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Du L, Zong Y, Li H, Wang Q, Xie L, Yang B, Pang Y, Zhang C, Zhong Z, Gao J. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduct Target Ther 2024; 9:212. [PMID: 39191722 DOI: 10.1038/s41392-024-01916-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/08/2024] [Accepted: 06/27/2024] [Indexed: 08/29/2024] Open
Abstract
Hyperuricemia, characterized by elevated levels of serum uric acid (SUA), is linked to a spectrum of commodities such as gout, cardiovascular diseases, renal disorders, metabolic syndrome, and diabetes, etc. Significantly impairing the quality of life for those affected, the prevalence of hyperuricemia is an upward trend globally, especially in most developed countries. UA possesses a multifaceted role, such as antioxidant, pro-oxidative, pro-inflammatory, nitric oxide modulating, anti-aging, and immune effects, which are significant in both physiological and pathological contexts. The equilibrium of circulating urate levels hinges on the interplay between production and excretion, a delicate balance orchestrated by urate transporter functions across various epithelial tissues and cell types. While existing research has identified hyperuricemia involvement in numerous biological processes and signaling pathways, the precise mechanisms connecting elevated UA levels to disease etiology remain to be fully elucidated. In addition, the influence of genetic susceptibilities and environmental determinants on hyperuricemia calls for a detailed and nuanced examination. This review compiles data from global epidemiological studies and clinical practices, exploring the physiological processes and the genetic foundations of urate transporters in depth. Furthermore, we uncover the complex mechanisms by which the UA induced inflammation influences metabolic processes in individuals with hyperuricemia and the association with its relative disease, offering a foundation for innovative therapeutic approaches and advanced pharmacological strategies.
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Grants
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
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Affiliation(s)
- Lin Du
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yao Zong
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, 6009, Australia
| | - Haorui Li
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qiyue Wang
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Lei Xie
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Bo Yang
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yidan Pang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Changqing Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
| | - Zhigang Zhong
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China.
| | - Junjie Gao
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China.
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
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Ge JY, Ji Y, Zhu ZY, Li X. Genetically Elevated Serum Uric Acid and Renal Function in an Apparently Healthy Population. Urol Int 2019; 104:277-282. [PMID: 31711059 DOI: 10.1159/000504267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The association between uric acid and kidney disease has been extensively investigated. Numerous studies have reported the association between circulating levels of uric acid and renal function. OBJECTIVES To test, by the Mendelian randomization method, whether there is a causal association between circulating levels of uric acid and renal function. METHODS In 989 participants, estimated glomerular filtration rate (eGFR) was calculated, the circulating level of uric acid was tested, and the uric acid polymorphism (rs11722228) was genotyped. RESULTS After adjusting for age, gender, smoking history, alcohol intake, antihypertensive medication, body mass index, waist-to-hip ratio, and levels of urea nitrogen and creatinine, a significant allelic difference was found in uric acid levels for each genotype (p < 0.0001). Furthermore, the circulating levels of uric acid were negatively associated with eGFR after adjusting for cardiovascular risk factors and other potential confounders (p < 0.0001). Meanwhile, eGFR was significantly associated with the genotypes of rs11722228 (β = -0.07; p = 0.02). CONCLUSIONS Evidence from the Mendelian randomization approach implied a causal relationship between uric acid and renal function in an apparently healthy population.
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Affiliation(s)
- Ji-Yong Ge
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Cardiology, The Second People's Hospital of Changzhou, Changzhou, China
| | - Yuan Ji
- Department of Cardiology, The Second People's Hospital of Changzhou, Changzhou, China
| | - Zhen-Yan Zhu
- Department of Cardiology, The First People's Hospital of Changzhou, Changzhou, China
| | - Xun Li
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China,
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Liao KF, Lin CL, Lai SW. Allopurinol use associated with increased risk of acute myocardial infarction in older people in a case-control study. Tzu Chi Med J 2019; 31:276-279. [PMID: 31867258 PMCID: PMC6905236 DOI: 10.4103/tcmj.tcmj_144_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/16/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022] Open
Abstract
Objective There is controversy about the association between the allopurinol use and the risk of acute myocardial infarction. The aim of the study was to examine the association between allopurinol use and acute myocardial infarction in older people in Taiwan. Materials and Methods We used the 2000-2013 database of the Taiwan National Health Insurance Program to conduct a case-control study. Cases were assigned as subjects aged 65 years and older with the first incident acute myocardial infarction. Matched controls were assigned as subjects aged 65 years and older without any type of coronary artery disease. Ever use of allopurinol was defined as subjects who had at least a prescription of allopurinol before the diagnosis date of first incident acute myocardial infarction. The odds ratio (OR) and the 95% confidence interval (CI) for acute myocardial infarction associated with allopurinol use were estimated by the multivariable logistic regression model. Results There were 4701 cases with the first incident acute myocardial infarction and 9369 matched controls. The adjusted OR of acute myocardial infarction was 2.2 (95% CI 1.7- 2.7) for subjects with ever use of allopurinol, compared with never use. The adjusted ORs of acute myocardial infarction were 2.0 (95% CI 1.5-2.6) for subjects with average daily dosage of allopurinol <200 mg and 2.5 (95% CI 1.6-4.0) for subjects with average daily dosage of allopurinol ≥200 mg. Conclusion Allopurinol use is associated with increased odds of acute myocardial infarction in older people, which is dosage dependent.
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Affiliation(s)
- Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Division of Hepatogastroenterology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Ding XH, Wang X, Cao R, Yang X, Xiao W, Zhang Y, Bai Y, Wu H, Ye P. A higher baseline plasma uric acid level is an independent predictor of arterial stiffness: A community-based prospective study. Medicine (Baltimore) 2017; 96:e5957. [PMID: 28178136 PMCID: PMC5312993 DOI: 10.1097/md.0000000000005957] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Hyperuricemia has been demonstrated to be a risk factor for cardiovascular diseases. Though the association between uric acid (UA) and arterial stiffness has been investigated previously in patients with basic diseases, the predictive value of baseline UA level for arterial stiffness has not been conducted. We aimed at identifying the predictive role of UA for arterial stiffness prospectively.A longitudinal follow-up study in a routine health check-up population was performed with an average follow-up of 4.8 years. The demographic information, baseline and follow-up anthropometric parameters, arterial stiffness (pulse-wave velocity, PWV), and biomarker variables including UA have been measured and analyzed.A total of 1447 valid follow-ups were available for the final analysis. Both of the baseline and follow-up UA levels were significantly higher in the arterial stiffness groups than that in the nonarterial stiffness groups (all P values <0.001). The follow-up carotid-femoral PWV [(cf-PWV), r = 0.161, P < 0.001] was strongly correlated with baseline UA. At the follow-up cross-section, cf-PWV was also closely associated with UA (r = 0.101, P < 0.001). Logistic regressions revealed that a higher baseline UA level was an independent predictor of follow-up arterial stiffness assessed by cf-PWV [odds ratio (OR): 1.824; P = 0.046].A higher baseline level of UA is closely related to arterial stiffness and is an independent predictor of arterial stiffening.
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Affiliation(s)
- Xiao-Han Ding
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
- Department of Health Care and Geriatrics, Lanzhou General Hospital of Lanzhou Military Command, Lanzhou, Gansu Province, China
| | - Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Xu Yang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Wenkai Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Yun Zhang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing
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