Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers

Abstract

We examined the association of serum uric acid (SUA) with development of hypertension (blood pressure > or = 140/90 mmHg and/or medication for hypertension) and impaired fasting glucose (IFG) (a fasting plasma glucose level 6.1-6.9 mmol/l) or Type II (non-insulin-dependent) diabetes (a fasting plasma glucose level > or = 7.0 mmol/l and/or medication for diabetes) over a 6-year follow-up among 2310 Japanese male office workers aged 35-59 years who did not have hypertension, IFG, Type II diabetes, or past history of cardiovascular disease at study entry. After controlling for potential predictors of hypertension and diabetes, the relative risk for hypertension compared with quintile 1 of SUA level was 1.27 [95% confidence interval (CI): 1.00-1.62] for quintile 2, 1.34 (95% CI: 1.08-1.74) for quintile 3, 1.48 (95% CI: 1.18-1.89) for quintile 4, and 1.58 (95% CI: 1.26-1.99) for quintile 5 (p for trend <0.001). The respective multivariate-adjusted relative risks for IFG or Type II diabetes compared with quintile 1 of SUA level were 1.55 (95% CI: 0.95-2.63), 1.62 (95% CI: 0.98-2.67), 1.61 (95% CI: 1.01-2.58), and 1.78 (95% CI: 1.11-2.85) (p for trend = 0.030). The association between SUA level and risk for hypertension and IFG or Type II diabetes was stronger among men with a body mass index (BMI) <24.2 kg/m2 than among men with a BMI > or = 24.2 kg/m2, although the absolute risk was greater in more obese men. These results indicate that SUA level is closely associated with an increased risk for hypertension and IFG or Type II diabetes.

Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults

“…BP was found to increase across SUA tertiles in black women in South Africa, 33 and these investigators also showed an independent relation between SUA and vascular resistance in men. Our finding of an association between SUA and BP in young adults in Seychelles concurs with the findings in adults: a positive relationship between SUA levels and BP was found in most studies, 2,3,5,6 although not in all. 34,35 It is important that this association be corroborated in children and young adults because studies in older adults are prone to confounding by many factors such as treatment, co-morbidity, reverse causation and so on.…”

“…[1][2][3][4][5][6] An independent SUA-BP association is further substantiated by the finding that BP was lowered upon treatment with allopurinol in a randomized controlled trial in adolescents. 24 Johnson et al 25 refer to two main mechanisms to Serum uric acid, blood pressure and adiposity T Lyngdoh et al account for a link between SUA and BP.…”

“…Although the direction of causality between SUA and adiposity is unclear, it is well known that SUA is highly correlated with obesity and other metabolic abnormalities, including insulin resistance. 5,13,14,50 It has been suggested that hyperuricemia inhibits nitric oxide availability and decreases insulin-mediated glucose uptake in skeletal muscle and may, therefore, have a role in the development of the metabolic syndrome. 51,52 Other studies have suggested that hyperinsulinemia, a consequence of the metabolic syndrome, enhances the tubular reabsorption of uric acid and that this occurs concurrently with a decrease in sodium and potassium excretion, leading to elevated BP.…”

“…[1][2][3][4][5][6] The strength of this association seems to be stronger in younger age groups 7 and tends to wane with increasing age and duration of hypertension. 8 Feig and Johnson 9 have suggested that SUA is involved in the early pathogenesis of primary hypertension.…”

“…12 In adults, hyperuricemia often co-exists with several cardiovascular risk factors including the metabolic syndrome and its individual components. 5,13,14 It has been suggested that insulin resistance determines SUA levels in patients with metabolic syndrome. 15 Furthermore, it has been suggested that hyperinsulinemia is the main link between abdominal obesity and high BP.…”