High Serum Uric Acid Levels Are Associated with All‐Cause and Cardiovascular, but Not Cancer, Mortality in Elderly Adults

Wu, Chengyuan; Hu, Hsiao Yun; Chou, Yiing Jenq; Huang, Nicole; Chou, Y.C.; Lee, Meng Sui; Li, Chung Pin

doi:10.1111/jgs.13607

Cited by 33 publications

(32 citation statements)

References 39 publications

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“… 12 Uric acid (UA) can inhibit inflammatory cascades, reduce the permeability of the blood–brain barrier, and protect central nervous tissue. 13 Similar to the situation reported for cardiovascular disease, 14 hyperuricemia appears to be common in post-stroke patients and is suggestive of a better prognosis. 15 However, low SUA levels after ischemic stroke have also been reported in previous experimental data and were indicative of poor outcomes.…”

Section: Introductionsupporting

confidence: 62%

Changes of serum uric acid and total bilirubin in elderly patients with major postischemic stroke depression

Gao¹,

Wang²,

Han³

et al. 2017

NDT

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BackgroundThis was a longitudinal study which investigated the relationship between serum uric acid (SUA) and total bilirubin (Tbil) upon admission in elderly stroke patients and the occurrence of postischemic stroke depression (IPSD) at 3, 6, and 9 months of post-stroke follow-up.Subjects and methodsData were analyzed for 525 acute ischemic stroke patients. Beck Depression Inventory (BDI) scores >17 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were used separately to screen and diagnose IPSD at 3, 6, and 9 months post-stroke. Once IPSD was diagnosed, follow-up activities were terminated.ResultsHigh levels of SUA (odds ratio [OR]=2.08, P<0.01) and Tbil (OR=2.31, P<0.01) in the first 3 months post-stroke and low levels of SUA (OR=2.05, P=0.03) and Tbil (OR=2.79, P<0.01) from 3 to 6 months post-stroke were identified as risk factors for major IPSD. At 3 months, patients with SUA levels ≥406.5 μmol/L (males with SUA levels of ≥409.5 μmol/L and females with SUA levels ≥385.5 μmol/L) and Tbil levels ≥23.65 μmol/L were more likely to develop major IPSD. At 6 months, both SUA (area under curve [AUC]=0.625, P=0.005, cutoff =194.0 μmol/L) and Tbil (AUC=0.681, P=0.004, cutoff =6.75 μmol/L) had minor diagnostic values (AUC<0.700), although SUA levels ≤214.5 μmol/L (AUC=0.756, P=0.001) in female patients had a good diagnostic value (AUC=0.722, P=0.006) for major IPSD. At 9 months, major IPSD showed no statistical relationship with either SUA (χ2=2.33, P=0.13) or Tbil (χ2=0.41, P=0.84).ConclusionHigher levels of SUA and Tbil on admission were closely related to the occurrence of major IPSD within 3 months of stroke. Lower levels of these two biomarkers on admission were characteristic for the occurrence of major IPSD between 3 and 6 months post-stroke, while 6 months after stroke, there was no relationship between major IPSD and these two biomarkers.

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Section: Introductionsupporting

confidence: 62%

Changes of serum uric acid and total bilirubin in elderly patients with major postischemic stroke depression

Gao¹,

Wang²,

Han³

et al. 2017

NDT

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“…Coefficients of variation for uric acid determinations were <2.8% at 164 μmol/L (2.76 mg/dL), 2.3% at 470 μmol/L (7.90 mg/dL) and 1.8% at 624 μmol/L (10.49 mg/dL). Due to gender difference in serum uric acid levels [2, 20, 41, 42], we used sex-specific quartiles to classify levels of uric acid into four quartiles. Uric acid levels in men were grouped into quartile 1 (<281 μmol/L), quartile 2 (281-319 μmol/L), quartile 3 (319-362 μmol/L) and quartile 4 (≥362 μmol/L).…”

Section: Methodsmentioning

confidence: 99%

Circulating uric acid levels and subsequent development of cancer in 493,281 individuals: findings from the AMORIS Study

et al. 2017

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ObjectivesSerum uric acid has been suggested to be associated with cancer risk. We aimed to study the association between serum uric acid and cancer incidence in a large Swedish cohort.ResultsA positive association was found between uric acid levels and overall cancer risk, and results were similar with adjustment for glucose, triglycerides and BMI. Hazard ratio (HR) for overall cancer for the 4th quartile of uric acid compared to the 1st was 1.08 (95% CI: 1.05–1.11) in men and 1.12 (1.09 – 1.16) in women. Site-specific analysis showed a positive association between uric acid and risk of colorectal, hepatobiliary, kidney, non-melanoma skin, and other cancers in men and of head and neck and other cancers in women. An inverse association was observed for pulmonary and central nervous system (CNS) cancers in men and breast, lymphatic and haematological, and CNS malignancies in women.Materials and MethodsWe included 493,281 persons aged 20 years and older who had a measurement of serum uric acid and were cancer-free at baseline in the AMORIS study. Multivariable Cox proportional hazards regression was used to investigate sex-specific quartiles of serum uric acid in relation to cancer risk in men and women. Analysis was further adjusted for serum glucose, triglycerides and, where available, BMI. Site-specific analysis was performed for major cancers.ConclusionsAltered uric acid levels were associated with risk of overall and some specific cancers, further indicating the potential role of uric acid metabolism in carcinogenesis.

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“…In patients with hypertrophic cardiomyopathy, SUA is a significant predictor of adverse outcome [184]. Increased SUA was appointed as independent risk factor for overall mortality and CV mortality [185], [186]. The relationship between SUA and CV mortality is higher in the lowest and highest quintiles in both men and women [187].…”

Section: Uric Acid and Cardiovascular System (Cvs)mentioning

confidence: 99%

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

Din

Salem

Abdulazim

2017

Journal of Advanced Research

289

165

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High Serum Uric Acid Levels Are Associated with All‐Cause and Cardiovascular, but Not Cancer, Mortality in Elderly Adults

Abstract: High serum uric acid levels are associated with greater risk of all-cause and cardiovascular mortality but not cancer mortality in elderly adults. Further studies are warranted to investigate the prognostic implications and potential utility in the monitoring of therapy.

Cited by 33 publications

References 39 publications

Changes of serum uric acid and total bilirubin in elderly patients with major postischemic stroke depression

Changes of serum uric acid and total bilirubin in elderly patients with major postischemic stroke depression

Circulating uric acid levels and subsequent development of cancer in 493,281 individuals: findings from the AMORIS Study

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

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