Session Title: Metabolic and Crystal Arthropathies II
Session Type: Abstract Submissions (ACR)
Background/Purpose: Uric acid may be involved in the atherosclerotic process by increasing the level of low-grade inflammation. The aims of this study were: 1) to investigate if uric acid was associated with ankle-brachial index (AAIx), carotid intima media thickness (c-IMT), and prevalent cardiovascular disease (CVD); 2) the extent to which any such association(s) could be explained by low-grade inflammation; and 3) whether these associations were different in subjects with normal (NGM) compared to disturbed (DGM) glucose metabolism. A difference between these subgroups may exist because of the influence of insulin and glucose on uric acid excretion.
Methods: We studied 530 subjects (60.6% men; mean age 58.9 ± 6.9 yrs; 52.6% NGM) with an increased risk of CVD from the Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) Study. Cross-sectional associations between uric acid and CVD, AAIx and c-IMT, and the mediating role of low-grade inflammation therein, were analyzed with logistic and linear regression analyses in the total population and stratified according to glucose metabolism status. Inflammation markers (hs-CRP, TNF-α, IL-6, IL-8, SAA, sICAM-1, haptoglobin, ceruloplasmin) were standardized and combined into an average inflammation score.
Results: After adjustment for potential confounders (gender, age, BMI, waist, alcohol, smoking, physical activity, hypertension, total:HDL cholesterol, triglycerides , fasting glucose and insulin, eGFR, diuretics) plasma uric acid concentration, expressed per SD (81.3 µmol/L), was positively associated with CVD in subjects with NGM (OR=1.66, 95%CI 1.06-2.58), but not with DGM (OR=0.82, 0.56-1.22; p for interaction=0.065). Uric acid was positively associated with c-IMT in the total population (β=0.027, 95%CI 0.010-0.045) and in subjects with NGM (β=0.030, 95%CI 0.007-0.054). Although the beta coefficient was similar, uric acid was not significantly associated with c-IMT in subjects with DGM (β=0.023, 95%CI -0.004-0.050; p for interaction=0.164). There was no association between uric acid and AAIx in any of the groups. Uric acid was positively associated with low-grade inflammation in the total population (β=0.073, 95%CI 0.012-0.133) and in DGM (β=0.115, 95%CI 0.026-0.203), but not in NGM (β=0.042, 95%CI -0.044-0.128, p for interaction=0.975). The significant associations between uric acid and CVD or c-IMT were not attenuated when adding low-grade inflammation to the models.
Conclusion: We found evidence of modest associations between uric acid and CVD and c-IMT, but these were not explained by low-grade inflammation. The data suggest the effect of uric acid may be different in subjects with NGM and DGM.
J. M. A. Wijnands,
P. C. Dagnelie,
M. M. J. van Greevenbroek,
C. J. H. van der Kallen,
C. G. Schalkwijk,
E. J. M. Feskens,
S. van der Linden,
C. D. A. Stehouwer,
I. C. W. Arts,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-role-of-low-grade-inflammation-in-the-association-between-uric-acid-and-atherosclerosis-the-codam-study/