Dataset Information

Uric Acid and Risk of Cardiovascular Disease and Mortality: A Longitudinal Cohort Study.

ABSTRACT:

Background

This study aimed to examine the association of serum uric acid levels with incident cardiovascular disease and mortality in Korean adults without gout.

Methods

This large longitudinal cohort study included adults aged > 19 years who had serum uric acid levels measured at least once at the National Health Insurance Service Ilsan Hospital from January 1, 2006 to December 31, 2015. Longitudinal data on person-level cardiovascular disease and cardiovascular mortality were linked to the National Health Insurance Service claims database and National Death Index.

Results

Among a total of 92,454 study participants with a median follow-up of 4.7 years, 7,670 (8.3%) composite events of cardiovascular disease or cardiovascular mortality were observed. Multivariable Cox proportional-hazards models revealed that each 1 mg/dL increment in uric acid level was associated with a 6% higher risk of composite outcomes. Compared with that for the uric acid level category of 4.0 to < 5.0 mg/dL, adjusted hazard ratios (95% confidence interval) for uric acid level categories of 5.0 to < 6.0, 6.0 to < 7.0, and ≥ 7.0 mg/dL were 1.10 (1.04-1.18), 1.20 (1.11-1.30), and 1.36 (1.25-1.47), respectively. In the secondary analyses for cardiovascular disease or cardiovascular mortality examined separately, a higher uric acid level was similarly associated with a higher risk of each adverse outcome. These associations were generally consistent across clinically relevant subgroups.

Conclusion

A graded association was noted between serum uric acid levels and cardiovascular risk, suggesting that higher uric acid levels may adversely affect cardiovascular health and survival in individuals without gout.

SUBMITTER: Kim JY

PROVIDER: S-EPMC10519779 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Uric Acid and Risk of Cardiovascular Disease and Mortality: A Longitudinal Cohort Study.

Kim Jae Young JY Seo Changhwan C Pak Haeyong H Lim Hyunsun H Chang Tae Ik TI

Journal of Korean medical science 20230925 38

<h4>Background</h4>This study aimed to examine the association of serum uric acid levels with incident cardiovascular disease and mortality in Korean adults without gout.<h4>Methods</h4>This large longitudinal cohort study included adults aged > 19 years who had serum uric acid levels measured at least once at the National Health Insurance Service Ilsan Hospital from January 1, 2006 to December 31, 2015. Longitudinal data on person-level cardiovascular disease and cardiovascular mortality were l ...[more]

PMID: 37750373

Similar Datasets

Project description:ObjectiveTo evaluate the associations between serum uric acid (SUA) levels and cardiovascular disease (CVD) risk factors, focusing on potential sex-specific differences.DesignA retrospective cohort study.SettingA large community-based survey was conducted every two years from 2010 to 2018 in Hangzhou, Zhejiang Province, outheastern China.Participants6119 participants aged 40 years and above who underwent at least three times of physical examinations were enrolled.MethodsParticipants were categorised into four groups (Q1-Q4) based on baseline SUA quartiles within the normal range, with hyperuricaemia (HUA) as the fifth group. The Q1 was the reference. By stratifying participants by gender, the relationships between SUA levels and systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) and total cholesterol (TC) were investigated using linear regression models in the generalised estimating equation. Additionally, the associations of elevated SUA levels and HUA with hypertension, hyperglycaemia and dyslipidaemia were correspondingly examined using multivariate logistic regression models.ResultsAfter adjusting for confounding variables, we found positive associations between SUA levels and SBP, DBP, FBG and TC in women, and with TC in men (p<0.01). Likewise, elevated SUA quartiles and HUA were linked to increased dyslipidaemia risk in both sexes, and increased hyperglycaemia risk only in women, with HRs (95% CI) of 1.64 (1.05 to 2.55) and 2.37 (1.47 to 3.81) in the Q4 and HUA group, respectively. Women with HUA had higher hypertension risk (HR=1.45, 95% CI 1.21 to 1.73), while no such association was observed in men. Stratified analyses revealed significant associations between elevated SUA levels and CVD risk factors in postmenopausal and non-obese women.ConclusionsElevated SUA levels increase the risk of dyslipidaemia in both sexes. SUA levels within normal range and HUA are positively associated with hyperglycaemia and hypertension in postmenopausal women, but not in men.

Project description:BackgroundThe predictive value of serum uric acid (SUA) for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.MethodsThe relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death) and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD). Cox models were used to assess the role of SUA as an independent risk factor.Results9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death), and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20-2.10). In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72-1.36) nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08-2.12). No relationship was observed in men (HR: 1.06; 95% CI: 0.82-1.36).ConclusionSUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all-cause mortality in women.

Project description:The relationship between serum uric acid (SUA) and mortality in patients with cardiovascular disease (CVD) remains controversial. We aimed to explore the relationship between SUA and all-cause mortality (ACM) and cardiovascular mortality (CVM) in adult patients with CVD. This cohort study included 3977 patients with CVD from the National Health and Nutrition Examination Survey (2005-2018). Death outcomes were determined by linking National Death Index (NDI) records through December 31, 2019. We explored the association of SUA with mortality using weighted Cox proportional hazards regression models, subgroup analysis, Kaplan-Meier survival curves, weighted restricted cubic spline (RCS) models, and weighted threshold effect analysis among patients with CVD. During a median follow-up of 68 months (interquartile range, 34-110 months), 1,360 (34.2%) of the 3,977 patients with cardiovascular disease died, of which 536 (13.5%) died of cardiovascular deaths and 824 (20.7%) died of non-cardiovascular deaths. In a multivariable-adjusted model (Model 3), the risk of ACM (HR 1.38, 95% CI 1.16-1.64) and the risk of CVM (HR 1.39, 95% CI 1.04-1.86) for participants in the SUA Q4 group were significantly higher. In patients with CVD, RCS regression analysis revealed a nonlinear association (p < 0.001 for all nonlinearities) between SUA, ACM, and CVM in the overall population and in men. Subgroup analysis showed a nonlinear association between ACM and CVM with SUA in patients with CVD combined with chronic kidney disease (CKD), with thresholds of 5.49 and 5.64, respectively. Time-dependent ROC curves indicated areas under the curve of 0.61, 0.60, 0.58, and 0.55 for 1-, 3-, 5-, and 10-year survival for ACM and 0.69, 0.61, 0.59, and 0.56 for CVM, respectively. We demonstrate that SUA is an independent prognostic factor for the risk of ACM and CVM in patients with CVD, supporting a U-shaped association between SUA and mortality, with thresholds of 5.49 and 5.64, respectively. In patients with CVD combined with CKD, the association of the ACM and the CVM with SUA remains nonlinear.

Project description:BackgroundCardiovascular disease (CVD) is a leading cause of global mortality, with increasing prevalence and impact, especially in the elderly and developing countries. Insulin resistance (IR) plays a significant role in CVD progression, and the triglyceride glucose-body mass index (TyG-BMI) index, combining fasting glucose and triglycerides, offers a simple, cost-effective method for assessing IR. However, its prognostic value in CVD populations remains underexplored. This study aims to investigate the relationship between TyG-BMI and mortality in CVD patients.MethodsData from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) combined with the linked National Death Index were analyzed. The CVD population was split into two groups (Q1 and Q2) based on the median TyG-BMI. The primary outcomes were all-cause mortality and cause-specific mortality.ResultsThe study ultimately included 2,576 participants, of which 56% were male. The median age of the participants was 69 years, and the median TyG-BMI was 256.59. After adjusting for potential confounders, a negative relationship was found between TyG-BMI and all-cause mortality in populations with CVD, coronary heart disease (CHD), congestive heart failure (CHF), and heart attack. The hazard ratios (HR) and 95% confidence intervals (CI) were 0.73 (0.64, 0.85), 0.67 (0.53, 0.84), 0.69 (0.54, 0.88), and 0.73 (0.59, 0.91), respectively. At the same time, a notable inverse relationship was noted between the TyG-BMI and non-CVD mortality in the CVD and CHD population, with HR and 95% CI of 0.70 (0.58, 0.84) and 0.61 (0.45, 0.82), respectively. In this study, there was no observed noteworthy relationship between TyG-BMI and CVD mortality. Furthermore, sensitivity analysis yielded similar results.ConclusionAmong populations with CVD in the United States, a heightened TyG-BMI was notably correlated with a decreased likelihood of mortality. This index can effectively classify the risk levels of CVD patients and may serve as a valuable prognostic marker.

Dataset Information

Uric Acid and Risk of Cardiovascular Disease and Mortality: A Longitudinal Cohort Study.

Background

Methods

Results

Conclusion

Publications

Uric Acid and Risk of Cardiovascular Disease and Mortality: A Longitudinal Cohort Study.

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