: 10.1016/j.atherosclerosis.2017.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS High levels of serum uric acid (SUA) are associated with increased mortality risk in the general population. Contrasting results are available in people with diabetes. The aim of our study was to investigate the association and its functional form between SUA and all cause-mortality in patients with type 2 diabetes mellitus (T2DM). METHODS We studied three cohorts of patients with T2DM: Gargano Mortality Study, Foggia Mortality Study, Pisa Mortality Study. All-cause mortality rate was the end point of this study. RESULTS The most reliable relationship between SUA levels and all-cause mortality rate was quadratic, with such model being well approximated by SUA tertiles. Both tertiles 1 and 3 were at higher risk of mortality as compared to tertile 2: Hazard Ratio (HR) [95% Confidence Interval (CI)] = 1.34 (1.07-1.68) and 1.61 (1.29-1.99), respectively. In the pseudo-sample, created from the real pooled sample, the best relationship between SUA and all-cause mortality rate was quadratic. In a tree-based Recursive Partitioning and Regression Tree analysis two subgroups at increased risk of mortality were identified, namely those with SUA levels ≥7.28 mg/dl and with SUA levels <4.16 mg/dl as compared to patients with intermediate SUA levels (i.e. 4.16-7.28), thus providing further evidence on the J-shaped relationship between SUA levels and mortality rate. CONCLUSIONS SUA was not linearly associated with all-cause mortality rate in patients with T2DM. For clinical and public health purposes such association is J-shaped.
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Affiliation(s)
- Olga Lamacchia
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Andrea Fontana
- Unit of Biostatistics, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Antonio Pacilli
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
| | - Stefania Fariello
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Monia Garofolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy; Mendel-Laboratory, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy; Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Salvatore De Cosmo
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
| | - Mauro Cignarelli
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
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Du XJ, Chen L, Li WF, Tang LL, Mao YP, Guo R, Sun Y, Lin AH, Ma J. Use of pretreatment serum uric acid level to predict metastasis in locally advanced nasopharyngeal carcinoma. Head Neck 2016; 39:492-497. [PMID: 27997061 DOI: 10.1002/hed.24631] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/27/2016] [Accepted: 10/07/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the predictive value of pretreatment serum uric acid (SUA) for metastasis in locally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy. METHODS This retrospective study examined 1063 patients with locally advanced NPC. Multivariate survival analysis was used. RESULTS High pretreatment SUA level (>353.4 μmol/L) independently predicted distant metastasis-free survival (p = .013) and was associated with high white blood cell (p = .005), lymphocyte counts (p < .001), and male sex (p < 0.001). In addition, SUA levels were significantly elevated in patients with T1 to T3 classification (p = .042). For patients with subsequent lung metastases after treatment, markedly higher pretreatment SUA levels were detected compared with patients who had other distant metastases (p =.012) and patients without distant metastasis (p = .024). CONCLUSION Pretreatment SUA may be a useful biomarker for evaluating treatment options for patients with locally advanced NPC. © 2016 Wiley Periodicals, Inc. Head Neck 39: 492-497, 2017.
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Affiliation(s)
- Xiao-Jing Du
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ling-Long Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Rui Guo
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
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Gancheva R, Kundurdjiev A, Ivanova M, Kundurzhiev T, Kolarov Z. Evaluation of cardiovascular risk in stages of gout by a complex multimodal ultrasonography. Rheumatol Int 2016; 37:121-130. [PMID: 27577941 DOI: 10.1007/s00296-016-3556-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/22/2016] [Indexed: 12/22/2022]
Abstract
The aim of our work was to assess ultrasound features of cardiovascular (CV) risk in stages of gout. Cross-sectional complex multimodal ultrasound study of 169 age-matched patients, with similar distribution of arterial hypertension, diabetes mellitus, obesity and chronic renal failure, was divided into four groups: 41 with asymptomatic hyperuricemia, 52 gout without tophi, 42 gouty tophi and 34 controls with osteoarthritis. Parameters independently associated with CV risk were measured: renal resistive index (RRI), left ventricular mass index (LVMi), mitral annulus early diastolic velocity (e'), intima-media thickness (IMT) and common carotid artery resistive index (CCARI). Multivariate analyses were performed to evaluate the impact of gout stages and CV risk factors on ultrasound alterations. Gouty tophi increased the risk of having IMT >0.90 mm with an OR 11.51 (95 % CI 2.32-57.21, p = 0.003), gout without tophi raised the risk with an OR 6.25 (95 % CI 1.37-28.44, p = 0.018), while asymptomatic hyperuricemia had no effect on IMT. The category of CCARI >0.70 was influenced by tophi with an OR 11.18 (95 % CI 2.61-47.83, p = 0.001) and by arterial hypertension with an OR 3.22 (95 % CI 1.11-9.36, p = 0.032). Neither asymptomatic hyperuricemia nor gout without tophi modified the development of abnormally high CCARI. Gout stages had no impact on LVMi, e' and RRI. Tophi are related to worsened ultrasonographic parameters evaluating target organs in gout, relative to earlier stages of the disease. They create a strong risk of carotid arteries' changes even beyond arterial hypertension.
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Affiliation(s)
- Rada Gancheva
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria.
| | - Atanas Kundurdjiev
- Department of Internal Medicine, Medical Faculty, Clinic of Nephrology, Medical University, University Hospital St. Iv. Rilski, 15, Iv. Geshov St., 1431, Sofia, Bulgaria
| | - Mariana Ivanova
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria
| | - Todor Kundurzhiev
- Faculty of Public Health, Medical University, 8, Bialo more St., 1527, Sofia, Bulgaria
| | - Zlatimir Kolarov
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria
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Wei F, Chang B, Yang X, Wang Y, Chen L, Li WD. Serum Uric Acid Levels were Dynamically Coupled with Hemoglobin A1c in the Development of Type 2 Diabetes. Sci Rep 2016; 6:28549. [PMID: 27328642 PMCID: PMC4916504 DOI: 10.1038/srep28549] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/03/2016] [Indexed: 01/24/2023] Open
Abstract
The aim of the study was to decipher the relationship between serum uric acid (SUA) and glycated hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG) in both type 2 diabetes mellitus (T2DM) patients and normal subjects. A total of 2,250 unrelated T2DM patients and 4,420 Han Chinese subjects from a physical examination population were recruited for this study. In T2DM patients SUA levels were negatively correlated with HbA1c (rs = -0.109, P = 0.000) and 2 h plasma glucose levels (rs = -0.178, P = 0.000). In the physical examination population, SUA levels were inversely correlated with HbA1c (rs = -0.175, P = 0.000) and FPG (rs = -0.131, P = 0.009) in T2DM patients but positively correlated with HbA1c (rs = 0.040, P = 0.012) and FPG (rs = 0.084, P = 0.000) in normal-glucose subjects. Multivariate analyses showed that HbA1c was significantly negatively associated with HUA both in T2DM patients (OR = 0.872, 95% CI: 0.790~0.963) and in the physical examination T2DM patients (OR = 0.722, 95% CI: 0.539~0.968). Genetic association studies in T2DM patients showed that alleles of two glucose-uric acid transporter genes, ABCG2 and SLC2A9 were significantly associated with SUA levels (P < 0.05). SUA level is inversely correlated with HbA1c in T2DM patients but positively correlated with HbA1c in normal-glucose subjects. The reverse transporting of uric acid and glucose in renal tubules might be accounted for these associations.
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Affiliation(s)
- Fengjiang Wei
- Center of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300070, P.R. China
| | - Baocheng Chang
- Metabolic Diseases Hospital, Tianjin Medical University, Tianjin, 300070, P.R. China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300070, P.R. China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300070, P.R. China
| | - Liming Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300070, P.R. China
| | - Wei-Dong Li
- Center of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300070, P.R. China
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Oyama JI, Tanaka A, Sato Y, Tomiyama H, Sata M, Ishizu T, Taguchi I, Kuroyanagi T, Teragawa H, Ishizaka N, Kanzaki Y, Ohishi M, Eguchi K, Higashi Y, Yamada H, Maemura K, Ako J, Bando YK, Ueda S, Inoue T, Murohara T, Node K. Rationale and design of a multicenter randomized study for evaluating vascular function under uric acid control using the xanthine oxidase inhibitor, febuxostat: the PRIZE study. Cardiovasc Diabetol 2016; 15:87. [PMID: 27317093 PMCID: PMC4912773 DOI: 10.1186/s12933-016-0409-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 06/09/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Xanthine oxidase inhibitors are anti-hyperuricemic drugs that decrease serum uric acid levels by inhibiting its synthesis. Xanthine oxidase is also recognized as a pivotal enzyme in the production of oxidative stress. Excess oxidative stress induces endothelial dysfunction and inflammatory reactions in vascular systems, leading to atherosclerosis. Many experimental studies have suggested that xanthine oxidase inhibitors have anti-atherosclerotic effects by decreasing in vitro and in vivo oxidative stress. However, there is only limited evidence on the clinical implications of xanthine oxidase inhibitors on atherosclerotic cardiovascular disease in patients with hyperuricemia. We designed the PRIZE study to evaluate the effects of febuxostat on a surrogate marker of cardiovascular disease risk, ultrasonography-based intima-media thickness of the carotid artery in patients with hyperuricemia. METHODS The study is a multicenter, prospective, randomized, open-label and blinded-endpoint evaluation (PROBE) design. A total of 500 patients with asymptomatic hyperuricemia (uric acid >7.0 mg/dL) and carotid intima-media thickness ≥1.1 mm will be randomized centrally to receive either febuxostat (10-60 mg/day) or non-pharmacological treatment. Randomization is carried out using the dynamic allocation method stratified according to age (<65, ≥65 year), gender, presence or absence of diabetes mellitus, serum uric acid (<8.0, ≥8.0 mg/dL), and carotid intima-media thickness (<1.3, ≥1.3 mm). In addition to administering the study drug, we will also direct lifestyle modification in all participants, including advice on control of body weight, sleep, exercise and healthy diet. Carotid intima-media thickness will be evaluated using ultrasonography performed by skilled technicians at a central laboratory. Follow-up will be continued for 24 months. The primary endpoint is percentage change in mean intima-media thickness of the common carotid artery 24 months after baseline, measured by carotid ultrasound imaging. CONCLUSIONS PRIZE will be the first study to provide important data on the effects of febuxostat on atherosclerosis in patients with asymptomatic hyperuricemia. Trial Registration Unique trial Number, UMIN000012911 ( https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000015081&language=E ).
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Affiliation(s)
- Jun-ichi Oyama
- />Department of Cardiovascular Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501 Japan
| | - Atsushi Tanaka
- />Department of Cardiovascular Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501 Japan
| | - Yasunori Sato
- />Department of Clinical Research, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Masataka Sata
- />Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tomoko Ishizu
- />Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Isao Taguchi
- />Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Takanori Kuroyanagi
- />Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Hiroki Teragawa
- />Department of Cardiovascular Medicine, Hiroshima General Hospital of West Japan Railway Company, Hiroshima, Japan
| | - Nobukazu Ishizaka
- />Internal Medicine (III), Department of Cardiology, Osaka Medical College, Takatsuki, Japan
| | - Yumiko Kanzaki
- />Internal Medicine (III), Department of Cardiology, Osaka Medical College, Takatsuki, Japan
| | - Mitsuru Ohishi
- />Department of Cardiovascular Medicine and Hypertension, Kagoshima University, Kagoshima, Japan
| | - Kazuo Eguchi
- />Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yukihito Higashi
- />Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hirotsugu Yamada
- />Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Koji Maemura
- />Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junya Ako
- />Department of Cardiovascular Medicine, Kitasato University, Sagamihara, Japan
| | - Yasuko K. Bando
- />Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichiro Ueda
- />Department of Clinical Pharmacology & Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Teruo Inoue
- />Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Toyoaki Murohara
- />Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Node
- />Department of Cardiovascular Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501 Japan
| | - On behalf of the PRIZE Study Investigators
- />Department of Cardiovascular Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501 Japan
- />Department of Clinical Research, Chiba University Graduate School of Medicine, Chiba, Japan
- />Department of Cardiology, Tokyo Medical University, Tokyo, Japan
- />Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
- />Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- />Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
- />Department of Cardiovascular Medicine, Hiroshima General Hospital of West Japan Railway Company, Hiroshima, Japan
- />Internal Medicine (III), Department of Cardiology, Osaka Medical College, Takatsuki, Japan
- />Department of Cardiovascular Medicine and Hypertension, Kagoshima University, Kagoshima, Japan
- />Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
- />Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
- />Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- />Department of Cardiovascular Medicine, Kitasato University, Sagamihara, Japan
- />Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- />Department of Clinical Pharmacology & Therapeutics, University of the Ryukyus, Nishihara, Japan
- />Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
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Yan D, Wang J, Jiang F, Zhang R, Wang T, Wang S, Peng D, He Z, Chen H, Bao Y, Hu C, Jia W. A causal relationship between uric acid and diabetic macrovascular disease in Chinese type 2 diabetes patients: A Mendelian randomization analysis. Int J Cardiol 2016; 214:194-9. [PMID: 27064641 DOI: 10.1016/j.ijcard.2016.03.206] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/17/2016] [Accepted: 03/26/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND As the association between uric acid and macrovascular disease has been heavily debated, we aimed to confirm whether there is a causal relationship between uric acid and diabetic macrovascular disease through Mendelian randomization analysis. METHODS In 3207 type 2 diabetes patients, seventeen SNPs (single nucleotide polymorphisms) related to uric acid were genotyped. A weighted GRS (genetic risk score) was calculated using selected SNPs and the strength of their effects on uric acid levels. Diabetic macrovascular disease was diagnosed through vascular ultrasound, magnetic resonance imaging or other clinical evidence. Associations of diabetic macrovascular disease with uric acid and weighted GRS were evaluated separately. RESULTS In total participants and among females, the prevalence of diabetic macrovascular disease was significantly higher in hyperuricemic group than in normouricemic group, and uric acid was associated with diabetic macrovascular disease (OR=1.068, p=0.0349; OR=1.122, p=0.0158). The prevalence of diabetic macrovascular disease increased with the weighted GRS in a J-shaped manner for the females. The weighted GRS was positively correlated with uric acid in total population, male patients and female patients (β=0.203, p<0.0001; β=0.255, p<0.0001; β=0.142, p<0.0001, respectively). The weighted GRS was significantly associated with diabetic macrovascular disease in female patients (OR=1.184, p=0.0039). Among females, the observed association between weighted GRS and diabetic macrovascular disease was greater than predicted. CONCLUSIONS Using the uric acid-related weighted GRS as an instrumental variable for Mendelian randomization analysis, our study provided an evidence for causal relationship between uric acid and diabetic macrovascular disease in Chinese females with type 2 diabetes mellitus.
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Affiliation(s)
- Dandan Yan
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jie Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Feng Jiang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Rong Zhang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Tao Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Shiyun Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Danfeng Peng
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Zhen He
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Haibing Chen
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yuqian Bao
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Cheng Hu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai 201499, China.
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Serum uric acid levels are associated with hypertension and metabolic syndrome but not atherosclerosis in Chinese inpatients with type 2 diabetes. J Hypertens 2016; 33:482-90; discussion 490. [PMID: 25405332 PMCID: PMC4309490 DOI: 10.1097/hjh.0000000000000417] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: Serum uric acid (SUA) is associated with many cardiovascular risk factors such as hypertension (HTN) and metabolic syndrome (MetS). However, the association of SUA with atherosclerosis remains controversial. Our aim was to investigate the relationships of SUA with HTN, MetS and atherosclerosis in Chinese inpatients with type 2 diabetes. Methods: This cross-sectional study was performed with a sample of 2388 hospitalized Chinese patients with type 2 diabetes. Both carotid and lower limb atherosclerotic lesions were assessed for intima–media thickness, plaque and stenosis by Doppler ultrasound. Atherosclerotic plaque and stenosis were defined as the presence of either carotid or lower limb plaques and stenoses, respectively. Results: There were significant increases in the prevalence of both HTN and MetS across the SUA quartiles (HTN: 43.4, 49.6, 56.1 and 66.3% for the first, second, third and fourth quartiles, respectively, P < 0.001; MetS: 59.9, 68.8, 74.7 and 84.9% for the first, second, third and fourth quartiles, respectively, P < 0.001). A fully adjusted multiple logistic regression analysis revealed that SUA quartile was independently associated with the presence of HTN (P = 0.001) and MetS (P = 0.006). The prevalence of atherosclerotic plaque and stenosis was obviously higher in the patients with either HTN or MetS than in those without HTN or MetS. However, there was no significant association of SUA quartile with the presence of atherosclerotic lesions. Conclusions: SUA levels were closely associated with HTN and MetS, but not with atherosclerosis in type 2 diabetes. Our findings strongly suggest that, in select populations such as those with type 2 diabetes, the role of uric acid in atherosclerosis might be attributable to other cardiovascular risk factors, such as HTN and MetS.
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Sah SK, Khatiwada S, Pandey S, Kc R, Das BKL, Baral N, Lamsal M. Association of high-sensitivity C-reactive protein and uric acid with the metabolic syndrome components. SPRINGERPLUS 2016; 5:269. [PMID: 27006878 PMCID: PMC4777974 DOI: 10.1186/s40064-016-1933-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/24/2016] [Indexed: 11/16/2022]
Abstract
Metabolic syndrome (MetS) has been found to be associated with inflammatory molecules. This study was conducted among 125 MetS patients at B P Koirala Institute of Health Sciences, Dharan, Nepal to find an association of high-sensitivity C-reactive protein (hs-CRP) and serum uric acid with MetS components. Anthropometric measurements, blood pressure, medical history and blood samples were taken. Estimation of hs-CRP, serum uric acid, blood glucose, triglyceride and high density lipoprotein (HDL) cholesterol was done. hs-CRP had positive correlation with blood glucose (r = 0.2, p = 0.026) and negative with HDL cholesterol (r = −0.361, p < 0.001). Serum uric acid had positive correlation with waist circumference (r = 0.178, p = 0.047). Patients with elevated hs-CRP and uric acid had higher waist circumference (p = 0.03), diastolic BP (p = 0.002) and lower HDL cholesterol (p = 0.004) than others. Elevated hs-CRP and high uric acid were individually associated with higher odds for low HDL cholesterol (7.992; 1.785–35.774, p = 0.002) and hyperglycemia (2.471; 1.111–5.495, p = 0.029) respectively. Combined rise of hs-CRP and uric acid was associated with severity of MetS (p < 0.001) and higher odds for hyperglycemia (8.036; 2.178–29.647, p = 0.001) as compared to individual rise of hs-CRP or uric acid. The present study demonstrates that hs-CRP and serum uric acid are associated with MetS components, and the combined rise of hs-CRP and uric acid is associated with the increase in severity of MetS.
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Affiliation(s)
- Santosh Kumar Sah
- Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Saroj Khatiwada
- Department of Biochemistry, Modern Technical College, Sanepa, Lalitpur, Nepal
| | - Sunil Pandey
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Rajendra Kc
- Department of Biochemistry, Modern Technical College, Sanepa, Lalitpur, Nepal
| | - Binod Kumar Lal Das
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nirmal Baral
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhab Lamsal
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
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Sun MJ, Li BH, Long CY, Wang YQ, Zhou Y, Liu Y, Liao SQ, Pi Y, Guo L, Zhang LL, Li JC. Association between serum uric acid levels and cerebral white matter lesions in Chinese individuals. Int J Neurosci 2016; 126:1103-11. [DOI: 10.3109/00207454.2015.1128903] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Kanagasabai T, Ardern CI. Contribution of Inflammation, Oxidative Stress, and Antioxidants to the Relationship between Sleep Duration and Cardiometabolic Health. Sleep 2015; 38:1905-12. [PMID: 26237775 DOI: 10.5665/sleep.5238] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/24/2015] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To explore the interrelationship and mediating effect of factors that are beneficial (i.e., antioxidants) and harmful (i.e., inflammation and oxidative stress) to the relationship between sleep and cardiometabolic health. DESIGN Cross-sectional data from the 2005-2006 National Health and Nutrition Examination Survey. SETTING Nationally representative population sample from the US. PARTICIPANTS Age ≥ 20 y with sleep data; final analytical sample of n = 2,079. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Metabolic syndrome was classified according to the Joint Interim Statement, and sleep duration was categorized as very short, short, adequate, and long sleepers (≤ 4, 5-6, 7-8, and ≥ 9 h per night, respectively). The indirect mediation effect was quantified as large (≥ 0.25), moderate (≥ 0.09), modest (≥ 0.01), and weak (< 0.01). In general, inflammation was above the current clinical reference range across all sleep duration categories, whereas oxidative stress was elevated among short and very short sleepers. Select sleep duration- cardiometabolic health relationships were mediated by C-reactive protein (CRP), γ-glutamyl transferase (GGT), carotenoids, uric acid, and vitamins C and D, and were moderated by sex. Specifically, moderate-to-large indirect mediation by GGT, carotenoids, uric acid, and vitamin D were found for sleep duration-waist circumference and -systolic blood pressure relationships, whereas vitamin C was a moderate mediator of the sleep duration-diastolic blood pressure relationship. CONCLUSIONS Several factors related to inflammation, oxidative stress, and antioxidant status were found to lie on the casual pathway of the sleep duration-cardiometabolic health relationship. Further longitudinal studies are needed to confirm our results.
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Affiliation(s)
| | - Chris I Ardern
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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