Effect of uric acid serum levels on carotid arterial stiffness and intima-media thickness: A high resolution Echo-Tracking Study

Abstract

Serum uric acid (UA) has been shown to be a predictor of cardiovascular (CV) morbidity and mortality, and it may play a role in the pathogenesis of CV disease affecting vascular structure and function. However, there is limited evidence of its specific association with carotid artery stiffness and structure. The aim of our study was to evaluate whether UA is associated with early signs of atherosclerosis, namely local carotid arterial stiffness and intima-media thickening. We evaluated 698 consecutive asymptomatic patients, referred to the Cardiovascular Department for risk factors evaluation and treatment. All patients underwent carotid artery ultrasonography with measurement of common carotid intima-media thickness (IMT) and echo-tracking carotid artery stiffness index Beta. Patients with hyperuricemia (defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women) had higher IMT (0.97±0.22 vs 0.91±0.18, p<0.001) and stiffness index Beta (8.3±3.2 vs 7.5±2.7, p=0.005). UA levels correlated with both IMT (r=0.225; p<0.001) and stiffness index Beta (r=0.154; p<0.001); the correlations were statistically significant in males and females. In a multivariate model which included age, arterial pressure, serum glucose and LDL-cholesterol, serum UA emerged as an independent explanatory variable of IMT and stiffness index Beta. Carotid IMT and local arterial stiffness are related to UA independently of established CV risk factors; UA may play a role in the early development of atherosclerosis.

Meta-analysis of the correlation between serum uric acid level and carotid intima-media thickness

“…Duplicate publications, lectures and review articles (n = 58), as well as articles that were not relevant to the subject and did not meet the inclusion criteria (n = 256), were excluded. The remaining 139 studies were screened after reading the full text, and 15 studies were included in the meta-analysis [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. The specific process is shown in Fig 1.…”

Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease

“…Uric acid (UA) is the end product of purine metabolism in humans, and approximately 70% of UA load is eliminated through the kidneys [ 7 ]. In the general population, hyperuricemia has been associated with many CV anomalies, including increased local arterial stiffness, carotid intima-media thickness, LVH, and atherosclerosis [ 8 , 9 , 10 , 11 , 12 ]. In patients with CKD, hyperuricemia has also been associated with many adverse CV outcomes, and high rates of CV events and CV mortality [ 13 , 14 , 15 ].…”

Carotid arterial stiffness and intima-media thickness: A little impact of uric acid

“…In the present issue of the Monaldi Archives of Chest Disease, Francesco Antonini-Canterin et al [21] report a study investigating the carotid ultrasound assessment of UA effect on carotid beta stiffness index (BSI) and intima-media thickness (CIMT). In a large sample of patients with high CV risk but no history of coronary artery disease, heart failure or cardiomyopathies, with normal or elevated UA levels, the authors found a significant correlation between UA levels and BSI and CIMT.…”