Title: Relationship between Hyperuricemia, Hyperglycemia and Elevated Triglyceride Levels in Cardiometabolic Disorder
Authors: Neha Sharma, Rajkumari Rathore, Dr Purnima Dey Sarkar, Dr Anil Bidwai
DOI: http://dx.doi.org/10.18535/jmscr/v4i1.20
Introduction: High levels of triglycerides and uric acid have each been reported to be independently associated with an elevated risk for coronary heart disease.(1,2) However, it is less well established whether high levels or triglycerides or uric acid, per se, represent independent cardiovascular risk factors. Rather, both hypertriglyceridemia and hyperuricemia serve as biomarkers for increased coronary heart disease risk. Materials and methods: We retrospectively analyzed results of serum uric acid, fasting plasma glucose (FPG) and triglyceride tests performed on the whole cohort of outpatient adults consecutively referred to our laboratory for routine blood testing for one year. This study included 150 cardiometabolic subjects aged 25 to 80 years. The body mass index (BMI), waist circumference, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Results: Data were analyzed using student t-test, pearson’s coefficient and linear regression model. The prevalence of a serum uric acid level >0.42 mmol/L in men was 18.32% and the prevalence of a serum uric acid level >0.36 mmol/L was 15.9% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.255 in men and r = 0.254 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI and waist circumference. This study shows that serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Conclusion: The mutual biological interrelationship observed between serum uric acid, hypertriglyceridemia and hyperglycemia raises the possibility of a potential pathogenetic overlap between these conditions. Keywords: Cardiometabolic disease, Hyperuricemia, Hypertriglyceridemia, Hyperglycemia, Metabolic syndrome. 1. Sarwar N, Danesh J, Eiriksdottir G, et al. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation. 2007;115:450-458. 2. Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404-2410 3. Saggiani F, Pilati S, Targher G, Branzi P, Muggeo M, Bonora E. Serum uric acid and related factors in 500 hospitalized subjects. Metabolism 1996;45:1557-6. 4. Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007;120:442-7. 5. Bonora E, Targher G, Zenere MB, Saggiani F, Cacciatori V, Tosi F, et al. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study. Int J Obes Relat Metab Disord 1996;20:975-80. 6. Ford ES, Li C, Cook S, Choi HK. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation 2007;115:2526-32. 7. Hjortnaes J, Algra A, Olijhoek J, Huisman M, Jacobs J, van der Graaf Y, Visseren F. Serum uric acid levels and risk for vascular diseases in patients with metabolic syndrome. J Rheumatol 2007 Aug 1; ŠEpub ahead of printĆ. 8. Liou TL, Lin MW, Hsiao LC, Tsai TT, Chan WL, Ho LT, et al. Is hyperuricemia another facet of the metabolic syndrome? J Chin Med Assoc 2006;69:104-9. 9. Lin JD, Chiou WK, Chang HY, Liu FH, Weng HF. Serum uric acid and leptin levels in metabolic syndrome: a quandary over the role of uric acid. Metabolism 2007; 56:751-6. 10. Marchesini G, Forlani G, Cerrelli F, et al. WHO and ATPIII proposals for the definition of the metabolic syndrome in patients with type 2 diabetes. Diabet Med. 2004 Apr; 21(4):383-7. 11. Bucolo, G., David, H., (1973) Clin. Chem. 19 :476 12. Trivedi R.C., et. al., Clin. Chem., 24(11), 1908-1911 (1978). 13. Fang J, Alderman MH,JAMA 2000 , 283:2404-2410 14. Saggiani F, Pilati S, Targher G, Branzi P, Muggeo M, Bonora E. Serum uric acid and related factors in 500 hospitalized subjects. Metabolism 1996;45:1557-6. 15. Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007;120:442-7. 16. Mazzali M, Kanellis J, Han L, Feng L, Xia YY, Chen Q, et al. Hyperuricemia induces a primary arteriolopathy in rats by a blood pressure-independent mechanism. Am J Physiol Renal Physiol 2002;282:F991–7. 17. Leyva F, Anker S, Swan JW, Gotsland EF, Wingrove CS, Chua TP, et al. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J 1997;18:858-65. 18. Johnson RJ, Kang D-J, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90. 19. Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 1991;266:3008-11. 20. Bakker SJ, Gans RO, ter Maaten JC, Teerlink T, Westerhoff HV, Heine RJ. The potential role of adenosine in the pathophysiology of the insulin resistance syndrome. Atherosclerosis 2001;155:283-90Abstract
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