IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203108
Open Access Original Research
The association between serum uric acid levels and 10-year cardiovascular disease incidence: results from the ATTICA prospective study
Show Less
1 First Department of Internal Medicine, Diabetes Center, Division of Endocrinology and Metabolism, AHEPA University Hospital, 54621 Thessaloniki, Greece
2 Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
3 Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
4 First Cardiology Clinic, School of Medicine, University of Athens, 15772 Athens, Greece
5 Department of Clinical Biochemistry, Royal Free Hospital campus, University College London Medical School, University College London (UCL), NW3 2QG London, UK

These authors contributed equally.

Rev. Cardiovasc. Med. 2021 , 22(3), 991–1001; https://doi.org/10.31083/j.rcm2203108
Submitted: 1 June 2021 | Revised: 24 June 2021 | Accepted: 29 July 2021 | Published: 24 September 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Limited data suggests possible gender-specific association between serum uric acid (SUA) and cardiovascular disease (CVD) incidence. The aim of the present analysis was to evaluate the association between SUA levels and 10-year CVD incidence (2002–2012) in the ATTICA study participants. Overall, 1687 apparently healthy volunteers, with SUA measurements, residing in the greater metropolitan Athens area (Greece), were included. Multivariable Cox-regression models were used to estimate the hazard ratios for SUA in relation to 10-year CVD incidence. Receiver operating curve analysis was conducted to detect optimal SUA cut-off values. Participants in the 2nd and 3rd SUA tertile had 29 and 73% higher 10-year CVD incidence compared with those in the 1st tertile (p < 0.001). In gender-specific analysis, only in women SUA was independently associated with CVD incidence; women in the 3rd SUA tertile had 79% greater 10-year CVD event risk compared to their 1st tertile counterparts. Obese in the 3rd SUA tertile had 2-times higher CVD incidence compared to those in the 1st tertile. Similar findings were observed in metabolically healthy (vs. unhealthy) and metabolically healthy obese. SUA thresholds best predicting 10-year CVD incidence was 5.05 and 4.15 mg/dL (0.30 and 0.25 mmol/L) in men and women, respectively. In conclusion, increased SUA levels were independently related to 10-year CVD event rate in women, obese and metabolically healthy individuals. SUA could predict 10-year CVD incidence even at low levels. Further studies are warranted to identify SUA cut-off values that may improve the detection of individuals at higher CVD risk in clinical practice.

Keywords
Serum uric acid
Cardiovascular disease
ATTICA study
Gender
Metabolic health status
Figures
Fig. 1.
Share
Back to top