The Role of Urate in Cardiovascular Risk in Adolescents and Young Adults With Hypertension, Assessed by Pulse Wave Velocity

Abstract

BackgroundUrate is increasingly recognized as a cardiovascular risk factor. It has been associated with hypertension, metabolic syndrome, obesity, chronic kidney disease and diabetes. Its prognostic role is less clear. The aim of our study was to evaluate the association between serum urate and pulse wave velocity, a measure of arterial stiffness in hypertensive adolescents and young adults.Methods269 adolescents and young adults with hypertension were included in the study. From all, anthropometric, blood pressure, pulse wave velocity and serum urate measurements were made. Variables were compared between sex, participants with or without obesity and with or without elevated urate.ResultsIn multiple regression analysis for urate as dependent variable gender and diastolic pressure were found to be statistically significant. The difference between urate levels were found between boys and girls (p < 0.001), obese and non-obese (p < 0.001); however, pulse wave velocity did not differ between hyper- and eu-uricemic group (p = 0.162).ConclusionAssociations between urate, gender, diastolic blood pressure and obesity were confirmed, however, no significant associations between pulse wave velocity and urate were detected.

Uric acid and arterial stiffness in children and adolescents: Role of insulin resistance and blood pressure

“…In a sample of 188 adolescents affected by type 1 diabetes, no association could be observed between arterial stiffness and SUA values, suggesting that SUA seems not to be associated with vascular abnormalities in this clinical setting (48). Accordingly, Mocnik et al (49) did not find any associations between SUA and arterial stiffness in a cohort of 269 hypertensive adolescents and young adults at increased risk for subclinical atherosclerosis. In the Lytvyn et al study (47), the lack of association between SUA and PWV might be due to the stimulatory effect of urinary glucose on the GLUT9 in the proximal tubule which increases uric acid excretion in diabetes (50).…”

Combining body mass index and waist height ratio to assess the relationship between obesity and serum uric acid levels in adolescents

“…The reason for the gender difference in SUA between boys and girls during adolescence is that the SUA of boys increase sharply, while the SUA of girls remain relatively unchanged ( 26 ). Studies have shown that increased renal urate retention may be the main underlying mechanism of increased SUA ( 27 ). Adolescents have a progressive decline in renal fractional UA excretion and clearance, leading to increased UA retention ( 28 ).…”