Serum uric acid as a predictor of mortality and future exacerbations of COPD

Abstract

Serum uric acid is increased in respiratory disease, especially in the presence of hypoxia and systemic inflammation. We evaluated serum uric acid as a biomarker for prediction of mortality and future acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Serum uric acid was measured in 314 eligible consecutive patients on admission for AECOPD. Patients were evaluated monthly for 1 year.Uric acid levels were higher in patients with more severe airflow limitation and in those experiencing frequent exacerbations. High uric acid levels (o6.9 mg?dL -1 ) were an independent predictor of 30-day mortality in multivariate Cox regression analysis (HR 1.317, 95% CI 1.011-1.736; p50.044), but not of 1-year mortality. Patients with high serum uric acid required more prolonged hospitalisation, and more often needed noninvasive ventilation and admission to the intensive care unit within 30 days. In addition, high uric acid levels were associated with increased risk and hospitalisation for AECOPD in 1 year in multivariate Poisson regression analysis (incidence rate ratio 1.184 (95% CI 1.125-1.246) and 1.190 (95% CI 1.105-1.282), respectively; both p,0.001).Serum uric acid is associated with increased 30-day mortality and risk for AECOPD and hospitalisations in 1-year follow-up. This low-cost biomarker may be useful in the identification of high-risk chronic obstructive pulmonary disease patients that could benefit from intensive management. @ERSpublications Serum uric acid was linked with airflow limitation in COPD and predicted mortality and future exacerbations

Regulation and Function of the Nucleotide Binding Domain Leucine-Rich Repeat-Containing Receptor, Pyrin Domain-Containing-3 Inflammasome in Lung Disease

“…The levels of eATP were elevated in the BAL of patients with COPD (44). Furthermore, serum UA correlated with 30-day mortality in patients with COPD exacerbations (45).…”

Prognostic role of serum uric acid in acute respiratory distress syndrome patients: A preliminary study

“…Additionally, PaO 2 /FIO 2 was statistically significant lower in dead than in survived one, moreover, there was a statistically significant negative correlation between uric acid and PaO 2 /FIO 2 , meaning that ARDS patients with more hypoxemia had a higher serum uric acid level as well as both correlated inversely. These findings were explained by Bartziokas and his associates [7] who found that serum uric acid which is the final product of purine degradation, increases significantly during hypoxia which is a hall mark feature in ARDS patients. Also, Fabbri and Rabe [9] reported that impaired pulmonary function reduces oxygen intake resulting in tissue hypoxia which was more prominent during acute exacerbation in COPD and this may lead to increased circulating uric acid levels originating from both lung and peripheral tissue damage.…”

“…ARDS is a life threatening respiratory condition characterized by hypoxemia [4]. Serum uric acid levels increases significantly during hypoxia [7][8][9]. Elevated uric acid levels have been associated with the presence of systemic inflammation [12].…”

“…Serum uric acid is the final product of purine degradation [5], which increases significantly during hypoxia [6]. Increased level of uric acid in respiratory disorders, including obstructive sleep apnea, pulmonary hypertension and COPD was reported in several studies [7,8].…”

Correlation of serum uric acid levels in patients of chronic obstructive pulmonary disease

“…7 There is data regarding the significance of serum uric acid level among patients with COPD. [8][9][10][11][12] Serum uric acid has been proposed as a marker of impaired oxidative metabolism and an independent prognostic marker in several cardio-vascular disorders such as congestive heart failure [13][14] pulmonary hypertension 15 and myocardial infarction and its related complications. [16][17] There are other biomarkers also which helps in assessing severity of COPD [18][19] but they are not easily available and are costlier also.…”