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Nagore D, Murie-Fernández M, Núñez-Córdoba JM, Vives M. Association between pre-operative hyperuricemia and risk of in-hospital death in high-risk patients undergoing cardiac surgery: An international prospective 14-centre study. Eur J Anaesthesiol 2024; 41:450-452. [PMID: 38269411 DOI: 10.1097/eja.0000000000001956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- David Nagore
- From the Department of Anaesthesia & Perioperative Medicine, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián (DN), Department of Neurology, Clínica San Miguel, Pamplona (MM-F), Research Support Service, Central Clinical Trials Unit, Clínica Universidad de Navarra, Pamplona (JMN-C), Department of Anesthesiology & Critical Care Medicine, Clínica Universidad de Navarra, Pamplona, Spain (MV)
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He J, Hu F, Wang Y, Mei Y. Potential protective effects of increased serum uric acid concentration in sarcopenia: A meta-analysis and systematic review. Medicine (Baltimore) 2024; 103:e37376. [PMID: 38428844 PMCID: PMC10906637 DOI: 10.1097/md.0000000000037376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/05/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Previous studies on the association between serum uric acid (UA) levels and sarcopenia have yielded contradictory results. This meta-analysis and literature review assessed the association between serum UA levels and sarcopenia. Moreover, we conducted a comparative analysis of the differences in serum UA concentrations between individuals with and without sarcopenia. METHODS A systematic search was conducted across various medical databases, namely PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang (from the start to August 20, 2023). This search focused on published studies that investigated the relationship between serum UA levels and sarcopenia. The relationship between serum UA concentration and the occurrence of sarcopenia was analyzed, and the differences in serum UA concentrations between individuals with sarcopenia and control groups were reviewed. Statistical analysis was performed using STATA 11.0 and R 4.1.3. RESULTS Sixteen studies were considered for our analysis. The results indicated a significant association between low serum UA concentration and a higher sarcopenia risk, particularly among male patients (adjusted odds ratio = 0.65, 95% confidence interval [CI] = 0.49, 0.87, P = .004, I2 = 0%). Individuals with sarcopenia exhibited decreased serum UA concentrations compared with those of the control group (mmol/L: weighted mean difference = -28.25, 95% CI = -40.45, -16.05, P < .001; mg/dL: weighted mean difference = -0.82, 95% CI = -1.05, -0.58, P < .001). Additionally, serum UA concentration was positively correlated with skeletal muscle mass index and handgrip strength (skeletal muscle index: correlation coefficient = 0.17, 95% CI = 0.11, 0.22, P < .001; handgrip strength: common odds ratios = 0.10, 95% CI = 0.06, 0.14, P < .001). CONCLUSION Individuals with sarcopenia have relatively low serum UA concentrations. A notable correlation between serum UA concentration and sarcopenia was observed. Hence, monitoring UA levels could aid in the early detection and treatment of sarcopenia, enabling timely intervention to preserve muscle mass and strength.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, China
| | - Fenghui Hu
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yan Wang
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, China
| | - Yang Mei
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, China
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Tuono RDM, Samou ABF, Mbiandjeu MT, Well A Well PBAK, Chuisseu PDD. Hyperuricemia and associated factors: The case of outpatients at the Bafoussam Regional Hospital- Cameroon, an analytical cross-sectional study. Health Sci Rep 2024; 7:e1891. [PMID: 38357483 PMCID: PMC10865416 DOI: 10.1002/hsr2.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Background and Aims Hyperuricemia constitutes a major public health issue due to its implication in many chronic diseases and metabolic syndromes. We propose to study the prevalence and associated factors of hyperuricemia to diagnose asymptomatic patients and make prognoses on the state of health of the patients. Methods An analytic cross-sectional study has been carried out at the Bafoussam Regional Hospital and the Biochemistry laboratory of the Université des Montagnes over 2 months. Sociodemographic and anthropometric characteristic was obtained; a blood sample was collected from the chosen patients and a biochemical test (uric acid, creatinine, urea, total cholesterol, high density lipoproteins cholesterol, triglyceride) was analyzed by spectrophotometric method. Statistical tests were carried out using SPSS statistical software. Logistic regression analyses identified factors associated with variables of interest. The significance was measured by a p < 0.05 with a confidential level of 95%. Results The patient population was made up of 100 patients. The sex ratio was 1.22 in favor of men. The prevalence of hyperuricemia in our study was 28.0% with 31.1% in women and 27.3% in men. The mean average of uric acid in the hyperuricemia population was 7.50 ± 1.24 mg/L and the normal uricemia population was 4.69 ± 1.49 mg/L (p < 0.0001). The mean average triglyceride in the hyperuricemia population was 143 ± 14 and 117.55 ± 55.52 mg/dL in normal uricemia with p = 0.046. Age range [35-45] and hypertriglyceridemia have been associated with hyperuricemia with respectively (odds ratio [OR] = 4.07, p < 0.015) confidence interval, CI: [0.89: 97.0]) and ([OR = 2.50, p < 0.046] CI: [1.01: 6.09]). Conclusion The prevalence of hyperuricemia was relatively high and has been associated with metabolic disorders in the population. It is necessary to focus on early diagnoses, treatment, and early intervention in view to prevent chronic diseases associated with hyperuricemia.
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Affiliation(s)
- Romaric De Manfouo Tuono
- Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
- Biomedical Sciences, Faculty of Health SciencesUniversité des MontagnesBangangtéCameroon
| | | | - Marius Tchoumke Mbiandjeu
- Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
- Biomedical Sciences, Faculty of Health SciencesUniversité des MontagnesBangangtéCameroon
| | - Pascal Blaise A Koul Well A Well
- Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
- Biomedical Sciences, Faculty of Health SciencesUniversité des MontagnesBangangtéCameroon
| | - Pascal Dieudonne Djamen Chuisseu
- Higher Institute of Health SciencesUniversité des MontagnesBangangtéCameroon
- Biomedical Sciences, Faculty of Health SciencesUniversité des MontagnesBangangtéCameroon
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Yang Z, Lv T, Lv X, Wan F, Zhou H, Wang X, Zhang L. Association of serum uric acid with all-cause and cardiovascular mortality in obstructive sleep apnea. Sci Rep 2023; 13:19606. [PMID: 37949893 PMCID: PMC10638300 DOI: 10.1038/s41598-023-45508-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
The study investigated the association between Serum Uric Acid (SUA) levels and all-cause as well as cardiovascular mortality in patients with Obstructive Sleep Apnea (OSA). This prospective cohort study enrolled participants with OSA from four cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008, and 2015-2018. A weighted Cox proportional hazards model was used to assess adjusted hazard ratios (aHRs) and their corresponding 95% confidence intervals (CI) for all-cause and cardiovascular mortality. Additionally, multivariable logistic regression and restricted cubic splines (RCS) models were employed to examine nonlinear relationships between SUA and all-cause and cardiovascular mortality. Among the 5,584 OSA participants included in the study, covering the four NHANES cycles and with a median follow-up of 4.333 years, a total of 537 deaths were observed, including 108 deaths attributed to cardiovascular disease. Comparing the fourth quartile (Q4) of uric acid levels, both the fifth quartile (Q5) (aHRs = 1.51, 95% CI [1.08, 2.12]) and the second quartile (Q2) (aHRs = 1.53, 95% CI [1.04, 2.25]) of uric acid levels were independently associated with an increased risk of all-cause mortality. Furthermore, comparing the fourth quartile (Q4) of uric acid levels, the second quartile (Q2) (aHRs = 2.40, 95% CI [1.08, 5.35]) of uric acid levels were independently associated with an increased risk of cardiovascular mortality. The RCS model demonstrated a U-shaped pattern in the association between SUA and all-cause mortality in OSA, with an inflection point observed at 5.83 mg/dl. The findings of this study suggest a U-shaped association between serum SUA levels and all-cause mortality and nonlinearity association between serum SUA levels and all-cause mortality. Further studies are warranted to determine the causal relationship between SUA levels and all-cause and cardiovascular mortality.
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Affiliation(s)
- Zhe Yang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Tian Lv
- Department of Neurology, Zhuji People's Hospital , Zhuji, Zhejiang, China
| | - Xiaoheng Lv
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Fangyuan Wan
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hong Zhou
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoling Wang
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lisan Zhang
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Ma Y, Zhang D, Xu J, Pang H, Hu M, Li J, Zhou S, Guo L, Yi F. Explainable machine learning model reveals its decision-making process in identifying patients with paroxysmal atrial fibrillation at high risk for recurrence after catheter ablation. BMC Cardiovasc Disord 2023; 23:91. [PMID: 36803424 PMCID: PMC9936738 DOI: 10.1186/s12872-023-03087-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND A number of models have been reported for predicting atrial fibrillation (AF) recurrence after catheter ablation. Although many machine learning (ML) models were developed among them, black-box effect existed widely. It was always difficult to explain how variables affect model output. We sought to implement an explainable ML model and then reveal its decision-making process in identifying patients with paroxysmal AF at high risk for recurrence after catheter ablation. METHODS Between January 2018 and December 2020, 471 consecutive patients with paroxysmal AF who had their first catheter ablation procedure were retrospectively enrolled. Patients were randomly assigned into training cohort (70%) and testing cohort (30%). The explainable ML model based on Random Forest (RF) algorithm was developed and modified on training cohort, and tested on testing cohort. In order to gain insight into the association between observed values and model output, Shapley additive explanations (SHAP) analysis was used to visualize the ML model. RESULTS In this cohort, 135 patients experienced tachycardias recurrences. With hyperparameters adjusted, the ML model predicted AF recurrence with an area under the curve of 66.7% in the testing cohort. Summary plots listed the top 15 features in descending order and preliminary showed the association between features and outcome prediction. Early recurrence of AF showed the most positive impact on model output. Dependence plots combined with force plots showed the impact of single feature on model output, and helped determine high risk cut-off points. The thresholds of CHA2DS2-VASc score, systolic blood pressure, AF duration, HAS-BLED score, left atrial diameter and age were 2, 130 mmHg, 48 months, 2, 40 mm and 70 years, respectively. Decision plot recognized significant outliers. CONCLUSION An explainable ML model effectively revealed its decision-making process in identifying patients with paroxysmal atrial fibrillation at high risk for recurrence after catheter ablation by listing important features, showing the impact of every feature on model output, determining appropriate thresholds and identifying significant outliers. Physicians can combine model output, visualization of model and clinical experience to make better decision.
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Affiliation(s)
- Yibo Ma
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Dong Zhang
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Jian Xu
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Huani Pang
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Miaoyang Hu
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Jie Li
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Shiqiang Zhou
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Lanyan Guo
- grid.233520.50000 0004 1761 4404Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi’an, 710032 Shaanxi China
| | - Fu Yi
- Department of Cardiology, Xijing Hospital, Air Force Medical University, 169 Changle West Road, Xi'an, 710032, Shaanxi, China.
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The Therapeutic Effect and the Potential Mechanism of Flavonoids and Phenolics of Moringa oleifera Lam. Leaves against Hyperuricemia Mice. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27238237. [PMID: 36500329 PMCID: PMC9738809 DOI: 10.3390/molecules27238237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
The aim of this study is to evaluate the anti-hyperuricemia effect and clarify the possible mechanisms of flavonoids and phenolics of MOL (MOL-FP) in mice. Hyperuricemia mice were generated via intraperitoneal (i.p.) administration of potassium oxonate (PO) and oral gavage (p.o.) of hypoxanthine (HX). Serum uric acid (UA), weight, serum XO activity, hepatic XO activity, urea nitrogen (BUN), creatinine (CRE), serum AST level, serum ALT level, mRNA expression of renal urate-anion transporter 1 (URAT1), glucose transporter 9 (GLUT9), organic anion transporters 1 (OAT1), organic anion transporters 3 (OAT3), and ATP-binding cassette transporter G2 (ABCG2) were determined. The molecular docking was conducted using AutoDock Vina 1.2.0 to screen potential XO inhibitors in MOL-FP. Serum metabolomics was established to collect the metabolic profiles of mice and explore the metabolic changes that occurred after MOL-FP treatment. MOL-FP could notably reduce the serum UA level of hyperuricemia mice by inhibiting XO activity and regulating renal urate transporters. Molecular docking studies indicated that 5-p-coumaroylquinic acid, 3-p-coumaroylquinic acid, and catechin could be potential XO inhibitors. Besides, MOL-FP prevented the pathological process of hyperuricemia by regulating biomarkers associated with purine metabolism, amino acid metabolism, and lipid metabolism.
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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: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Affiliation(s)
- William T Crawley
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA
| | - Cyprien G Jungels
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA
| | - Kurt R Stenmark
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA; Division of Pulmonary and Critical Care, Department of Pediatrics, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA
| | - Mehdi A Fini
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA; Division of Pulmonary and Critical Care, Department of Medicine, Anschutz Medical Campus, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA.
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