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Joint Bone Spine Oct 2019Hyperuricemia is a common condition, and in a subset of patients leads to gout, the most common inflammatory arthritis. Osteoarthritis is the most common form of... (Review)
Review
Hyperuricemia is a common condition, and in a subset of patients leads to gout, the most common inflammatory arthritis. Osteoarthritis is the most common form of arthritis overall, and gout and osteoarthritis frequently coexist in the same patient. However, the relationship between the two remains poorly defined. More particularly, the impact of osteoarthritis on the development of gout, and the impact of gout on the development of osteoarthritis, remain to be determined. Additionally, whether hyperuricemia mediates osteoarthritis in the absence of gout is uncertain. Here, we review the evidence linking gout and osteoarthritis, with a special focus on the role of hyperuricemia in the presence or absence of gout. Since disease modifying agents are currently available for hyperuricemia and gout but not for osteoarthritis, a contributory role for urate in the pathogenesis of osteoarthritis could have important clinical implications.
Topics: Biomarkers; Global Health; Humans; Hyperuricemia; Osteoarthritis; Prevalence; Uric Acid
PubMed: 30471419
DOI: 10.1016/j.jbspin.2018.11.002 -
European Review For Medical and... Sep 2022To investigate the association between asymptomatic hyperuricemia and knee osteoarthritis in older outpatients in Vietnam.
OBJECTIVE
To investigate the association between asymptomatic hyperuricemia and knee osteoarthritis in older outpatients in Vietnam.
PATIENTS AND METHODS
This cross-sectional study included 257 older outpatients (195 in the knee osteoarthritis group and 62 in the non-knee osteoarthritis group) aged ≥60 years (mean age 73.31 ± 7.96 years) attending rheumatologic and geriatric clinics from November 2020 to May 2021. Data were collected for both groups, including demographics, symptoms and signs of knee osteoarthritis, serum uric acid levels, and knee radiographs. The association between asymptomatic hyperuricemia and knee osteoarthritis was assessed using logistic regression.
RESULTS
The mean serum uric acid level among patients with knee osteoarthritis was higher than that among patients without knee osteoarthritis (6.3 ± 1.74 mg/dl vs. 5.71 ± 1.45 mg/dl, p = 0.017). Hyperuricemia was more common among older outpatients with knee osteoarthritis than among those without knee osteoarthritis (39% vs. 19%, p = 0.005). After adjusting for age, sex, body mass index (BMI), and other comorbidities, the association between asymptomatic hyperuricemia and knee osteoarthritis remained significant (odds ratio [OR] 2.61, 95% confidence interval [CI] 1.22-5.60, p = 0.013). Subgroup analyses were performed according to sex and BMI groups. Significant associations between asymptomatic hyperuricemia and knee osteoarthritis were observed among women (p = 0.017) and among individuals who were underweight-normal-weight according to BMI (p = 0.009).
CONCLUSIONS
Asymptomatic hyperuricemia is a common comorbidity among older outpatients with knee osteoarthritis. An independent association was identified between asymptomatic hyperuricemia and knee osteoarthritis among older Vietnamese outpatients, although sex and BMI may be confounding factors that impact this association.
Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Hyperuricemia; Osteoarthritis, Knee; Outpatients; Risk Factors; Uric Acid
PubMed: 36196710
DOI: 10.26355/eurrev_202209_29760 -
Frontiers in Endocrinology 2022Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly emerged term that is suggested to better reflect the pathogenesis of nonalcoholic fatty liver...
BACKGROUND AND AIMS
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly emerged term that is suggested to better reflect the pathogenesis of nonalcoholic fatty liver disease (NAFLD); however, the association between hyperuricemia and MAFLD has not been explored in the Chinese population. Meantime, this study also examined the temporal relationship between the two entities in a longitudinal cohort.
METHODS
We conducted a retrospective cross-sectional study including 1,587,962 individuals from 19 health check-up centers in China from 2009-2017 and a longitudinal study with 16,112 individuals. A logistic regression model was applied to determine the association between hyperuricemia and MAFLD in a cross-sectional study. The Cox regression model was used to explore the association between hyperuricemia at baseline and subsequent onset of MAFLD or the association between the presence of MAFLD at baseline and the subsequent incidence of hyperuricemia. The cross-lagged analysis was applied to exam the temporal relationship between hyperuricemia and MAFLD.
RESULTS
In the cross-sectional study, hyperuricemia showed a strong positive association with MAFLD after controlled potential confounders. In the longitudinal cohorts, hyperuricemia at baseline was associated with the new-onset of MAFLD, with a hazard ratio (HR) of 1.765 (95% CI: 1.512, 2.060). Interestingly, baseline MAFLD was also associated with the subsequent incidence of hyperuricemia, with an HR of 1.245 (95% CI: 1.106, 1.400). The cross-lagged path analysis revealed a bidirectional relationship between hyperuricemia and MAFLD.
CONCLUSIONS
The results suggested that hyperuricemia and MAFLD form a vicious cycle, resulting in more deterioration of metabolic status.
Topics: Cross-Sectional Studies; Humans; Hyperuricemia; Longitudinal Studies; Non-alcoholic Fatty Liver Disease; Prevalence; Retrospective Studies
PubMed: 35250880
DOI: 10.3389/fendo.2022.821689 -
Medical Science Monitor : International... Jul 2016Uric acid is the final oxidation product of purine metabolism in humans. Xanthine oxidoreductase (XOR) catalyzes oxidative hydroxylation of hypoxanthine to xanthine to... (Review)
Review
Uric acid is the final oxidation product of purine metabolism in humans. Xanthine oxidoreductase (XOR) catalyzes oxidative hydroxylation of hypoxanthine to xanthine to uric acid, accompanying the production of reactive oxygen species (ROS). Uric acid usually forms ions and salts known as urates and acid urates in serum. Clinically, overproduction or under-excretion of uric acid results in the elevated level of serum uric acid (SUA), termed hyperuricemia, which has long been established as the major etiologic factor in gout. Accordingly, urate-lowering drugs such as allopurinol, an XOR-inhibitor, are extensively used for the treatment of gout. In recent years, the prevalence of hyperuricemia has significantly increased and more clinical investigations have confirmed that hyperuricemia is an independent risk factor for cardiovascular disease, hypertension, diabetes, and many other diseases. Urate-lowering therapy may also play a critical role in the management of these diseases. However, current XOR-inhibitor drugs such as allopurinol and febuxostat may have significant adverse effects. Therefore, there has been great effort to develop new XOR-inhibitor drugs with less or no toxicity for the long-term treatment or prevention of these hyperuricemia-related diseases. In this review, we discuss the mechanism of uric acid homeostasis and alterations, updated prevalence, therapeutic outcomes, and molecular pathophysiology of hyperuricemia-related diseases. We also summarize current discoveries in the development of new XOR inhibitors.
Topics: Allopurinol; Animals; Enzyme Inhibitors; Febuxostat; Humans; Hyperuricemia; Reactive Oxygen Species; Risk Factors; Xanthine Dehydrogenase
PubMed: 27423335
DOI: 10.12659/msm.899852 -
The American Journal of Managed Care Nov 2005Gout is one of the most readily manageable of the rheumatic diseases. This article reviews basic pathways in purine metabolism, uric acid handling, and the pathogenic... (Review)
Review
Gout is one of the most readily manageable of the rheumatic diseases. This article reviews basic pathways in purine metabolism, uric acid handling, and the pathogenic mechanism of clinical gout, as well as the areas in those pathways amenable to intervention. Attention is also given to associated comorbidities, such as hyperuricemia and obesity, hypertension, hyperinsulinemia, and coronary artery disease. The significance of lifestyle modifications, such as weight loss and alcohol reduction, is discussed as an important adjunct to pharmacotherapy in gout. Current and investigational agents used in gout management are also reviewed. Finally, treatment recommendations for acute and chronic gout are suggested.
Topics: Acute Disease; Adrenal Cortex Hormones; Behavior Therapy; Chronic Disease; Colchicine; Female; Gout; Gout Suppressants; Health Behavior; Humans; Hyperuricemia; Male; Practice Guidelines as Topic; Purines; Risk Factors; Uric Acid
PubMed: 16300459
DOI: No ID Found -
The correlation between dietary inflammatory index and risk of hyperuricemia in the U.S. population.Medicine May 2023The dietary inflammatory index (DII) has been reported to be related to chronic diseases as a novel inflammatory marker. However, the correlation between DII score and...
The dietary inflammatory index (DII) has been reported to be related to chronic diseases as a novel inflammatory marker. However, the correlation between DII score and hyperuricemia in adults in the United States is still unclear. Therefore, our goal was to explore the correlation between them. A total of 19,004 adults were enrolled in the National Health and Nutrition Examination Survey from 2011 to 2018. DII score was calculated according to 28 dietary items obtained by 24-hour dietary interview data. Hyperuricemia was defined by serum uric acid level. We used multilevel logistic regression models and subgroup analysis to determine whether the 2 were associated. DII scores were positively associated with serum uric acid and the risk of hyperuricemia. Per unit increased in DII score was associated with a 3 mmol/L increase in serum uric acid in males (β 3.00, 95% confidence interval (CI) 2.05-3.94) and 0.92mmol/L in females (β 0.92, 95% CI 0.07-1.77), respectively. Compared with the lowest tertile of DII score, the rise of DII grade increased the risk of hyperuricemia among the whole participants (T2: odds ratio (OR) 1.14, 95% CI 1.03, 1.27; T3: OR 1.20 [1.07, 1.34], P for trend = .0012) and males [T2: 1.15 (0.99, 1.33), T3: 1.29 (1.11, 1.50), P for trend = .0008]. For females, the correlation between DII score and hyperuricemia was statistically significant in the subgroup stratified by body mass index (BMI) (BMI < 30, OR 1.08, 95% CI 1.02-1.14, P for interaction = .0134), which indicates that the association depends on BMI. In the United States male population, the DII score has a positive correlation with hyperuricemia. Anti-inflammatory dietary intake can be beneficial for lower serum uric acid.
Topics: Adult; Female; Humans; Male; United States; Uric Acid; Nutrition Surveys; Hyperuricemia; Diet; Logistic Models; Risk Factors; Inflammation
PubMed: 37335705
DOI: 10.1097/MD.0000000000033374 -
Nutrients May 2022In this paper, we aimed to examine the protective role of hyperuricemia in the prevalence of osteoporosis in a large Asian cohort. A total of 119,037 participants from...
In this paper, we aimed to examine the protective role of hyperuricemia in the prevalence of osteoporosis in a large Asian cohort. A total of 119,037 participants from 29 recruitment centers in Taiwan were enrolled onto our study. Participants with serum uric acid greater than 7.0 mg/dL in men and 6.0 mg/dL in women were classified as the hyperuricemia group whereas the others were the control group. The mean age of all participants was 50; there were 23,114 subjects (19%) with hyperuricemia. Osteoporosis was observed in 8243 (9%) and 1871 (8%) participants in the control and hyperuricemia groups, respectively. After adjusting for confounders, a lower risk of osteoporosis was found in the hyperuricemia group compared with the control group (odds ratio, 0.916; 95% confidence interval, 0.864 to 0.970). A subgroup analysis showed that hyperuricemia was associated with a lower risk of osteoporosis in females, but not in males. Women with serum uric acid greater than 8.0 mg/dL were not associated with a greater risk of osteoporosis. Our study suggests that hyperuricemia decreases the risk of osteoporosis in females, but not in males. The protective role was no longer apparent when the serum uric acid level was greater than 8 mg/dL.
Topics: Cohort Studies; Female; Humans; Hyperuricemia; Male; Odds Ratio; Osteoporosis; Risk Factors; Uric Acid
PubMed: 35684005
DOI: 10.3390/nu14112206 -
Arthritis Care & Research Jan 2011A novel rodent model and a recent randomized trial of hyperuricemic adolescents with hypertension suggest a pathogenetic role of uric acid in hypertension, but it... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
A novel rodent model and a recent randomized trial of hyperuricemic adolescents with hypertension suggest a pathogenetic role of uric acid in hypertension, but it remains unknown whether these findings would be applicable to adult populations where the larger disease burden exists. We conducted a systematic review and meta-analysis to determine if hyperuricemia was associated with incident hypertension, particularly in various demographic subgroups.
METHODS
We searched major electronic databases using medical subject headings and keywords without language restrictions (through April 2010). We included prospective cohort studies with data on incident hypertension related to serum uric acid levels. Data abstraction was conducted in duplicate. We analyzed age, sex, and race subgroups.
RESULTS
A total of 18 prospective cohort studies representing data from 55,607 participants were included. Hyperuricemia was associated with an increased risk for incident hypertension (adjusted risk ratio [RR] 1.41, 95% confidence interval [95% CI] 1.23-1.58). For a 1 mg/dl increase in uric acid level, the pooled RR for incident hypertension after adjusting for potential confounding was 1.13 (95% CI 1.06-1.20). These effects were significantly larger in younger study populations (P = 0.02) and tended to be larger in women (P = 0.059). Two studies suggested that the effect may also be larger among African American individuals. Furthermore, later publication year and US-based studies were significantly associated with a lower effect estimate (P values <0.02).
CONCLUSION
Hyperuricemia is associated with an increased risk for incident hypertension, independent of traditional hypertension risk factors. This risk appears more pronounced in younger individuals and women.
Topics: Age Factors; Animals; Cohort Studies; Female; Humans; Hypertension; Hyperuricemia; Incidence; Male; Prospective Studies; Risk Factors; Sex Factors
PubMed: 20824805
DOI: 10.1002/acr.20344 -
Arthritis and Rheumatism Feb 2012Basic research and clinical studies have implicated a role for hyperuricemia and for xanthine oxidoreductase (XOR), the enzyme that generates uric acid (UA), in not only... (Review)
Review
Basic research and clinical studies have implicated a role for hyperuricemia and for xanthine oxidoreductase (XOR), the enzyme that generates uric acid (UA), in not only gout but also vascular diseases. At present, asymptomatic hyperuricemia (i.e., in the absence of gout, urate nephrolithiasis, or tumor lysis syndrome) is not an indication for therapy. With the rise over the past several decades in prevalence of both gout and hyperuricemia, clarifying the potential adverse effects of hyperuricemia (in patients with and without gout) is of public health importance. UA is not simply an inert end-product of purine metabolism in humans, but rather has potential antioxidant, pro-oxidant, and pro-inflammatory effects. However controversy remains as to which, if any, of these effects are of clinical relevance in development and complications of human vascular diseases in gout and asymptomatic hyperuricemia. Clearly, not all individuals with hyperuricemia develop gout, and studies to date have also been unable to clarify in which subjects hyperuricemia may have detrimental effects on the vasculature. Further, studies of urate-lowering therapy with XOR inhibition or uricosuric agents have not been able to definitively identify whether any such effects may be mediated by UA versus XO. Adequately sized, prospective randomized clinical trials of sufficient duration, and employing appropriate biomarkers, now appear critical to resolve the putative toxic roles of UA and XO in the human arterial circulation.
Topics: Cardiovascular System; Humans; Hyperuricemia; Xanthine Oxidase
PubMed: 21953377
DOI: 10.1002/art.33369 -
Seminars in Nephrology Sep 2011During the past few decades, the mean serum uric acid levels and the prevalence of hyperuricemia in the general population appear to have increased. Correspondingly, the... (Review)
Review
During the past few decades, the mean serum uric acid levels and the prevalence of hyperuricemia in the general population appear to have increased. Correspondingly, the prevalence and incidence of gout have doubled. Potential reasons behind these trends include the increasing prevalence of obesity and metabolic syndrome, Western lifestyle factors, increased prevalence of medical conditions (eg, renal conditions, hypertension, and cardiovascular disorders), and use of medications that increase uric acid levels (eg, diuretics and low-dose aspirin). The substantial increase in sugar-sweetened soft drinks and associated fructose consumption also has coincided with the secular trend of hyperuricemia and gout. Recently, several large-scale epidemiologic studies have clarified a number of these long-suspected risk factors in relation with hyperuricemia and gout. Furthermore, recent studies have illuminated the substantial comorbidities of hyperuricemia and gout, particularly metabolic-cardiovascular-renal conditions. Although many prospective studies have suggested an independent association between serum uric acid levels and the future risk of cardiovascular-metabolic morbidities and mortality, only a limited number of randomized clinical trials and observational studies recently have shown that the use of allopurinol can be beneficial against these outcomes. Because these data are scarce and the effects of allopurinol might not be limited to decreasing serum uric acid levels, the potential causal role of uric acid on these outcomes remains to be clarified with further studies.
Topics: Adult; Aged; Aged, 80 and over; Beverages; Diabetes Mellitus; Female; Fructose; Gout; Humans; Hyperuricemia; Male; Metabolic Syndrome; Middle Aged; Obesity; Risk Factors; Uric Acid; Young Adult
PubMed: 22000647
DOI: 10.1016/j.semnephrol.2011.08.004