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Volume 3 - Jun 2014
Abstract
Uric Acid (UA) is the final product of the activity of xanthine oxidase (XO) in the purine metabolism. The enzyme, XO linked to oxidative stress, endothelial dysfunction and heart failure in humans. Clinically, an association of hyperuricemia with hypertension, diabetes, renal disease and cardiovascular disease (CVD) has been observed over the years. With the increasing prevalence of obesity and diabetes worldwide, co-existing hyperuricemia is getting more focused attention than ever before. Despite its proposed protective role against aging and oxidative stress, epidemiological studies revealed an association between altered levels of serum uric acid (SUA) and various multi-factorial disorders such as hypertension, gout, dyslipidemia, obesity, glucose intolerance, insulin resistance and renal disease etc. Therefore, manipulation of SUA levels is now either included in, or being investigated for, the treatment of CVD including stroke. The role of SUA as an independent risk factor for myocardial infarction (MI) and cerebrovascular ischemic stroke (CVIS) has been previously discussed, though this association has been under keen observation in view of conflicting reports. Here we discuss the recent progress in our understanding about the clinical conditions which are related to SUA in MI and CVIS diseases. Also we describe here the possible involvement of SUA in monitoring, prognosis and therapy of these diseases which is not delved so far.
Keywords
Uric acid, cardiovascular disease, myocardial infarction and cerebrovascular ischemic stroke
References
- Scheele KW. "Examen Chemicum Calculi Urinari," Opuscula 2, 73-79, 1776
- Waring WS, Webb DJ and Maxwell SR. Uric acid as a risk factor for cardiovascular disease. Q J Med. 93: 707–713, 2000
- Marangella M. Uric acid elimination in the urine. Pathophysiological implications. Contrib Nephrol. 147: 132-48, 2005
- Mount DB, Kwon CY and Nejad ZK. Renal urate transport. Rheum Dis Clin North Am.32: 313–331, 2006
- Anzai N, Kanai Y and Endou H. New insights into renal transport of urate.Curr Opin Rheumatol. 19:151–157, 2007
- Kylin E. Studien ueber das hypertonie-hypergly-kämie-hyperurikämiesyndrom. Zentral-blatt fuer Innere Medizin 44:105-27, 1923
- Liou TL, Lin MW, Hsiao LC, Tsai TT, Chan WL, Ho LT, Hwu CM: Is hyperuricemia another facet of the metabolic syndrome? J Chin Med Assoc 69:104-9, 2006
- Johnson RJ, Kang DH, Feig D et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertens. 41: 1183–90, 2003
- Lin KC, Lin HY and Chou P. The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study. J Rheumatol. 27: 1501–1505, 2000
- Glynn RJ, Campion EW and Silbert JE. Trends in serum uric acid levels 1961–1980. Arthr Rheum. 26:87–93, 1983
- Nicholls A, Snaith ML and Scott JT. Effect of oestrogen therapy on plasma and urinary levels of uric acid. Br Med J. 1: 449–451, 1973
- Hisatome I, Tsuboi M and Shigemasa C. Renal hypouricemia. Nippon Rinsho. 54: 3337–3342, 1996
- Feig DI, Kang DH and Johnson CM. Uric acid and cardiovascular risk. N. Eng. J Med. 359: 1811-182, 2008
- Maxwell AJ and Bruinsma KA. Uric acid is closely linked to vascular nitric xide activity. Evidence for mechanism of association with cardiovascular disease. J Am Coll Cardiol. 38: 1850-1858, 2001
- Coe FL. Uric Acid and Calcium Oxalate Nephrolithiasis. Kidney Int. 24: 392-403, 1983
- Yu KH, See LC, Huang YC, Yang CH and Sun JH: Dietary factors associated with hyperuricemia in adults. Semin Arthritis Rheum. 37: 243-250, 2008
- Choi HK, Mount DB and Reginato AM. Pathogenesis of gout. Ann Intern Med. 143: 499–516, 2005
- Loeffler LF, Navas-Acien A, Brady TM, et al. Uric acid level and elevated blood pressure in US Adolescents: National Health and Nutrition Examination Survey, 1999–2006. Hypertension. 59: 811–817, 2012
- Doehner W, Schoene N, Rauchhaus M, Leyva-Leon F, Pavitt DV, Reaveley DA, Schuler G, Coats AJ, Anker SD and Hambrecht R: Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies. Circulation. 105: 2619-2624, 2002
- Takahashi MM, de Oliveira EP, Moreto F, McLellan PKC and Burini RC: Association of dyslipidemia with intakes of fruit and vegetables and the body fat content of adults clinically selected for a lifestyle modification program. Arch Latinoam Nutr. 60: 148-154, 2010
- Garrod A. Observations on certain pathological conditions of the blood and urine in gout, rheumatism and Bright’s disease. Med Chir Trans. 31: 83–97, 1848
- Barlow KA. Hyperlipidemia in primary gout. Metabolism. 17: 289-99, 1968
- Jossa F, Farinaro E, Panico S, Krogh V, Celentano E, Galasso R, Mancini M and Trevisan M. Serum uric acid and hypertension: the Olivetti heart study. J Hum Hypertens 8: 677–68, 1994
- Heinig M and Johnson RJ. Role of uric acid in hypertension, renal disease and metabolic syndrome. Cleve Clin J Med. 73: 1059-63, 2006
- Wannamethee SG. Serum Uric Acid and Risk of Coronary Heart Disease. Curr Pharm Des 11: 4125-32, 2005
- Mazzali M, Hughes J, Kim YG, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 38:1101–1106, 2001
- Hsu PF, Chuang SY, Yu WC, Leu HB, Chan WL and Chen CH.The Impacts of Serum Uric Acid on arterial hemodynamics and Cardiovascular Risks. Acta Cardiol Sin. 29:142-150, 2013
- O’Brien WM, Burch TA and Bunim JJ. Genetics of hyperuricaemia in Blackfeet and Pima Indians. Ann Rheum Dis. 25:117–119, 1966
- Krizek V. Serum uric acid in relation to body weight. Ann Rheum Dis 25: 456-458, 1966
- Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T and Matsuzawa Y. 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. 47: 929-33, 1998
- Burch TA, O'Brien WM, Need R and Kurland LT. Hyperuricaemia and gout in the Mariana Islands. Ann Rheum Dis. 25: 114-6, 1966
- Emmerson BT. Alteration of urate metabolism by weight reduction. Aust NZ J Med 3: 410-2, 1973
- Ogura T, Matsuura K, Matsumoto Y, Mimura Y, Kishida M, Otsuka F and Tobe K. Recent trends of hyperuricemia and obesity in Japanese male adolescents, 1991 through 2002. Metabolism 53: 448-53, 2004
- Garcia-Lorda P, Bullo M, Vila R, del Mar Grasa M, Alemany M, Salvado SJ. Leptin concentrations do not correlate with fat mass nor with metabolic risk factors in morbidly obese females. Diabetes Nutr Metab. 14: 329-36, 2001
- Donahue RP, Prineas RJ, Donahue RD, Zimmet P, Bean JA, De Courten M, Collier G, Goldberg RB, Skyler JS and Schneiderman N: Is fasting leptin associated with insulin resistance among nondiabetic individuals? The Miami Community Health Study. Diabetes Care. 22: 1092-1096, 1999
- Matsubara M, Chiba H, Maruoka S and Katayose S. Elevated serum leptin concentrations in women with hyperuricemia. J Atheroscler Thromb. 9:28-34. 2002
- Medalie JH, Papier CM, Goldbourt U, Herman JB. Major factors in the development of diabetes mellitus in 10,000 Israeli men. Arch Intern Med. 135: 811-7. 1975
- Ohlson LO, Larsson B, Bjorntorp P, Eriksson H, Svardsudd K, Welin L, Tibblin G, Wilhelmsen L. Risk factors for type 2 (non-insulin-dependent) diabetes mellitus. Thirteen and one-half years of follow-up of the participants in a study of Swedish men born in 1913. Diabetologia. 31: 798-805, 1988
- Meisinger C, Thorand B, Schneider A, Stieber J, Doring A and Lowel H. Sex differences in risk factors for incident type 2 diabetes mellitus: the MONICA. Augsburg cohort study. Arch Intern Med. 162: 82-89, 2002
- Dehghan A, van Hoek M, Sijbrands EJ, et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care.31: 361-362, 2008
- Lin KC, Tsai ST, Lin HY and Chou P. Different progressions of hyperglycemia and diabetes among hyperuricemic men and women in the kinmen study. J Rheumatol 31: 1159-65, 2004
- Chien KL, Chen MF, Hsu HC, Chang WT, Su TC, Lee YT and Hu FB. Plasma uric acid and the risk of type 2 diabetes in a Chinese community. Clin Chem. 54: 310-316, 2008
- Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F and Burnier M. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health. 4: 9-22. 2004
- Cardona F, Tinahones FJ, Collantes E, Escudero A and Fuentes GE, Soriguer FJ. The elevated prevalence of apolipoprotein E2 in patients with gout is associated with reduced renal excretion of urates. Rheumatology. 42: 468-72, 2003
- Markkola VH and Jarvinen YH. Hyperuricemia and insulin resistance. J Clin Endocrinol Metab 78: 25-9, 1994
- Enas EA and Senthilkumar A. Coronary artery disease in Asian Indians: an update and review. Internet J Cardiol. 1: 71-72, 2001
- Schmidt M, Jacobsen JB, Lash TL, Botker HE and Sorensen HT. 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: A Danish nationwide cohort study BMJ. 344: e356 doi: 10.1136/bmj.e356, 2012
- Dalal P, Bhattacharjee, Vairale J and Bhat P. Mumbai stroke registry (2005-6): Surveillance using WHO STEPS stroke instrument-challenges and opportunities. JAPI,56: 675-79, 2008
- Car S and Trkulja V. Higher serum uric acid on admission is associated with higher short term mortality and poorer long term survival after myocardial infarction: Retrospective prognostic study. Croat Med J. 50: 559-66, 2009
- Gupta R and Gupta KD. Coronary Heart Disease in Low Socioeconomic Status Subjects in India: An Evolving Epidemic. Indian J. Heart. 61:358-367, 2009
- Gertler MM, Garn SM, Levine SA: Serum uric acid in relation to age and physique in health and in coronary heart disease. Ann Intern Med. 34: 1421-1426, 1951
- Rastogi T, Vaz M, Spiegelman D, Reddy KS, Bharathi AV, Stampfer MJ, et al. Physical activity and risk of coronary heart disease in India. Int J Epidemiol. 33: 759-67, 2004
- 53. Nielsen HS, Pedersen CP , Finer N , Caterson ID , Gaal LV, James WPT , Maggioni AP, Sharma AM, Coutinho W and Andersson C. Uric Acid as a Risk Factor for Cardiovascular Disease and Mortality in Overweight/Obese Individuals. PLoS ONE.8: e59121, 2013
- Niskanen LK, Laaksonen DE, Nyyssonen K, Alfthan G, Lakka HM, Lakka TA,Salonen JT, Uric acid level as a risk factor for cardiovascular and all cause mortality in middle-aged men: a prospective cohort study. Arch Inter. Med. 164: 1546-1551, 2004
- Strazzullo P and Puig JG. Uric acid and oxidative stress: relative impact on cardiovascular risk? Nutr Metab Cardiovasc Dis.17: 409-14. 2007
- Strasak A, Ruttmann E, Brant L, Kelleher C, Klenk J, Concin H, Diem G, Pfeiffer K and Ulmer H. Serum uric acid and risk of cardiovascular mortality: a prospective long-term study of 83,683 Austrian men. Clin Chem. 54: 273–284, 2008
- Bickel C, Rupprecht HJ, Blankenberg S, Rippin G, Hafner G, Daunhauer A, Hofmann KP and Meyer J. Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease. Am J Cardiol. 89: 12-7, 2002
- Eisen A, Benderly M, Goldbourt U and Haim M. Is serum uric acid level an independent predictor of heart failure among patients with coronary artery disease? Clin Cardiol. 36:110-116, 2013
- Culleton BF, Larson MG, Kannel WB and Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med. 131:7-13,1999
- Ndrepepa G, Braun S, Haase HU, Schulz S, Ranftl S, Hadamitzky M, Mehilli J, Schömig A and Kastrati A. Prognostic value of uric acid in patients with acute coronary syndromes. Am J Cardiol. 109: 1260-5, 2012
- Kivity S, Kopel E, Maor E, Abu-Bachar F, Segev S, Sidi Y and Olchovsky D. Association of serum uric acid and cardiovascular disease in healthy adults. Am J Cardiol. 111: 1146-1151, 2013
- Chiquete E, Ruiz-Sandoval JL, Murillo-Bonilla LM, Arauz A, Orozco-Valera DR, Ochoa-Guzmán A, Villarreal-Careaga J, León-Jiménez, Barina-garrementeria F, Ramos-Moreno A and Cantú-Brito C. Serum Uric Acid and Outcome after Acute Ischemic Stroke-PREMIER Study. Cerebrovasc Dis. 35:168-174, 2013
- Rosendorff C and Jogendra MRD. Uric Acid: Where Are We? The Journal of Clinical Hypertension. 15:, DOI: 10.1111/ jch.12034, 2013
- Davies KJ, Sevanian A, Muakkassah-Kelly SF and Hochstein P . Uric acid iron ion complexes. A new aspect of the antioxidant functions of uric acid. Biochem J. 235: 747–754, 1986
- Nieto FJ, Iribarren C, Gross MD, Comstock GW and Cutler RG. Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis. 148: 131–9, 2000
- De Scheerder IK, van de Kraay AM, Lamers JM, Koster JF, de Jong JW and Serruys PW. Myocardial malondialdehyde and uric acid release after short-lasting coronary occlusions during coronary angioplasty: potential mechanisms for free radical generation. Am J Cardiol. 68: 392–395, 1991
- Hage F and Szalai A. C-reactive protein gene polymorphisms, C-reactive protein blood levels, and cardiovascular disease risk. J Am Coll Cardiol. 50:1115–1122, 2007
- Guzy, PM Creatine phosphokinase-MB (CPK-MB) and the diagnosis of myocardial infarction.West J Med.127: 455-60, 1977
- Trkulja V and Car S. On admission serum uric acid predicts outcomes after acute myocardial infarction: systematic review and meta-analysis of prognostic studies. Croat Med J. 53: 162-72, 2012
- Fang J and Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA. 283: 2404–2410, 2000
- Wheeler JG, Juzwishin KD, Eiriksdottir G, Gudnason V and Danesh J. Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS Med 2: e76, 2005
- Bourassa M.G., Tardif J.C., “Antioxidants and Cardiovascular Disease. 2nd Editionâ€, Springer Science, New York, 2006, p 193, 264-266, 370
- Busl KM and Greer DM. Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. Neuro Rehabil . 26: 5-13, 2010
- Grysiewicz RA, Thomas K and Pandey DK. Epidemiology of Ischemicand Hemorrhagic Stroke: Incidence, Prevalence, Mortality, and Risk Factors. Neurol Clin 26: 871–895, 2008
- Van der Worp HB, Macleod MR and Kollmar R. Therapeutic hypothermia for acute ischemic stroke: ready to start large randomized trials. J Cerebral Blood Flow Meta. 30: 1079–1093, 2010
- Shah B and Mathur P. Workshop Report on Stroke Surveil lance in India. Division of Non communicable Diseases, Indian Council of Medical Research, New Delhi, 2006
- Kolominsky-Rabas PL, Sarti C, Heuschmann PU, et al. A prospective community- based study of stroke in Germany - The Erlangen Stroke Project (ESPro) incidence and case fatality at 1, 3, and 12 months. Stroke 1998;29:2501-2506
- Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Long-Term Risk of Recurrent Stroke After A First-Ever Stroke - the Oxfordshire Community Stroke Project. Stroke 1994;25:333-337
- Muir SW, Harrow C, Dawson J, Lees KR and Weir CJ. Allopurinol use yields potentially beneficial effects on inflammatory indices in those with recent ischemic stroke. Stroke. 39:3303-3307, 2008
- Kazmierski R. Predictors of early mortality in patients with ischemic stroke. Expert Rev Neurother. 6: 1349-1362, 2006
- Imarhiagbe FA and Idemudia JO. Serum uric acid and acute stroke outcome in Nigerian Africans. Annals Nigerian Medicine. 6: 75-79, 2012
- Devereux RB and Dahlof B. Potential mechanisms of stroke benefit favoring Losartan Intervention for Endpoint reduction (LIFE) study. Curr Med Res Opin. 23: 443-57, 2007
- Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol.39: 44-84, 2007
- Amaro S and Chamorro A. Translational stroke research of the combination of thrombolysis and antioxidant therapy. Stroke. 42:1495-9, 2011
- Vane JR, Anggard EE, Botting RM. Regulatory functions of the vascular endothelium. N Engl J Med. 323: 27-36. 1990
- Mozos I, Chiulana C, Gorun C and Costea ST. Serum uric acid in stroke. Series of Chemistry.16: 227-236, 2007
- Bowman GL, Shannon J, Frei B, Kaye JA and Quinn JF. Uric acid as a CNS antioxidant. J Alzheimers Dis. 19: 1331-1336, 2010
- Miller NJ, Rice-Evans C, Davies MJ, Gopinathan V and Milner A. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci. 84: 407-12, 1993
- Barbosa MCC, Brandao AA, Pozzan R, Magalhães MEC, Campana EMG, Fonseca FL, Pizzi OL, de Freitas EV and Brandão AP. Association between uric acid and cardiovascular risk variables in a non-hospitalized population. Arq Bras Cardiol. 96: 96: 212-218, 2011
- Wu H, Jia Q, Liu G, Liu L, Pu Y, Zhao X, Wang C, Wang and Wang Y. decreased uric acid levelc with poor outcomes in Acute Ischemic Stroke Patients, but not in Cerebral Hemorrhage Patients. J Stroke and Cerebrovascular Diseases. 2013
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