The Relationship of Sex Steroids to Uric Acid Levels in Plasma and Urine

Adamopoulos, Dionysios; Vlassopoulos, C.; Seitanides, B.; Contoyiannis, P A; Vassilopoulos, P.

doi:10.1530/acta.0.0850198

Cited by 99 publications

(73 citation statements)

References 4 publications

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Section: Discussionmentioning

confidence: 91%

“…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.…”

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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: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

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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“…Interestingly, postmenopausal Hmong women exhibited a greater prevalence of gout than premenopausal women (Figure 2). This is likely a reflection of the reduced exposure to estrogen, which enhances renal clearance of uric acid (33). Another potential factor that could lead to a greater prevalence of gout in this subgroup is the use of diuretics, which are known to lower uric acid clearance and consequently increase serum uric acid levels.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of gouty arthritis among the Hmong population in Minnesota

Portis¹,

Laliberte²,

Tatman³

et al. 2010

Arthritis Care & Research

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Objective. The prevalence of gout is on the rise worldwide, especially among newly industrialized populations. We evaluated the prevalence of gout in the recently established Hmong of Minneapolis/St. Paul (MSP) compared with that in non-Hmong populations. Methods. The prevalence of self-reported gout in the Hmong population was estimated from 2 cross-sectional community surveys and compared with national data extrapolated from the Third National Health and Nutrition Examination Survey. The prevalence of physician-diagnosed gout in Hmong and non-Hmong MSP residents was separately estimated from the diagnosis codes of 11 MSP primary care clinics. Results. The prevalence of self-reported gout among MSP Hmong was 2-fold higher than in the general US population (6.5% versus 2.9%; P < 0.001). Although women of both groups reported gout at a rate of 1.9%, Hmong men were significantly more likely than their non-Hmong counterparts to report gout (11.5% versus 4.1%; P < 0.001). Similar results were observed when investigating physician-diagnosed gout in MSP (2.8% Hmong versus 1.5% non-Hmong; P < 0.001). No difference was observed between the women of the 2 groups (0.8% versus 0.7%; P ‫؍‬ 0.833), whereas Hmong men were more than twice as likely to be diagnosed with gout compared with their non-Hmong counterparts (6.1% versus 2.5%; P < 0.001). Among Hmong men, advancing age was associated with a considerably higher likelihood of being diagnosed with gout. Conclusion. A significant association is observed between Hmong ethnicity and gout, both self-reported and physician diagnosed. This unique population may provide an opportunity to further our understanding of the pathophysiology of gout.

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“…19,20) It is also known that there is gender difference in the serum uric acid level, 21) for which uric acid clearance increased by estrogen has been reported to be a cause. 22) In other words, the uric acid transporter may be controlled by sex hormones. We now plan to carry out a further study identifying which constituent in the crude composition of FBEP was involved in mediating the serum uric acid-lowering effect, while paying attention to the organic anion transporter.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Fermented Barley Extract on Subjects with Slightly High Serum Uric Acid or Mild Hyperuricemia

Hokazono

Omori²,

Yamamoto³

et al. 2010

Bioscience, Biotechnology, and Biochemistry

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The uric acid-lowering effect and safety of a fermented barley extract P (FBEP) prepared from barleyshochu distillery by-products were investigated in a randomized, placebo-controlled, parallel-group, doubleblinded study. A total of 111 subjects with serum uric acid levels of 6.0-7.9 mg/dl were provided with either a drink containing 2 g/d of FBEP (test group) or a placebo drink. After 12 weeks, the serum uric acid levels changed by À0:21 AE 0:56 mg/dl in the test group, showing a significant decrease in comparison to those of the placebo group (þ0:02 AE 0:54 mg/dl). Additionally, the uric acid clearance in the test group showed a tendency to increase after 12 weeks more than in the placebo group (p ¼ 0:054). No abnormalities in the physical and clinical tests were observed, and no adverse diagnostic findings were attributed to the intake of the test meal. These results demonstrated the benefits and safety of the FBEP treatment to subjects with slightly high serum uric acid or mild hyperuricemia.Key words: barley; shochu distillery by-product; uric acid; hyperuricemiaThe number of cases in Japan of gout and its cause, hyperuricemia, have been increasing yearly as a result of the adoption of westernized and Americanized diets. Even though there have been few epidemiological studies, the incidences of gout and hyperuricemia have also been increasing worldwide with changes in environmental factors.1,2) The Japanese Society of Gout and Nucleic Acid Metabolism defines hyperuricemia as a condition with over 7.0 mg/dl of serum uric acid, irrespective of the gender and age. Hyperuricemia has been attracting attention not only as the underlying cause of gout, but also as an independent predictive factor in cardiac and cerebrovascular disorders. 3,4) Hyperuricemia is classified into 3 types: the increased production type, in which uric acid is excessively produced; the decreased excretion type, in which the capability for uric acid excretion is reduced due to decreased renal function; and the mixed type, which is a combination of both the above types. Eighty-five percent of all the cases of gout and hyperuricemia in Japan involve decreased excretion of uric acid from the kidney.5,6) It has been reported that chitosan, as a foodstuff, decreases serum uric acid by inhibiting the absorption of purine.7) However, it has not been reported that a foodstuff can effectively decrease serum uric acid in humans by accelerating the uric acid excretion.We have studied the effective application of shochu distillery by-products (SDB) and have reported the effects of a fermented barley extract (FBE) obtained from barley-SDB. The effects of FBE on preventing fatty liver induction by orotic acid, 8) preventing liver injury caused by D-galactosamine 9) and preventing alcohol-induced liver injury have been reported. 10)Additionally, in an exploratory open study, we have reported that supplementation with FBEP at a dose of 2 g/d reduced serum uric acid in subjects with slightly high serum uric acid or mild hyperuricemia.11) The present stud...

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The Relationship of Sex Steroids to Uric Acid Levels in Plasma and Urine

Cited by 99 publications

References 4 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

High prevalence of gouty arthritis among the Hmong population in Minnesota

Effects of a Fermented Barley Extract on Subjects with Slightly High Serum Uric Acid or Mild Hyperuricemia

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