Serum Uric Acid Is Associated with Left Ventricular Hypertrophy Independent of Serum Parathyroid Hormone in Male Cardiac Patients

Abstract

BackgroundSeveral studies have shown that serum uric acid (UA) is associated with left ventricular (LV) hypertrophy. Serum levels of parathyroid hormone (PTH), which has bbe shown to be correlated with UA, is also known to be associated with cardiac hypertrophy; however, whether the association between UA and cardiac hypertrophy is independent of PTH remains unknown.PurposeWe investigated whether the relationship between serum uric acid (UA) and LV hypertrophy is independent of intact PTH and other calcium-phosphate metabolism-related factors in cardiac patients.Methods and ResultsIn a retrospective study, the association between UA and left ventricular mass index was assessed among 116 male cardiac patients (mean age 65±12 years) who were not taking UA lowering drugs. The median UA value was 5.9 mg/dL. Neither age nor body mass index differed significantly among the UA quartile groups. Patients with higher UA levels were more likely to be taking loop diuretics. UA showed a significant correlation with intact PTH (R = 0.34, P<0.001) but not with other calcium-phosphate metabolism-related factors. Linear regression analysis showed that log-transformed UA showed a significant association with left ventricular mass index, and this relationship was found to be significant exclusively in patients who were not taking loop and/or thiazide diuretics. Multivariate logistic regression analysis showed that log-transformed UA was independently associated with LV hypertrophy with an odds ratio of 2.79 (95% confidence interval 1.48–5.28, P = 0.002 per one standard deviation increase).ConclusionsAmong cardiac patients, serum UA was associated with LV hypertrophy, and this relationship was, at least in part, independent of intact PTH levels, which showed a significant correlation with UA in the same population.

Is Serum Uric Acid Independently Associated With Left Ventricular Mass Index, Ejection Fraction, and B-Type Natriuretic Peptide Among Female and Male Cardiac Patients?

“…Among these patients, 21 were taking a xanthine oxidase inhibitor (either allopurinol or febuxostat) and/or a uricosuric drug, respectively, and were subsequently excluded. Although we analyzed SUA data from 116 male patients in our previous paper, 14) to compare the data between female and male patients over the same study period, here we further analyzed data from 519 male patients selected by the same inclusion and exclusion criteria used for female patients. These 519 male patients included 116 patients whose data have been reported previously.…”

“…These 519 male patients included 116 patients whose data have been reported previously. 14) Laboratory analysis: Blood samples were collected in the morning under fasting conditions at the time of admission as a general rule. Aliquots of serum and plasma were obtained and stored at -80°C degrees immediately until use.…”

“…[14][15][16][17][18] In addition, between women and men, not only mean SUA levels, but also the SUA threshold at which cardiovascular or metabolic syndrome-associated risks might increase, may vary; 19) therefore, we should analyze the data for each gender separately. In addition, the strength of the association between SUA and certain cardiac abnormalities might differ between women and men.…”

“…[4][5][6][7][8][9][10][11] Editorial p. 467 To assess whether serum SUA is associated with cardiac hypertrophy and heart failure, 12) we may have to take various possible confounders into account, such as estimated glomerular filtration rate (eGFR), phosphate, 13) and the recently identified phosphaturic hormone fibroblast growth factor 23 (FGF23) that might directly induce hypertrophy of cardiomyocytes. [14][15][16][17][18] In addition, between women and men, not only mean SUA levels, but also the SUA threshold at which cardiovascular or metabolic syndrome-associated risks might increase, may vary; 19) therefore, we should analyze the data for each gender separately. In addition, the strength of the association between SUA and certain cardiac abnormalities might differ between women and men.…”

Gender Specific Association between Serum Fibroblast Growth Factor 23/α-Klotho and Coronary Artery and Aortic Valve Calcification

“…It has been reported that coronary artery calcification (CAC) can be used as a surrogate marker of the total burden of coronary atherosclerosis and that the presence of CAC is associated with peripheral isch-"serum albumin"), and designated as corrected calcium (cCa). The measurement of FGF23 and -Klotho was performed using enzyme immunoassay kits as described elsewhere 7,24) . The eGFR was calculated by the following Modification of Diet in Renal Disease equation modified for Japanese subjects: eGFR 194 (serum creatinine) 1.094 (age) 0.…”