1
|
Britto-Júnior J, Furlaneto R, Lima AT, de Oliveira MG, Severino B, Frecentese F, Fiorino F, Caliendo G, Muscará MN, De Nucci G. GKT137831 and hydrogen peroxide increase the release of 6-nitrodopamine from the human umbilical artery, rat-isolated right atrium, and rat-isolated vas deferens. Front Pharmacol 2024; 15:1348876. [PMID: 38645555 PMCID: PMC11026650 DOI: 10.3389/fphar.2024.1348876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/01/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction: The human umbilical artery (HUA), rat-isolated right atrium, and rat-isolated vas deferens present a basal release of 6-nitrodopamine (6-ND). The basal release of 6-ND from these tissues was significantly decreased (but not abolished) when the tissues were pre-incubated with Nω-nitro-L-arginine methyl ester (L-NAME). Methods: In this study, the effect of the pharmacological modulation of the redox environment on the basal release of 6-ND was investigated. The basal release of 6-ND was measured using Liquid chromatography with tandem mass spectrometry (LC-MS/MS). Results and Discussion: Pre-incubation (30 min) of the tissues with GKT137831 (1 μM) caused a significant increase in the basal release of 6-ND from all tissues. In the HUA, pre-incubation with diphenyleneiodonium (DPI) (100 μM) also caused significant increases in the basal release of 6-ND. Preincubation of the HUA with hydrogen peroxide (H2O2) (100 μM) increased 6-ND basal release, whereas pre-incubation with catalase (1,000 U/mL) significantly decreased it. Pre-incubation of the HUA with superoxide dismutase (SOD) (250 U/mL; 30 min) also significantly increased the basal release of 6-ND. Preincubation of the HUA with either allopurinol (100 μM) or uric acid (1 mM) had no effect on the basal release of 6-ND. Pre-treatment of the HUA with L-NAME (100 μM) prevented the increase in the basal release of 6-ND induced by GKT137831, diphenyleneiodonium, and H2O2. The results obtained indicate a major role of endogenous H2O2 and peroxidases as modulators of 6- ND biosynthesis/release and a lack of peroxynitrite contribution.
Collapse
Affiliation(s)
- José Britto-Júnior
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Rafael Furlaneto
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- Department of Pharmacology, Faculty of Medicine, Sao Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Antonio Tiago Lima
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Beatrice Severino
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Frecentese
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Ferdinando Fiorino
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Caliendo
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marcelo Nicolás Muscará
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), Sāo Paulo, Brazil
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), Sāo Paulo, Brazil
- Department of Pharmacology, Faculty of Medicine, Sao Leopoldo Mandic, Campinas, São Paulo, Brazil
| |
Collapse
|
2
|
Curaj A, Vanholder R, Loscalzo J, Quach K, Wu Z, Jankowski V, Jankowski J. Cardiovascular Consequences of Uremic Metabolites: an Overview of the Involved Signaling Pathways. Circ Res 2024; 134:592-613. [PMID: 38422175 DOI: 10.1161/circresaha.123.324001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The crosstalk of the heart with distant organs such as the lung, liver, gut, and kidney has been intensively approached lately. The kidney is involved in (1) the production of systemic relevant products, such as renin, as part of the most essential vasoregulatory system of the human body, and (2) in the clearance of metabolites with systemic and organ effects. Metabolic residue accumulation during kidney dysfunction is known to determine cardiovascular pathologies such as endothelial activation/dysfunction, atherosclerosis, cardiomyocyte apoptosis, cardiac fibrosis, and vascular and valvular calcification, leading to hypertension, arrhythmias, myocardial infarction, and cardiomyopathies. However, this review offers an overview of the uremic metabolites and details their signaling pathways involved in cardiorenal syndrome and the development of heart failure. A holistic view of the metabolites, but more importantly, an exhaustive crosstalk of their known signaling pathways, is important for depicting new therapeutic strategies in the cardiovascular field.
Collapse
Affiliation(s)
- Adelina Curaj
- Institute of Molecular Cardiovascular Research, RWTH Aachen University, Germany (A.C., K.Q., Z.W., V.J., J.J.)
| | - Raymond Vanholder
- Department of Internal Medicine and Pediatrics, Nephrology Section, University Hospital, Ghent, Belgium (R.V.)
| | - Joseph Loscalzo
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (J.L.)
| | - Kaiseng Quach
- Institute of Molecular Cardiovascular Research, RWTH Aachen University, Germany (A.C., K.Q., Z.W., V.J., J.J.)
| | - Zhuojun Wu
- Institute of Molecular Cardiovascular Research, RWTH Aachen University, Germany (A.C., K.Q., Z.W., V.J., J.J.)
| | - Vera Jankowski
- Institute of Molecular Cardiovascular Research, RWTH Aachen University, Germany (A.C., K.Q., Z.W., V.J., J.J.)
| | - Joachim Jankowski
- Institute of Molecular Cardiovascular Research, RWTH Aachen University, Germany (A.C., K.Q., Z.W., V.J., J.J.)
- Experimental Vascular Pathology, Cardiovascular Research Institute Maastricht, University of Maastricht, the Netherlands (J.J.)
- Aachen-Maastricht Institute for Cardiorenal Disease, RWTH Aachen University, Aachen, Germany (J.J.)
| |
Collapse
|
3
|
Oncel Yoruk E, Dost FS, Ontan MS, Ates Bulut E, Aydin AE, Isik AT. Hyperuricemia may be associated with muscle wellness in older adults. Int Urol Nephrol 2023; 55:2981-2988. [PMID: 37029327 DOI: 10.1007/s11255-023-03588-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Sarcopenia, associated with morbidity and mortality, is a common geriatric syndrome in older adults. In this study, we investigated the relationship between uric acid, which is a powerful antioxidant and has intracellular proinflammatory activity, and sarcopenia in older adults. METHODS This is a cross-sectional retrospective study involving a total of 936 patients. The diagnosis of sarcopenia was evaluated based on the EGWSOP 2 criteria. The patients were divided into two groups according to hyperuricemia (for females > 6 mg/dl, for males > 7 mg/dl); hyperuricemia and control. RESULTS The frequency of hyperuricemia was 65.40%. Patients with hyperuricemia were older than the control group and female gender frequency was higher (p = 0.001, p < 0.001, respectively). Sarcopenia was negatively associated with hyperuricemia as a result of the adjustment analysis made according to demographic characteristics, comorbidities, laboratory results, malnutrition, and malnutrition risk. (p = 0.034). Besides, muscle mass and muscle strength were associated with hyperuricemia (p = 0.026 and p = 0.009, respectively). CONCLUSIONS Considering the positive effect of hyperuricemia on sarcopenia, avoiding aggressive uric acid-lowering therapy may be a good option in older adults with asymptomatic hyperuricemia.
Collapse
Affiliation(s)
- Eda Oncel Yoruk
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatma Sena Dost
- Department of Geriatric Medicine, Kocaeli Darica Farabi Training and Research Hospital, Kocaeli, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Mehmet Selman Ontan
- Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Esra Ates Bulut
- Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Ali Ekrem Aydin
- Department of Geriatric Medicine, Sivas State Hospital, Sivas, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Ahmet Turan Isik
- Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
- Geriatric Science Association, Izmir, Turkey.
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| |
Collapse
|
4
|
Su XF, Chen X, Zhang T, Song JM, Liu X, Xu XL, Fan N. A risk model for the early diagnosis of acute myocardial infarction in patients with chronic kidney disease. Front Cardiovasc Med 2023; 10:1253619. [PMID: 37881722 PMCID: PMC10597667 DOI: 10.3389/fcvm.2023.1253619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/22/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction Acute myocardial infarction (AMI) remains a critical disease, characterized by a high fatality rate in several countries. In clinical practice, the incidence of AMI is increased in patients with chronic kidney disease (CKD). However, the early diagnosis of AMI in the above group of patients is still poor. Methods In the present study, a total of 829 patients with CKD, defined by an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73 m2 or 60-90 ml/min/1.73 m2 for patients with mildly reduced kidney function, who attended the Sichuan Provincial People's Hospital (SPPH) between January 2018 and November 2022 were enrolled. All patients underwent coronary angiography due to the presence of typical or atypical symptoms of AMI. Patients were divided into the following two groups: The training cohort, including 255 participants with AMI and 242 without AMI; and the testing cohort, including 165 and 167 subjects with and without AMI, respectively. Furthermore, a forward stepwise regression model and a multivariable logistic regression model, named SPPH-AMI-model, were constructed to select significant predictors and assist the diagnosis of AMI in patients with CKD, respectively. Results The following factors were evaluated in the model: Smoking status, high sensitivity cardiac troponin I, serum creatinine and uric acid levels, history of percutaneous coronary intervention and electrocardiogram. Additionally, the area under the curve (AUC) of the receiver operating characteristic curve were determined in the risk model in the training set [AUC, 0.78; 95% confidence interval (CI), 0.74-0.82] vs. the testing set (AUC, 0.74; 95% CI, 0.69-0.79) vs. the combined set (AUC, 0.76; 95% CI, 0.73-0.80). Finally, the sensitivity and specificity rates were 71.12 and 71.21%, respectively, the percentage of cases correctly classified was 71.14%, while positive and negative predictive values of 71.63 and 70.70%, respectively, were also recorded. Discussion The results of the current study suggested that the SPPH-AMI-model could be currently considered as the only risk scoring system for the early diagnosis of AMI in patients with CKD. This method could help clinicians and emergency physicians to quickly and accurately diagnose AMI in patients with CKD to promote the immediate and effective treatment of these patients.
Collapse
Affiliation(s)
- Xiao-Feng Su
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xu Chen
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Zhang
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun-Mei Song
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xin Liu
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xing-Li Xu
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Na Fan
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
5
|
Gharib AF, Nafea OE, Alrehaili AA, Almalki A, Alharthi A, Alsalmi O, Alsaeedi FA, Alhazmi A, Allahyani M, Etewa RL, Alsulimani AH, Badr SO. Association Between Serum Uric Acid Levels and Oxido-Inflammatory Biomarkers With Coronary Artery Disease in Type 2 Diabetic Patients. Cureus 2023; 15:e47913. [PMID: 38034261 PMCID: PMC10683838 DOI: 10.7759/cureus.47913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Cardiovascular disease signifies a major cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). Serum uric acid (SUA) levels are elevated during the initial phases of impaired glucose metabolism. This work was designed to explore the association between SUA levels, serum oxido-inflammatory biomarkers, and the risk of coronary artery disease (CAD) in T2DM patients as the primary outcome. The secondary outcome was to assess the prognostic role of SUA in the prediction of the risk of CAD in T2DM patients. METHODS In this case-control study, we enrolled 110 patients with T2DM who were further divided into patients with CAD and without CAD. In addition, 55 control participants were stringently matched to cases by age. RESULTS Diabetic patients with CAD had significantly higher serum levels of the inflammatory biomarkers and the oxidative malondialdehyde but significantly lower levels of serum total antioxidant capacity (TAC) compared with the controls and diabetic patients without CAD. Significant positive correlations existed between SUA levels and serum levels of the inflammatory biomarkers and malondialdehyde, while a significant negative correlation existed between SUA levels and serum TAC. SUA demonstrated an accepted discrimination ability. SUA can differentiate between T2DM patients with CAD and patients without CAD, an area under the curve of 0.759. CONCLUSIONS Elevated serum levels of SUA and oxido-inflammatory biomarkers are associated with an increased risk of CAD in T2DM. SUA levels reflect the body's inflammatory status and oxidant injury in T2DM. SUA could be utilized as a simple biomarker in the prediction of CAD risk in T2DM.
Collapse
Affiliation(s)
- Amal F Gharib
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Ola E Nafea
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, SAU
| | - Amani A Alrehaili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Abdulraheem Almalki
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Afaf Alharthi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Ohud Alsalmi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Fouzeyyah A Alsaeedi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Ayman Alhazmi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Mamdouh Allahyani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Rasha L Etewa
- Department of Pathology, College of Medicine, Jouf University, Sakaka, SAU
| | - Alaa H Alsulimani
- Department of Laboratory, King Faisal Medical Complex (KFMC) and Research Center, Taif, SAU
| | - Sara O Badr
- Department of Internal Medicine, Faculty of Medicine, Port Said University, Port Said, EGY
| |
Collapse
|
6
|
Toprak K, Yılmaz R, Kaplangoray M, Memioğlu T, İnanır M, Akyol S, Özen K, Biçer A, Demirbağ R. Comparison of the effect of uric acid/albumin ratio on coronary colleteral circulation with other inflammation-based markers in stable coronary artery disease patients. Perfusion 2023:2676591231202105. [PMID: 37674333 DOI: 10.1177/02676591231202105] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND The Uric acid/Albumin ratio (UAR) has recently been identified as a prominent marker in cardiovascular diseases. In this study, we aimed to reveal the effect of UAR on coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD) patients by comparing it with conventional inflammation-based markers. METHODS In this study, 415 consecutive patients who underwent coronary angiography for stable angina pectoris and were found to have chronic total occlusion in at least one coronary artery were retrospectively included. The study population was divided into two groups as good CCC (Rentrop 2-3) and poor CCC (Rentrop 0-1) according to the Rentrop classification, and the groups were compared in terms of UAR and other traditional inflammation-based markers. RESULTS In the poor CCC group, C-reactive protein/albumin ratio (CAR), monocyte/high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and UAR were found to be significantly high (p < .05, for all). UAR negatively correlated with rentrop classification (r = -0.383, p < .001). In multivariate regression analysis, MHR, NLR, SII and UAR were determined as independent predictors for poor CCC (p < .05, for all). The ability of UAR to predict poor CCC was superior to uric acid and albumin alone (p < .0001, for both). In addition, UAR was found to be superior to other inflammation-based markers in predicting poor CCC (p < .005, for all). CONCLUSION UAR was identified as a strong and independent predictor of CCC. In this context, UAR may be a useful biomarker in the risk prediction of patients with stable CAD.
Collapse
Affiliation(s)
- Kenan Toprak
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Rüstem Yılmaz
- Faculty of Medicine, Department of Cardiology, Samsun University, Samsun, Turkey
| | - Mustafa Kaplangoray
- Medical Faculty, Department of Cardiology, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Medical Faculty, Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Medical Faculty, Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Selahattin Akyol
- Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, İstanbul, Turkey
| | - Kaya Özen
- Department of Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
| | - Asuman Biçer
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| |
Collapse
|
7
|
Cheng J, Lyu Y, Mei Y, Chen Q, Liu H, Li Y. Serum growth differentiation factor-15 and non-esterified fatty acid levels in patients with coronary artery disease and hyperuricemia. Lipids Health Dis 2023; 22:31. [PMID: 36864452 PMCID: PMC9979416 DOI: 10.1186/s12944-023-01792-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND High serum NEFA and GDF-15 are risk factors for CAD and have been linked to detrimental cardiovascular events. It has been hypothesized that hyperuricemia causes CAD via the oxidative metabolism and inflammation. The current study sought to clarify the relationship between serum GDF-15/NEFA and CAD in individuals with hyperuricemia. METHODS Blood samples collected from 350 male patients with hyperuricemia(191 patients without CAD and 159 patients with CAD, serum UA > 420 μmol/L) to measure serum GDF-15 and NEFA concentrations with baseline parameters. RESULTS Serum circulating GDF-15 concentrations(pg/dL) [8.48(6.67,12.73)] and NEFA levels(mmol/L) [0.45(0.32,0.60)] were higher in hyperuricemia patients with CAD. Logistic regression analysis revealed that the OR (95% CI) for CAD were 10.476 (4.158, 26.391) and 11.244 (4.740, 26.669) in quartile 4 (highest) respectively. The AUC of the combined serum GDF-15 and NEFA was 0.813 (0.767,0.858) as a predictor of whether CAD occurred in male with hyperuricemia. CONCLUSIONS Circulating GDF-15 and NEFA levels correlated positively with CAD in male patients with hyperuricemia and measurements may be a useful clinical adjunct.
Collapse
Affiliation(s)
- Jingru Cheng
- grid.412632.00000 0004 1758 2270Department of Clinical Laboratory,institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yongnan Lyu
- grid.412632.00000 0004 1758 2270Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yufeng Mei
- grid.412632.00000 0004 1758 2270Department of Clinical Laboratory,institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Chen
- grid.412632.00000 0004 1758 2270Department of Clinical Laboratory,institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hang Liu
- grid.412632.00000 0004 1758 2270Department of Clinical Laboratory,institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory,institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China.
| |
Collapse
|
8
|
Hagino T, Saeki H, Fujimoto E, Kanda N. Effects of Biologic Therapy on Laboratory Indicators of Cardiometabolic Diseases in Patients with Psoriasis. J Clin Med 2023; 12:jcm12051934. [PMID: 36902720 PMCID: PMC10004419 DOI: 10.3390/jcm12051934] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Psoriasis is associated with cardiometabolic and cardiovascular diseases. Biologic therapy targeting tumor necrosis factor (TNF)-α, interleukin (IL)-23, and IL-17 may improve not only psoriasis but also cardiometabolic diseases. We retrospectively evaluated whether biologic therapy improved various indicators of cardiometabolic disease. Between January 2010 and September 2022, 165 patients with psoriasis were treated with biologics targeting TNF-α, IL-17, or IL-23. The patients' body mass index; serum levels of HbA1c, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, triglyceride (TG), and uric acid (UA); and systolic and diastolic blood pressures were recorded at weeks 0, 12, and 52 of the treatment. Baseline psoriasis area and severity index (week 0) positively correlated with TG and UA levels but negatively correlated with HDL-C levels, which increased at week 12 of IFX treatment compared to those at week 0. UA levels decreased at week 12 after ADA treatment compared with week 0. HDL-C levels decreased 52 weeks after IXE treatment. In patients treated with TNF-α inhibitors, HDL-C levels increased at week 12, and UA levels decreased at week 52, compared to week 0. Thus, the results at two different time points (at weeks 12 and 52) were inconsistent. However, the results still indicated that TNF-α inhibitors may improve hyperuricemia and dyslipidemia.
Collapse
Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai 270-1694, Japan
- Correspondence: ; Tel.: +81-476-99-1111
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Eita Fujimoto
- Fujimoto Dermatology Clinic, Funabashi 274-0063, Japan
| | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai 270-1694, Japan
| |
Collapse
|
9
|
Zamani B, Golabchi A, Ghadakkar N, Motedayyen H. C-reactive protein and uric acid roles in distinguishing ST-segment elevation myocardial infarction from non-ST-elevation acute coronary syndrome. J Immunoassay Immunochem 2023; 44:66-75. [PMID: 36073558 DOI: 10.1080/15321819.2022.2119866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Acute coronary syndrome (ACS) is defined as a range of conditions which the blood flow to the heart was reduced or stopped. This disorder is correlated to a systemic inflammatory response and some biochemical factors. Therefore, the aim of this study was investigations of serum C-reactive protein (CRP) and uric acid levels in ST-segment elevation myocardial infarction (STEMI) and non-ST-elevation ACS (NSTE ACS), as common subtypes of ACS. Patients with ACS (n = 140) were assessed with coronary arteriography and divided into STEMI and NSTE ACS groups. The serum levels of hs-CRP and uric acid were investigated using a routine clinical chemistry analyzer. Patients with STEMI showed a significant increase in uric acid level compared to those with NSTE ACS (P < .0001). Other data indicated that hs-CRP level in patients with STEMI was significantly higher than individuals with NSTE ACS (P < .0001). Modeling analysis revealed that the increased levels of acid uric and hs-CRP in patients with STEMI were independent of the effects of age, gender, background diseases, and familial history (P < .001). The current study provides further evidence to indicate that hs-CRP and uric acid may be considered as biofactors for comparing STEMI from NSTE ACS and determining disease outcome.
Collapse
Affiliation(s)
- Batool Zamani
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Allahyar Golabchi
- The Advocate Center for Clinical Research, Ayatollah Yasrebi Hospital, Kashan, Iran
| | - Nasrin Ghadakkar
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
10
|
Lu Y, Wang J, An Y, Liu J, Wang Y, Wang G, Leng S. Impaired sensitivity to thyroid hormones is associated with hyperuricemia in a Chinese euthyroid population. Front Endocrinol (Lausanne) 2023; 14:1132543. [PMID: 37152966 PMCID: PMC10154591 DOI: 10.3389/fendo.2023.1132543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Objective Impaired sensitivity to thyroid hormones has been reported as a common metabolic disorder, and it remains poorly understood whether it interplays with uric acid (UA) metabolism as an established risk factor for cardiovascular diseases (CVDs). We aimed to investigate the relationship between thyroid hormone sensitivity and elevated UA in a Chinese euthyroid population. Methods A total of 15,955 euthyroid subjects were included in this study. Thyroid hormone sensitivity indices were calculated, including the thyroid feedback quantile-based index (TFQI), the Chinese-referenced parametric TFQI (PTFQI), the TSH index (TSHI), and the thyrotropin thyroxine resistance index (TT4RI), and the FT3/FT4 ratio. Linear and logistic regression analyses were performed to detect the association between thyroid hormone sensitivity and elevated UA. Results Subjects with reduced sensitivity to thyroid hormones had increased UA levels in both genders (p for trend < 0.001). Logistic and linear regression analyses showed that higher TFQI, PTFQI, TSHI, and TT4RI were positively associated with elevated UA levels, but negatively associated with the FT3/FT4 ratio. The odds ratio (OR) of the highest versus the first quartile of TFQI was 1.20 (1.05, 1.38) in men and 1.80 (1.46, 2.23) in women (p < 0.001). PTHQI, TSHI, and TT4RI obtained similar results in both genders. Conversely, the highest quartile of the FT3/FT4 ratio was negatively correlated with elevated UA levels [men: OR 0.78 (0.68,0.89), women: OR 0.66 (0.53,0.81)]. Conclusion Impaired sensitivity to thyroid hormones was associated with elevated UA levels in euthyroid subjects. Our findings shed light on the role of thyroid hormone sensitivity in UA metabolism.
Collapse
Affiliation(s)
- Yingning Lu
- Health Management Center, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jie Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yu An
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Song Leng
- Health Management Center, The Second Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Song Leng,
| |
Collapse
|
11
|
Hyperuricemia and Endothelial Function: Is It a Simple Association or Do Gender Differences Play a Role in This Binomial? Biomedicines 2022; 10:biomedicines10123067. [PMID: 36551823 PMCID: PMC9775568 DOI: 10.3390/biomedicines10123067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
The endothelium plays a fundamental role in the biological processes that ensure physiological vessel integrity, synthesizing numerous substances that are capable of modulating the tone of vessels, inflammation and the immune system, and platelet function. Endothelial dysfunction refers to an anomaly that develops at the level of the tunica that lines the internal surface of arterial and venous vessels, or, more precisely, an alteration to normal endothelial function, which involves the loss of some structural and/or functional characteristics. Studies on sex differences in endothelial function are conflicting, with some showing an earlier decline in endothelial function in men compared to women, while others show a similar age of onset between the sexes. Since increased cardiovascular risk coincides with menopause, female hormones, particularly estrogen, are generally believed to be cardioprotective. Furthermore, it is often proposed that androgens are harmful. In truth, these relationships are more complex than one might think and are not just dependent on fluctuations in circulating hormones. An increase in serum uric acid is widely regarded as a possible risk factor for cardiovascular disease; however, its role in the occurrence of endothelial dysfunction has not yet been elucidated. Several studies in the literature have evaluated sex-related differences in the association between elevated uric acid levels and cardiovascular events, with conflicting results. The association between uric acid and cardiovascular disease is still controversial, and it is not yet clear how gender differences affect the serum concentration of these substances. This review was primarily aimed at clarifying the effects of uric acid at the level of the vascular endothelium and describing how it could theoretically cause damage to endothelial integrity. The second aim was to determine if there are gender differences in uric acid metabolism and how these differences interact with the vascular endothelium.
Collapse
|
12
|
Copur S, Demiray A, Kanbay M. Uric acid in metabolic syndrome: Does uric acid have a definitive role? Eur J Intern Med 2022; 103:4-12. [PMID: 35508444 DOI: 10.1016/j.ejim.2022.04.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 12/25/2022]
Abstract
Increased serum uric acid (SUA) levels are commonly seen in patients with metabolic syndrome and are widely accepted as risk factors for hypertension, gout, non-alcoholic fatty liver disease, chronic kidney disease (CKD), and cardiovascular diseases. Although some ambiguity for the exact role of uric acid (UA) in these diseases is still present, several pathophysiological mechanisms have been identified such as increased oxidative stress, inflammation, and apoptosis. Accumulating evidence in genomics enlightens genetic variabilities and some epigenetic changes that can contribute to hyperuricemia. Here we discuss the role of UA within metabolism and the consequences of asymptomatic hyperuricemia while providing newfound evidence for the associations between UA and gut microbiota and vitamin D. Increased SUA levels and beneficial effects of lowering SUA levels need to be elucidated more to understand its complicated function within different metabolic pathways and set optimal target levels for SUA for reducing risks for metabolic and cardiovascular diseases.
Collapse
Affiliation(s)
- Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
| |
Collapse
|
13
|
Yang F, Lu Y, Chen S, Wang K, Hu T, Cui H. Sex-specific effect of serum urate levels on coronary heart disease and myocardial infarction prevention: A Mendelian randomization study. Nutr Metab Cardiovasc Dis 2022; 32:1266-1274. [PMID: 35197211 DOI: 10.1016/j.numecd.2022.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Observational studies have examined serum urate levels in relation to coronary heart disease (CHD) and myocardial infarction (MI). Whether these associations are causal remains controversial, due to confounding factors and reverse causality. We aim to investigate the causality of these associations using Mendelian randomization method. METHODS AND RESULTS Instrumental variables were obtained from the largest genome-wide association studies of serum urate (457,690 individuals) to date. Summary statistics were from CARDIoGRAMplusC4D consortium (60,801 CHD cases; 43,676 MI cases), FinnGen (21,012 CHD cases; 12,801 MI cases), UK Biobank (10,157 CHD cases; 7018 MI cases), and Biobank Japan (29,319 CHD cases). Inverse-variance weighted method was applied as the main results. Other statistical methods and reverse MR analysis were conducted in the supplementary analyses. Elevated genetically determined serum urate levels were associated with increased risks of CHD and MI. The association pattern remained for the datasets in FinnGen, the combined results of three independent data sources (CHD: odds ratio (OR), 1.10; 95%CI, 1.06-1.15; p = 4.2 × 10-6; MI: OR, 1.12; 95%CI, 1.07-1.18; p = 2.7 × 10-6), and East Asian population. Interestingly, sex-specific subgroup analyses revealed that these associations kept in men only, but not among women in individuals of European ancestry. No consistent evidence was found for the causal effect of CHD or MI on serum urate levels. CONCLUSION We provide consistent evidence for the causal effect of genetically predicted serum urate levels on CHD and MI, but not the reverse effect. Urate-lowering therapy may be of cardiovascular benefit in the prevention of CHD and MI, especially for men.
Collapse
Affiliation(s)
- Fangkun Yang
- Department of Cardiology, Ningbo Hospital of Zhejiang University (Ningbo First Hospital), School of Medicine, Zhejiang University, Ningbo, Zhejiang, China
| | - Yunlong Lu
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Songzan Chen
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kai Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Teng Hu
- School of Medicine, Ningbo University, Ningbo, China
| | - Hanbin Cui
- Cardiology Center, Ningbo First Hospital, Ningbo University, Ningbo, Zhejiang, China.
| |
Collapse
|
14
|
De Luca L, Gulizia MM, Gabrielli D, Meessen J, Mattei L, D'Urbano M, Colivicchi F, Temporelli PL, Borghi C, Desideri G. Impact of serum uric acid levels on cardiovascular events and quality of life in patients with chronic coronary syndromes: Insights from a contemporary, prospective, nationwide registry. Nutr Metab Cardiovasc Dis 2022; 32:393-401. [PMID: 34893417 DOI: 10.1016/j.numecd.2021.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/05/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Hyperuricemia is a metabolic disorder that has been associated with adverse cardiovascular (CV) events. Using the data from a nationwide, prospective registry on patients with chronic coronary syndromes (CCS), we assessed the impact of serum uric acid (SUA) levels on quality of life (QoL) and major adverse CV events (MACE), a composite of CV death and hospitalization for myocardial infarction, heart failure (HF), angina or revascularization at 1-year. METHODS AND RESULTS Among the 5070 consecutive CCS patients enrolled in the registry, levels of SUA were available for 2394 (47.2%). Patients with SUA levels available at baseline were grouped as low tertile (n = 860; 4.3 [3.7-4.7] mg/dL), middle tertile (n = 739; 5.6 [5.3-5.9] mg/dL) and high tertile (n = 795; 7.1 [6.7-7.9] mg/dL). At 1 year, the incidence of MACE was 3.7%, 4.1% and 6.8% for low, middle and high tertiles, respectively (p = 0.005 for low vs high tertile). Patients in the high tertile of SUA had a significantly higher rate of CV mortality (1.4% vs 0.4%; p = 0.05) and hospital admission for HF (2.8% vs 1.6%; p = 0.03) compared to the low tertile. However, hyperuricemia did not result as an independent predictor of MACE at multivariable analysis [hazard ratio: 1.27; 95% confidence intervals: 0.81-2.00; p = 0.3]. CONCLUSIONS In this contemporary, large cohort of CCS, those in the high tertile of SUA had a greater burden of CV disease and worse QoL. However, SUA did not significantly influence the higher rate of CV mortality, hospitalization for HF and MACE observed in these patients during 1-year follow-up.
Collapse
Affiliation(s)
- Leonardo De Luca
- Department of Cardiosciences, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
| | | | - Domenico Gabrielli
- Department of Cardiosciences, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Jennifer Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Luisa Mattei
- Division of Cardiology, Ospedale Monfalcone-Gorizia, Italy
| | | | | | - Pier L Temporelli
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno, Novara, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|
15
|
Cheng F, Li Y, Zheng H, Tian L, Jia H. Mediating Effect of Body Mass Index and Dyslipidemia on the Relation of Uric Acid and Type 2 Diabetes: Results From China Health and Retirement Longitudinal Study. Front Public Health 2022; 9:823739. [PMID: 35155363 PMCID: PMC8831836 DOI: 10.3389/fpubh.2021.823739] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022] Open
Abstract
ObjectiveThis study assessed temporal relationships of serum uric acid (SUA) with blood glucose and determine the mediating effects of body mass index (BMI) and dyslipidemia on the relation of SUA and risk of type 2 diabetes.MethodsParticipants aged ≥ 45 years were participated in 2011 and followed up until 2015. Cox proportional hazards regression with a robust variance estimator was performed to explore the association of SUA with the risk of diabetes, and crosslagged path analysis was introduced to examine the temporal relationships between SUA and blood glucose. A mediation analysis was finally used to identify the mediating effect of BMI and dyslipidemia on the relation of SUA and the future risk of diabetes.ResultsA total of 9,020 participants were included with an average age of 58.59 years at baseline in 2011, and 53.6% of them were women. Linear dose–response relationship was identified by restricted spline cubic analysis between baseline SUA and follow-up blood glucose (the non-linear trend for fasting plasma glucose (FPG): β2 = −0.71, p = 0.52; for HbA1c: β2 = 0.05, p = 0.07; for risk of diabetes: β2 = 0.12, p = 0.39). Additionally, compared with the lowest quartiles of SUA, the adjusted risk ratios of diabetes were 1.00 (95% CI: 0.82–1.23), 1.08 (95% CI: 0.89–1.31), and 1.37 (95% CI: 1.11–1.96) for quartile 2–4 (p-trend < 0.01), respectively. Further additional adjustments for BMI or dyslipidemia, these ratios were not statistically significant. In addition, a unidirectional relationship from baseline SUA to follow-up FPG (ρ1 = 0.24, p = 0.03) was further confirmed using crosslagged path analysis. After stratifying by genders, the above results were only significant in the women subgroup, and we thus conducted a mediation analysis in women and found that the BMI and dyslipidemia partially mediated the effect of SUA on diabetes with a 23.05 and 18.82% mediating effect, respectively.ConclusionsThese findings provide strong evidence that hyperuricemia preceded diabetes, and the effect of baseline SUA on follow-up type 2 diabetes was more pronounced among middle-aged and elderly Chinese women, especially in postmenopausal women, and this effect is partly mediated by BMI and dyslipidemia at baseline.
Collapse
Affiliation(s)
- Fang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanzhi Li
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Han Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lu Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongying Jia
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Hongying Jia
| |
Collapse
|
16
|
Miyazaki S, Hamada T, Sugihara S, Mizuta E, Endo Y, Ohtahara A, Komatsu K, Kuwabara M, Fukuuchi T, Kaneko K, Ichida K, Ogino K, Ninomiya H, Yamamoto K, Nakamura T, Hisatome I. Xanthinuria Type 1 with a Novel Mutation in Xanthine Dehydrogenase and a Normal Endothelial Function. Intern Med 2022; 61:1383-1386. [PMID: 35491177 PMCID: PMC9152847 DOI: 10.2169/internalmedicine.7897-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Whether or not extremely low levels of serum uric acid (SUA) in xanthinuria are associated with impairment of the endothelial function and exercise-induced acute kidney injury (EIAKI) is unclear. A 59-year-old woman without EIAKI or urolithiasis had undetectable levels of UA in serum and urine and elevated levels of hypoxanthine and xanthine in urine. A genetic analysis revealed homozygous mutations in the XDH gene [c.1585 C>T (p. Gln529*)]. Flow-mediated dilation was within the normal range. This is the first report of a case with extremely low levels of SUA, xanthinuria with novel mutations of xanthine dehydrogenase (XDH) and a normal endothelial function.
Collapse
Affiliation(s)
| | - Toshihiro Hamada
- Department of Community-Based Family Medicine, Tottori University, Faculty of Medicine, Japan
| | | | | | - Yusuke Endo
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Japan
| | | | - Koji Komatsu
- Department of Psychiatry Disease, Tottori University, Japan
| | | | - Tomoko Fukuuchi
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University, Japan
| | - Kiyoko Kaneko
- Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Japan
| | - Kimiyoshi Ichida
- Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Japan
| | - Kazuhide Ogino
- Department of Cardiology, Japanese Red Cross Tottori Hospital, Japan
| | - Haruaki Ninomiya
- Department of Biological Regulation, Tottori University Faculty of Medicine, Japan
| | - Kazuhiro Yamamoto
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Japan
| | | | - Ichiro Hisatome
- Department of Cardiovascular Medicine, Yonago Medical Center, Japan
| |
Collapse
|
17
|
Myke-Mbata B, Meludu S, Mba I, Okwara J, Olisah M. Evaluation of uric acid as a biomarker for cardiovascular disease risk stratification among patients with type 2 diabetes mellitus. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_113_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
|
18
|
Michael OS, Bamidele O, Ogheneovo P, Ariyo TA, Adedayo LD, Oluranti OI, Soladoye EO, Adetunji CO, Awobajo FO. Watermelon rind ethanol extract exhibits hepato-renal protection against lead induced-impaired antioxidant defenses in male Wistar rats. Curr Res Physiol 2021; 4:252-259. [PMID: 34841269 PMCID: PMC8607130 DOI: 10.1016/j.crphys.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/14/2021] [Accepted: 11/10/2021] [Indexed: 10/28/2022] Open
Abstract
Lead acetate associated tissue injury has been linked to altered antioxidant defenses, hyperuricemia and inflammation. We hypothesized that watermelon rind extract, would ameliorate lead acetate-induced hepato-renal injury. Thirty Male Wistar rats received distilled water, lead acetate (Pb; 5 mg/kg) with or without watermelon rind extract (WM; 400 mg/kg; WM + Pb; 15 days of WM pretreatment); Pb + WM (15 days of WM post treatment) and simultaneous treatment (WM-Pb) for 30 days. Lead toxicity led to elevated serum malondialdehyde, creatinine, urea, uric acid, lactate dehydrogenase, liver injury enzymes, as well as decreased body weight. Decreased serum levels of reduced glutathione, nitric oxide, total protein and glutathione peroxidase activity was also observed. However, these alterations were ameliorated by watermelon rind extract in lead acetate-treated rats. Watermelon rind ethanol extract protects against lead acetate-induced hepato-renal injury through improved antioxidant defenses at least in part, via uric acid/nitric oxide-dependent pathway signifying the health benefits of this agricultural waste and a potential for waste recycling while limiting environmental pollution.
Collapse
Key Words
- ALP, Alkaline Phosphatase
- ALT, Alanine Transferase
- AST, Aspartate Transaminase
- GPx, Glutathione Peroxidase
- GSH, Reduced Glutathione
- LDH, Lactate Dehydrogenase
- Lead acetate
- MDA, Malondialdehyde
- Nitric oxide
- Oxidative stress
- Pb, Lead Acetate
- Uric acid
- WM, Watermelon rind extract
- Watermelon
- rpm, revolutions per minute
Collapse
Affiliation(s)
- Olugbenga S Michael
- Cardiometabolic Research Unit, Department of Physiology, Bowen University, Iwo, Nigeria
| | - Olubayode Bamidele
- Department of Physiology, College of Health Science, Bowen University, Iwo, Nigeria
| | - Pamela Ogheneovo
- Department of Physiology, College of Health Science, Bowen University, Iwo, Nigeria
| | - Temitope A Ariyo
- Department of Physiology, College of Health Science, Bowen University, Iwo, Nigeria
| | - Lawrence D Adedayo
- Department of Physiology, College of Health Science, Bowen University, Iwo, Nigeria
| | - Olufemi I Oluranti
- Department of Physiology, College of Health Science, Bowen University, Iwo, Nigeria
| | | | - Charles O Adetunji
- Microbiology, Biotechnology and Nanotechnology Laboratory, Department of Microbiology Edo University Iyamho, Edo State, Nigeria
| | - Funmileyi O Awobajo
- Department of Physiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| |
Collapse
|
19
|
Amiya E. Link between hyperuricemia, renal dysfunction, and hypertension. J Clin Hypertens (Greenwich) 2021; 23:2078-2079. [PMID: 34806304 PMCID: PMC8696238 DOI: 10.1111/jch.14389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Therapeutic Strategy for Heart Failure, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
20
|
Zhao Z, Zhao Y, Zhang Y, Shi W, Li X, Shyy JYJ, He M, Wang L. Gout-induced endothelial impairment: The role of SREBP2 transactivation of YAP. FASEB J 2021; 35:e21613. [PMID: 33977576 DOI: 10.1096/fj.202100337r] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022]
Abstract
Gout is a multifaceted inflammatory disease involving vascular impairments induced by hyperuricemia. Experiments using human umbilical vein endothelial cells treated with uric acid (UA), monosodium urate (MSU), or serum from gout patients showed increased expression of pro-inflammatory genes (ie, VCAM1, ICAM1, CYR61, CCNA1, and E2F1) with attendant increase in monocyte adhesion. Mechanistically, UA- or MSU-induced SREBP2 expression and its transcriptional activity. RNA sequencing analysis and real-time PCR showed the induction of YAP signaling and pro-inflammatory pathways in HUVECs transfected with adenovirus-SREBP2. The SREBP2 knockdown by siRNA partially abolished UA- or MSU-induced YAP activity, pro-inflammatory gene expression, and monocytes adhesion. Vascular intima from transgenic mice overexpressing SREBP2 in endothelium or mice with hyperuricemia exhibited activated YAP signaling and increased expression of pro-inflammatory genes. Betulin, an SREBP pharmacological inhibitor, attenuated the UA-, MSU-, or gout serum-induced endothelial cell inflammation and dysfunction. In the human study, endothelial cell function, assessed by EndoPAT, was negatively correlated with serum UA level among gouty patients and healthy controls. Collectively, UA or MSU causes endothelial dysfunction via SREBP2 transactivation of YAP. Betulin inhibition of SREBP2 may restrain gout-induced endothelial dysfunction.
Collapse
Affiliation(s)
- Zunlan Zhao
- Department of General Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Yingshuai Zhao
- Department of General Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuqing Zhang
- Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Weili Shi
- Department of General Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiqing Li
- Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - John Y-J Shyy
- Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Ming He
- Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Liuyi Wang
- Department of General Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
21
|
Association between Uric Acid and In-Hospital Heart Failure in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention. DISEASE MARKERS 2021; 2021:7883723. [PMID: 34306257 PMCID: PMC8285207 DOI: 10.1155/2021/7883723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 12/03/2022]
Abstract
Objective To investigate the association of serum uric acid levels with in-hospital heart failure (HF) in patients with acute myocardial infarction (AMI) who are undergoing percutaneous coronary intervention (PCI). Methods Two hundred sixteen patients with AMI who were treated with PCI were enrolled in our study. Univariate and multivariate logistic regression analyses were performed to estimate the associations between uric acid levels and the risk of in-hospital HF in AMI patients. Analyses of the areas under the receiver operating characteristic (ROC) curve were performed to determine the accuracy of uric acid levels in predicting in-hospital HF. Results A dose-response relationship was found for the incidence of in-hospital HF and levels of uric acid, showing increased HF from the lowest to the highest tertile of uric acid. Compared with subjects in the bottom tertile, the adjusted odds ratio for in-hospital HF was 1.92 (95% CI 0.70–5.24) and 3.33 (95% CI 1.18-9.46) in the second tertile group and the third tertile group, respectively. Every 1 mg/dl increase in the serum uric acid level was associated with a 1.60-fold increased risk of incident in-hospital HF (OR, 1.60; 95% CI 1.22–2.11; P = 0.001). ROC curve analysis showed that the optimal cut-off value of uric acid to predict in-hospital HF was 5.75 mg/dl with a sensitivity of 69.2% and specificity of 56.3%. Conclusions Our study showed that the serum uric acid level on admission is an independent predictor of in-hospital heart failure in patients with AMI.
Collapse
|
22
|
Xu H, Liu Y, Meng L, Wang L, Liu D. Effect of Uric Acid-Lowering Agents on Patients With Heart Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Front Cardiovasc Med 2021; 8:639392. [PMID: 34046437 PMCID: PMC8144321 DOI: 10.3389/fcvm.2021.639392] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/29/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Elevated serum uric acid (SUA) level is considered an independent predictor of all-cause mortality and the combined endpoint of death or readmission in cardiovascular disease patients. However, the causal relationship between uric acid-lowering therapies (ULTs) and heart failure is still controversial. Design: Meta-analyses were performed to systematically compile available evidence to determine the overall effect of ULTs on heart failure patients. Method: We conducted this systematic review following the PRISMA statement guidelines. Databases were searched to identify randomised controlled trials related to the influence of a ULT intervention in people with heart failure. Data extracted from the included studies were subjected to a meta-analysis to compare the effects of ULTs to a control. Results: Pooled analysis of left ventricular ejection fraction (LEVF) showed an insignificant result towards the ULT group (MD, 1.63%; 95%CI, −1.61 to 4.88; p = 0.32; three studies). Pooled analysis of the 6-Minute Walk Test (6MWT) showed an insignificant result towards the ULT group (MD, 4.59; 95%CI, −12.683 to 22.00; p = 0.61; four studies). Pooled analysis of BNP/NT-pro-BNP led to a nearly statistically significant result towards the ULT group (SMD, −0.30; 95%CI, −0.64 to 0.04; p = 0.08; five studies). Pooled analysis of all-cause mortality and cardiovascular death between ULTs (all XOIs) and placebo did not show a significant difference (RR, 1.26; 95% CI, 0.74 to 2.15, p = 0.39). Conclusion: ULTs did not improve LVEF, BNP/NT-pro-BNP, 6MWT, all-cause mortality, and CV death in heart failure patients. UA may just be a risk marker of heart failure.
Collapse
Affiliation(s)
- Hongxuan Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunqing Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Li Wang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Departments of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.,Peking University Health Science Centre, Peking University Fifth School of Clinical Medicine, Beijing, China
| |
Collapse
|
23
|
Erdem B, Gok M. Evaluation of the Effects of Intravitreal Aflibercept and Ranibizumab on Systemic Inflammatory and Cardiovascular Biomarkers in Patients with Neovascular Age-related Macular Degeneration. Curr Eye Res 2021; 46:1387-1392. [PMID: 33471564 DOI: 10.1080/02713683.2021.1879868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To investigate the effects of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) on systemic inflammatory and cardiovascular biomarkers in treatment-naive patients with neovascular age-related macular degeneration (nAMD)Methods: This study included 24 eyes of 24 patients treated with 0.5 mg ranibizumab (IVR group) and 25 eyes of 25 patients treated with 2.0 mg aflibercept (IVA group). Complete blood count, C-reactive protein (CRP), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), uric acid (UA), albumin, fibrinogen levels were measured in blood samples before and after the three-monthly loading dose treatment. Neutrophil/lymphocyte ratio (NLR), monocyte/HDL-c ratio (MHR), CRP/albumin ratio (CAR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) were also calculated.Results: A statistically significant decline was determined in post-treatment CRP (P = .002), LDL-c (P < .001) levels, white blood cell (WBC, P = .001), neutrophil (P < .001), monocyte (P = .019) counts and NLR (P = .020), MHR (P = .042), CAR (P = .010) ratios comparing with pre-treatment values in the IVA group. No statistically significant change was found in any of the parameters evaluated in the study in the IVR group. Also, there was no significant change in fibrinogen, lymphocyte count, MLR, HDL-c, UA, PLR, and platelet count values in both groups.Conclusion: Compared to IVR, IVA treatment had a small but significant effect on systemic inflammatory and cardiovascular biomarkers.
Collapse
Affiliation(s)
- Burak Erdem
- Department of Ophthalmology, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Mustafa Gok
- Department of Ophthalmology, Private Atanur Eye Hospital, Isparta, Turkey
| |
Collapse
|
24
|
Si K, Wei C, Xu L, Zhou Y, Lv W, Dong B, Wang Z, Huang Y, Wang Y, Chen Y. Hyperuricemia and the Risk of Heart Failure: Pathophysiology and Therapeutic Implications. Front Endocrinol (Lausanne) 2021; 12:770815. [PMID: 34867815 PMCID: PMC8633872 DOI: 10.3389/fendo.2021.770815] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/15/2021] [Indexed: 12/12/2022] Open
Abstract
The association between hyperuricemia and cardiovascular disease (CVD) has been reported and studied in the past two decades. Xanthine oxidase (XO) induced uric acid (UA) serves as a risk factor and has the independent prognostic and functional impact of heart failure (HF), but whether it plays a positive role in the pathogenesis of HF has remained unclear. Growing evidence suggest the up-regulated XO avtivity and increased production of free oxygen radical (ROS) correspondingly are the core pathogenesis of HF with hyperuricemia, which results in a whole cluster of pathophysiologic cardiovascular effects such as oxidative stress, endothelial dysfunction, vascular inflammation, left ventricular (LV) dysfunction as well as insulin resistance (IR). The use of XO inhibition represents a promising therapeutic choice in patients with HF due to its dual effect of lowering serum UA levels as well as reducing ROS production. This review will discuss the pathophysiologic mechanisms of hyperuricemia with HF, the targeted therapeutic interventions of UA lowering therapies (ULT) with XO inhibition and mechanism underlying beneficial effects of ULT. In addition, the review also summarizes current evidence on the role of ULT in HF and compares CV risk between allopurinol and febuxostat for practical and clinical purposes. Guidelines and implementation of CV risk management in daily practice will be discussed as well.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ying Chen
- *Correspondence: Yangang Wang, ; Ying Chen,
| |
Collapse
|
25
|
Yu W, Cheng JD. Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective. Front Pharmacol 2020; 11:582680. [PMID: 33304270 PMCID: PMC7701250 DOI: 10.3389/fphar.2020.582680] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/16/2020] [Indexed: 12/22/2022] Open
Abstract
Uric acid (UA) is the end product of purine nucleotide metabolism in the human body. Hyperuricemia is an abnormally high level of UA in the blood and may result in arthritis and gout. The prevalence of hyperuricemia has been increasing globally. Epidemiological studies have shown that UA levels are positively correlated with cardiovascular diseases, including hypertension, atherosclerosis, atrial fibrillation (AF), and heart failure (HF). Hyperuricemia promotes the occurrence and development of cardiovascular diseases by regulating molecular signals, such as inflammatory response, oxidative stress, insulin resistance/diabetes, endoplasmic reticulum stress, and endothelial dysfunction. Despite extensive research, the underlying molecular mechanisms are still unclear. Allopurinol, a xanthine oxidase (XO) inhibitor, has been shown to improve cardiovascular outcomes in patients with HF, coronary heart disease (CHD), type 2 diabetes (T2D), and left ventricular hypertrophy (LVH). Whether febuxostat, another XO inhibitor, can improve cardiovascular outcomes as well as allopurinol remains controversial. Furthermore, it is also not clear whether UA-lowering treatment (ULT) can benefit patients with asymptomatic hyperuricemia. In this review, we focus on the latest cellular and molecular findings of cardiovascular disease associated with hyperuricemia and clinical data about the efficacy of ULT in patients with cardiovascular disease.
Collapse
Affiliation(s)
- Wei Yu
- Department of Internal Medicine, Xiang'an Hospital of Xiamen University, Xiamen, China
| | - Ji-Dong Cheng
- Department of Internal Medicine, Xiang'an Hospital of Xiamen University, Xiamen, China
| |
Collapse
|
26
|
Zhang L, Li JL, Guo LL, Li H, Li D, Xu G. The interaction between serum uric acid and triglycerides level on blood pressure in middle-aged and elderly individuals in China: result from a large national cohort study. BMC Cardiovasc Disord 2020; 20:174. [PMID: 32293295 PMCID: PMC7160924 DOI: 10.1186/s12872-020-01468-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of the research was to explore the extent of interaction between triglycerides (TG) and serum uric acid (SUA) level with blood pressure (BP) in middle-aged and elderly individuals in China. Methods Data were selected from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional study. 3345(46.99%) men with average ages of 60.24 ± 9.24 years and 3774 (53.01%) women with average ages of 59.91 ± 9.95 years were included in the study. Differences between gender, or between categories of blood pressure levels were evaluated by t-test or chi-square test. The adjusted associations between various characteristics and BP status were first compared using linear regression models, as appropriate. Then, A general linear model adjusted for confounding factors (socio-demographic characteristics [age, educational levels, marital status, place of residence], health behaviors [cigarette smoking, alcohol drinking, eating habits, social and leisure activities, accidental injury, physical activities], medical history [history of cardiovascular diseases, hepatitis history, antidiabetic drugs, history of antilipidemic medication, anti-hypertensive therapy], metabolic measures [C-reactive protein (CRP), hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR), body mass index (BMI)]) was used to examine the synergistic effect of SUA and TG level on BP in middle-aged and elderly individuals in China. Results Age-adjusted partial Pearson’s correlation coefficient showed that SUA and TG level positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women. Multiple linear regression analysis showed the TG level was significantly and positively associated with SBP and DBP in both men (SBP: β =0.068, P = 0.001; DBP: β =0.064, P = 0.002) and women (SBP: β =0.061, P = 0.002; DBP: β =0.084, P = 0.000), but SUA were significantly and positively associated with SBP in both men (SBP: β =0.047, P = 0.013) and women (SBP: β =0.040, P = 0.028), regardless of other confounding factors. After adjusting for related potential confounders, evidence of interaction between SUA and TG level on SBP (men: β = − 1.090, P = 0.726; women: β = − 0.692, P = 0.861) and DBP (men: β = − 1.026, P = 0.572; women: β = − 0.794, P = 0.842) was not observed. Conclusion The interaction effect of SUA and TG level on BP was not observed in our study. Moreover, high SUA level was significantly associated with SBP, while high TG level was strongly related to both DBP and SBP.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Jin-Long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, People's Republic of China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Hong Li
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Guang Xu
- Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Heping Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China.
| |
Collapse
|
27
|
Xue J, Wu Z, Gong S, Qin S, Gu A. High-dose atorvastatin improves vascular endothelial function in patients with leukoaraiosis. J Clin Lab Anal 2020; 34:e23081. [PMID: 32154613 PMCID: PMC7083452 DOI: 10.1002/jcla.23081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/17/2019] [Accepted: 09/29/2019] [Indexed: 12/22/2022] Open
Abstract
Objective Leukoaraiosis (LA), as an age‐related white matter degeneration, is mainly caused by chronic ischemia. Our study aims to explore the efficacy of different doses of atorvastatin (ATV) in the vascular endothelial function in patients with LA. Methods Our study enrolled 402 LA patients who were then randomly included as control or treated with ATV (10 mg), ATV (20 mg), or ATV (30 mg). The total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), and low‐density lipoprotein cholesterol (LDL‐C) were detected by enzyme colorimetric assay. The high‐sensitivity C‐reactive protein (hs‐CRP) level, reactive hyperemia index (RHI), endothelin‐1 (ET‐1) content, and nitric oxide (NO) level were tested by latex agglutination test, peripheral arterial tonometry technology, radioimmunoassay, and nitrate reductase assay, respectively. Results After 8 weeks of ATV treatment, the levels of TC, LDL‐C, and HS‐CRP decreased significantly, and the trends were demonstrated in a more significant way with the increases of dose of ATV. The treatment with ATV at different doses elevated NO level and RHI and declined ET‐1 content. Gastrointestinal reaction, muscular pain, and increased aminopherase were observed after treatment with the ATV at different doses with more obvious symptoms detected accompanied by the increase of the dose. The RHI was in negative correlation with the ET‐1 and HS‐CRP while in positive correlation with NO. Conclusion Our study demonstrates that ATV can significantly improve the vascular endothelial function in LA patients with a dose‐dependent effect.
Collapse
Affiliation(s)
- Jianan Xue
- Department of Clinical Laboratory, Jingjiang Chinese Medicine Hospital, Jingjiang, China
| | - Zhisheng Wu
- Department of Neurology, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| | - Shujie Gong
- Department of Neurology, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
| | - Shengying Qin
- Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Aiming Gu
- Department of Neurology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
| |
Collapse
|
28
|
Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. Body mass index and serum uric acid level: Individual and combined effects on blood pressure in middle-aged and older individuals in China. Medicine (Baltimore) 2020; 99:e19418. [PMID: 32118796 PMCID: PMC7478523 DOI: 10.1097/md.0000000000019418] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Few studies on the individual and combined analysis between serum uric acid (SUA) and body mass index (BMI) and blood pressure (BP) were conducted in individuals aged ≥45 years. We aimed to assess the extent to which BMI and SUA and their interaction affect BP in Chinese middle-aged and older adults.Data were selected from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5888 individuals aged 45 to 96 was included. Differences between BMI, or between categories of blood pressure were evaluated by t test or chi-square test. The trend of related variables according to four BMI categories was also tested using contrast analysis. The adjusted associations between various characteristics and BP status were first compared using linear regression models, as appropriate. Then, general linear models adjusting for related potential confounders were used to examine the synergistic effect of SUA and BMI level on BP for middle-aged and elderly individuals in China.Age-adjusted partial Pearson correlation coefficient showed that BMI was significantly and positively correlated with BP both in male and female, SUA positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in males with BMI <24.0 kg/m and females with BMI <24.0 kg/m. However, SUA level significantly and positively correlated with DBP, but not with SBP, in females with BMI ≥24.0 kg/m. Multiple linear regression analysis showed that BMI was independently associated with BP both in male and female, SUA significantly and positively associated with SBP in both males and females with BMI <24.0 kg/m, However, SUA level positively correlated with DBP in females with BMI <24.0 kg/m, but not with males with BMI <24.0 kg/m, independent of other confounding factors. A general linear model analysis adjusted for confounding factors did not reveal interaction between BMI, SUA levels and SBP (β=-1.404, P = .686 in males; β=-2.583, P = .575 in females) and DBP (β=-2.544, P = .263 in males; β=-2.619, P = .622 in females).No interaction between BMI, SUA levels, and BP was observed in either males or females; However, BMI was independently associated with BP both in male and female, SUA independently associated with SBP both in males and females with BMI <24.0 kg/m, and SUA independently associated with DBP in females with BMI ≥24.0 kg/m.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Jin-Long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, Chongqing Road, Linghe District, Jinzhou City, Liaoning Province
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Hong Li
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province, P.R.China
| |
Collapse
|
29
|
Liang L, Hou X, Bainey KR, Zhang Y, Tymchak W, Qi Z, Li W, Banh HL. The association between hyperuricemia and coronary artery calcification development: A systematic review and meta-analysis. Clin Cardiol 2019; 42:1079-1086. [PMID: 31571239 PMCID: PMC6837029 DOI: 10.1002/clc.23266] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022] Open
Abstract
Hyperuricemia coincides with coronary artery calcification (CAC) development, but the role of serum uric acid (SUA) as a risk factor for CAC remains unclear. The objective of this study was to gain an insight into the association between SUA and CAC in adults by performing a meta-analysis. MEDLINE, EMBASE, the Cochrane Library, and EBSCO (CINAHL) were searched for relevant observational studies published until 2 June 2019. Studies were included only if they reported data on CAC presence (Agatston score > 0) or progression related to hyperuricemia in subclinical adult patients. The pooled estimates of crude and adjusted odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between CAC presence or progression and hyperuricemia. A total of 11 studies were identified involving 11 108 adults. The pooled OR based on the frequency of CAC presence showed that patients in the high SUA group had 1.806-fold risk for developing CAC (95% CI: 1.491-2.186) under the minimal threshold of hyperuricemia (more than 6 mg/dL or 357 μmoL/L). When SUA levels were analyzed as categorical variables, the pooled estimate of adjusted ORs was 1.48 (95% CI: 1.23-1.79) for CAC presence. Additionally, for each increase of 1 mg/dL of SUA level, the risk of CAC progression was increased by 31% (95% CI: 1.15-1.49) with an average follow-up duration ranged from 4.6 to 6.1 years. Hyperuricemia is closely associated with increased risk of CAC development and CAC progression in asymptomatic patients.
Collapse
Affiliation(s)
- Ling Liang
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Cardiology, First Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xianghua Hou
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Nephrology, First Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Kevin R Bainey
- Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Yanlin Zhang
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Nephrology, First Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Wayne Tymchak
- Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Zhongquan Qi
- Institute of Organ Transplantation, Xiamen University, Xiamen, China
| | - Weihua Li
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Department of Cardiology, First Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Hoan Linh Banh
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
30
|
Lin WD, Deng H, Guo P, Liu FZ, Chen RY, Fang XH, Zhan XZ, Liao HT, Huang WX, Liu Y, Wang F, Zheng MR, Liu HZ, Huang J, Wei W, Xue YM, Wu SL. High prevalence of hyperuricaemia and its impact on non-valvular atrial fibrillation: the cross-sectional Guangzhou (China) Heart Study. BMJ Open 2019; 9:e028007. [PMID: 31147367 PMCID: PMC6549638 DOI: 10.1136/bmjopen-2018-028007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES There are country and regional variations in the prevalence of hyperuricaemia (HUA). The prevalence of HUA and non-valvular atrial fibrillation (NVAF) in southern China is unknown. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS A total of 11 488 permanent residents aged 35 or older from urban and rural areas of Guangzhou, China were enrolled. A questionnaire was used to compile each participant's demographic information and relevant epidemiological factors for HUA and NVAF. All participants were assessed using a panel of blood tests and single-lead 24-hour ECG. MAIN OUTCOME MEASURES HUA was defined as serum uric acid level >420 μmol/L in men and >360 μmol/L in women. NVAF was diagnosed as per guidelines. RESULTS The prevalence of HUA was 39.6% (44.8% in men and 36.7% in women), and 144 residents (1.25%) had NVAF. Prevalence of HUA increased with age in women but remained stably high in men. After adjusting for potential confounders, age, living in urban areas, alcohol consumption, central obesity, elevated fasting plasma glucose level, elevated blood pressure, lower high-density lipoprotein cholesterol level and elevated triglycerides level were associated with increased risk of HUA. Residents with HUA were at higher risk for NVAF. Serum uric acid level had a modest predictive value for NVAF in women but not men. CONCLUSIONS HUA was highly prevalent among citizens of southern China and was a predictor of NVAF among women.
Collapse
Affiliation(s)
- Wei-dong Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Fang-zhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ru-yin Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Xian-hong Fang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xian-zhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hong-tao Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wen-xiang Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yang Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Feng Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mu-rui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hua-zhang Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-mei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shu-lin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| |
Collapse
|
31
|
Mandurino-Mirizzi A, Crimi G, Raineri C, Pica S, Ruffinazzi M, Gianni U, Repetto A, Ferlini M, Marinoni B, Leonardi S, De Servi S, Oltrona Visconti L, De Ferrari GM, Ferrario M. Elevated serum uric acid affects myocardial reperfusion and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. J Cardiovasc Med (Hagerstown) 2018; 19:240-246. [PMID: 29470249 DOI: 10.2459/jcm.0000000000000634] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIMS Elevated serum uric acid (eSUA) was associated with unfavorable outcome in patients with ST-segment elevation myocardial infarction (STEMI). However, the effect of eSUA on myocardial reperfusion injury and infarct size has been poorly investigated. Our aim was to correlate eSUA with infarct size, infarct size shrinkage, myocardial reperfusion grade and long-term mortality in STEMI patients undergoing primary percutaneous coronary intervention. METHODS We performed a post-hoc patients-level analysis of two randomized controlled trials, testing strategies for myocardial ischemia/reperfusion injury protection. Each patient underwent acute (3-5 days) and follow-up (4-6 months) cardiac magnetic resonance. Infarct size and infarct size shrinkage were outcomes of interest. We assessed T2-weighted edema, myocardial blush grade (MBG), corrected Thrombolysis in myocardial infarction Frame Count, ST-segment resolution and long-term all-cause mortality. RESULTS A total of 101 (86.1% anterior) STEMI patients were included; eSUA was found in 16 (15.8%) patients. Infarct size was larger in eSUA compared with non-eSUA patients (42.3 ± 22 vs. 29.1 ± 15 ml, P = 0.008). After adjusting for covariates, infarct size was 10.3 ml (95% confidence interval 1.2-19.3 ml, P = 0.001) larger in eSUA. Among patients with anterior myocardial infarction the difference in delayed enhancement between groups was maintained (respectively, 42.3 ± 22.4 vs. 29.9 ± 15.4 ml, P = 0.015). Infarct size shrinkage was similar between the groups. Compared with non-eSUA, eSUA patients had larger T2-weighted edema (53.8 vs. 41.2 ml, P = 0.031) and less favorable MBG (MBG < 2: 44.4 vs. 13.6%, P = 0.045). Corrected Thrombolysis in myocardial infarction Frame Count and ST-segment resolution did not significantly differ between the groups. At a median follow-up of 7.3 years, all-cause mortality was higher in the eSUA group (18.8 vs. 2.4%, P = 0.028). CONCLUSION eSUA may affect myocardial reperfusion in patients with STEMI undergoing percutaneous coronary intervention and is associated with larger infarct size and higher long-term mortality.
Collapse
Affiliation(s)
- Alessandro Mandurino-Mirizzi
- Division of Cardiology.,School of Cardiovascular Disease, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | | | - Silvia Pica
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan
| | - Marta Ruffinazzi
- School of Cardiovascular Disease, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Umberto Gianni
- Division of Cardiology.,School of Cardiovascular Disease, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | | | | | - Sergio Leonardi
- Cardiac Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | | | - Gaetano M De Ferrari
- School of Cardiovascular Disease, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia.,Cardiac Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | |
Collapse
|
32
|
Dipeptidyl peptidase-4 inhibition protects the liver of insulin-resistant female rats against triglyceride accumulation by suppressing uric acid. Biomed Pharmacother 2018; 110:869-877. [PMID: 30557836 DOI: 10.1016/j.biopha.2018.12.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/20/2018] [Accepted: 12/07/2018] [Indexed: 02/07/2023] Open
Abstract
Dipeptidyl peptidase-4 (DPP-4) inhibition has been shown to exert beneficial effects against insulin resistance (IR) and type 2 diabetes. Combined oral contraceptive (COC) treatment is associated with impaired glucose and lipid metabolism but the mechanisms are elusive. We therefore, hypothesized that DPP-4 inhibition ameliorates COC-induced glucose dysregulation and hepatic triglyceride (TG) accumulation through adenosine deaminase (ADA) /xanthine oxidase (XO) /uric acid-dependent pathway. Female Wistar rats received (po) vehicle and COC (1.0 μg ethinylestradiol plus 5.0 μg levonorgestrel; po) with or without DPP-4 inhibitor (sitagliptin; 100 mg/kg; po) for 8 weeks (n = 6/group). Glucose dysmetabolism was assessed by elevated fasting blood glucose, impaired oral glucose tolerance test and homeostatic model assessment of IR. Treatment with COC led to increased plasma fasting glucose, triglyceride-glucose index, 1-h postload glucose response, insulin, free fatty acid, IR and impaired glucose tolerance. COC treatment also resulted in increased plasma and hepatic TG, TG/HDL-cholesterol ratio, malondialdehyde, uric acid (plasma; 25.2 ± 0.6 mg/dl; hepatic 128.9 ± 8.0 mg/100 mg tissue), lactate dehydrogenase, DPP-4, ADA and XO (plasma;10.5 ± 1.1 U/L; hepatic 21.2 ± 1.4 U/g protein) activities. Likewise, COC led to reduction in nitric oxide level. However, DPP-4 inhibition significantly ameliorated these alterations induced by COC treatment through suppression of uric acid (plasma; 15.1 ± 1.0 mg/dl, hepatic; 75.6 ± 5.0 mg/100 mg tissue), XO (plasma; 4.1 ± 0.9 U/L, hepatic; 8.7 ± 0.4 U/g protein), ADA and DPP-4 activities suggesting their involvement in glucose dysregulation and hepatic TG accumulation induced by COC treatment. Therefore, DPP-4 inhibition would impact positively on cardiometabolic disorders, at least in part, through XO, ADA and uric acid suppression.
Collapse
|
33
|
Serum Uric Acid as an Independent Risk Factor for the Presence and Severity of Early-Onset Coronary Artery Disease: A Case-Control Study. DISEASE MARKERS 2018; 2018:1236837. [PMID: 30425752 PMCID: PMC6218741 DOI: 10.1155/2018/1236837] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/22/2018] [Accepted: 09/20/2018] [Indexed: 12/13/2022]
Abstract
Serum uric acid (UA) is the final product of purine metabolism in humans. The present study is aimed at identifying the potential association between serum UA and early-onset coronary artery disease (EOCAD). The study population consisted of 1093 EOCAD patients aged ≤50 years, and 1117 age- and sex-matched apparently healthy people served as controls. The concentrations of UA were measured by uricase method. The severity of CAD was evaluated by Gensini score. The mean serum level of UA was 5.843 ± 1.479 mg/dl in EOCAD patients and 5.433 ± 1.529 mg/dl in controls. Serum UA levels were significantly higher in the EOCAD group than those in the control group (P < 0.001) and was an independent risk factor for EOCAD (OR = 1.100, 95% CI: 1.022–1.185). The early-onset myocardial infarction patients with 3-vessel disease had higher serum UA levels than those with 1- or 2-vessel disease. The serum UA levels of EOCAD patients with acute coronary syndrome were significantly higher than those with chronic coronary artery disease. EOCAD patients with hyperuricemia had higher Gensini scores than those without hyperuricemia. In addition, the serum UA levels were affected by drinking (P < 0.01) and were positively correlated with serum creatinine (r = 0.323) and weight (r = 0.327). Our results show that serum UA was an independent risk factor for EOCAD. The serum UA levels were associated with the presence and severity of EOCAD and suggested that UA may be involved in the progression of EOCAD.
Collapse
|
34
|
Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, Cautela J, Thuny F, Barraud J, Mottola G, Rossi P, Fenouillet E, Ruf J, Guieu R, Paganelli F. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal 2018. [PMID: 29626320 DOI: 10.1007/s11302-018-96q4-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
The role of serum uric acid in coronary artery disease has been extensively investigated. It was suggested that serum uric acid level (SUA) is an independent predictor of endothelial dysfunction and related to coronary artery lesions. However, the relationship between SUA and severity of coronary atherosclerosis evaluated via endothelial dysfunction using peripheral arterial tone (PAT) and the reactive hyperhemia index (RHI) has not been investigated during a first episode of acute coronary syndrome (ACS). The aim of our study was to address this point. We prospectively enrolled 80 patients with a first episode of ACS in a single-center observational study. All patients underwent coronary angiography, evaluation of endothelial function via the RHI, and SUA measurement. The severity of the coronary artery lesion was assessed angiographically, and patients were classified in three groups based on the extent of disease and Gensini and SYNTAX scores. Endothelial function was considered abnormal if RHI < 1.67. We identified a linear correlation between SUA and RHI (R2 = 0.66 P < 0.001). In multivariable analyses, SUA remained associated with RHI, even after adjustment for traditional cardiovascular risk factors and renal function. SUA was associated with severity of coronary artery disease. SUA is associated with severity of coronary atherosclerosis in patients with asymptomatic hyperuricemia. This inexpensive, readily measured biological parameter may be useful to monitor ACS patients.
Collapse
Affiliation(s)
| | - Marion Marlinge
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Marine Alessandrini
- EA 3279 Public Health, Chronic Disease and Quality of Life-Research Unit, Aix-Marseille University, Marseille, France
| | - Marc Laine
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Julien Fromonot
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | | | - Franck Thuny
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Giovanna Mottola
- Laboratory of Biochemistry, Hopital Timone, Marseille, France
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Pascal Rossi
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Emmanuel Fenouillet
- UMR MD2, Aix-Marseille University, Marseille, France
- Institut des Sciences Biologiques, CNRS, Paris, France
| | - Jean Ruf
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Régis Guieu
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.
- UMR MD2, Aix-Marseille University, Marseille, France.
- Faculté de Médecine Nord, Boulevard P. Dramard, F-13015, Marseille, France.
| | | |
Collapse
|
35
|
Ahmadnezhad M, Arefhosseini SR, Parizadeh MR, Tavallaie S, Tayefi M, Darroudi S, Ghazizadeh H, Moohebati M, Ebrahimi M, Heidari-Bakavoli A, Azarpajouh MR, Ferns GA, Mogharebzadeh V, Ghayour-Mobarhan M. Association between serum uric acid, high sensitive C-reactive protein and pro-oxidant-antioxidant balance in patients with metabolic syndrome. Biofactors 2018; 44:263-271. [PMID: 29638023 DOI: 10.1002/biof.1424] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 02/03/2023]
Abstract
There is persuasive evidence that oxidative stress and inflammation are features of the metabolic syndrome (MetS). We have investigated the relationship between serum pro-oxidant-antioxidant balance (PAB), serum uric acid, and high sensitive C-reactive protein (hs-CRP) in 7,208 participants from the MASHAD study cohort, who were categorized as having MetS, or not, using International Diabetes Foundation (IDF) criteria. Serum hs-CRP was measured by Polyethylene glycol (PEG)-enhanced immunoturbidimetry method using an Alycon analyzer (ABBOTT, Chicago, IL, USA). A colorimetric method was used to determine serum PAB. Serum PAB values were significantly higher in the individuals with MetS compared to those without (P < 0.001). Furthermore, there was a step-wise increase in mean serum PAB concentrations as the number of components of the MetS increased. The combination of features of MetS had different association with serum PAB and hs-CRP. Multiple linear regression analysis showed that body mass index (BMI, B = 2.04, P < 0.001), physical activity level (PAL, B = 18.728, P = 0.001), serum uric acid (B = -1.545, P = 0.003), and serum C-reactive protein (B = 0.663, P < 0.001) were associated with serum PAB in individuals with MetS. Multiple logistic regression analysis showed that serum PAB (B = 0.002, P < 0.001, CI = 1.001-1.003), serum C-reactive protein (B = 0.007, P < 0.015, CI = 1.001-1.013), and serum uric acid (B = 0.207, P < 0.001, CI = 1.186-1.277) were all significantly associated with MetS. Serum PAB was strongly associated with serum uric acid and serum hs-CRP. Moreover, serum PAB as well as serum uric acid and serum hs-CRP were independently associated with MetS. Individual features of MetS were also associated with serum hs-CRP and PAB. © 2018 BioFactors, 44(3):263-271, 2018.
Collapse
Affiliation(s)
- Mahsa Ahmadnezhad
- Nutrition Research Center, Department of Community Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Tavallaie
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- Molecular Medicine Group, Department of Modern Science and Technologies, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari-Bakavoli
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Azarpajouh
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Vahid Mogharebzadeh
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
36
|
Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, Cautela J, Thuny F, Barraud J, Mottola G, Rossi P, Fenouillet E, Ruf J, Guieu R, Paganelli F. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal 2018; 14:191-199. [PMID: 29626320 DOI: 10.1007/s11302-018-9604-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
The role of serum uric acid in coronary artery disease has been extensively investigated. It was suggested that serum uric acid level (SUA) is an independent predictor of endothelial dysfunction and related to coronary artery lesions. However, the relationship between SUA and severity of coronary atherosclerosis evaluated via endothelial dysfunction using peripheral arterial tone (PAT) and the reactive hyperhemia index (RHI) has not been investigated during a first episode of acute coronary syndrome (ACS). The aim of our study was to address this point. We prospectively enrolled 80 patients with a first episode of ACS in a single-center observational study. All patients underwent coronary angiography, evaluation of endothelial function via the RHI, and SUA measurement. The severity of the coronary artery lesion was assessed angiographically, and patients were classified in three groups based on the extent of disease and Gensini and SYNTAX scores. Endothelial function was considered abnormal if RHI < 1.67. We identified a linear correlation between SUA and RHI (R2 = 0.66 P < 0.001). In multivariable analyses, SUA remained associated with RHI, even after adjustment for traditional cardiovascular risk factors and renal function. SUA was associated with severity of coronary artery disease. SUA is associated with severity of coronary atherosclerosis in patients with asymptomatic hyperuricemia. This inexpensive, readily measured biological parameter may be useful to monitor ACS patients.
Collapse
Affiliation(s)
| | - Marion Marlinge
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | - Marine Alessandrini
- EA 3279 Public Health, Chronic Disease and Quality of Life-Research Unit, Aix-Marseille University, Marseille, France
| | - Marc Laine
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Julien Fromonot
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | | | - Franck Thuny
- Department of Cardiology, Hopital Nord, Marseille, France
| | | | - Giovanna Mottola
- Laboratory of Biochemistry, Hopital Timone, Marseille, France.,UMR MD2, Aix-Marseille University, Marseille, France
| | - Pascal Rossi
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Emmanuel Fenouillet
- UMR MD2, Aix-Marseille University, Marseille, France.,Institut des Sciences Biologiques, CNRS, Paris, France
| | - Jean Ruf
- UMR MD2, Aix-Marseille University, Marseille, France
| | - Régis Guieu
- Laboratory of Biochemistry, Hopital Timone, Marseille, France. .,UMR MD2, Aix-Marseille University, Marseille, France. .,Faculté de Médecine Nord, Boulevard P. Dramard, F-13015, Marseille, France.
| | | |
Collapse
|
37
|
Liu FZ, Liao HT, Lin WD, Xue YM, Zhan XZ, Fang XH, Rao F, Deng H, Huang J, Hai JJ, Tse HF, Wu SL. Predictive effect of hyperuricemia on left atrial stasis in non-valvular atrial fibrillation patients. Int J Cardiol 2018; 258:103-108. [PMID: 29467096 DOI: 10.1016/j.ijcard.2018.01.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the relationship between hyperuricemia and left atrial thrombus (LAT)/spontaneous echo contrast (SEC) and to determine the predictive value of hyperuricemia in non-valvular (NV) atrial fibrillation (AF) patients. METHODS The study retrospectively reviewed 1198 consecutive patients (male 801, female 397, and mean age of 56.84 ± 12.22) who were diagnosed with AF and accepted transesophageal echocardiography (TEE) prior to catheter ablation, appendage occlusion and electrical cardioversion using a single-center database. The clinical baseline characteristics were collected from medical record review and analyzed. Patients were categorized into an LAT/SEC group and a normal group. RESULTS According to the TEE examination, there were 97 (8.1%) patients with abnormality; of these, 49 were with LAT and 48 with SEC. The mean serum uric acid (SUA) level and hyperuricemia proportion were markedly higher in patients with LAT/SEC. The significant predictive effect was observed in the SUA level (OR = 1.006) and hyperuricemia (OR = 2.04). After adjustment for persistent/permanent-AF, age, gender, LA dimension > 40 mm, previous stroke, hypertension and diabetes, the SUA level (OR = 1.004) and hyperuricemia (OR = 1.69) were independent predictors for LAT/SEC. The SUA level (OR = 1.004) and hyperuricemia (OR = 1.69) were independent predictors for LAT/SEC, Further subgroup analysis in different CHA2DS2-VASc categories, it might be helpful to refine the LAT/SEC risk via combination area CHA2DS2-VASc score and hyperuricemia, especially in those with CHA2DS2-VASc score < 2. CONCLUSIONS The SUA level and hyperuricemia proportion are closely associated with LA stasis. Hyperuricemia might independently predict and refine LA stasis risk among NVAF patients, especially in those with CHA2DS2-VASc score < 2.
Collapse
Affiliation(s)
- Fang-Zhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Hong-Tao Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Wei-Dong Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Yu-Mei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Xian-Zhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Xian-Hong Fang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Fang Rao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China; Research Center of Medical Science, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Jun Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China
| | - Jo-Jo Hai
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, China
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, China; Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, China
| | - Shu-Lin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China.
| |
Collapse
|
38
|
Chen IC, Kuo CS, Wu CC, Tsai HY, Lin CP, Li SY, Chou RH, Huang PH, Chen JW, Lin SJ. Chronic hyperuricemia impairs blood flow recovery in the ischemic hindlimb through suppression of endothelial progenitor cells. Oncotarget 2018; 9:9285-9298. [PMID: 29507690 PMCID: PMC5823617 DOI: 10.18632/oncotarget.24290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
Objective Chronic hyperuricemia is associated with cardiovascular disease, but its impact on endothelial progenitor cells (EPC) and ischemia-induced neovascularization remains unclear. Herein we investigated whether chronic hyperuricemia could impede blood flow recovery in response to tissue ischemia by suppression of EPC. Methods Human EPC were isolated and cultured in a high-level uric acid medium for functional testing. Cell proliferation, nitric oxide (NO) production and apoptosis assay were examined. A chronic hyperuricemia mouse model was established by potassium oxonate treatment and/or a high-level uric acid diet to evaluate the actions of chronic hyperuricemia on ischemia-induced blood flow recovery. After 4 weeks of drug treatment, hindlimb ischemia surgery was performed in the control and hyperuricemia mice. Blood flow recovery was followed up every week before and after ischemic surgery using a laser Doppler Perfusion Imager System. The circulating EPC number in the peripheral blood was determined by flow cytometry (Sca-1+/Flk-1+). Results Incubation with a high-level uric acid medium (10 mg/dL) significantly suppressed EPC proliferation, reduced NO production, and lessened phosphorylation of Akt and eNOS. Moreover, EPC treated with high-level uric acid increased reactive oxygen species production, promoted cellular apoptosis and senescence, and also inhibited EPC tube formation. Four weeks after hindlimb ischemia surgery, the chronic hyperuricemia mice had significantly reduced tissue reperfusion, EPC mobilization, and impaired neovascularization in the ischemic hindlimbs compared with the control mice. Conclusions Chronic hyperuricemia impaired blood flow recovery and EPC mobilization in response to tissue ischemia, and these effects could have occurred through suppression of EPC.
Collapse
Affiliation(s)
- I-Chun Chen
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Sung Kuo
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Cheng Wu
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,National Tsing-Hua University, Institute of Biomedical Engineering, Hsinchu, Taiwan.,National Taiwan University Hospital, College of Medicine, Taipei, Taiwan.,Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Hsiao-Ya Tsai
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Pei Lin
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Biotechnology and Laboratory Science in Medicine and Institute of Biotechnology in Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Szu-Yuan Li
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ruey-Hsing Chou
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jaw-Wen Chen
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute and Department of Pharmacology, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
39
|
Role of Hyperhomocysteinemia and Hyperuricemia in Pathogenesis of Atherosclerosis. J Stroke Cerebrovasc Dis 2017; 26:2695-2699. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.10.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/01/2016] [Accepted: 10/10/2016] [Indexed: 11/17/2022] Open
|
40
|
Potje SR, Chen Z, Oliveira SDS, Bendhack LM, da Silva RS, Bonini MG, Antoniali C, Minshall RD. Nitric oxide donor [Ru(terpy)(bdq)NO] 3+ induces uncoupling and phosphorylation of endothelial nitric oxide synthase promoting oxidant production. Free Radic Biol Med 2017; 112:587-596. [PMID: 28899725 PMCID: PMC5647835 DOI: 10.1016/j.freeradbiomed.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 02/07/2023]
Abstract
[Ru(terpy)(bdq)NO]3+ (TERPY) is a nitric oxide (NO) donor that promotes relaxation of the mesenteric artery and aorta in rats. We sought to investigate whether it acts as both an NO donor and endothelial NO synthase (eNOS) activator, as shown previously for nitroglycerin. Human umbilical vein endothelial cells (HUVECs) and human embryonic kidney 293 cells transfected with empty vector (HEK) or eNOS cDNA (HEK-eNOS) were treated with TERPY (1µM) for different lengths of time. eNOS expression, dimerization, and Ser1177 phosphorylation, caveolin-1 (Cav-1) oligomerization, Cav-1 Tyr14 phosphorylation were evaluated by Western blotting. Studies also assessed the production of reactive oxygen/nitrogen species (ROS/RNS) in HUVECs and HEK-eNOS cells. In HEK cells devoid of eNOS, TERPY released NO without additional stimulus indicating that is an NO donor. Moreover, in HEK-eNOS cells, TERPY-induced NO production that was blocked by L-NAME. In addition, TERPY increased ROS and ONOO- production which were blocked by more than 80% by BH4 (essential eNOS co-factor) and eNOS siRNA. These results suggest that TERPY-induced ROS and ONOO- production were originated from eNOS. HUVECs stimulated with TERPY showed increased eNOS Ser1177 and Cav-1 Tyr14 phosphorylation, and decreased eNOS dimerization, Cav-1 oligomerization, and Cav-1/eNOS interaction after 20min. It suggests that TERPY induces eNOS hyperactivation and uncoupling by disrupting Cav-1/eNOS interaction and depleting BH4. Endothelium-dependent vasodilation in response to NO donor TERPY is associated with eNOS activation and uncoupling, and thereby appears to be mediated, at least in part, via eNOS-dependent ROS/RNS production.
Collapse
Affiliation(s)
- Simone R Potje
- Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas, Department of Basic Sciences, School of Dentistry, São Paulo State University, Araçatuba, Brazil; Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Zhenlong Chen
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Lusiane M Bendhack
- Department of Physics and Chemistry, School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, Brazil
| | - Roberto S da Silva
- Department of Physics and Chemistry, School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcelo G Bonini
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Cristina Antoniali
- Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas, Department of Basic Sciences, School of Dentistry, São Paulo State University, Araçatuba, Brazil.
| | - Richard D Minshall
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA; Department of Pharmacology, University of Illinois at Chicago, Chicago, IL, USA.
| |
Collapse
|
41
|
Lamacchia O, Fontana A, Pacilli A, Copetti M, Fariello S, Garofolo M, Penno G, Trischitta V, De Cosmo S, Cignarelli M. On the non-linear association between serum uric acid levels and all-cause mortality rate in patients with type 2 diabetes mellitus. Atherosclerosis 2017; 260:20-26. [PMID: 28334637 DOI: 10.1016/j.atherosclerosis.2017.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS High levels of serum uric acid (SUA) are associated with increased mortality risk in the general population. Contrasting results are available in people with diabetes. The aim of our study was to investigate the association and its functional form between SUA and all cause-mortality in patients with type 2 diabetes mellitus (T2DM). METHODS We studied three cohorts of patients with T2DM: Gargano Mortality Study, Foggia Mortality Study, Pisa Mortality Study. All-cause mortality rate was the end point of this study. RESULTS The most reliable relationship between SUA levels and all-cause mortality rate was quadratic, with such model being well approximated by SUA tertiles. Both tertiles 1 and 3 were at higher risk of mortality as compared to tertile 2: Hazard Ratio (HR) [95% Confidence Interval (CI)] = 1.34 (1.07-1.68) and 1.61 (1.29-1.99), respectively. In the pseudo-sample, created from the real pooled sample, the best relationship between SUA and all-cause mortality rate was quadratic. In a tree-based Recursive Partitioning and Regression Tree analysis two subgroups at increased risk of mortality were identified, namely those with SUA levels ≥7.28 mg/dl and with SUA levels <4.16 mg/dl as compared to patients with intermediate SUA levels (i.e. 4.16-7.28), thus providing further evidence on the J-shaped relationship between SUA levels and mortality rate. CONCLUSIONS SUA was not linearly associated with all-cause mortality rate in patients with T2DM. For clinical and public health purposes such association is J-shaped.
Collapse
Affiliation(s)
- Olga Lamacchia
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Andrea Fontana
- Unit of Biostatistics, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Antonio Pacilli
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
| | - Stefania Fariello
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Monia Garofolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy; Mendel-Laboratory, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy; Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Salvatore De Cosmo
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
| | - Mauro Cignarelli
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| |
Collapse
|
42
|
Hsu WL, Li SY, Liu JS, Huang PH, Lin SJ, Hsu CC, Lin YP, Tarng DC. High Uric Acid Ameliorates Indoxyl Sulfate-Induced Endothelial Dysfunction and Is Associated with Lower Mortality among Hemodialysis Patients. Toxins (Basel) 2017; 9:toxins9010020. [PMID: 28067806 PMCID: PMC5308252 DOI: 10.3390/toxins9010020] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/22/2016] [Accepted: 01/02/2017] [Indexed: 01/08/2023] Open
Abstract
High uric acid (UA) can act as a pro-oxidant in normal physiological conditions; however, emerging evidence is still debatable with regard to the association between high UA and poor outcomes among chronic hemodialysis (HD) patients. In the present study, 27,229 stable prevalent HD patients were enrolled and divided into four groups according to the quartiles of baseline UA concentration, and 5737 died during a median follow-up of 38 months. Multivariate Cox regression analysis showed that a UA level of <6.1 mg/dL was associated with a higher risk of all-cause mortality compared with a UA level of >8.1 mg/dL [HR, 1.20, 95% CI (1.10–1.31)] adjusting for baseline demographic and biochemical parameters. Moreover, a UA level of <6.1 mg/dL was associated with greater risks of cardiovascular mortality [HR, 1.26, 95% CI (1.13–1.41)] and stroke-related mortality [HR, 1.59, 95% CI (1.12–2.25)], respectively. In vitro experiments further showed an increase in oxidative stress and an inhibition nitric oxide synthesis by indoxyl sulfate (IS) in human aortic endothelial cells, which were significantly attenuated by UA in a dose-dependent manner. We concluded that higher UA in serum was associated with lower risk of all-cause and cardiovascular mortality among HD patients probably through its antioxidant property in ameliorating the IS-related vascular toxicity.
Collapse
Affiliation(s)
- Wei-Liang Hsu
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Jia-Sin Liu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan 35053, Taiwan.
| | - Po-Hsun Huang
- Faculty of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Cardiovascular Research Center, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Cardiovascular Research Center, National Yang-Ming University, Taipei 11217, Taiwan.
- Department of Medical Research, Taipei Veterans General Hospital, Taipe 11217, Taiwan.
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan 35053, Taiwan.
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan.
| | - Yao-Ping Lin
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Der-Cherng Tarng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
- Department and Institute of Physiology, National Yang-Ming University, Taipei 11217, Taiwan.
| |
Collapse
|
43
|
Huang Z, Hong Q, Zhang X, Xiao W, Wang L, Cui S, Feng Z, Lv Y, Cai G, Chen X, Wu D. Aldose reductase mediates endothelial cell dysfunction induced by high uric acid concentrations. Cell Commun Signal 2017; 15:3. [PMID: 28057038 PMCID: PMC5217275 DOI: 10.1186/s12964-016-0158-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 12/20/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Uric acid (UA) is an antioxidant found in human serum. However, high UA levels may also have pro-oxidant functions. According to previous research, aldose reductase (AR) plays a vital role in the oxidative stress-related complications of diabetes. We sought to determine the mechanism by which UA becomes deleterious at high concentrations as well as the effect of AR in this process. METHOD and vWF levels were measured in vivo. RESULTS production in hyperuricemic mice and protected endothelial cell function. CONCLUSIONS could protect endothelial function and maintain the antioxidant activities of UA. These findings provide new insight into the role of UA in chronic kidney disease.
Collapse
Affiliation(s)
- Zhiyong Huang
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China.,Department of Nephrology, The 175th Hospital of PLA, Zhangzhou Fujian, 36300, People's Republic of China
| | - Quan Hong
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Xueguang Zhang
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Wenzhen Xiao
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Liyuan Wang
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Shaoyuan Cui
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Zhe Feng
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Yang Lv
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Guangyan Cai
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Xiangmei Chen
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China
| | - Di Wu
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, People's Republic of China.
| |
Collapse
|
44
|
Koratala A, Singhania G, Alquadan KF, Shimada M, Johnson RJ, Ejaz AA. Serum Uric Acid Exhibits Inverse Relationship with Estimated Glomerular Filtration Rate. Nephron Clin Pract 2016; 134:231-237. [PMID: 27548821 DOI: 10.1159/000448629] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/22/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In this study, we investigated the relationship between serum uric acid (SUA) and renal function in a unique patient cohort wherein SUA levels fluctuate during the course of standard care. METHODS Correlation coefficients between SUA and serum creatinine (SCr) and kinetic estimated GFR (KeGFR) were retrospectively investigated in acute myeloid leukemia (AML) patients, and statistically significant and clinically relevant determinants were studied in multiple regression models. RESULTS One hundred and twenty-six patients were included in the analysis. Baseline SUA was associated with an increased risk for acute kidney injury (AKI; OR 1.27, 95% CI 1.1-1.5, p = 0.003) and laboratory tumor lysis syndrome (OR 1.26, 95% CI 1.1-1.5, p = 0.005). Prophylactic uric acid-lowering therapy and hydration resulted in lower SUA values from baseline in 88.1% of the patients, the lowest values were observed on post-induction day 1 (20.4% reduction). Significant linear correlations were observed between SUA and SCr (r = 0.35, p < 0.001) values with a significant inverse correlation between SUA and KeGFR on day 1 (r = -0.33, p < 0.001) that persisted through day 4. By subgroup analysis, patients with primary AML (r = -0.49, p < 0.001), baseline SUA >5.5 mg/dl (r = -0.41, p = 0.002) and baseline eGFR >60 ml/min/1.73 m2 (r = -0.51, p < 0.001) demonstrated robust relationships between SUA and KeGFR. The relationship was more robust when the groups were combined (primary AML plus baseline SUA >5.5 mg/dl plus baseline eGFR >60 ml/min/1.73 m2, r = -0.52, p < 0.001). CONCLUSION The demonstration of linear relationship between SUA and SCr and inverse relationship between SUA and KeGFR reinforces the emerging translational physiological evidence regarding the role of uric acid in AKI.
Collapse
Affiliation(s)
- Abhilash Koratala
- Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Fla., USA
| | | | | | | | | | | |
Collapse
|
45
|
Long H, Jiang J, Xia J, Jiang R, He Y, Lin H, Fan Z, Zeng T. Hyperuricemia Is an Independent Risk Factor for Erectile Dysfunction. J Sex Med 2016; 13:1056-62. [DOI: 10.1016/j.jsxm.2016.04.073] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/17/2016] [Accepted: 04/22/2016] [Indexed: 11/29/2022]
|
46
|
Uric Acid for Cardiovascular Risk: Dr. Jekyll or Mr. Hide? Diseases 2016; 4:diseases4010012. [PMID: 28933392 PMCID: PMC5456305 DOI: 10.3390/diseases4010012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/18/2016] [Accepted: 02/19/2016] [Indexed: 02/07/2023] Open
Abstract
Uric acid (UA) is a potent endogenous antioxidant. However, high concentrations of this molecule have been associated with cardiovascular disease (CVD) and renal dysfunction, involving mechanisms that include oxidative stress, inflammatory processes, and endothelial injury. Experimental and in vitro results suggest that this biomarker behaves like other antioxidants, which can shift from the physiological antioxidant action to a pro-oxidizing effect according to their level and to microenvironment conditions. However, data on patients (general population or CAD cohorts) are controversial, so the debate on the role of hyperuricemia as a causative factor for CVD is still ongoing. Increasing evidence indicates UA as more meaningful to assess CVD in women, even though this aspect needs deeper investigation. It will be important to identify thresholds responsible for UA “biological shift” from protective to harmful effects in different pathological conditions, and according to possible gender-related differences. In any case, UA is a low-tech and inexpensive biomarker, generally performed at patient’s hospitalization and, therefore, easily accessible information for clinicians. For these reasons, UA might represent a useful additive tool as much as a CV risk marker. Thus, in view of available evidence, progressive UA elevation with levels higher than 6 mg/dL could be considered an “alarm” for increased CV risk.
Collapse
|
47
|
Li P, Zhang L, Zhang M, Zhou C, Lin N. Uric acid enhances PKC-dependent eNOS phosphorylation and mediates cellular ER stress: A mechanism for uric acid-induced endothelial dysfunction. Int J Mol Med 2016; 37:989-97. [PMID: 26935704 PMCID: PMC4790645 DOI: 10.3892/ijmm.2016.2491] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/03/2016] [Indexed: 12/18/2022] Open
Abstract
The mechanism by which hyperuricemia induced-endothelial dysfunction contributes to cardiovascular diseases (CVDs) is not yet fully understood. In the present study, we used uric acid (UA) to trigger endothelial dysfunction in cultured endothelial cells, and investigated the effects of induced reactive oxygen species (ROS) generation, endoplasmic reticulum (ER) stress induction, and the protein kinase C (PKC)-dependent endothelial nitric oxide synthase (eNOS) signaling pathway. Human umbilical vein endothelial cells (HUVECs) were incubated with 6, 9 or 12 mg/dl UA, ROS scavenger polyethylene glycol-superoxide dismutase (PEG‑SOD), ER stress inhibitor 4-phenylbutyric acid (4-PBA), and PKC inhibitor polymyxin B for 6-48 h. Nitric oxide (NO) production, eNOS activity, intracellular ROS, ER stress levels, and the interaction between eNOS and calmodulin (CaM) and cytosolic calcium levels were assessed using fluorescence microscopy and western blot analysis. Apoptosis was assessed by annexin V staining. UA increased HUVEC apoptosis and reduced eNOS activity and NO production in a dose- and time-dependent manner. Intracellular ROS was elevated after 3 h, while ER stress level increased after 6 h. UA did not alter intracellular Ca2+, CaM, or eNOS concentration, or eNOS Ser1177 phosphorylation. However, PKC-dependent eNOS phosphorylation at Thr495 was greatly enhanced, and consequently interaction between eNOS and CaM was reduced. Cellular ROS depletion, ER stress inhibition and PKC activity reduction inhibited the effect of UA on eNOS activity, NO release and apoptosis in HUVECs. Thus, we concluded that UA induced HUVEC apoptosis and endothelial dysfunction by triggering oxidative and ER stress through PKC/eNOS-mediated eNOS activity and NO production.
Collapse
Affiliation(s)
- Peng Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministy of Education and Chinese Ministy of Public Health, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Lina Zhang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Mei Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministy of Education and Chinese Ministy of Public Health, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Changyong Zhou
- Department of Emergency Room, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Nan Lin
- Department of Emergency Room, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| |
Collapse
|
48
|
Mantovani A, Rigolon R, Pichiri I, Pernigo M, Bergamini C, Zoppini G, Bonora E, Targher G. Hyperuricemia is associated with an increased prevalence of atrial fibrillation in hospitalized patients with type 2 diabetes. J Endocrinol Invest 2016; 39:159-67. [PMID: 26178737 DOI: 10.1007/s40618-015-0354-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 06/30/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE Hyperuricemia/gout and atrial fibrillation (AF) are two pathological conditions that are highly prevalent in type 2 diabetes and share multiple cardiovascular risk factors. However, the relationship between elevated levels of serum uric acid and risk of AF in type 2 diabetes is currently poorly known. METHODS We studied a hospital-based sample of 842 (male/female = 463/379) patients with type 2 diabetes discharged from our Division of Endocrinology during 2007-2011. Hyperuricemia was defined as a serum uric acid level >7 mg/dl for men and >6 mg/dl for women or allopurinol use. The diagnosis of AF was confirmed in affected participants on the basis of ECGs and medical history by experienced cardiologists. RESULTS Overall, 243 (28.9 %) patients had hyperuricemia and 91 (10.8 %) patients had persistent or permanent AF. Compared with those with normal serum uric acid levels, patients with hyperuricemia had a remarkably greater prevalence of AF (20.6 vs. 7.1 %; p < 0.001). Hyperuricemia was significantly associated with an increased risk of prevalent AF (odds ratio 3.41, 95 % CI 2.19-5.32; p < 0.001). Adjustments for age, sex, smoking, hemoglobin A1c, hypertension status, chronic kidney disease, chronic obstructive pulmonary disease and previous histories of hyperthyroidism, ischemic heart disease and valvular heart diseases did not weaken this association (adjusted-odds ratio 6.27, 95 % CI 1.82-21.5; p < 0.01). CONCLUSIONS These results indicate that hyperuricemia is associated with an increased prevalence of AF in hospitalized patients with type 2 diabetes, independently of multiple risk factors and potential confounders.
Collapse
Affiliation(s)
- A Mantovani
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - R Rigolon
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - I Pichiri
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - M Pernigo
- Department of Medicine, Section of Cardiology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - C Bergamini
- Department of Medicine, Section of Cardiology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - G Zoppini
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - E Bonora
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - G Targher
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
| |
Collapse
|
49
|
Dai XM, Wei L, Ma LL, Chen HY, Zhang ZJ, Ji ZF, Wu WL, Ma LY, Kong XF, Jiang LD. Serum uric acid and its relationship with cardiovascular risk profile in Chinese patients with early-onset coronary artery disease. Clin Rheumatol 2015; 34:1605-11. [PMID: 25630308 DOI: 10.1007/s10067-015-2878-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 01/12/2015] [Accepted: 01/16/2015] [Indexed: 12/12/2022]
Abstract
The prevalence of coronary artery disease (CAD) is growing in the young population. We aimed to investigate the association between serum uric acid (SUA) levels and cardiovascular involvement in individuals under 45 years old diagnosed with early-onset CAD (EOCAD). Seven hundred eighty-six EOCAD patients were recruited and stratified into four groups by SUA levels. General information, serum indicators, and results of coronary angiography and echocardiography were recorded. The associations between SUA levels were explored by univariate and multivariate logistic regressions. With the increasing of SUA levels, the prevalence of hypertension and hyperlipidemia, triple branches involved, heart failure, and cardiac enlargement of left ventricle (LV), left atrium (LA), and right ventricle (RV) were significantly higher (all P < 0.05). The fourth group (SUA >8 mg/dl) had the highest proportions than other groups (all P < 0.05). After controlling potential confounders, multiple logistic regression analysis showed that odds ratios of SUA >8 mg/dl were 2.345 for triple branches involved (95 % confidence interval (CI) 1.335-4.119), 4.168 for heart failure (95 % CI 1.599-10.862), and 4.122 for LV enlargement (95 % CI 1.874-9.065) (P < 0.05). SUA >8 mg/dl was independently associated with triple branches involvement, heart failure and LV enlargement in Chinese EOCAD patients. Higher SUA level might play an important role in cardiac dysfunction and severity of EOCAD.
Collapse
Affiliation(s)
- Xiao-Min Dai
- Department of Rheumatology, Zhongshan Hospital affiliated to Fudan University, No. 180, Fenglin Road, Shanghai, 200032, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Serum Uric Acid Levels and Diabetic Peripheral Neuropathy in Type 2 Diabetes: a Systematic Review and Meta-analysis. Mol Neurobiol 2015; 53:1045-1051. [PMID: 25579387 DOI: 10.1007/s12035-014-9075-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/29/2014] [Indexed: 12/22/2022]
Abstract
Previous studies suggested a possible association between serum uric acid levels and peripheral neuropathy in patients with type 2 diabetes, but no definite evidence was available. A systematic review and meta-analysis of relevant studies were performed to comprehensively estimate the association. Pubmed, Web of Science, Embase, and China Biology Medicine (CBM) databases were searched for eligible studies. Study-specific data were combined using random-effect or fixed-effect models of meta-analysis according to between-study heterogeneity. Twelve studies were finally included into the meta-analysis, which involved a total of 1388 type 2 diabetic patients with peripheral neuropathy and 4746 patients without peripheral neuropathy. Meta-analysis showed that there were obvious increased serum uric acid levels in diabetic patients with peripheral neuropathy (weighted mean difference [WMD] = 50.03 μmol/L, 95% confidence interval [95%CI] 22.14-77.93, P = 0.0004). Hyperuricemia was also significantly associated with increased risk of peripheral neuropathy in patients with type 2 diabetes (risk ratio [RR] = 2.83, 95%CI 2.13-3.76, P < 0.00001). Meta-analysis of two studies with adjusted risk estimates showed that hyperuricemia was independently associated with increased risk of peripheral neuropathy in type 2 diabetic patients (RR = 1.95, 95%CI 1.23-3.11, P = 0.005). Type 2 diabetic patients with peripheral neuropathy have obvious increased serum uric acid levels, and hyperuricemia is associated with increased risk of peripheral neuropathy. Further prospective cohort studies are needed to validate the impact of serum uric acid levels on peripheral neuropathy risk.
Collapse
|