Gender Differences for Uric Acid as Predictor of Hard Events in Patients Referred for Coronary Angiography

Vassalle, Cristina; Chatzianagnostou, Kyriazoula; Vannucci, Alessandro; Guiducci, Letizia; Battaglia, Debora; Maffei, Silvia; Arvia, C; Landi, Patrizia; Carpeggiani, Clara

doi:10.2217/bmm.16.5

Cited by 7 publications

(8 citation statements)

References 29 publications

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Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 98%

“…Accordingly, UA elevation has been associated to the reduction of NO, endothelial dysfunction, and stiffness of the arteries, hypertension, insulin resistance metabolic syndrome, and inflammation [ 38 ]. Moreover, UA levels increased with aging in both sexes [ 39 , 40 ]. Futhermore, UA has been related with the induction of platelet adhesiveness, smooth muscle cell proliferation, and association with coronary artery calcium levels [ 41 , 42 , 43 ].…”

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

“…Moreover, in view of the known association between hyperuricemia and insulin resistance and diabetes, the gender-specific difference in the association of UA with CVD risk may be compatible with the stronger relationship between UA and diabetes in women, given that diabetes confers a greater risk for CVD in women than in men [ 38 ]. Accordingly, we observed a stronger association between UA and diabetes in CAD females than in males, and a significant correlation between UA levels and fasting glucose and glycated hemoglobin only in women [ 40 ]. Nonetheless, although UA is more related with hard events (overall mortality and nonfatal myocardial infarction) in CAD female patients ( n = 843, UA cut off corresponding to 5.7 mg/dL; n = 2177, UA cut off 7 mg/dL for males), it does not seem to be an independent risk factors for hard events in both sexes [ 40 ].…”

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

“…Accordingly, we observed a stronger association between UA and diabetes in CAD females than in males, and a significant correlation between UA levels and fasting glucose and glycated hemoglobin only in women [ 40 ]. Nonetheless, although UA is more related with hard events (overall mortality and nonfatal myocardial infarction) in CAD female patients ( n = 843, UA cut off corresponding to 5.7 mg/dL; n = 2177, UA cut off 7 mg/dL for males), it does not seem to be an independent risk factors for hard events in both sexes [ 40 ]. Conversely, very recent data from two cohorts (general population of 15,083 participants in the Scottish Heart Health Extended Cohort Study, and in 13,273 CAD patients) confirmed a stronger association of UA and total mortality in female subjects than in men [ 57 , 58 ].…”

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

“…Specifically, UA can act as a pro-oxidant by generating free radicals during its degradation through xantine oxidase activity ( Figure 1 ). Moreover, UA results correlated with different inflammatory parameters in a general population of the InCHIANTI study and in CAD patients, although it is not clear whether UA could represent a marker of pro-inflammatory state rather than a cause of inflammation [ 40 , 63 ]. In this context, in vitro data suggest that UA induces monocyte apoptosis through the activation of both death receptor and mitochondrial-mediated pathways, and stimulates mononuclear cells to produce TNFα [ 64 ].…”

Section: Ua Role As Cvd Maker (Mr Hide) or Marker (Dr Jekyll)mentioning

confidence: 99%

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Uric Acid for Cardiovascular Risk: Dr. Jekyll or Mr. Hide?

et al. 2016

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Uric acid (UA) is a potent endogenous antioxidant. However, high concentrations of this molecule have been associated with cardiovascular disease (CVD) and renal dysfunction, involving mechanisms that include oxidative stress, inflammatory processes, and endothelial injury. Experimental and in vitro results suggest that this biomarker behaves like other antioxidants, which can shift from the physiological antioxidant action to a pro-oxidizing effect according to their level and to microenvironment conditions. However, data on patients (general population or CAD cohorts) are controversial, so the debate on the role of hyperuricemia as a causative factor for CVD is still ongoing. Increasing evidence indicates UA as more meaningful to assess CVD in women, even though this aspect needs deeper investigation. It will be important to identify thresholds responsible for UA “biological shift” from protective to harmful effects in different pathological conditions, and according to possible gender-related differences. In any case, UA is a low-tech and inexpensive biomarker, generally performed at patient’s hospitalization and, therefore, easily accessible information for clinicians. For these reasons, UA might represent a useful additive tool as much as a CV risk marker. Thus, in view of available evidence, progressive UA elevation with levels higher than 6 mg/dL could be considered an “alarm” for increased CV risk.

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Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 98%

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

Section: Uric Acid Cvd and Gender Issuesmentioning

confidence: 99%

Section: Ua Role As Cvd Maker (Mr Hide) or Marker (Dr Jekyll)mentioning

confidence: 99%

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Uric Acid for Cardiovascular Risk: Dr. Jekyll or Mr. Hide?

et al. 2016

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Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Jung

Chung

Yoo

et al. 2020

Euro J of Neurology

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Background and purpose As a major antioxidant, uric acid (UA) is known to be associated with the clinical progression of Parkinson’s disease (PD). This study investigated whether baseline UA levels are associated with the risk for levodopa‐induced dyskinesia (LID) in PD in a sex‐dependent manner. Methods In all, 152 patients with de novo PD (78 males and 74 females) who were followed up for >2 years were enrolled. The effect of baseline serum UA levels on LID‐free survival was assessed by Cox regression, separately for sex, whilst being adjusted for potential confounding factors. The optimal UA level cut‐off value to determine the high‐risk group for LID was set using Contal and O’Quigley’s method. Results Levodopa‐induced dyskinesia developed in 23 (29.5%) male patients and 30 (40.5%) female patients. Cox regression showed a significant interaction between UA level and sex. Higher UA levels were associated with a higher risk for LID in male PD patients (hazard ratio 1.380; 95% confidence interval 1.038–1.835; P = 0.027), although this relationship was not observed in female PD patients. The optimal UA level cut‐off for LID in male PD was 7.2 mg/dl, and the high UA group had a 5.7‐fold higher risk of developing LID than the low UA group. Conclusions Contrary to a presumptive beneficial role of UA, the present study demonstrated that higher UA levels are associated with increased risk of LID occurrence in male patients with PD, suggesting a sex‐dependent role of UA in LID.

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Gender-Related Association Between Uric Acid, Homocysteine, γ-Glutamyltransferase, Inflammatory Biomarkers and Metabolic Syndrome in Subjects Affected by Obesity

et al. 2017

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Gender Differences for Uric Acid as Predictor of Hard Events in Patients Referred for Coronary Angiography

Abstract: Hyperuricemia was not an independent risk for HE, and being correlated with antioxidant capacity, its elevation appears more likely compensatory than causative for HE.

Cited by 7 publications

References 29 publications

Uric Acid for Cardiovascular Risk: Dr. Jekyll or Mr. Hide?

Uric Acid for Cardiovascular Risk: Dr. Jekyll or Mr. Hide?

Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Gender-Related Association Between Uric Acid, Homocysteine, γ-Glutamyltransferase, Inflammatory Biomarkers and Metabolic Syndrome in Subjects Affected by Obesity

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