F Viazzi1, D Garneri2, G Leoncini2, A Gonnella2, M L Muiesan3, E Ambrosioni4, F V Costa4, G Leonetti5, A C Pessina6, B Trimarco7, M Volpe8, E Agabiti Rosei3, G Deferrari2, R Pontremoli2. 1. Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy. Electronic address: francesca.viazzi@unige.it. 2. Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy. 3. Department of Internal Medicine, University of Brescia, Brescia, Italy. 4. Department of Internal Medicine, University of Bologna, Bologna, Italy. 5. Istituto Auxologico Italiano, Ospedale S. Luca, Milan, Italy. 6. Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy. 7. Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy. 8. Cardiology Division, Department of Clinical and Molecular Medicine, University of Rome 'Sapienza', Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy.
Abstract
BACKGROUND AND AIMS: The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensive patients with a high prevalence of diabetes. METHODS AND RESULTS: A total of 2429 patients (mean age 62 ± 11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73 m(2) or as the presence of microalbuminuria (albumin-to-creatinine ratio ≥2.5 mg/mmol in men and ≥3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respectively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95% CI 1.03-1.18; P = 0.0060; OR 1.28, 95% CI 1.15-1.42; P < 0.0001). These associations were stronger in patients without diabetes and with normal renal function. CONCLUSIONS: Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensive patients under specialist care. Intervention trials are needed to investigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk.
BACKGROUND AND AIMS: The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensivepatients with a high prevalence of diabetes. METHODS AND RESULTS: A total of 2429 patients (mean age 62 ± 11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73 m(2) or as the presence of microalbuminuria (albumin-to-creatinine ratio ≥2.5 mg/mmol in men and ≥3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respectively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95% CI 1.03-1.18; P = 0.0060; OR 1.28, 95% CI 1.15-1.42; P < 0.0001). These associations were stronger in patients without diabetes and with normal renal function. CONCLUSIONS: Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensivepatients under specialist care. Intervention trials are needed to investigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk.
Authors: Kimber L Stanhope; Valentina Medici; Andrew A Bremer; Vivien Lee; Hazel D Lam; Marinelle V Nunez; Guoxia X Chen; Nancy L Keim; Peter J Havel Journal: Am J Clin Nutr Date: 2015-04-22 Impact factor: 7.045
Authors: L Liu; Y Gu; C Li; Q Zhang; G Meng; H Wu; H Du; H Shi; Y Xia; X Guo; X Liu; X Bao; Q Su; L Fang; F Yu; H Yang; B Yu; S Sun; X Wang; M Zhou; Q Jia; Q Guo; K Song; G Huang; G Wang; K Niu Journal: J Hum Hypertens Date: 2016-07-28 Impact factor: 3.012
Authors: Francesca Viazzi; Barbara Bonino; Elena Ratto; Salvatore De Cosmo; Roberto Pontremoli Journal: High Blood Press Cardiovasc Prev Date: 2014-08-01