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      Epidemiological associations between hyperuricemia and cardiometabolic risk factors: a comprehensive study from Chinese community

      research-article
      , , ,
      BMC Cardiovascular Disorders
      BioMed Central
      Hyperuricemia, Cardiometabolic risk factor

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          Abstract

          Background

          This study aimed to assess the associations of serum uric acid (SUA) levels and hyperuricemia with cardiometabolic risk factors in a Chinese community-dwelling population.

          Methods

          A large cohort of 4706 residents was enrolled in this study. Physical examinations and laboratory tests were performed following a standardized protocol. Multiple linear and logistic regression analyses were conducted with adjustment of cardiometabolic risk factors including age, sex, body mass index (BMI), blood pressure (BP), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c) and fasting blood glucose (FBG) levels using SPSS version 17 software.

          Results

          The prevalence of hyperuricemia was 7.6 %. There were significant differences in age, BMI, BP, TG, HDL-c, LDL-c and FBG levels and the proportion of men between participants with and without hyperuricemia. Multiple linear regression analysis showed that SUA levels were positively associated with age, sex, BMI, BP, TG and LDL-c levels, but negatively associated with HDL-c and FBG levels. Multiple logistic regression analysis showed that per unit increase in age was associated with a 1.014 times higher odds of the presence of hyperuricemia. Men had a 1.858 times higher odds of the presence of hyperuricemia compared with women. Per unit increases in BMI, BP, TG and LDL-c levels were associated with 1.103, 1.016, 1.173 and 1.200 times higher odds of the presence of hyperuricemia, respectively. Per unit increases in HDL-c and FBG levels were associated with 0.616 and 0.900 times lower odds of the presence of hyperuricemia, respectively.

          Conclusions

          In a Chinese community-dwelling population, age, sex, BMI, BP, TG, HDL-c, LDL-c and FBG levels are cardiometabolic risk factors that are significantly associated with SUA levels, as well as the presence of hyperuricemia.

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          Most cited references16

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          Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study.

          Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain. To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from all causes. Community-based, prospective observational study. Framingham, Massachusetts. 6763 Framingham Heart Study participants (mean age, 47 years). Serum uricacid level at baseline (1971 to 1976); event rates per 1000 person-years by sex-specific uric acid quintile. During 117,376 person-years of follow-up, 617 coronary heart disease events, 429 cardiovascular disease deaths, and 1460 deaths from all causes occurred. In men, after adjustment for age, elevated serum uric acid level was not associated with increased risk for an adverse outcome. In women, after adjustment for age, uric acid level was predictive of coronary heart disease (P = 0.002), death from cardiovascular disease (P = 0.009), and death from all causes (P = 0.03). After additional adjustment for cardiovascular disease risk factors, uric acid level was no longer associated with coronary heart disease, death from cardiovascular disease, or death from all causes. In a stepwise Cox model, diuretic use was identified as the covariate responsible for rendering serum uric acid a statistically nonsignificant predictor of outcomes. These findings indicate that uric acid does not have a causal role in the development of coronary heart disease, death from cardiovascular disease, or death from all causes. Any apparent association with these outcomes is probably due to the association of uric acid level with other risk factors.
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            Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease.

            It is a matter of controversy as to whether uric acid is an independent predictor of mortality in patients with coronary artery disease (CAD) or whether it represents only an indirect marker of adverse outcome by reflecting the association between uric acid and other cardiovascular risk factors. Therefore, we studied the influence of uric acid levels on mortality in patients with CAD. In 1,017 patients with angiographically proven CAD, classic risk factors and uric acid levels were determined at enrollment. A follow-up over a median of 2.2 years (maximum 3.1) was performed. Death from all causes was defined as an end point of the study. In CAD patients with uric acid levels 433 micromol/L (7.1 mg/dl) (highest quartile), the mortality rate increased from 3.4% to 17.1% (fivefold increase). After adjustment for age, both sexes demonstrated an increased risk for death with increasing uric acid levels (female patients: hazard ratio [HR] 1.30, 95% confidence intervals [CI] 1.14 to 1.49, p < or = 0.001; male patients: HR 1.39 [95% CI 1.21 to 1.59], p < or = 0.001). In multivariate Cox regression analysis performed with 12 variables that influence overall mortality-including diuretic use-elevated levels of uric acid demonstrated an independent, significant positive relation to overall mortality (HR 1.23 [95% CI 1.11 to 1.36], p <0.001) in patients with CAD. Thus, uric acid is an independent predictor of mortality in patients with CAD.
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              Serum uric acid is a determinant of metabolic syndrome in a population-based study.

              Determination of serum uric acid concentrations and role in risk of metabolic syndrome (MS) were investigated in 1877 participants in a cross-sectional population-based study including a brief follow-up. The MS was identified by modified criteria of the Adult Treatment Panel III, and coronary heart disease (CHD) by clinical findings and Minnesota coding of resting electrocardiograms. Uric acid concentrations were measured by the uricase method. Metabolic syndrome was present in 39.1% of the cohort. Linear regression analysis of uric acid levels in a model comprising 13 variables identified gender, waist girth, total cholesterol (TC), alcohol usage, triglycerides, log C-reactive protein (CRP), and log gamma-glutamyl transferase (GGT), and in women diuretic use and elevated blood pressure (BP), as significant independent covariates whereby the largest contribution (1.6 mg/dL) was generated by waist girth. Logistic regression analysis of serum uric acid for MS disclosed for the top versus the bottom tertile an odds ratio (OR) of 1.89 (95% confidence interval [CI]: 1.45-2.46) in men and women combined, after adjustment for sex, age, TC, log CRP, log GGT, alcohol, and diuretic drug use, presence of diabetes/impaired fasting glucose, elevated BP, and smoking status. This corresponded to an increase by 35% in MS likelihood for each 1 SD uric acid increment. This rate declined to a significant 15% by inclusion of waist girth into the model. The OR of uric acid concentrations for prevalent and incident CHD, adjusted for age, MS, smoking, and diuretic use, was not significant among women and only tended toward significance in men. Abdominal obesity is the main determinant of uric acid variance. An increment of 1 SD in serum uric acid levels are associated in both sexes with a 35% higher MS likelihood, independent of 10 risk factors related to MS. After adjustment for waist girth, a more modest but significant likelihood persists, which suggests that serum uric acid is a determinant of MS.
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                Author and article information

                Contributors
                86-10-88626362 , lleim@sina.com
                86-10-88626362 , yeping301@sina.com
                Journal
                BMC Cardiovasc Disord
                BMC Cardiovasc Disord
                BMC Cardiovascular Disorders
                BioMed Central (London )
                1471-2261
                16 October 2015
                16 October 2015
                2015
                : 15
                : 129
                Affiliations
                [ ]Department of Geriatric Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, 100853 China
                [ ]Department of Cardiology and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, 100853 China
                Article
                116
                10.1186/s12872-015-0116-z
                4608157
                26475463
                ef4d6eab-4287-494d-bb4f-b4e5162f3ac5
                © Fu et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 December 2014
                : 30 September 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Cardiovascular Medicine
                hyperuricemia,cardiometabolic risk factor
                Cardiovascular Medicine
                hyperuricemia, cardiometabolic risk factor

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