TY - JOUR
T1 - Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension
T2 - Insights from the I-DEMAND study
AU - Viazzi, F.
AU - Garneri, D.
AU - Leoncini, G.
AU - Gonnella, A.
AU - Muiesan, M. L.
AU - Ambrosioni, E.
AU - Costa, F. V.
AU - Leonetti, G.
AU - Pessina, A. C.
AU - Trimarco, B.
AU - Volpe, M.
AU - Agabiti Rosei, E.
AU - Deferrari, G.
AU - Pontremoli, R.
PY - 2014
Y1 - 2014
N2 - 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) 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.
AB - 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) 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.
KW - Cardiovascular risk
KW - Chronic kidney disease
KW - Hypertension
KW - Metabolic syndrome
KW - Uric acid
UR - http://www.scopus.com/inward/record.url?scp=84904719669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904719669&partnerID=8YFLogxK
U2 - 10.1016/j.numecd.2014.01.018
DO - 10.1016/j.numecd.2014.01.018
M3 - Article
C2 - 24675005
AN - SCOPUS:84904719669
VL - 24
SP - 921
EP - 927
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
SN - 0939-4753
IS - 8
ER -