The predictive role of asymptomatic hyperuricemia – correlations with metabolic syndrome and atherosclerosis

Introduction: Cardiovascular diseases dominate the spectrum of human pathology through incidence, evolution and clinical consequences. There are various hypotheses about the status of the risk factor attributed to hyperuricemia. The correlation between serum uric acid and cardiovascular disease has been detected even at values within the normal range, but the assessment of the independent character of hyperuricemia is made difficult by the metabolic syndrome that is dis-covered in many cases, thus there is a constellation of risk factors. Hyperuricemia is responsible for inducing endothelial dysfunction, proliferation of smooth mus-cle cells in the blood vessels, stimulation of inflamma-tion and atherosclerosis. Peroxynitrite product, derived from uric acid, is a component of the reactive oxygen species.
Methods: We performed a prospective study, involving a selection of representative groups of patients from the Cardiology Department of the Oradea Clinical Emer-gency Hospital between January 2017 and October 2017, with the follow-up of selected subjects througho-ut the year. A control batch, consisting of 20 subjects with normal acid values, and a reference batch com-posed of 30 subjects with asymptomatic hyperuricemia was thus established. The correlation between uric acid values and abdominal circumference, body mass index, LDL and HDL cholesterol values, and blood pressure values were followed. The variation of the recorded levels of uric acid relative to those elements was also monitorized.
Results: Hyperuricemia has been associated with the following parameters: BMI, abdominal circumference, LDL, TAS, TAD, creatinemia. In the case of the 90 cm abdominal circumference, the AUS value was 8 mg/dl, and the maximum of 127 cm of this parameter coinci-ded with an uricemia value of 13 mg/dl. At AUC values ranging from 8-11 mg/dl, BMI predominantly reflects obesity grade I and II and AUS values in the range of 13-15 mg/dl was associated with BMI values of 40 kg/ m², the patients having obesity grade III. Hyperurice-mia was associated with elevated blood pressure, HTA grade II and III being characteristic of LR and reported in 46.66% of cases and 33.33% of cases respectively. On the contrary, LC showed predominantly HTA grade I and II in a proportion of 70% and 30% respectively, and HTA grade III was not reported in this batch. An in-verse correlation was found between elevated AUS and HDL, hyperuricemia affecting the decrease in HDL. In the LR the incidence of acute myocardial infarction was 21.4%, 26.66% for unstable pectoral angina and 73.33% for stable angina pectoris.
Conclusions: The dual effect of uric acid, both pro-oxi-dant and antioxidant, is clinically expressed by the initi-ation of the oxidative stress. Decreasing the availability of nitric oxide and promoting the synthesis of oxidized LDL particles will result in endothelial dysfunction, respectively the increase in abdominal circumference. As the uric acid increased, a positive correlation with high-grade hypertension, increased LDL cholesterol and decreased HDL cholesterol was noted. Also, acute coronary events and hospitalizations for stable angina pectoris were recorded primarily in subjects with ele-vated uric acid levels. It is therefore necessary to detect this accessible biomarker and monitor it for high-risk subjects.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)