Uric acid level as predictor of mortality in the acute care setting of advanced age population

Breuer, Gabriel S.; Schwartz, Y.; Freier‐Dror, Yossi; Nesher, Gideon

doi:10.1016/j.ejim.2017.07.021

Cited by 12 publications

(10 citation statements)

References 30 publications

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“…Hyperuricemia is also associated with cardiovascular disease and is a strong predictor of cardiovascular mortality (Anker et al, 2003;Kanbay et al, 2013;Niskanen et al, 2004;Zuo et al, 2016). Furthermore, hyperuricemia was identified as a predictor of mortality in acute care of hospitalized elderly patients (Breuer et al, 2017) and from several prospective studies as a risk factor for all-cause mortality (Niskanen et al, 2004;Zuo et al, 2016). Overall, this highlights that uric acid is associated with a range of metabolic and physiological disorders and potentially linked to human mortality as suggested by our study.…”

Section: Discussionsupporting

confidence: 68%

Sugar-Induced Obesity and Insulin Resistance Are Uncoupled from Shortened Survival in Drosophila

et al. 2020

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High-sugar diets cause thirst, obesity, and metabolic dysregulation, leading to diseases including type 2 diabetes and shortened lifespan. However, the impact of obesity and water imbalance on health and survival is complex and difficult to disentangle. Here, we show that high sugar induces dehydration in adult Drosophila, and water supplementation fully rescues their lifespan. Conversely, the metabolic defects are water-independent, showing uncoupling between sugar-induced obesity and insulin resistance with reduced survival in vivo. High-sugar diets promote accumulation of uric acid, an end-product of purine catabolism, and the formation of renal stones, a process aggravated by dehydration and physiological acidification. Importantly, regulating uric acid production impacts on lifespan in a water-dependent manner. Furthermore, metabolomics analysis in a human cohort reveals that dietary sugar intake strongly predicts circulating purine levels. Our model explains the pathophysiology of high-sugar diets independently of obesity and insulin resistance and highlights purine metabolism as a pro-longevity target.

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Section: Discussionsupporting

confidence: 68%

Sugar-Induced Obesity and Insulin Resistance Are Uncoupled from Shortened Survival in Drosophila

et al. 2020

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“…Yet, it is worth considering that only few studies have explored the association between SUA and mortality in older adults [14][15][16]. Most evidence refers to middle-aged individuals or subset of the older population, for example, diabetic or hospitalized older patients, and available data on older individuals are inconsistent [17][18][19][20]. Additionally, some results suggest a J-shaped relationship between SUA and mortality at old age, with a slight risk increase in the presence of low SUA levels [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

Ungar

Rivasi

Bari

et al. 2021

Journal of Hypertension

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Objectives:In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study.Methods:Eight thousand URRAH participants aged 65+ were included in the analysis. The predictive role of SUA was assessed using Cox regression models stratified according to the cut-off age of 75. SUA was tested as continuous and categorical variable (age-specific quartiles). The prognostic threshold of SUA for mortality was analysed using receiver operating characteristic curves.Results:Among participants aged 65–74, multivariate Cox regression analysis adjusted for CV risk factors and comorbidities identified an independent association of SUA with both all-cause mortality (hazard ratio [HR] 1.169, 95% confidence interval [CI] 1.107–1.235) and CV mortality (HR 1.146, 95% CI 1.064–1.235). The cut-off value of 4.8 mg/dl discriminated mortality status. In participants aged 75+, we observed a J-shaped relationship of SUA with all-cause and CV mortality, with risk increasing at extreme SUA levels.Conclusions:These results confirmed the predictive role of SUA for all-cause and CV mortality in older adults, while revealing considerable age-related differences. Mortality risk increased at higher SUA levels in participants aged 65–74, with a prognostic threshold of 4.8 mg/dl. The relationship between SUA and mortality was J-shaped in oldest participants. Large interventional studies are needed to clarify the benefits and possible risks of urate-lowering treatments in older adults.

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“…In a prospective cohort study, there is a significant correlation between serum uric acid and hospital mortality. The serum uric acid level of the dead patients was significantly higher than that of the surviving patients at discharge 39 . In another study, it was found that uric acid can be used as an independent predictor of mortality in hospitalized patients 40 .…”

Section: Discussionmentioning

confidence: 71%

Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

Liu

Zhong

Liu

2022

Sci Rep

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This study evaluated the relationship between hyperuricemia at admission and the clinical prognosis of patients with sepsis. The data were obtained from the Intensive Care Medical Information Database III. The patients were divided into a normal serum uric acid group and a hyperuricemia group. The main outcome was 90-day mortality, and the secondary outcomes were hospital mortality, 30-day mortality, and acute kidney injury. Propensity score matching was used to balance the baseline characteristics of the groups. Our study retrospectively included 954 patients. Before and after propensity score matching, the incidence of AKI, the 30-day and 90-day mortality rates were significantly higher in the hyperuricemia group. Cox regression analysis showed that hyperuricemia was significantly associated with 90-day mortality (HR 1.648, 95% CI 1.215–2.234, p = 0.006), and hyperuricemia was significantly associated with the incidence of AKI (HR 1.773, 95% CI 1.107–2.841, p = 0.017). The Kaplan–Meier survival curve showed that the 90-day survival rate was significantly lower in the hyperuricemia group. In patients with sepsis in the intensive care unit, hyperuricemia was significantly associated with increased risk 90-day all-cause mortality and the incidence of AKI.

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Uric acid level as predictor of mortality in the acute care setting of advanced age population

Cited by 12 publications

References 30 publications

Sugar-Induced Obesity and Insulin Resistance Are Uncoupled from Shortened Survival in Drosophila

Sugar-Induced Obesity and Insulin Resistance Are Uncoupled from Shortened Survival in Drosophila

The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

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