RESEARCH PAPER
Uric acid in hypertension – a marker of cardiovascular risk related to body composition
 
More details
Hide details
1
Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland;
2
Department of Dietetics, University of Life Sciences-SGGW, Warsaw, Poland
3
Laboratory Diagnostics Unit, Military Institute of Medicine, Warsaw, Poland
 
J Pre Clin Clin Res. 2015;9(2):124–128
KEYWORDS:
ABSTRACT:
Introduction:
Introduction. Elevated uric acid (UA) is associated with arterial hypertension (AH), obesity, dyslipidemia and insulin resistance. However, its association with body components has not been previously investigated

Objective:
The aim of this study was to evaluate the relationship between UA and cardiovascular risk factors, anthropometric parameters and body composition in patients with AH

Materials and method:
In 138 patients with AH the following parameters were evaluated: UA, low and high density lipoproteins (LDL-C, HDL-C), triglycerides (TG), fasting glucose (FG), creatinine; body mass index (BMI), waist circumference (WC), fat mass (FM), fat free mass (FFM) and total body water (TBW).

Results:
Positive correlations were shown between UA and LDL-C (p=0.041), TG (p<0.001), FG (p=0.025) and creatinine (p<0.001) and negative between UA and HDL-C (p<0.001). Significant associations between UA and anthropometric parameters and body components, such as WC (p<0.001), BMI (p<0.001), FFM (p<0.001) and TBW (p<0.001), were also observed. In the multiple regression model, independent predictors of UA concentration were serum creatinine and TBW (R2=0.45; p<0.001).

Conclusions:
In patients with AH, uric acid was significantly related to cardiovascular risk factors, including obesity. However, the main anthropometric determinant of plasma UA concentration is FFM. The consideration of body composition in the interpretation of UA concentration appears to be justified, but the verification of this hypothesis requires further studies.

CORRESPONDING AUTHOR:
Ewelina Pałkowska   
Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów 128, 04-441 Warsaw, Nowoursynowska 159c, 02-776 Warsaw, Poland
 
REFERENCES (32):
1. World Health Organization. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization; 2010; 11.
2. Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res. (Hoboken) 2011; 63: 102–110.
3. Turak O, Ozcan F, Tok D, Işleyen A, Sökmen E, Taşoğlu I, et al. Serum uric acid, inflammation and nondipping circadian pattern in essential hypertension. J Clin Hypertens. (Greenwich) 2013; 15: 7–13.
4. Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Uric acid is a risk factor for myocardial infarction and stroke – The Rotterdam Study. Stroke 2006; 37: 1503–1507.
5. Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA. Hyperuricemia and Coronary Heart Disease: A Systematic Review and Meta-Analysis. Arthritis Care Res. (Hoboken) 2010; 62: 170–180.
6. Sui X, Church TS, Meriwether RA, Lobelo F, Blair SN. Uric acid and the development of metabolic syndrome in women and men. Metabol Clin Exp. 2008; 57: 845–852.
7. Lippi G, Montagnana M, Luca Salvagno G, Targher G, Cesare Guidi G. Epidemiological association between uric acid concentration in plasma, lipoprotein(a), and the traditional lipid profile. Clin Cardiol. 2010; 33: 76–80.
8. Soltani Z, Rasheed K, Kapusta DR, Reisin E. Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep.2013; 15: 175–181.
9. Tykarski A. [The mechanism of hyperuricemia and the assessment of the impact of antihypertensive drugs on the transport of uric acid and its precursors in nehron in primary hypertension.] Habilitation thesis. Poznan University of Medical Sciences, Poznan; 1997.
10. Kim TH, Lee SS, Yoo JH, Kim SR, Yoo SJ, Song HC, et al. The relationship between the regional abdominal adipose tissue distribution and the serum uric acid levels in people with type 2 diabetes mellitus. Diabetol Metab Syndr. 2012; 4: 3.
11. Cicero AF, Rosticci M, Cagnati M, Urso R, Scapagnini G, Morbini M, et al. Brisighella Heart Study Group. Serum uric acid and markers of low-density lipoprotein oxidation in nonsmoking healthy subjects: data from the Brisighella Heart Study. Pol Arch Med Wewn. 2014; 124: 661–668.
12. Frey FJ. Serum concentration of uric acid, a diagnostic ‘must’ in patients with hyponatremia. Ther Umsch. 2004; 61: 583–587.
13. Reyes AJ. The increase in serum uric acid concentration caused by diuretics might be beneficial in heart failure. Eur J Heart Fail. 2005; 7: 461–467.
14. Wu Y, Zhang D, Pang Z, Jiang W, Wang S, Tan Q. Association of serum uric acid level with muscle strength and cognitive function among Chinese aged 50–74 years. Geriatr Gerontol Int. 2013; 13: 672–677.
15. Li X, Katashima M, Yasumasu T, Li KJ. Visceral fat area, waist circumference and metabolic risk factors in abdominally obese Chinese adults. Biomed Environ Sci. 2012; 25: 141–148.
16. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31: 1281–1357.
17. Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome: a new worldwide definition. Lancet 2005; 366: 1059–1062.
18. de Oliveira EP, Moreto F, Silveira LV, Burini RC. Dietary, anthropometric, and biochemical determinants of uric acid in free-living adults. Nutr J. 2013; 12: 11.
19. Tsushima Y, Nishizawa H, Tochino Y, Nakatsuji H, Sekimoto R, Nagao H, et al. Uric acid secretion from adipose tissue and its increase in obesity. J Biol Chem. 2013; 288: 27138–27149.
20. 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: 3008–3011.
21. Kodama S, Saito K, Yachi Y, Asumi M, Sugawara A, Totsuka K, et al. Association between serum uric acid and development of type 2 diabetes. Diabetes Care 2009; 32: 1737–1742.
22. Zhao LJ, Zhao D, Liu J, Wang W, Wu GX, Qin LP, Liu J, et al. Association between serum uric acid and triglyceride in a Chinese community. Zhonghua Nei Ke Za Zhi. 2005; 44: 664–667.
23. Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, et al. Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 1998; 47: 929–933.
24. Vekic J, Jelic-Ivanovic Z, Spasojevic-Kalimanovska V, Memon L, Zeljkovic A, Bogavac-Stanojevic N, et al. High serum uric acid and low-grade inflammation are associated with smaller LDL and HDL particles. Atherosclerosis 2009; 203: 236–242.
25. Karabacak M, Varol E, Kahraman F, Ozaydin M, Türkdogan AK, Ersoy IH. Low high-density lipoprotein cholesterol is characterized by elevated oxidative stress. Angiology 2014; 65: 927–931.
26. Hikita M, Ohno I, Mori Y, Ichida K, Yokose T, Hosoya T. Relationship between hyperuricemia and body fat distribution. Intern Med. 2007; 46: 1353–1358.
27. Tamba S, Nishizawa H, Funahashi T, Okauchi Y, Ogawa T, Noguchi M, et al. Relationship between the serum uric acid level, visceral fat accumulation and serum adiponectin concentration in Japanese men. Intern Med. 2008; 47: 1175–1180.
28. Kinugawa T, Ogino K, Kato M, Kato T, Osaki S, Endo A, et al. Altered purine and glycogen metabolism in skeletal muscle during exercise in patients with heart failure. Metabolism. 1999; 48: 484–488.
29. Ellegård L, Tengvall M. Bioelectrical Impedance to Predict Muscle Mass in the Elderly. In: Preedy VR, eds. Handbook of Anthropometry: Physical Measures of Human Form in Health and Disease. Springer New York: Dordrecht Heidelberg; 2012; 375–385.
30. Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM, et al. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol. 2008; 3: 348–354.
31. Satirapoj B, Supasyndh O, Nata N, Phulsuksombuti D, Utennam D, Kanjanakul I, et al. High levels of uric acid correlate with decline of glomerular filtration rate in chronic kidney disease. J Med Assoc Thai 2010; 93: 65–70.
32. Zoccali C, Mallamaci F. Uric acid, hypertension, and cardiovascular and renal complications. Curr Hypertens Rep. 2013; 15: 531–537.
eISSN:1898-7516
ISSN:1898-2395