Metabolic Factors Mediate the Association Between Serum Uric Acid to Serum Creatinine Ratio and Cardiovascular Disease

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.

Significance of Cardiometabolic Index in Predicting Acute Exacerbation of Stable Chronic Obstructive Pulmonary Disease for Clinical Nursing

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Association of serum creatinine with hepatic steatosis and fibrosis: a cross-sectional study

“…Serum creatinine (SCr), a biosynthetic product of phosphocreatine metabolism in muscle, is widely used in clinical practice to assess renal function and is more direct and readily available than glomerular filtration rate (GFR). Several clinical studies have shown that even within the normal range, higher SCr is strongly associated with the risk of several diseases, such as cardiovascular disease and diabetes [ 16 , 17 ]. Currently, few clinical studies have investigated the relationship between HS and SCr levels and HS-accompanied fibrosis.…”

Serum Uric Acid to Serum Creatinine Ratio and Risk of Stroke Recurrence in Young Adults with Ischemic Stroke

“… 36 Wang et al performed a nationwide study and reported that SUA/SCr was positively associated with cardiovascular disease and partially mediated by metabolic factors. 14 However, studies regarding SUA/SCr and stroke recurrence among young adults were limited.…”

“…Recent studies found that SUA/SCr was associated with metabolic and cardiovascular diseases. 14 However, few studies have explored the potential role of SUA/SCr among young patients with ischemic stroke.…”