Impact of the Serum Uric Acid Level on Subclinical Atherosclerosis in Middle-aged and Elderly Chinese

Abstract

Aim:The carotid intima-media thickness (CIMT) is now validated as a sensitive marker of atherosclerosis and is directly associated with an increased risk of cardiovascular disease. Considering that the independent association between the serum uric acid level and CIMT remains controversial due to the complex interrelationship with other known cardiovascular risk factors, further studies are needed. The aim of the present study is to explore the association between the serum uric acid level and CIMT in a general Chinese population and determine whether the association differs according to varied metabolic status. Methods: The present study was cross-sectional in design. A total of 10,281 community-based participants 40 years of age or older from Shanghai, China were included in the current analysis. All participants underwent a detailed questionnaire interview, anthropometric measurements and ultrasonography to assess the CIMT. Blood and urine samples were collected for the biochemical measurements. Results: The serum uric acid levels were positively associated with obesity-and diabetes-related parameters and the CIMT. In a logistic regression model controlling for potential confounders, compared with the participants in the first quartile of the uric acid level, those in the fourth quartile had a higher odds of an elevated CIMT in both men (odds ratio [OR] 1.37; 95% confidence interval [CI] 1.07-1.75) and women (OR 1.48; 95% CI 1.12-1.94). The subgroup analyses revealed that an association between an elevated CIMT and the serum uric acid level persisted regardless of diuretic use and the hypertension, diabetes mellitus and chronic kidney disease status. However, the association disappeared in the patients who consumed alcohol and in premenopausal women. Conclusions: The serum uric acid level is positively associated with an elevated CIMT in middleaged and elderly Chinese subjects, independent of known risk determinants of cardiovascular disease. J Atheroscler Thromb, 2015; 22: 823-832.

Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment

“…The prognosis of PAD is determined by complicated coronary heart disease and stroke 3–5) . Therefore, the present findings agree with the findings of recent studies that high serum uric acid levels are associated with increased cardiovascular disease mortality in Japanese men and women 25) and with subclinical atherosclerosis evaluated based on IMT in Chinese men and women 26) . Moreover, a recent clinical study demonstrated that serum uric acid levels are associated with coronary lipid-rich plaques in Japanese men and women 27) .…”

Asymptomatic hyperuricemia is independently associated with coronary artery calcification in the absence of overt coronary artery disease

“…The positive associations between serum UA levels and other surrogate markers of atherosclerosis have generally been validated in previous cross-sectional studies. [44–46] However, the results were not fully consistent depending on the measurement method and subgroup categories. Chen et al [46] suggests that there is a close association between serum UA level and atherosclerotic lesions regardless of the underlying comorbid conditions.…”

“…[44–46] However, the results were not fully consistent depending on the measurement method and subgroup categories. Chen et al [46] suggests that there is a close association between serum UA level and atherosclerotic lesions regardless of the underlying comorbid conditions. In contrast, several other studies have been more compatible with our results in that the relationship between serum UA level and atherosclerotic disease depends on underlying comorbidities.…”

Hyperuricemia as a Predictive Marker for Progression of Nephrosclerosis: Clinical Assessment of Prognostic Factors in Biopsy-Proven Arterial/Arteriolar Nephrosclerosis

“…Although the precise mechanism of the nephrotoxicity of HU has not been fully elucidated, recent data showed a direct harmful effect of UA on endothelial cells 59) and smooth muscle cells 60) . In humans, it has been reported that serum uric acid level is independently associated with an elevated carotid intimamedia thickness 61) . Therefore, UA injures renal vessels, which are the major lesion of arterial/arteriolar nephrosclerosis.…”