Impact of the Serum Uric Acid Level on Subclinical Atherosclerosis in Middle-aged and Elderly Chinese

Chen, Ying; Xu, Bo; Sun, Wanwan; Sun, Jichao; Wang, Tiange; Xu, Yu; Xu, Min; Lu, Jieli; Li, Xiaoying; Bi, Yufang; Wang, Weiqing; Ning, Guang

doi:10.5551/jat.26260

Cited by 24 publications

(25 citation statements)

References 44 publications

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“…The prognosis of PAD is determined by complicated coronary heart disease and stroke 3–5) . Therefore, the present findings agree with the findings of recent studies that high serum uric acid levels are associated with increased cardiovascular disease mortality in Japanese men and women 25) and with subclinical atherosclerosis evaluated based on IMT in Chinese men and women 26) . Moreover, a recent clinical study demonstrated that serum uric acid levels are associated with coronary lipid-rich plaques in Japanese men and women 27) .…”

Section: Discussionsupporting

confidence: 93%

Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment

Sotoda

Hirooka

Orita

et al. 2017

J Atheroscler Thromb

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Aim: We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment.Methods: Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI.Results: Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, −0.292 (p < 0.01)] and leg exercise-induced decrease in ABI [Pearson's correlation coefficient, 0.236 (p < 0.05)]. However, there was no significant correlation between uric acid levels and maximum or mean IMT. Odds ratios of subjects with the 3rd tertile versus subjects with the 1st tertile for uric acid levels were significantly higher than the reference level of 1.00 for low ABI [4.44 (95% confidence interval, 1.45–13.65, p < 0.01)] and for high % decrease in ABI after exercise [4.31 (95% confidence interval, 1.34–13.82, p < 0.05)]. The associations of uric acid levels with the indicators of leg ischemia were also found after adjustment for age, history of revascularization therapy, diabetes, smoking, alcohol consumption, body mass index, triglyceride levels, and renal function.Conclusion: Uric acid levels are associated with the degree of leg ischemia in patients with PAD. Further interventional studies are needed to determine whether the correction of uric acid levels is effective in preventing the progression of PAD.

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Section: Discussionsupporting

confidence: 93%

Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment

Sotoda

Hirooka

Orita

et al. 2017

J Atheroscler Thromb

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“…The positive associations between serum UA levels and other surrogate markers of atherosclerosis have generally been validated in previous cross-sectional studies. [44–46] However, the results were not fully consistent depending on the measurement method and subgroup categories. Chen et al [46] suggests that there is a close association between serum UA level and atherosclerotic lesions regardless of the underlying comorbid conditions.…”

Section: Discussionmentioning

confidence: 93%

“…[44–46] However, the results were not fully consistent depending on the measurement method and subgroup categories. Chen et al [46] suggests that there is a close association between serum UA level and atherosclerotic lesions regardless of the underlying comorbid conditions. In contrast, several other studies have been more compatible with our results in that the relationship between serum UA level and atherosclerotic disease depends on underlying comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic hyperuricemia is independently associated with coronary artery calcification in the absence of overt coronary artery disease

Kim

Choi

et al. 2017

Medicine

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Recently, the pathogenic role of uric acid (UA) in both systemic metabolic and atherosclerotic diseases has been investigated. We sought to determine the independent correlation between serum UA levels and coronary artery calcification, as a marker of subclinical atherosclerosis. A total of 4188 individuals without prior coronary artery disease or urate-deposition disease were included. All of the participants underwent multidetector computed tomography (MDCT) for the evaluation of coronary artery calcification (CAC) during their health check-ups. The subjects were divided into thre groups according to CAC scores (group 1: 0; group 2: 1-299; group 3: ≥300). After controlling for other confounders, serum UA levels were found to be positively associated with increasing CAC scores (P = 0.001). Adjusted mean serum UA levels in each CAC group were estimated to be 5.2 ± 0.1 mg/dL, 5.3 ± 0.1 mg/dL, and 5.6 ± 0.2 mg/dL from groups 1, 2, and 3, respectively. Subsequent subgroup analyses revealed that this positive association was only significant in participants who were male, relatively older, less overweight, and did not have diabetes mellitus (DM), hypertension, smoking history, or renal dysfunction. In conclusion, serum uric acid levels were independently associated with CAC score severity and this finding is particularly relevant to the subjects who were male, relatively older, less overweight (body mass index < 25 kg/m 2 ), and without a history of DM, hypertension, smoking, or renal dysfunction.Abbreviations: BMI = body mass index, BUN = blood urea nitrogen, CAC = coronary artery calcification, CHD = coronary heart disease, CRP = C-reactive protein, CSF-1 = colony-stimulating factor 1, DM = diabetes mellitus, eGFR = estimated glomerular filtration rate, HDL = high-density lipoprotein, LDL = low-density lipoprotein, MDCT = multidetector computed tomography, MDRD = the Modification of Diet in Renal Disease, RANKL = receptor activator of NF-kB ligand, TNF-a = tumor necrosis factor-a, UA = uric acid.

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“…Although the precise mechanism of the nephrotoxicity of HU has not been fully elucidated, recent data showed a direct harmful effect of UA on endothelial cells 59) and smooth muscle cells 60) . In humans, it has been reported that serum uric acid level is independently associated with an elevated carotid intimamedia thickness 61) . Therefore, UA injures renal vessels, which are the major lesion of arterial/arteriolar nephrosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia as a Predictive Marker for Progression of Nephrosclerosis: Clinical Assessment of Prognostic Factors in Biopsy-Proven Arterial/Arteriolar Nephrosclerosis

Momoki

Kataoka

Moriyama

et al. 2017

J Atheroscler Thromb

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Aim: The influence of serum urate on kidney disease is attracting attention, but the effects of uric acid (UA) on nephrosclerosis have not been elucidated.Methods: We reviewed data from 45 patients diagnosed with arterial/arteriolar nephrosclerosis. The renal outcomes of the arterial/arteriolar nephrosclerosis patients were assessed by performing logistic and Cox regression analyses. A Kaplan-Meier analysis was used to evaluate the impact of hyperuricemia (HU) on kidney survival. The renal outcomes of patients with and without HU were compared by using a propensity score-matched cohort.Results: The logistic regression models showed no significant differences in renal outcomes, according to baseline parameters or follow-up parameters, except the serum UA value and body mass index (BMI). Baseline serum UA level had the highest odds ratio (OR) for estimated glomerular filtration rate (eGFR) decline (OR, 1.86; 95% confidence interval (CI), 1.12 to 3.45), among the parameters assessed. In the multivariate Cox regression analysis, HU (UA ≥ 8.0 mg/dL) (P = 0.01) and BMI (P = 0.03) were significantly associated with a ≥ 50% eGFR decline or ESRD. The Kaplan-Meier analysis in the propensity score-matched cohort indicated that the renal survival rate of the group of arterial/arteriolar nephrosclerosis patients with HU was significantly lower than that of the group without HU (log rank, P = 0.03).Conclusion: The results of this study suggest that the baseline serum UA value can serve as a renal outcome predictor in arterial/arteriolar nephrosclerosis patients.

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Impact of the Serum Uric Acid Level on Subclinical Atherosclerosis in Middle-aged and Elderly Chinese

Cited by 24 publications

References 44 publications

Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment

Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment

Asymptomatic hyperuricemia is independently associated with coronary artery calcification in the absence of overt coronary artery disease

Hyperuricemia as a Predictive Marker for Progression of Nephrosclerosis: Clinical Assessment of Prognostic Factors in Biopsy-Proven Arterial/Arteriolar Nephrosclerosis

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