Association between serum uric acid and cardiovascular risk in nonhypertensive and nondiabetic individuals: The Taiwan I-Lan Longitudinal Aging Study

Chun-Chin Chang, Cheng-Hsueh Wu, Li-Kuo Liu, Ruey-Hsing Chou, Chin-Sung Kuo, Po-Hsun Huang, Liang-Kung Chen, Shing-Jong Lin, Chun-Chin Chang, Cheng-Hsueh Wu, Li-Kuo Liu, Ruey-Hsing Chou, Chin-Sung Kuo, Po-Hsun Huang, Liang-Kung Chen, Shing-Jong Lin

Abstract

Serum uric acid level is a risk factor for cardiovascular disease (CVD). However, whether it is an independent risk factor or not remains controversial. We analyzed the association between serum uric acid level and cardiovascular risk. In total, 973 nonhypertensive and nondiabetic participants in the I-Lan Longitudinal Aging Study were eligible for this study. Subjects were divided into tertiles according to uric acid levels. The 10-year cardiovascular risk was calculated using Framingham risk score (FRS). Study subjects in the highest tertile of serum uric acid level were older, more likely to be male, and had higher systolic blood pressure, body mass index, carotid artery intima-media thickness and serum triglyceride, high-sensitivity C-reactive protein, and low-density lipoprotein cholesterol levels and lower serum high-density lipoprotein cholesterol levels (all p < 0.05). Subjects in the highest tertile had significantly higher FRS (p < 0.001). After adjusting for other risk factors, serum uric acid level remained associated significantly with the FRS (p < 0.05). In binary logistic regression analysis, the serum uric acid level was an independent predictive factor for high (≥20%) FRS (odds ratio 1.33, 95% confidence interval 1.10-1.68). These findings warrant attention to this cardiovascular risk factor in apparently healthy adults.

Conflict of interest statement

The authors declare no competing interests.

References

    1. Nieto FJ, Iribarren C, Gross MD, Comstock GW, Cutler RG. Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis. 2000;148:131–139. doi: 10.1016/S0021-9150(99)00214-2.
    1. Nishioka K, Mikanagi K. Hereditary and environmental factors influencing on the serum uric acid throughout ten years population study in Japan. Advances in experimental medicine and biology. 1980;122A:155–159. doi: 10.1007/978-1-4615-9140-5_25.
    1. Benedek TG. Correlations of serum uric acid and lipid concentrations in normal, gouty, and atherosclerotic men. Annals of internal medicine. 1967;66:851–861. doi: 10.7326/0003-4819-66-5-851.
    1. Steele TH, Oppenheimer S. Factors affecting urate excretion following diuretic administration in man. The American journal of medicine. 1969;47:564–574. doi: 10.1016/0002-9343(69)90187-9.
    1. Bonora E, et al. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity. 1996;20:975–980.
    1. Gertler MM, Garn SM, Levine SA. Serum uric acid in relation to age and physique in health and in coronary heart disease. Annals of internal medicine. 1951;34:1421–1431. doi: 10.7326/0003-4819-34-6-1421.
    1. Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. Jama. 2000;283:2404–2410. doi: 10.1001/jama.283.18.2404.
    1. Niskanen LK, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Archives of internal medicine. 2004;164:1546–1551. doi: 10.1001/archinte.164.14.1546.
    1. Puddu PE, et al. Serum uric acid and eGFR_CKDEPI differently predict long-term cardiovascular events and all causes of deaths in a residential cohort. International journal of cardiology. 2014;171:361–367. doi: 10.1016/j.ijcard.2013.12.029.
    1. Puddu PE, Schiariti M, Torromeo C. Gender and Cardiovascular Mortality in Northern and Southern European Populations. Current pharmaceutical design. 2016;22:3893–3904. doi: 10.2174/1381612822666160502153154.
    1. Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Annals of internal medicine. 1999;131:7–13. doi: 10.7326/0003-4819-131-1-199907060-00003.
    1. Moriarity JT, Folsom AR, Iribarren C, Nieto FJ, Rosamond WD. Serum uric acid and risk of coronary heart disease: Atherosclerosis Risk in Communities (ARIC) Study. Annals of epidemiology. 2000;10:136–143. doi: 10.1016/S1047-2797(99)00037-X.
    1. Wheeler JG, Juzwishin KD, Eiriksdottir G, Gudnason V, Danesh J. Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS medicine. 2005;2:e76. doi: 10.1371/journal.pmed.0020076.
    1. Choi YJ, et al. Uric acid induces endothelial dysfunction by vascular insulin resistance associated with the impairment of nitric oxide synthesis. FASEB journal: official publication of the Federation of American Societies for Experimental Biology. 2014;28:3197–3204. doi: 10.1096/fj.13-247148.
    1. Ho WJ, et al. Association between endothelial dysfunction and hyperuricaemia. Rheumatology. 2010;49(1929–1934):184.
    1. Chiu CC, et al. Association between previous history of gout attack and risk of deep vein thrombosis - a nationwide population-based cohort study. Scientific reports. 2016;6:26541. doi: 10.1038/srep26541.
    1. Canepa M, et al. Longitudinal Association Between Serum Uric Acid and Arterial Stiffness: Results From the Baltimore Longitudinal Study of Aging. Hypertension. 2017;69:228–235. doi: 10.1161/HYPERTENSIONAHA.116.08114.
    1. Hsu PF, et al. Associations of serum uric acid levels with arterial wave reflections and central systolic blood pressure. International journal of cardiology. 2013;168:2057–2063. doi: 10.1016/j.ijcard.2013.01.164.
    1. Zoppini G, et al. Elevated serum uric acid concentrations independently predict cardiovascular mortality in type 2 diabetic patients. Diabetes care. 2009;32:1716–1720. doi: 10.2337/dc09-0625.
    1. Liu LK, et al. Sarcopenia, and its association with cardiometabolic and functional characteristics in Taiwan: results from I-Lan Longitudinal Aging Study. Geriatrics & gerontology international. 2014;14(Suppl 1):36–45. doi: 10.1111/ggi.12208.
    1. D’Agostino RB, Sr., et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117:743–753. doi: 10.1161/CIRCULATIONAHA.107.699579.
    1. Chang CC, et al. Association between frailty and carotid intima media thickness and inflammatory marker in an elderly population. Geriatrics & gerontology international. 2017

Source: PubMed

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