Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: Insights from the I-DEMAND study

F. Viazzi, D. Garneri, G. Leoncini, A. Gonnella, M. L. Muiesan, E. Ambrosioni, F. V. Costa, G. Leonetti, A. C. Pessina, B. Trimarco, M. Volpe, E. Agabiti Rosei, G. Deferrari, R. Pontremoli

Research output: Contribution to journalArticle

19 Citations (Scopus)

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) 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.

Original languageEnglish
Pages (from-to)921-927
Number of pages7
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume24
Issue number8
DOIs
Publication statusPublished - 2014

Fingerprint

Metabolic Syndrome X
Uric Acid
Hypertension
Serum
Chronic Renal Insufficiency
Kidney
Cardio-Renal Syndrome
Hyperuricemia
Albumins
Creatinine
Adenosine Triphosphate
Logistic Models
History
Regression Analysis
Population

Keywords

  • Cardiovascular risk
  • Chronic kidney disease
  • Hypertension
  • Metabolic syndrome
  • Uric acid

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension : Insights from the I-DEMAND study. / Viazzi, F.; Garneri, D.; Leoncini, G.; Gonnella, A.; Muiesan, M. L.; Ambrosioni, E.; Costa, F. V.; Leonetti, G.; Pessina, A. C.; Trimarco, B.; Volpe, M.; Agabiti Rosei, E.; Deferrari, G.; Pontremoli, R.

In: Nutrition, Metabolism and Cardiovascular Diseases, Vol. 24, No. 8, 2014, p. 921-927.

Research output: Contribution to journalArticle

Viazzi, F, Garneri, D, Leoncini, G, Gonnella, A, Muiesan, ML, Ambrosioni, E, Costa, FV, Leonetti, G, Pessina, AC, Trimarco, B, Volpe, M, Agabiti Rosei, E, Deferrari, G & Pontremoli, R 2014, 'Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: Insights from the I-DEMAND study', Nutrition, Metabolism and Cardiovascular Diseases, vol. 24, no. 8, pp. 921-927. https://doi.org/10.1016/j.numecd.2014.01.018
Viazzi, F. ; Garneri, D. ; Leoncini, G. ; Gonnella, A. ; Muiesan, M. L. ; Ambrosioni, E. ; Costa, F. V. ; Leonetti, G. ; Pessina, A. C. ; Trimarco, B. ; Volpe, M. ; Agabiti Rosei, E. ; Deferrari, G. ; Pontremoli, R. / Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension : Insights from the I-DEMAND study. In: Nutrition, Metabolism and Cardiovascular Diseases. 2014 ; Vol. 24, No. 8. pp. 921-927.
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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) 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.",
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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.

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AU - Deferrari, G.

AU - Pontremoli, R.

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