Relationship between Serum Uric Acid Concentration, Metabolic Syndrome and Carotid Atherosclerosis

Kawamoto, Ryuichi; Tomita, Hitomi; Oka, Yuichiro; Ohtsuka, Nobuyuki

doi:10.2169/internalmedicine.45.1661

Cited by 92 publications

(67 citation statements)

References 34 publications

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“…To date, a few studies have specifically evaluated the association of SUA and carotid atherosclerosis, with some reporting higher SUA levels to be associated with carotid atherosclerosis 20,22,23,26 , consistent with our findings, while others found no association 21,24,25 . Prior epidemiologic studies of hyperuricemia and adverse clinical cardiovascular outcomes have also been conflicting.…”

Section: Discussionsupporting

confidence: 90%

“…If hyperuricemia is indeed an independent risk factor for CVD, it might motivate a change in traditional treatment recommendations. [20][21][22][23][24][25][26] . Such conflicting results may in part be related to differences in analytic approaches and/or effectiveness of controlling for potential confounding.…”

Section: Nih Public Accessmentioning

confidence: 99%

“…This association was consistent regardless of the presence or absence of conditions that may be associated with both uric acid and carotid atherosclerosis. While the uricosuric effects of estrogen 35 and the lower likelihood of preclinical atherosclerotic disease in premenopausal women may account for lack of association noted among women, hyperuricemia appeared to be associated with a higher prevalence of carotid plaques among postmenopausal women (women ≥ age 55 yrs).To date, a few studies have specifically evaluated the association of SUA and carotid atherosclerosis, with some reporting higher SUA levels to be associated with carotid atherosclerosis 20,22,23,26 , consistent with our findings, while others found no association 21,24,25 . Prior epidemiologic studies of hyperuricemia and adverse clinical cardiovascular outcomes have also been conflicting.…”

mentioning

confidence: 99%

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Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Neogi

Ellison

Hunt³

et al. 2009

J Rheumatol

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Objective-To examine the association of serum uric acid (SUA) with a marker of preclinical cardiovascular disease (CVD), carotid atherosclerotic plaques (PLQ), where early evidence of risk may be evident, focusing on individuals without CV risk factors.Methods-The National Heart, Lung, and Blood Institute Family Heart Study is a multicenter study designed to assess risk factors for heart disease. PLQ were assessed with carotid ultrasound. We conducted sex-specific logistic regression to assess the association of SUA with presence of PLQ, including analyses among persons without risk factors related to both CVD and hyperuricemia.Results-In total, 4866 participants had both SUA and carotid ultrasound assessed (54% women, mean age 52 yrs, mean body mass index 27.6). The association of SUA with PLQ increased with increasing SUA levels, demonstrating a dose-response relation for men [OR 1.0, 1.29, 1.61, 1.75, for SUA categories < 5 (reference), 5 to < 6, 6 to < 6.8, ≥ 6.8 mg/dl, respectively; p = 0.002]. Similar associations were found in men without CV risk factors. We found no relation of SUA with PLQ in women. Studies examining the relation of hyperuricemia with cardiovascular disease (CVD) have had conflicting results. While many have found an independent association of higher serum uric acid (SUA) concentrations with increased risk of adverse cardiovascular outcomes 1-7 , others have not [8][9][10] . Biological mechanisms linking hyperuricemia to CVD risk exist, but direct effects of uric acid on the vasculature remain controversial 11,12 . Moreover, some have argued that the positive association between SUA and CVD may be due to the concurrent cardiovascular comorbidities seen in many persons with hyperuricemia, including diabetes, dyslipidemia, hypertension, and obesity [13][14][15] . Conclusion-In NIH Public AccessClarifying the relation of SUA to CVD risk has clinical implications and public health importance. First, there has been a secular increase in the incidence and prevalence of gout and hyperuricemia 16,17 . Second, asymptomatic hyperuricemia is presently not an indication for urate-lowering therapy. If hyperuricemia is indeed an independent risk factor for CVD, it might motivate a change in traditional treatment recommendations. [20][21][22][23][24][25][26] . Such conflicting results may in part be related to differences in analytic approaches and/or effectiveness of controlling for potential confounding.Further, prior studies have not examined SUA's effects in individuals who are free from comorbidities, which themselves can both increase SUA and increase risk for preclinical CVD. If SUA were associated with preclinical CVD in persons without any such comorbidities, it would constitute stronger evidence for SUA's association with CVD than has been presented in previous studies.We evaluated the association of SUA with carotid plaques in a large multicenter study, the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study, and further assessed these associations for the modifyi...

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Section: Discussionsupporting

confidence: 90%

Section: Nih Public Accessmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Neogi

Ellison

Hunt³

et al. 2009

J Rheumatol

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“…Patients with a history of upper abdominal surgery were excluded to avoid any possible effect on the measurement of fat thickness. Visceral obesity was shown as P max 6.9 mm in men or 10 mm in women (equal to visceral fat accumulation 100 cm 2 as measured by computed tomography [15][16][17][18] ).…”

Section: Ultrasound Image Analysismentioning

confidence: 99%

“…We applied condition-specific cutoff points for MetS based on the guidelines, with modifications, for the diagnosis of this condition in Japan 18) . MetS was defined as visceral obesity assessed by ultrasonography and at least two of the following three conditions: hypertension, dyslipidemia and impaired fasting glucose.…”

Section: Metsmentioning

confidence: 99%

Metabolic Syndrome may be a Risk Factor for Early Carotid Atherosclerosis in Women but not in Men

Kawamoto

Tomita

Inoue

et al. 2007

JAT

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Aim: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities and a predictor of both type 2 diabetes mellitus and adverse cardiovascular events. Whether there are gender differences in the association between early atherosclerosis and MetS has not yet been thoroughly elucidated. Methods: The subjects consisted of 388 men aged 64 16 years and 480 women aged 70 13 years. Early atherosclerosis was assessed by carotid intima-media thickness (IMT) on B-mode ultrasonography. Results: Carotid IMT values were significantly greater in both male (P 0.007) and female (P 0.002) subjects with MetS. After adjusting for established risk factors, the difference persisted on a significant level in women (P 0.003), but was weak in men (P 0.013). Multiple regression analysis using IMT as an objective variable, with adjustment for various risk factors as explanatory variables, showed that MetS (P 0.016) was a significant independent contributing factor along with known risk factors only in women. Among the components of MetS, hypertension (P 0.036) and dyslipidemia (P 0.008) had a strong impact on carotid IMT in men, whereas hypertension (P 0.003) ranked first in women. Conclusion: The effect of MetS in early carotid atherosclerosis is more pronounced in women than in men, and the impact of MetS components on carotid IMT differs between men and women.

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Association of serum uric acid with Pro12Ala polymorphism in PPAR-γ2 among Chinese nonagenarians/centenarians

Zhou,

Huang,

et al. 2012

Aging Clin Exp Res

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Relationship between Serum Uric Acid Concentration, Metabolic Syndrome and Carotid Atherosclerosis

Cited by 92 publications

References 34 publications

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

Metabolic Syndrome may be a Risk Factor for Early Carotid Atherosclerosis in Women but not in Men

Association of serum uric acid with Pro12Ala polymorphism in PPAR-γ2 among Chinese nonagenarians/centenarians

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