Estimation of serum uric acid level in acute ischemic stroke

Background: The impact of uric acid as a stand-alone risk factor for non-communicable illness has been debated for decades. Strong free radical scavengers like hydroxyl ions, peroxynitrite, and other an?oxidants like ascorbic acid are all scavenged by serum uric acid. Neuroprotec?ve agents include uric acid and its connec?on to ischemic stroke is s?ll debatable. Therefore, the current study tried to evaluate the serum uric levels in acute ischemic stroke pa?ents. Methods: Pa?ents with acute stroke were included in the trial, thus if rTPA was given to them, it was noted. The pa?ent’s baseline blood pressure was taken (in a supine posi?on). All acute stroke pa?ents had blood drawn within 24 hours of admission to assess their lipid profiles, fas?ng blood sugar levels, and uric acid levels. A neurologist assessed each pa?ent, and computer tomography (CT) and magne?c resonance imaging were used to dis?nguish between ischemic stroke and other types of stroke (MRI). Results: Serum UA levels were found to be significantly higher in stroke pa?ents, with 77.5 percent of pa?ents having high levels (>6 mg/dL) compared to 30.0 percent of controls. When compared to the controls, the mean serum UA level in pa?ents was considerably higher (p=0.0212). Mul?ple logis?c regression analysis was used to determine the rela?onship between serum UA levels and outcome. Independent of other prognos?c criteria, pa?ents with high serum UA levels had a significantly worse outcome. Conclusion: A significant rela?onship exists between high serum UA levels and ischemic stroke, stroke subtypes (excluding lacunar stroke), and poor outcomes. Finding and managing modifiable risk factors for stroke has advanced quite a bit. Hyperuricemia could be therapeu?cally targeted in the same manner that other risk factors, such as dyslipidemia and blood pressure, are regularly treated a?er stroke.

A cohort study on the correlation between serum uric acid trajectory and the progression of renal function in patients with Type 2 diabetes mellitus / 中南大学学报(医学版)

OBJECTIVES@#Diabetic kidney disease is one of the most serious complications of diabetes mellitus (DM), and it is a main cause for chronic kidney disease and end-stage kidney disease (ESRD). It is important to find out the factors that cause the progression of renal function. The study aims to explore the relationship between serum uric acid (SUA) trajectory and the progression of renal function in patients with Type 2 diabetes mellitus (T2DM).@*METHODS@#A total of 846 patients with T2DM, who were admitted to the Department of Nephrology and Endocrinology, the Third Xiangya Hospital of Central South University, from January 2009 to December 2021 and met the criteria of baseline estimated glomerular filtration rate (eGFR)≥60 mL/(min·1.73 m2), were selected as the research subjects. The SUA data of multiple measurements were collected and identified as different SUA trajectories by group-based trajectory modeling (GBTM). According to the SUA trajectories, the patients were divided into a low trajectory group (105 cases), a middle trajectory group (396 cases), a middle high trajectory group (278 cases), and a high trajectory group (67 cases). Cox regression analysis was used to examine the effect of SUA trajectory on the progression of renal function in patients with T2DM. Subgroup analysis was performed by sex, age, course of disease, body mass index (BMI) and hemoglobin A1c (HbA1c).@*RESULTS@#The median follow-up was 4.8 years. At the end of follow-up, 158 patients had different degrees of decline in renal function. After adjusting for multiple confounding factors by Cox regression analysis, the risks of eGFR<60 mL/(min·1.73 m2), eGFR reduction rate≥50%, serum creatinine (Scr) doubling and composite endpoint (eGFR reduction rate≥50%, Scr doubling or ESRD) in the high trajectory group were significantly higher than those in the low trajectory group, with HR of 3.84 (95% CI 1.83 to 8.05), 6.90 (95% CI 2.27 to 20.96), 6.29 (95% CI 2.03 to 19.52), and 8.04 (95% CI 2.68 to 24.18), respectively. There was no significant difference in the risk of ESRD among the above 4 groups (all P>0.05). Subgroup analysis showed that: compared with the low trajectory group, the risks of eGFR<60 mL/(min·1.73 m2) in patients with high trajectory in the subgroup of male, female, age<65 years, course of disease<10 years, BMI≥24 kg/m2 and HbA1c≥7% were increased (all P<0.05). The SUA trajectory had no interaction with sex, age, course of disease, BMI and HbA1c (all interactive P>0.05).@*CONCLUSIONS@#The high SUA trajectory increases the risk for progression of renal function in patients with T2DM. Long-term longitudinal changes of SUA should be paid attention to.

Correlation of gut dominant microbiota with hyperuricemia / 浙江大学学报·医学版

OBJECTIVES@#To study the correlation of intestinal dominant flora with hyperuricemia, and to explore influencing factors of hyperuricemia.@*METHODS@#Data of gut dominant microbiota were collected from subjects who underwent health check-up in Shulan (Hangzhou) Hospital from January 2018 to April 2020. Subjects with high uric acid and normal uric acid were matched by propensity score matching method according to age, gender and body mass index (BMI). This resulted in 178 pairs as hyperuricemia group and control group. The gut dominant microbiota between hyperuricemia and normal control group were compared. Pearson or Spearman correlation coefficient method was used to analyze the correlation between blood uric acid and intestinal dominant flora. Univariate and multivariate logistic regression were used to analyze the influencing factors of hyperuricemia.@*RESULTS@#The abundance of Atopobium, Lactobacillus, Bacteroides, Enterococcus, Clostridium leptum, Fusobacterium prausnitzii, Bifidobacterium, Clostridium butyricum and the ratio of Bifidobacterium to Enterobacter (B/E) in the hyperuricemia group were significantly lower than those in the control group (all P<0.01). The correlation analysis showed that serum uric acid were negatively correlated with the abundance of Atopobium (r=－0.224, P<0.01), Bacteroides (r=－0.116, P<0.05), Clostridium leptum (r=－0.196, P<0.01), Fusobacterium prausnitzii (r=－0.244, P<0.01), Bifidobacterium (r=－0.237, P<0.01), Eubacterium rectale (r=－0.125, P<0.05), Clostridium butyricum (r=－0.176, P<0.01) and B/E value (r=－0.127, P<0.05). Multivariate logistic regression analysis showed that glutamyl transpeptidase was an independent risk factor for hyperuricemia (OR=1.007, 95%CI: 1.002-1.012, P<0.05), and the Atopobium was an independent protective factor for hyperuricemia (OR=0.714, 95%CI: 0.605-0.842, P<0.01).@*CONCLUSIONS@#There are alterations in abundance of gut dominant microbiota in patients with hyperuricemia, and Atopobium abundance appears as a protective factor for hyperuricemia.

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio (UHR) and the risk of nonalcoholic fatty liver disease (NAFLD) in Chinese adults.@*METHODS@#A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination and a blood test. NAFLD was diagnosed using ultrasonography after other etiologies were excluded. Logistic regression and restricted cubic spline model were conducted to evaluate the relationship of UHR with NAFLD risk.@*RESULTS@#The multivariable adjusted odds ratio (95% confidence interval, CI) for NAFLD in the highest versus lowest quartile of UHR was 3.888 (2.324-6.504). In analyses stratified by sex and age, we observed significant and positive associations between UHR and the risk of NAFLD in each subgroup. In analyses stratified by body mass index (BMI), a significant and positive association was found only in individuals with a BMI of ≥ 24 kg/m2. Our dose-response analysis indicated a linear positive correlation between UHR and the risk of NAFLD.@*CONCLUSION@#UHR is positively associated with the risk of NAFLD and may serve as an innovative and noninvasive marker for identifying individuals at risk of NAFLD.

Association between serum uric acid/high density lipoprotein cholesterol and diabetic retinopathy in diabetic and pre-diabetic people / 中华健康管理学杂志

Objective:To evaluate the relationship between the blood uric acid/high-density lipoprotein cholesterol ratio (UHR) and diabetes retinopathy (DR) in diabetic and pre-diabetic population.Methods:A cross-sectional study. The data from a health survey from 2010 to 2011 on chronic diseases and risk factors in Changping District in Beijing was used in this study. Total of 2 507 pre-diabetic and diabetic patients who met the inclusion and exclusion criteria were screened out in this study, included 1 212 men and 1 295 women. The patients were divided into DR group and non-DR (NDR) group according to whether DR was present or not. Independent sample t-test, chi-square test and multivariate logistic regression were used for case-control study to investigate whether there was independent correlation between UHR and DR. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of UHR for DR. Results:There were gender differences in the relationship between uric acid related indicators and DR, no significant correlation was found in women. In males, the age, duration of diabetes,fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), serum uric acid, UHR levels and the proportion of diabetes and hypertension history in DR group were all significantly higher than those in NDR group (all P<0.05). Logistic regression analysis showed that SUR ( OR=1.054, 95%CI: 1.004-1.106, P=0.033) and UHR ( OR=1.391, 95%CI: 1.061-1.823, P=0.017) were the relative risk factors of DR. After adjusting for age, registered residence, education level, smoking, drinking, physical exercise, waist circumference, hypertension history, SBP, DBP, total cholesterol and other risk factors, UHR was still associated to DR [ OR ( 95%CI): 1.438 (1.084-1.908), P=0.012]. The area under the ROC curve of UHR was 0.610 ( 95%CI: 0.514-0.707, P=0.030). When the cut-off value of UHR for predicting DR was 0.24, the sensitivity and specificity were the highest, which was 78.8% and 58.7%, respectively. Conclusion:UHR is significantly correlated with the risk of DR in men with pre-diabetes and diabetes, but not in women. The risk of DR increases with the elevated level of UHR. UHR is helpful to diagnose DR and screen people with DR risk.

Research progress on the relationship between serum uric acid and sarcopenia / 公共卫生与预防医学

Objective With the deepening of population aging, sarcopenia has become an important public health problem affecting the health and quality of life of the elderly population. As the end-product of purine metabolism in human body, uric acid has dual effects of anti-oxidation, pro-oxidation and pro-inflammatory reaction , which affects the occurrence and development of sarcopenia to a certain extent. This paper reviews the research progress of serum uric acid and sarcopenia. Methods PubMed database, Web of Science core collection database, Embase database, China National Knowledge Infrastructure (CNKI) and Wanfang database were searched for literatures on the relationship between serum uric acid (SUA) level and sarcopenia up to February 7, 2022, and then reviewed. Results A total of 4 epidemiological studies were found on serum uric acid levels and the risk of sarcopenia. Among them, 3 studies found that SUA within a certain level range was a protective factor for sarcopenia, and 1 study suggested that the risk of sarcopenia increased with the increase of SUA levels. There was a gender difference between serum uric acid level and sarcopenia risk. Conclusion At present, the results of studies on the relationship between serum uric acid levels and the risk of sarcopenia are still controversial, which may be caused by the different effects of uric acid in human body. In the future , more extensive and in-depth studies are needed to investigate the relationship between the two.

Association of serum uric acid with waist-hip ratio: A promising index for assessing cardiovascular disease risk profile

Background: Abdominal obesity is associated with insulin resistance, in turn, hyperinsulinemia and visceral adiposity lead to an increased uric acid (UA) absorption in renal tubules. Aim and Objectives: Accumulation of visceral fat is an underlying component of metabolic syndrome. Furthermore, the waist-hip ratio is an indirect tool for assessing visceral fat. The present study evaluates the association of UA levels with the waist-hip ratio. Materials and Methods: 160 subjects aged 18–60 years were enrolled in the study (those having any anatomical deformity, diabetes, and/or hypertension for more than 5 years were excluded from the study). Their anthropometric parameters, blood pressure, lipid profile, fasting plasma glucose, and serum UA levels were measured. Results: The study population was divided into three groups based on UA levels. The waist-hip ratio in a group of the hyperuricemic population was more as compared to groups of normal and below normal UA levels population and the association of UA level with waist-hip ratio was found to be significant (P = 0.045). Conclusion: The over-inflow of free fatty acid to the liver from accumulated visceral fat may be linked to the de novo purine synthesis through the pentose phosphate pathway, which may accelerate the production of UA.

Serum Uric Acid as an Independent Risk Factor for Acute Ischemic Stroke

Serum Uric Acid as an Independent Risk Factor for Acute Ischemic StrokeBackground: Stroke is a neurological deficit due to acute focal injury of the central nervous system due to any vascular cause. The role of serum uric acid as a risk factor for acute stroke is an area of importance to many researchers. We in the current study tried to determine the levels of serum uric acid in cases of acute ischemic stroke and compare them with those in age and sex-matched controls. Methods: This hospital-based case-control study was performed in the Department of General Medicine, Prathima Ins?tute of Medical Sciences, Naganoor, Karimnagar. All the subjects were interviewed, examined, and inves?gated as per the predesigned and pre-tested proforma. Biochemical inves?ga?ons included es?ma?on of serum uric acid, serum triglycerides, fas?ng blood glucose, Renal func?on tests, and Liver func?on tests. Results: Mean Serum Uric Acid level was lower in the pa?ents with lacunar stroke as compared to the pa?ents with larger infarcts (6.16 ± 1.68 mg/dl vs. 6.73 ± 2.07 mg/dl). Bu?hisdifference was not sta?s?cally significant as the p-value is >0.05.The correla?on between SUA and NIHSS score was studied with the help of Spearman rank correla?on. It was found that there was a significant posi?ve correla?on between SUA and NIH stroke scale score on admission as well as at the ?me of discharge (p<0.05 for both). Conclusion: Elevated serum uric acid level is independently associated with acute ischemic stroke. It was observed that serum uric acid levels were correlated with hypertension, diabetes mellitus, smoking, obesity, and metabolic syndrome. It was found that cases with elevated serum acid levels had poor prognosis and overall mortality rate.

Effect of serum uric acid on recurrent stroke in patients with acute cerebral infarction / 中华急诊医学杂志

Objective:investigate the effect of serum uric acid (SUA) on long-term cerebrovascular mortality and recurrent stroke in patients with acute cerebral infarction.Methods:A total of 132 patients from the same center were enrolled in this study. The patients were divided into three groups according to the quartile level of SUA: group 1 (SUA < 442 μmol/L, n= 69) , group 2 (SUA 442-620 μmol/L, n=35) and group 3 (SUA > 620 μmol/L, n= 28). SUA, blood urea nitrogen, serum creatinine, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglyceride and hypersensitive c-reactive protein (hs-CRP) were measured in the three groups, the National Institutes of Health Stroke Scale (NIHSS) score was determined on the day of admission, and the patients were followed up until December 31, 2020. The differences of recurrent stroke and cerebrovascular mortality in the three groups were analyzed. Results:Sixty-nine patients were selected in group 1, 35 in group 2 and 28 in group 3. Patients in group 2 and group 3 were younger, and had higher hs-CRP levels, higher SUA levels, and higher rates of recurrent stroke and cerebrovascular mortality, and the differences were statistically significant (all P<0.05). Cerebrovascular mortality (log-rank χ2 =13.19, P=0.001) and recurrent stroke (log-rank χ2 =10.30, P=0.006) were significantly increased in group 3. The risk of recurrent stroke in group 3 was 3.55 times higher than that in group 1. Conclusions:The risks of long-term cerebrovascular mortality and recurrent stroke were significantly increased in patients of acute cerebral infarction with elevated serum uric acid.

Reference range of serum uric acid and prevalence of hyperuricemia: a cross-sectional study from baseline data of ELSA-Brasil cohort

Abstract Background: Most of the few studies that have established reference ranges for serum uric acid (SUA) have not taken into account factors which may interfere with its levels and followed rigorous laboratory quality standards. The aim of this study was to establish reference ranges for SUA and determine the prevalence of hyperuricemia. Method: Cross-sectional study including 15,100 participants (all sample) aged 35 to 74 years from baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicentric cohort of volunteer civil servants from five universities and one research institute located in different regions of Brazil. It was established a reference sample excluding participants with factors that directly influence SUA levels: glomerular filtration rate lower than 60 ml/min, excessive alcohol intake, use of diuretics, aspirin, estrogen or urate-lowering therapy. SUA was measured using the uricase method and following rigorous international quality standards. Reference ranges were defined as values between percentiles 2.5 (P2.5) and 97.5 (P97.5) of SUA distribution in the reference sample, stratified by sex. Hyperuricemia was defined as SUA ≥ 7 mg/100 ml in the all sample. Results: The reference sample was composed of 10,340 individuals (55.3% women, median age 50 years). Reference ranges (P2.5 to P97.5) for SUA were: 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Sex was a major determinant for SUA levels (median [IQR], mg/100 ml: 6.1 [5.3-7.0] for men versus 4.5 [3.9-5.3] for women, p < 0.001). Higher levels of SUA were found in patients with higher BMI. Higher age had (a modest) influence only for women. The prevalence of hyperuricemia for all sample (N = 15,100) was 31.9% (95% confidence interval [CI] 30.8- 33.0%) in men and 4.8% (95% CI 4.3-5.3%) in women. Conclusion: SUA reference ranges were 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Prevalence of hyperuricemia was 31.9% in men and 4.8% in women. Updated SUA reference ranges and prevalence of hyperuricemia are higher nowadays and might be used to guide laboratories and the screening for diseases related to SUA.

Assessment of Serum Uric Acid, Urea, and Glucose Levels and Associated Factors among Breast Cancer Patients Attending A Tertiary Hospital in Bahirdar, Ethiopia: A Comparative CrossSectional Study

BACKGROUND: Breast cancer is currently become a major public health problem in both developed and developing regions, it is one of the most common surgical problems in Ethiopia. Therefore, this study assessed serum uric acid, urea, and glucose levels and associated factors among benign, malignant breast cancer patients and apparently healthy women attending at Felege-Hiwot comprehensive Specialized Hospital. METHODS: Hospital based comparative cross-sectional study was conducted among benign, malignant breast cancer patients and apparently healthy women attending at Felege-Hiwot Comprehensive Specialized Hospital. Out of 178 study participants 66 benign and 23 malignant fine needle aspirate cytology confirmed breast cancer patients and 89 apparently healthy women, included. Multivariable logistic regression models used to measure the strength of associations. A P value of < 0.05 was considered statistically significant. RESULTS: Majority of the study participants, 81(91%) controls, 55(83.3%) benign, and 17(73.9%) malignant cases were premenopausal. Serum glucos144.47±74.35 and uric acid 6.84±2.54 levels were significantly elevated in malignant cases than control (p-value< 0.05). Patients with malignant status were 4.38 times more likely to have hyperglycemia (AOR=4.38, 95%CI: 1.98-19.97) and 5.53 times more likely have hyperuricemia (AOR=20.43-95% CI: 6.80- 61.23), 4 times more likely to have uremia (AOR=4.09, 95% CI: 1.06-15.91) compared to apparently healthy women. CONCLUSION: Serum glucose, and uric acid levels were significantly higher in malignant and benign cases compared with apparently healthy women. Family history of breast cancer, body mass index, systolic hypertension, comorbidity, residence and menopausal status were significantly associated with hyperglycemia, uremia and hyperuricemia.

Salivary uric acid: Clinical application and future prospects / 中华内分泌代谢杂志

Saliva, like blood, urine, and other body fluids, contains extremely rich substances, among which salivary uric acid has a good correlation with serum uric acid, and could replace serum uric acid to a certain extent. In recent years, it has been found that salivary uric acid has a unique clinical value that serum uric acid does not have, and it is related to the occurrence and development of adolescent hypertension, adolescent body fat accumulation and preeclampsia, etc., so it is speculated that salivary uric acid has a certain application prospect. The aim of this review is to provide an update on the research of salivary uric acid and its future prospect.

Factors affecting dyslipidemia among residents in Haining City / 预防医学

Objective@#To investigate the prevalence and risk factors of dyslipidemia among residents in Haining City, Zhejiang Province, so as to provide into the management of dyslipidemia.@*Methods@#Totally 1 953 residents at ages of 15 to 69 years were recruited using a multi-stage stratified cluster sampling method in 5 townships (streets) of Hainan City. Subjects' demographic features, smoking status, alcohol consumption, family history of diseases and development of chronic diseases were collected. The height, body weight, waist circumstance and blood pressure were measured, and the fasting blood glucose, serum uric acid and blood lipid levels were determined. The prevalence of dyslipidemia was analyzed and standardized by the 7th population census data. The factors affecting dyslipidemia were identified using a multivariable logistic regression model.@*Results@#Totally 1 893 valid questionnaires were recovered. The respondents included 949 males (50.13%) and 944 females (49.87%), and had a mean age of (47.90±14.34) years. A total of 513 participants were detected with dyslipidemia, and the prevalence and standardized prevalence of dyslipidemia were 27.10% and 27.01%, respectively. The prevalence of hypertriglyceridemia, hypercholesterolemia, hyperlipoproteinemia and hypolipoproteinemia was 16.53%, 3.22%, 1.74% and 15.27%, respectively. Multivariate logistic regression analysis showed that male (OR=1.571, 95%CI: 1.268-1.947), family history of stroke (OR=1.645, 95%CI: 1.192-2.270), hyperuricemia (OR=1.809, 95%CI: 1.370-2.388), central obesity (OR=1.423, 95%CI: 1.066-1.900), obesity (OR=1.736, 95%CI: 1.335-2.257), underweight (OR=0.171, 95%CI: 0.049-0.593) significantly correlated with dyslipidemia.@*Conclusions@#The prevalence of dyslipidemia is lower than the national level among residents at ages of 15 to 69 years in Haining City, and hypertriglyceridemia and hypolipoproteinemia are predominant types of dyslipidemia. Male, obesity, family history of stroke and hyperuricemia are risk factors of dyslipidemia.

Impact of different lifestyle indexes on serum uric acid levels in young and middle-aged men / 中华内分泌代谢杂志

Objective:To investigate the impact of lifestyle index (LSI) on serum uric acid levels in young and middle-aged men.Methods:This was a cross sectional study. A total of 8 067 subjects underwent check-up in Taihu Sanatorium of Jiangsu Province from March 2020 to June 2021 were enrolled, average age were(46.46±8.81) years. According to age, subjects were divided into young male group (18-44 years old, n=3 269) and middle-aged male group (45-60 years old, n=4 798). Height, weight, body mass index, alcohol drinking, smoking, diet, exercise, fasting blood glucose, total cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol(LDL-C), serum uric acid and other data in all cases were measured and recorded. Results:The serum uric acid level in allsubjects was (376.80±74.43)μmol/L and the prevalence of hyperuricemia was 25.7%.The serum uric acid level in the young male group was higher than that in the middle-aged male group [(381.86±74.32)μmol/L vs (373.34±74.32)μmol/L, P<0.001]. The prevalence of hyperuricemia in the young male group was higher than that in the middle-aged male group (27.4% vs 24.5%), and the difference was statistically significant ( P<0.001). With the improvement of LSI scores, the serum uric acid levels in young and middle-aged men showed a decreasing trend ( P<0.01). Logistic regression analysis showed that after adjusting for age, fasting blood glucose, total cholesterol, triglyceride, HDL-C, LDL-C, hypertension, and diabetes, LSI was an independent factor for serum uric acid levels in young and middle-aged men. The risk of hyperuricemia in young and middle-aged male decreased ( OR 0.83 and 0.84, respectively, P<0.01) for every 1-point increase in LSI. Exercise and body mass index were independently associated with hyperuricemia in the young male group ( OR 0.83 and 0.54, respectively, P<0.05). Exercise, body mass index, and alcohol drinking were independently associated with hyperuricemia in the middle-aged male group ( OR 0.85, 0.51 and 0.65, respectively, P<0.05). Conclusion:LSI is an independent factor associated with hyperuricemia in young and middle-aged men and a healthy lifestyle has a protective effect on serum uric acid levels in young and middle-aged men.

Association of the interaction between serum uric acid and diastolic blood pressure on the risk of tophi / 中华内分泌代谢杂志

Objective:To analyze the influencing factors of gout patients and explore whether there is an interaction between serum uric acid and diastolic blood pressure affecting the onset of tophi.Methods:A total of 4 798 gout patients were retrospective selected in the outpatient Department of the Gout Clinical Medical Center of the Affiliated Hospital of Qingdao University from September 2016 to May 2020. It was divided into tophi group and non-tophi group to compare the differences in indicators. A logistic regression model was used to analyze the influencing factors of tophi, and an interaction model was constructed to analyze the interactions.Results:Multivariate logistic regression analysis showed significant associations between age, diastolic blood pressure, alcohol consumption history, gout family history, blood uric acid, urea nitrogen, and creatinine clearance and tophi formation. The results of blood uric acid-related interaction analysis showed a significant interaction between blood uric acid and diastolic blood pressure( Pinteraction=0.014), and the risk of developing tophi in low diastolic blood pressure and high diastolic blood pressure group increased by 34.4%( OR=1.344, 95% CI 1.105-1.635, P=0.003) and 95.4%( OR=1.954, 95% CI 1.558-2.450, P<0.001) in the high blood uric acid group compared with the low blood uric acid group. The results of diastolic blood pressure and blood uric acid subgroup analysis showed that there was no statistical difference in the risk of developing tophi in people with low uric acid levels( P=0.238), but in people with high uric acid levels, the risk of developing tophi was 67%( OR=1.670, 95% CI 1.379-2.022, P<0.001) higher than that in the low uric acid group. Conclusion:Age, diastolic blood pressure, combined alcohol consumption history and gout family history, blood uric acid, renal function are related to the occurrence of tophi. High uric acid and high diastolic blood pressure have interaction on the occurrence of tophi. Attention and proactive intervention shall be applied to this group of patients.

Association of interaction between urinary glucose excretion and body mass index on serum uric acid in type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the relationship between urinary glucose excretion, body mass index, and serum uric acid in type 2 diabetes mellitus, and to evaluate the association of interaction between uric glucose and body mass index on the risk of hyperuricemia.Methods:A total of 867 hospitalized patients with type 2 diabetes mellitus were included in this study. The height, weight, blood pressure and other general conditions were measured. 24-hour urine glucose quantification, glycolipid metabolism, and serum uric acid were collected. Multivariate linear regression analysis and multivariate logistic regression analysis were performed to determine the association of body mass index and urinary glucose with hyperuricemia.Results:After adjusting for age, sex, course of disease, blood pressure, HbA 1C, insulin, homeostasis model assessment for insulin resistance, fasting plasma glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, creatinine, and glomerular filtration rate, body mass index was positively associated with serum uric acid( β=4.281, 95% CI 2.645-5.917, P<0.001), and 24-hour urine glucose was negatively associated with serum uric acid( β=-0.435, 95% CI -0.708--0.162, P=0.002). Body mass index is an independent risk factor of hyperuricemia( P<0.01). There was a significant interaction between urine glucose and body mass index(interaction P<0.05). In the low urine glucose group, obese patients displayed odds ratio of 2.203 for hyperuricemia compared with non-obese patients, whereas the odds ratio was not significant in the high urine glucose group.The associations between body mass index and hyperuricemia were stronger in participants with low urine glucose than in those with high urine glucose. Conclusion:Urinary glucose excretion can weaken the positive correlation between body mass index and serum uric acid, suggesting that promoting urinary glucose excretion may be an effective strategy to control serum uric acid levels in type 2 diabetes mellitus, especially in obese patients.

Serum uric acid and short term prognosis of acute ischemic stroke in patients received intravenous thrombolysis / 中华内分泌代谢杂志

Objective:To investigate the relationship between serum uric acid (SUA) and 3-month outcomes in patients with acute ischemic stroke undergoing intravenous thrombolysis.Methods:A total of 386 patients with acute ischemic stroke received intravenous thrombolysis therapy from 1 January 2017 to 31 December 2019 in the Affiliated Hospital of Lianyungang, Xuzhou Medical University were enrolled prospectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. The functional outcome was evaluated by the modified Rankin Scale at discharge or 3 months after onset. Pearson′s correlation was used to assess the relationship between SUA and NIHSS scores at baseline and discharge. Propensity score matching was used to balance confounding factors. Multivariate logistic regression model was used to identify the correlation between SUA and prognostic outcome after thrombolysis.Results:A total of 386 eligible patients were included. Two hundred and thirty patients (59.6%) had good outcomes in the follow-up after 3 months. The levels of SUA are negatively associated with the NIHSS score at discharge ( r=-0.171, P=0.003). A positive correlation was observed between the levels of SUA and the difference of NIHSS at baseline and discharge ( r=0.118, P=0.032). Patients were divided into three groups according to the quartile of SUA. Multivariate logistic regression analysis showed that high SUA levels were independently associated with good outcome three months after stroke ( OR=0.421, 95% CI 0.327-0.541, P<0.001). Conclusion:In patients with acute ischemic stroke, elevated SUA levels can predict better recovery and short-term outcomes in patients undergoing intravenous thrombolysis.

Serum uric acid levels among physical examination populations in Balikun County / 预防医学

Objective@#To investigate the serum uric acid levels among residents living in Balikun County, Xinjiang Uygur Autonomous Region from 2018 to 2021, so as to provide insights into local hyperuricemia control.@*Methods@#The residents at ages of 20 to 69 years undergoing physical examinations in Balikun County Hospital during the period from 2018 to 2021 were enrolled. Their age, gender, and history of medication and disease were collected, and serum uric acid levels were measured. The gender- and age-specific prevalence of hyperuricemia and hypouricemia was descriptively analyzed.@*Results@#A total of 3 097 subjects were enrolled, which included 1 210 males ( 39.07% ) and 1 887 females ( 60.93% ) and had a mean age of ( 46.12±12.84 ) years. The overall mean serum uric acid was ( 260.41±71.99 ) μmol/L, and the mean serum uric acid was ( 298.22±69.57 ) μmol/L in men and ( 236.17±62.44 ) μmol/L in women. The serum uric acid level appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hyperuricemia was 4.26%, with 4.63% prevalence in men and 4.03% in women. The prevalence of hyperuricemia appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hypouricemia was 0.71%, with 0.25% prevalence in men and 1.01% in women; the prevalence of moderate hypouricemia was 11.11%, with 2.56% prevalence in men and 16.59% in women.@*Conclusions@#Low level of serum uric acid and prevalence of hyperuricemia is detected among residents living in Balikun County. Monitoring of serum uric acid is recommended to be intensified among men.

An analytical Study to Evaluate the correlation between Serum Uric Acid Levels and Deaths in Acute Myocardial Infarction Patients At a Tertiary Level Institute Catering to Rural Population of Western Maharashtra

Background: Cardiovascular diseases are the number one cause of mortality all over the world. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease. We conducted this study to assess serum uric acid levels on admission as a potential predictor of short-term mortality (7 days) in acute myocardial infarction patients. Methodology: Total of 200 patients diagnosed with the myocardial infarction (MI) in our hospital along with 200 age and gender matched controls were selected for this study. The clinical history, examination, ECG changes and biochemical markers were evaluated on day 0, 3 and 7. Association with Killips class and mortality in STEMI / NSTEMI cases was done. Results:The study had 200 cases and 200 controls. The mean age of cases was 62.54 ± 18.24 years and controls were 61.94±17.25 years. There were majority males among both cases 114 (57%) and controls 112 (56%). The patients were classified using Killip's class. Majority belong to class I 98 (49%) followed by II 42 (21%). There were 26 (13%) of class III and 34 (17%) into class IV. There is significant difference seen between uric acid levels of cases and control on day 1, 3 and 7 (p<0.001). There was 25% mortality (50 deaths) seen among the cases. There was association seen between Killips class III & IVand mortality, there was higher mortality seen in STEMI as compared to NSTEMI (i.e. p<0.05). Conclusion:Our study concludes that the serum uric acid (SUA) levels have significant association with Killip's class and mortality in Acute Myocardial Infarction cases.

Effect of antipsychotics on serum uric acid in patients with schizophrenia： a Meta-analysis / 四川精神卫生

ObjectiveTo investigate the impact of antipsychotics on serum uric acid level in patients with schizophrenia， and to clarify the antioxidant properties of antipsychotics， so as to provide evidence-based guidelines for the treatment of schizophrenia. MethodsKeywords combined with free-text search strategies were used to retrieve English and Chinese databases including PubMed， Embase， Web of Science， Cochrane Library， CNKI， Wanfang Database， VIP database and Chinese Biomedical Literature Database. Randomized controlled trials related to the effects of antipsychotics on serum uric acid level in patients with schizophrenia were included. Meta-analysis was performed using RevMan 5.3. ResultsA total of 9 kinds of antipsychotics and 1 434 schizophrenia patients in 15 Chinese and English literatures were included. Meta-analysis showed that olanzapine （MD=14.01， 95% CI： 2.39~21.62， P<0.05） and chlorpromazine （MD=51.36， 95% CI： 42.15~60.57， P<0.05） increased the serum uric acid level in schizophrenia patients， while risperidone， aripiprazole， clozapine， haloperidol， quetiapine and ziprasidone had no significant effect on serum uric acid （P>0.05）. ConclusionThe effect of different kinds of antipsychotics on serum uric acid level in schizophrenia patients varies， among which olanzapine and chlorpromazine can elevate serum uric acid level in patients with schizophrenia， whereas no other antipsychotics have been found to have any effect on serum uric acid level.