Association between hyperuricemia and chronic kidney disease: a cross-sectional study in Bangladeshi adults.

BACKGROUND AND AIMS: Chronic kidney disease (CKD) is a public health concern worldwide and has been recognized as a significant risk factor for cardiovascular disease. The elevated level of uric acid (hyperuricemia) has been suggested to be associated with obesity, hypertension, cardiovascular disease and diabetes. However, there is limited information on the relationship between hyperuricemia and CKD. Therefore, this study aimed to estimate the prevalence of CKD and assess its relationship with hyperuricemia in Bangladeshi adults. METHODS: In this study, blood samples were collected from 545 participants (398 males and 147 females) aged ≥ 18 years. Biochemical parameters such as serum uric acid (SUA), lipid profile markers, glucose, creatinine and urea were measured by colorimetric methods. The estimated glomerular filtration rate (eGFR) and CKD were determined based on serum creatinine levels with existed formula. Multivariate logistic regression analysis was performed to evaluate the association between SUA and CKD. RESULTS: The overall prevalence of CKD was 5.9% with 6.1% in males and 5.2% in females. Hyperuricemia was prevalent in 18.7% of participants with 23.2% in males and 14.6% in females. An increasing trend of CKD prevalence was observed with increasing age in the groups. The mean eGFR level was significantly lower in male (95.1 ± 31.8 ml/min/1.73m2) than in female (109.3 ± 77.4 ml/min/1.73m2) subjects (p < 0.01). The mean level of SUA was significantly higher (p < 0.01) in participants having CKD (7.1 ± 1.9 mg/dL) than in participants without CKD (5.7 ± 1.6 mg/dL). A decreasing trend for eGFR concentration and an increasing trend for CKD prevalence was observed across the SUA quartiles (p < 0.001). In regression analysis, a significant positive association was found between hyperuricemia and CKD. CONCLUSION: This study showed an independent association between hyperuricemia and CKD in Bangladeshi adults. Further mechanistic studies are needed to explore the potential link between hyperuricemia and CKD.

Association of serum xanthine oxidase levels with hypertension: a study on Bangladeshi adults.

Xanthine oxidase (XO) is a metalloflavoenzyme associated with the uric acid formation in purine metabolism. Serum XO has been suggested to be associated with liver and kidney dysfunction, diabetes and cardiovascular diseases. However, there is limited information on the relationship between serum XO levels and hypertension. This study aimed to assess the relationship between serum XO levels and hypertension in Bangladeshi adults. In this study, fasting blood samples were collected from 312 participants (225 males and 87 females), aged ≥ 20 years. Serum levels of XO were determined by ELISA and other biochemical parameters including serum uric acid (SUA) were measured by colorimetric methods. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or self-reported recent use of anti-hypertensive medications. Association between serum XO levels and hypertension was evaluated by multinomial logistic regression analysis. The mean level of XO was significantly higher (p < 0.001) in females (5.8 ± 3.2 U/L) than in males (3.9 ± 2.5 U/L). When the participants were divided by blood pressure levels, the mean level of serum XO was significantly higher (p < 0.01) in the hypertensive group (5.0 ± 2.7 U/L) compared to the normotensive control group (4.0 ± 2.7 U/L). An increasing trend for SBP and DBP levels was observed across the XO quartiles (at least p < 0.01 for both cases). A significant positive correlation was found for XO with SBP and DBP (p < 0.01). In regression analysis, the serum levels of XO showed a significant and independent association with hypertension prevalence. In conclusion, the mean level of serum XO was significantly higher in hypertensive individuals and XO was independently associated with the prevalence of hypertension. Our results indicate that XO may have a potential role in the pathophysiology of elevated blood pressure through generating of reactive oxygen species. Further large-scale longitudinal studies are needed to determine the underlying mechanisms between XO and hypertension.

Assessment of the relationship between serum xanthine oxidase levels and type 2 diabetes: a cross-sectional study.

Xanthine oxidase (XO) is an enzyme associated with purine metabolism. The relationship between XO levels and type 2 diabetes (T2D) is not clear yet or little is known so far. Therefore, we conducted a cross-sectional study to determine the association of XO levels with T2D in a Bangladeshi adult cohort. A total of 325 participants (234 males and 91 females) were enrolled in the study. The participants were divided into three groups; diabetic (n = 173), prediabetic (n = 35), and non-diabetic control (n = 117). Serum levels of XO were measured by enzyme-linked immunosorbent assay (ELISA) and other biochemical parameters including fasting blood glucose (FBG), serum uric acid (SUA), and lipid profile markers measured by colorimetric methods. Participants with T2D were confirmed according to the definition of the American Diabetic Association. The association between serum XO levels and T2D was determined by logistic regression models. The mean level of serum XO was significantly higher in females (6.0 ± 3.7 U/L) compared to male (4.0 ± 2.8 U/L) participants (p < 0.001). In contrast, males had a higher mean level of SUA (6.1 ± 1.9 mg/dL) than female (4.4 ± 1.9 mg/dL) participants (p < 0.001). The mean level of XO was significantly higher in the diabetic group (5.8 ± 3.6 U/L) compared to the prediabetic (3.7 ± 1.9 U/L) and control (2.9 ± 1.8 U/L) groups (p < 0.001). On the other hand, the mean SUA concentration was significantly lower in the diabetic group than in the other two groups (p < 0.001). A significant increasing trend was observed for FBG levels across the XO quartiles (p < 0.001). A decreasing trend was found for SUA levels in the XO quartiles (p < 0.001). Serum levels of XO and SUA showed a positive and negative correlation with FBG, respectively. In regression analysis, serum XO levels showed an independent association with T2D. In conclusion, this study reports a positive and independent association between XO levels and T2D in Bangladeshi adults. Monitoring serum levels of XO may be useful in reducing the risk of T2D. Further research is needed to determine the underlying mechanisms of the association between elevated XO levels and T2D.

Assessment of the relationship between serum uric acid levels and liver enzymes activity in Bangladeshi adults.

Serum uric acid (SUA) level has been suggested to be associated with cardiovascular disease, diabetes and metabolic syndrome. However, little is known about the relationship between SUA and liver enzymes activity in the general population. The present study aimed to assess the relationship between SUA and serum liver enzymes in an adult population in Bangladesh. In this cross-sectional study, a total of 410 blood samples were collected from apparently healthy adults aged > 18 years. SUA, liver enzymes, lipid profile and other biochemical markers were measured in the collected samples by using standard methods. Multinomial logistic regression model was used to assess the relationship between SUA and elevated levels of liver enzymes among the participants. Overall, the prevalence of hyperuricemia was 30.1% with 32.2% in male and 18.6% in female participants. About 33% of the participants had at least one or more elevated levels of liver enzymes. The mean level of SUA was significantly higher in males (389.3 ± 96.9 µmol/L) than in the female (290.4 ± 89.8 µmol/L) subjects (p < 0.001). There was a significant difference in the mean levels of serum ALT and GGT between the male (34.5 ± 16.0 U/L and 26.7 ± 19.5 U/L, respectively) and female (25.0 ± 13.0 U/L and 19.5 ± 13.2 U/L, respectively) participants (p < 0.001 and p < 0.01, respectively). An increasing trend was observed in the mean levels of serum ALT and GGT across the SUA quartile groups (p < 0.001 and p < 0.01, respectively). SUA showed a positive and significant correlation with serum ALT (p < 0.001) and GGT (p < 0.01). In further statistical analysis after adjustment for potential confounders, SUA showed an independent and significant association with serum ALT and GGT in all regression models. In conclusion, SUA was strongly associated with serum levels of ALT and GGT after adjustment for potential confounders. More prospective studies are needed to clarify the complex relationship between SUA and liver enzymes in the general population.

Prevalence of preeclampsia and the associated risk factors among pregnant women in Bangladesh.

Preeclampsia is a multi-organ system disorder of pregnancy and is responsible for a significant rate of maternal morbidity and mortality worldwide. In Bangladesh, a large number of obstetric deaths occur every year but the exact reasons are not well investigated. The data regarding preeclampsia and its associated risk factors are scarce or limited in pregnant women in Bangladesh. Therefore, we aimed to conduct a cross-sectional study to estimate the prevalence of preeclampsia and identify the possible risk factors in a pregnant women cohort in Bangladesh. In this cross-sectional study, a total of 111 participants were enrolled and asked to include their anthropometric, socio-demographic, and other related lifestyle information in a standard questionnaire form. Blood samples were also collected from each participant to analyze serum levels of lipid profile, liver enzymes, uric acid, and creatinine by using standard methods. Logistic regression analysis was performed to identify the factors associated with preeclampsia. The overall prevalence of preeclampsia was 14.4%. About 10% of the pregnancies were found to have preeclampsia after 20 weeks of gestation without a previous history of hypertension. On the other hand, the prevalence of preeclampsia that superimposed on chronic hypertension was found to be 5.4%. Serum levels of TC, LDL-C, ALT and uric acid were significantly higher and HDL-C was significantly lower in preeclamptic pregnancies than the non-preeclamptic pregnancies. Respondents who required to take antihypertensive medications (AOR 5.45, 95% CI [1.09, 27.31]) and who never took antenatal care (AOR 6.83, 95% CI [1.00, 46.48]) were more likely to be preeclamptic. In conclusion, the present study showed a comparatively high prevalence of preeclampsia among pregnant women in Bangladesh. Some programmatic interventions such as medication for hypertension, antenatal visits to doctors, delivery and postnatal care services should be considered to reduce and prevent the hypertensive pregnancy disorders in Bangladesh.

Assessment of the relationship of serum liver enzymes activity with general and abdominal obesity in an urban Bangladeshi population.

Obesity is a global health concern because of its increasing trend both in developed and developing countries. A limited number of studies have evaluated the association of liver enzymes with both general and abdominal obesity in the general population; data for the Bangladeshi population are not available yet. This study aimed to assess the relationship of serum liver enzymes activity with both general and abdominal obesity in Bangladeshi adults. In total, 540 blood samples were obtained from the participants (388 males and 152 females) and analyzed for serum levels of ALT, AST, GGT, and ALP using standard methods. General obesity was defined as body mass index (BMI) ≥ 27.5 kg/m2 and abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in males and ≥ 80 cm in females. The relationship between liver enzymes and obesity was evaluated by multivariate logistic regression models. Overall, 58% of participants in the general obesity group and 55% of the participants in the abdominal obesity group had at least one or more elevated levels of liver enzymes. The prevalence of elevated liver enzymes was significantly higher in the obesity group compared to the normal BMI and WC groups (p < 0.05 for all cases). The mean level of serum ALT, AST and GGT were significantly higher in the obesity group than the normal BMI group (p < 0.05). In the WC groups, mean AST and GGT were significantly higher in the obesity group compared to the normal group (p < 0.05). In regression analysis, serum levels of ALT showed an independent and significant association with general obesity, whereas, serum GGT showed a significant association with both general and abdominal obesity. In conclusion, a high prevalence of elevated liver enzymes was observed among participants included in the present study. Of the four enzymes, serum GGT was independently associated with both general and abdominal obesity. Further studies are required to understand the complex relationship between liver enzymes and obesity in the general population.

Association between serum uric acid and metabolic syndrome: a cross-sectional study in Bangladeshi adults.

Elevated levels of serum uric acid (SUA) have been suggested to associate with cardiovascular disease, diabetes and metabolic syndrome (MetS). However, information is limited on the association between SUA and MetS in general adults. This study aimed to assess the relationship of SUA with MetS and its components in general adults in Bangladesh. A total of 420 participants were enrolled in this study and biochemical parameters including SUA, fasting blood glucose (FBG) and lipid profile were analyzed using standard methods. The NECP criteria were applied to define MetS. The association of SUA with MetS and its components were evaluated by multinomial logistic regression models. The overall prevalence of MetS was 22% with 21.9% in males and 22.1% in female participants. Male subjects had a high prevalence of elevated components of MetS than in the female subjects (p < 0.05 for all cases). The mean concentration of SUA was significantly higher in subjects of the MetS group compared to the non-MetS group (p < 0.05). The components of MetS were raised with the increasing concentrations of SUA across the quartiles. In regression analysis, SUA was significantly associated with the prevalence of MetS in Bangladeshi adults. In conclusion, elevated SUA was significantly associated with the prevalence of MetS and its components.