Uric acid as a potential mediator of cardiovascular morbidity in obstructive sleep apnea syndrome

Kanbay, Asiye; Inonu, Handan; Solak, Yalçın; Erden, Abdülsamet; Uslu, Emine; Yuksel, Sevgi Arik; Öztürk, Mehmet Akif; McFann, Kim; Johnson, Richard J.

doi:10.1016/j.ejim.2014.04.005

Cited by 42 publications

(29 citation statements)

References 28 publications

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“…The mortality risks of people with high serum uric acid levels (male 8.9 mg/dL and female 6.4 mg/dL) are greater than those of people with low uric acid levels (22,23). In our study, uric acid >3.5 was found to be the most specific and sensitive point for predicting severity of PHT in Eisenmenger syndrome (Figure 2).…”

Section: Discussionsupporting

confidence: 46%

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Pamukçu¹,

Yılmaz²,

Narın³

et al. 2016

Erciyes Med J

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Objective: Noninvasive methods for follow-up of pulmonary hypertensive children are limited. The main aim of this study was to determine the cutoff levels for uric acid and N-terminal pro-brain natriuretic peptide (NT-proBNP) for follow-up of Eisenmenger patients and their relationships with classical methods. To our best knowledge, this is the first study to investigate the levels of NT-proBNP and uric acid in pediatric Eisenmenger patients. Materials and Methods:Sixteen patients with Eisenmenger syndrome and 37 healthy children as controls were included in the study. The serum NT-proBNP and uric acid levels of the participants were measured. The echocardiography, six-minute walk test, and right cardiac catheterization data of the two groups were compared.Results: NT-proBNP>81.4 pg/mL and uric acid >3.5 mg/dL were found to be the most specific and sensitive points for predicting the severity of pulmonary hypertension in Eisenmenger syndrome. There was no significant difference between mean pulmonary arterial pressure and serum NT-proBNP level; however, the differences between pulmonary vascular resistance and serum NT-proBNP level and between mean pulmonary arterial pressure and serum NT-proBNP level were significant. There was no significant difference between NT-proBNP level and New York Heart Association functional classification or six-minute walk test distance. There was no significant difference between serum uric acid level and pulmonary vascular resistance, right atrial pressure, or mean pulmonary arterial pressure. Conclusion:It is too early to determine if serum biomarkers can replace classical diagnostic methods in Eisenmenger syndrome; further studies are required.

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Section: Discussionsupporting

confidence: 46%

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Pamukçu¹,

Yılmaz²,

Narın³

et al. 2016

Erciyes Med J

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“…Snoring is a common symptom of sleep apnea syndrome in the elderly. 26 The possible mechanism of this interesting phenomenon may be that poor quality sleep leads to further fatigue and energy loss, resulting in the accumulation of metabolic products including uric acid. 26 The related mechanism remains unclear and needs to be further studied.…”

Section: Discussionmentioning

confidence: 99%

<p>Risk Factors For Hyperuricemia In Chinese Centenarians And Near-Centenarians</p>

Han¹,

Zhang²,

Zhao³

et al. 2019

CIA

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Hyperuricemia is an important potential pathogenic factor for hypertension, cardiovascular disease and stroke. The current study aimed to investigate the prevalence of hyperuricemia and its relationship to lifestyle characteristics and dietary habits in centenarians and near-centenarians. Patients and methods: In total, 966 centenarians and 788 near-centenarians were included. Community-based surveys were conducted to collect information about lifestyle. Blood examinations were performed using enzymatic assays. T-tests and χ2 tests were used to investigate significant indicators of hyperuricemia, and multivariate logistic regression was used to analyze the related risk factors. A comprehensive analysis of nineteen modifiable factors, including lifestyle characteristics, dietary habits, general characteristics and blood test indexes, was conducted. Results: The prevalence of hyperuricemia was 29.02%. The percentage of men, waist circumference (WC), waist-hip ratio, estimated glomerular filtration rate (eGFR), levels of total protein (TP), alanine aminotransferase, aspartate aminotransferase, triglycerides, highdensity lipoprotein cholesterol, serum homocysteine, serum uric acid, serum urea and serum creatinine, passive smoking, alcohol consumption, snoring, preference for fried flavors, and meat, seafood and vegetable consumption were significantly different between the hyperuricemia group and the normouricemia group (p<0.05). Multivariate logistic regression analysis showed that WC (OR=1.020), eGFR (OR=0.960), TP level (OR=1.038), serum urea level (OR=1.154), passive smoking (OR=2.589), snoring (OR=2.003), meat consumption (OR=2.506), seafood consumption (OR=1.422) and vegetable consumption (OR=0.521) were significantly associated with the risk of hyperuricemia (p<0.05). Conclusion: Low eGFR and vegetable consumption, high WC, TP, and serum urea levels, passive smoking, snoring, and high meat and seafood consumption were independent risk factors for hyperuricemia. It is recommended that people at high risk for hyperuricemia should actively limit their intake of fried food, alcohol and purine-rich food, increase their intake of fresh vegetables, actively treat sleep apnea syndrome, avoid passive smoking, maintain a healthy WC and seek to improve their kidney and liver function.

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“…First of all, a close link between serum uric acid levels and microvascular dysfunction has been established by previous in vivo and in vitro studies. High serum uric acid concentrations may induce endothelial dysfunction by decreasing NO bioavailability, stimulating vascular smooth muscle cell proliferation and activating the renin‐angiotensin system, which cumulatively lead to microvascular damage and dysfunction . Higher levels of serum uric acid in a population of asymptomatic subjects were independently associated with endothelial dysfunction .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, uric acid has been a key area of focus as a potential causal factor in a multitude of diseases including but not limited to hypertension, nephropathy, atherosclerosis, heart failure and acute kidney injury . The common pathophysiologic denominator of these pathways is thought to be oxidative stress and inflammation resulting from a hyperuricemic state …”

Section: What Is Known and Objectivementioning

confidence: 99%

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non‐small‐cell lung cancer

et al. 2019

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What is known and objective Erlotinib is a small molecule tyrosine kinase inhibitor which blocks the activation of epidermal growth factor receptor (EGFR), a transmembrane receptor that is upregulated in many cancer types. Inhibition of angiogenesis with consequent impairments in intratumoral microcirculation is one of the mechanisms through which EGFR inhibition halts the progression of cancer. A consequence of impaired microcirculation is intratumoral hypoxia, which results in increases in serum uric acid levels. The goal of this study was to investigate the relationship between serum uric acid levels and response to erlotinib in metastatic non‐small‐cell lung cancer (NSCLC). Methods A total of 56 patients with metastatic non‐small‐cell lung cancer who received erlotinib for a duration of at least 3 months were included in this retrospective cohort study. Demographic characteristics, progression status, baseline serum uric levels and 3‐month serum uric acid levels were recorded and analysed. Results and discussion Of the study population, 21 (37.5%) were female and 35 (62.5%) were male patients. No significant difference in above demographic characteristics was observed among exitus, survivor with progression and survivor without progression groups. Patients who responded favourably to erlotinib with no progression of their disease had significantly increased uric acid levels at 3‐month follow‐up (P = .01). Such a correlation was not observed if the patient was exitus (P = .47) or had progressed on erlotinib therapy (P = .19). What is new and conclusion In conclusion, this study is the first to demonstrate significant increases in serum uric acid levels in patients with metastatic NSCLC who responded favourably to erlotinib and had no progression under erlotinib therapy. Further studies are required to confirm and characterize serum uric acid as a novel biomarker in predicting the outcome in those with metastatic NSCLC.

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Uric acid as a potential mediator of cardiovascular morbidity in obstructive sleep apnea syndrome

Cited by 42 publications

References 28 publications

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

<p>Risk Factors For Hyperuricemia In Chinese Centenarians And Near-Centenarians</p>

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non‐small‐cell lung cancer

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