Association between uric acid and pulse wave velocity in hypertensive patients and in the general population: a systematic review and meta-analysis

Purpose: The association between serum uric acid (SUA) and pulse wave velocity (PWV), has been extensively evaluated but with some discrepancies in results. A further limitation refers to the fact that only few data were analyzed taking into account the possible effects of gender. The purpose of this study was to estimate the association between SUA and arterial stiffness in general population and hypertensive patients, as a whole population and as divided by gender, by pooling results from existing studies.Materials and methods: Carotid-femoral and brachial-ankle PWV (cf- and ba-PWV) have been analyzed separately and subgroup analyses by gender are reported. Among 692 potentially relevant works, 24 articles were analyzed.Results: Seven studies referred to cf-PWV in the general population with an overall positive association at adjusted analysis for both males and females (beta regression coefficient (ß): 0.07; 95%CI: 0.03; 0.11 and ß: 0.06; 95%CI: 0.03; 0.09, respectively). Twelve studies referred to ba-PWV in the general population with the finding of a positive association at adjusted analysis for females (ß: 0.04; 95% confidence interval (CI): 0.01;0.07), but not for males (ß: 0.13; 95%CI: -0.09; 0.34). In hypertensive patients only four studies evaluated cf-PWV and one ba-PWV with only one study (with cf-PWV) finding positive association.Conclusion: The association between SUA and cf-PWV resulted significant in general population in both males and females while it was only significant for female regarding ba-PWV. Furthermore, the few available studies found no significant relationship between SUA and both cf- and ba-PWV in hypertensive subjects.

A body shape index and vascular structure and function in Spanish adults (MARK study): A cross-sectional study

A body shape index (ABSI) has been introduced as a marker of the relationship between body composition and all-cause mortality. However, until now, the relationships between ABSI and vascular structure and function have not been evaluated. The aim of this study was to investigate the association of ABSI with vascular structure and function in Spanish adults with intermediate cardiovascular risk. This cross-sectional study analyzed the data of 2354 subjects [age, 35-74 years (median, 62.0 years [range, 56.0-67.0 years]), 61.9% men] enrolled into the MediAte Risk management (MARK) study. ABSI was calculated by using the following formula: ABSI = waist circumference (m)/[body mass index × height (m))]. Vascular function was assessed by measuring cardio-ankle vascular index (CAVI) with the VaSera device and brachial ankle pulse wave velocity (baPWV) by using a validated equation. Vascular structure was assessed by measuring carotid intima-media thickness (IMT) by ultrasonography. Median value of ABSI was 0.083 (range, 0.081-0.090), mean CAVI was (8.5 ± 1.2), and median IMT was 0.727 (range, 0.672-0.799). The values of ABSI and CAVI were higher in men. After adjusting for confounders, ABSI was positively associated with CAVI, baPWV, and average mean IMT. Thus, for each unit increase in ABSI, CAVI increased by 0.16 units, baPWV by 0.25 m/s, and IMT by 0.033 mm. In the logistic regression analysis, the odds ratio of ABSI was > 1 for high CAVI ≥ 9, baPWV ≥ 15 m/s, and IMT ≥ 0.90 mm in the overall subject group, and in the sex- and age-specific (> 62 years, ≤ 62 years) subgroups, after adjusting for confounders. The area under the receiver-operating characteristic curve of the ABSI was 0.631 (95% confidence interval [CI], 0.608-0.654) for CAVI ≥ 9, and 0.617 (95% CI, 0.593-0.641) for high baPWV ≥ 15 m/s. ABSI showed a positive association with vascular structure and function, independent of other confounders that might influence weight and fat mass distribution in Spanish subjects at intermediate cardiovascular risk.Trial Registration: ClinicalTrials.gov Identifier: NCT01428934 (registered: September 2, 2011; last updated: September 8, 2016).

Comparison of Hemoglobin Alc, Glycated Albumin and Fasting Plasma Glucose for Prediction of Arterial Stiffness in Chinese Adults

OBJECTIVE

Although diabetes is closely related to cardiovascular disease, there are some disputes whether diabetes can promote arterial stiffness. Therefore, the objective of this study is to compare the predictive abilities of related-glycemic markers including fast plasma glucose (FPG), glycated hemoglobin (HbAlc) and glycated albumin (GA) for the arterial stiffness.

METHODS

In the present study, 3640 subjects (2171 men, 1469 women) were enrolled, and anthropometrics, brachial ankle pulse wave velocity (baPWV) and other laboratory data were obtained. Spearman correlation and multivariate logistic regression analyses were used to evaluate the relationships between FPG, HbAlc, GA and baPWV.

RESULTS

Age, BMI, blood pressure, blood lipids, γ-Glutamyl transpeptidase, uric acid, hypersensitive C-reactive protein, baPWV, FPG, HbAlc, GA, estimated glomerular filtration rate and the incidences of diabetes and hypertension in high baPWV group were much greater than those in control group. Moreover, these above three glycemic markers were positively related to baPWV, and the correlation coefficient of HbAlc was the highest. After adjusting the above factors, HbAlc and FPG, but not GA, were still positively associated with baPWV regardless of diabetes status.

CONCLUSION

Our data demonstrated that, regardless of diabetes status, HbAlc and FPG were superior to GA for predicting arterial stiffness and HbAlc had the highest correlation with arterial stiffness, revealing that HbAlc may be regarded as an early diagnosis marker for atherosclerosis.

Gene-Diet Interaction between SIRT6 and Soybean Intake for Different Levels of Pulse Wave Velocity

Soybean is a common food for the Chinese people. We aimed to investigate the risk for brachial ankle pulse wave velocity (baPWV) with inflammatory-related SNPs and soybean. baPWV was measured, and 16 inflammatory-related SNPs located on ADIPOQ, CDH13, SIRT3, SIRT6, CXCL12, CXCR4, NOS1, PON1 and CDKN2B were genotyped in 1749 Chinese participants recruited from various communities. ADIPOQ rs12495941 (GT/TT vs. GG: crude OR = 1.27, p = 0.044) and SIRT6 rs107251 (CT/TT vs. CC: crude OR = 0.74, p = 0.009) were associated with abnormal baPWV (baPWV ≥ 1700 cm/s). After adjustment for conventional environmental risk factors, rs12495941 was associated with abnormal baPWV (GT/TT vs. GG: adjusted OR = 1.43, p = 0.011), but the association between rs107251 and abnormal baPWV was not significant (CT/TT vs. CC: adjusted OR = 0.83, p = 0.173). The interaction between rs107251 and soybean intake for different levels of baPWV was statistically significant (p = 0.017). Compared with a high level of soybean intake, a low level of soybean intake can significantly decrease the risk of abnormal baPWV in individuals of rs107251 CT/TT genotypes (≤100 vs. >100 g/week: adjusted OR = 0.542, p = 0.003). In this study, associations between ADIPOQ rs12495941, SIRT6 rs107251 and baPWV, as well as an interaction between SIRT6 rs107251 and soybean intake for different levels of baPWV were found.

Casein Hydrolysate Containing Milk-Derived Peptides Reduces Facial Pigmentation Partly by Decreasing Advanced Glycation End Products in the Skin: A Randomized Double-Blind Placebo-Controlled Trial

Casein hydrolysate has been shown to improve arterial stiffness as estimated by brachial-ankle pulse wave velocity (baPWV) in untreated hypertensive patients. Facial pigmentation is associated with atherosclerosis, both of which are supposed to be modulated by tissue accumulation of advanced glycation end products (AGEs). However, effects of casein hydrolysate on facial pigmentation and AGEs remain largely unknown. This randomized double-blind placebo-controlled trial evaluated whether and how casein hydrolysate improves facial pigmentation in 80 nonhypertensive Japanese patients. Study participants were randomly assigned to receive either active tablets containing casein hydrolysate or placebo for 48 weeks. Facial pigmentation area, baPWV, and skin accumulation levels of AGEs were evaluated by Robo Skin Analyzer RSA50S II, volume-plethysmographic apparatus, and AGE Reader, respectively, at baseline and at the end of the intervention. Treatment with casein hydrolysate, but not placebo significantly reduced triglycerides and facial pigmentation area. There were significant differences of changes in triglycerides, facial pigmentation area, skin accumulation levels of AGEs, and baPWV between the two groups. Furthermore, changes in triglycerides and skin accumulation levels of AGEs were positively and independently associated with those in facial pigmentation area, whereas changes in baPWV were not. This study suggests that casein hydrolysate reduces facial pigmentation area in nonhypertensive participants partly by decreasing skin accumulation levels of AGEs. Clinical-Trials.gov ID: UMIN000027675.

Association of Brachial Ankle Pulse Wave Velocity With New Onset Stroke in Hypertensive Patients Aged Less Than 65 With Normal Fasting Glucose Among Chinese Community-Based Population

BACKGROUND

Previous studies have shown an association of stroke and brachial ankle pulse wave velocity (baPWV). However, due to limitations on total population size and small numbers of stroke cases, lack of power has prevented further detection among subgroups such as age and laboratory testing.

METHODS

A total of 19217 participants including 660 incident stroke patients were pooled in the present study. Participants were divided to 2 groups, aged less than 65 years [56.0 (50.0, 61.0)] and aged 65 years or more [70.0 (67.0, 74.0)].

RESULTS

After adjustment for demographic, anthropometric, and laboratory parameters, the incident stroke was positively associated to baPWV in the group aged less than 65 years (OR, 1.16; 95% CI, 1.05-1.28), but not in the older group aged 65 or more. When baPWV was assigned as quartiles, a significant, increased risk of new-onset stroke was found in quartiles 3-4 compared with quartile 1. In addition, the predictive value of baPWV for incident stroke was modified by fasting glucose in participants aged less than 65 years (P-interaction = 0.010). An increase in baPWV was strongly, positively associated to new-onset stroke in the subgroup of normal fasting glucose (< 5.6 mmol/L) (OR, 1.34; 95% CI, 1.15 - 1.57), but no effect was seen in the impaired fasting glucose (5.6-7.0 mmol/L) or diabetic fasting glucose (> 7.0 mmol/L) subgroups.

CONCLUSIONS

Increased baPWV was significantly associated with new-onset stroke in a hypertensive population aged less than 65 years. Particularly, it is of great importance to monitor baPWV for predicting incident stroke in "relatively healthy" hypertensive patients, i.e. aged less than 65 years with normal fasting glucose.