Background Uric acid （UA） is suspected to play a neuro-protective role in Parkinson＇s disease （PD）.This study aimed to evaluate whether the serum UA level was associated with the disease progression of PD in a re...Background Uric acid （UA） is suspected to play a neuro-protective role in Parkinson＇s disease （PD）.This study aimed to evaluate whether the serum UA level was associated with the disease progression of PD in a relatively large population of Chinese patients.Methods Serum UA levels were measured from 411 Chinese PD patients and 396 age-matched controls; following the uric acid colorimetric method,the serum creatinine （Scr） levels were also measured to reduce the bias caused by possible differences in renal excretion function.The disease progression was scored by Hoehn and Yahr （H＆Y） scales and disease durations; PD group was divided into 3 subgroups according to H＆Y scales.Independent-samples ttest was performed to analyze the differences between PD group and control group.Multiple analysis of covariance was performed to analyze the differences between PD subgroups.Spearman rank-correlation was performed to evaluate the associations between serum UA or Scr level and disease progression.Results PD patients were found to have significantly lower levels of serum UA than controls （（243.38±78.91） vs.（282.97±90.80） pmol/L,P〈0.01）.As the disease progression,the serum UA levels were gradually reduced.There was a significantly inverse correlation of UA levels with H＆Y scales （Rs=-0.429,P 〈0.01） and disease duration （Rs=-0.284,P 〈0.01） in PD patients of both females and males.No significant difference of the Scr level between PD patients and controls was found （（70.01±14.70） vs.（69.84±16.46） μmol/L）,and the Scr level was not involved in disease progression.Conclusion Lower serum UA levels may possess a higher risk of PD,which may be a potential useful biomarker to indicate the progression of PD.展开更多
INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HU...INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.展开更多
Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary ar...Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease(CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.Methods Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores(low Syntax score group: Syntax score ≤10.0; moderate Syntax score group: 10.0 <Syntax score ≤18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events(MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group(n=251, with SUA <416 μmol/L for men and SUA <357 μmol/L for women) and high SUA group(n=96, with SUA ≥416 μmol/L for men and SUA ≥357 μmol/L for women). All participants were followed for a mean of 22.0 months(1–75 months, interquartile range: 28 months) for major adverse cardiovascular events(MACEs), including all-cause death, recurrent nonfatal myocardial infarction(re-MI) and recurrent percutaneous coronary intervention(re-PCI). Results A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group((392.3±81.6) μmol/L vs.(329.9±71.0) μmol/L, P <0.001;(392.3±81.6) μmol/L vs.(311.4±64.7) μmol/L, P <0.001). The SUA level was positively correlated not only with the Syntax score(r=0.421, P <0.001; 95% CI: 0.333–0.512), but also with the number of diseased vessels(r=0.298, P <0.001; 95% CI: 0.194–0.396). After multip展开更多
Background Previous studies have demonstrated that serum uric acid （UA） is an independent predictor of incident type 2 diabetes mellitus （T2DM） in general populations. This study aimed to investigate specific char...Background Previous studies have demonstrated that serum uric acid （UA） is an independent predictor of incident type 2 diabetes mellitus （T2DM） in general populations. This study aimed to investigate specific characteristics of UA and its relationship between UA and blood glucose and other risk factors in the Chinese population.Methods A total of 946 subjects were included in this study. UA, glucose, insulin, fractional excretion of UA （FEua）,creatinine clearance rate （Ccr）, hemoglobin A1c （HbA1c）, fructosamine （FA）, blood pressure and lipids were studied and also reexamined after the patients underwent two weeks of combined therapeutics.Results UA levels were the highest in subjects with impaired glucose regulation （IGR）, followed by subjects with normoglycemia （NGT） and finally by subjects with T2DM. The level of the 2-hour postprandial insulin and the area under the curve for insulin （AUCins） showed a similar tendency. The UA levels initially increased with increasing fasting blood glucose （FBG） and postprandial blood glucose （PPBG） levels, up to 7 mmol/L and 10 mmol/L, respectively, and thereafter decreased at higher FBG and PPBG levels. Compared with subjects in the lower serum UA quartile, subjects in the upper quartile of serum UA levels had higher weights, triglyceride levels, and creatinine levels as well as lower Ccr and FEua levels. Compared with women＇s group, UA levels were higher, and FEua levels were lower in men＇s group. Sex,body mass index （BMI）, mean arterial blood pressure （MAP）, serum triglycerides （TG）, FA and Ccr were independent correlation factors of UA. UA decreased and FEua increased after the patients underwent a combined treatment.Conclusions UA increased initially and then decreased as glucose levels increased from NGT to IGR and T2DM.Compared with NGT and T2DM, IGR subjects had higher SUA levels, which related to its high levels of insulin. Under T2DM, male gender, BMI, MAP, Ccr, TG and FA are independent correlation factors展开更多
Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used b...Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used blood urea nitrogen （BUN）,uric acid （UA）,and β2-microglobulin （β2-MG） remains to be explored.This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.Methods：Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled.The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes （KDIGO） criteria and classified by stage.Measurement data were analyzed using the t-test or Wilcoxon rank-sum test;enumerated data were analyzed using the Chi-square test or Fisher＇s exact test.Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic （ROC） curve analysis.Results：This study excluded 976 cases and analyzed 697 patients （578 men and 1 1 9 women）;the post-OLT AKI incidence was 0.409.Compared with the no-AKI group,the AKI group showed very significant differences in Model for End-stage Liver Disease score （14.74 ± 9.91 vs.11.07 ± 9.54,Z =5.404;P ＜ 0.001）,hepatic encephalopathy （45 [15.8％] vs.30 [7.3％],x2 =12.699;P ＜ 0.001）,hemofiltration （28 [9.8％] vs.0 [0.0％],x2 =42.171;P ＜ 0.001）,and 28-day mortality （23 [8.1％] vs.9 [2.2％],x2 13.323;P ＜0.001）.Moreover,mean values of Cr,BUN,UA,and β2-MG in the AKI group differed significantly at postoperative days 1,3,and 7 （all P ＜0.001）.ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 （sensitivity 80.1％,specificity 75.7％,cutoffvalue 88.23 μmol/L）,0.916 for Stage 2 （sensitivity 87.6％,specificity 82.6％,cutoff value 99.9 μmol/L）,and 0.972 for Stage 3 （sensitivity 94.1％,specificity 88.2％,cutoff value 122.90 μmol/L）.Conclusion：The sensitivity and specificity of serum Cr might be a high-value indicator for the diagno展开更多
Background Recently there has been a great deal of interest in the role of serum uric acid （SUA） in atrial fibrillation （AF）. The objective of this study was to establish whether there is a relationship between le...Background Recently there has been a great deal of interest in the role of serum uric acid （SUA） in atrial fibrillation （AF）. The objective of this study was to establish whether there is a relationship between levels of SUA and recurrence of paroxysmal AF after catheter ablation. Methods Three hundred and thirty patients diagnosed with paroxysmal AF were analyzed. Patients were categorized into quartiles on the basis of their pre-operative SUA measurement and follow-up, and Kaplan-Meier estimation with a Log-rank test was used for the analysis of the influence of SUA on the recurrence of AF. Pre-procedural clinical variables were correlated with the clinical outcome after ablation using multivariate Logistic analysis. A Cox proportional hazards model was used to estimate the relationship between SUA and the recurrence of AF. Results After a mean follow-up of （9.341＋3.667） （range 3.0-16.3） months, recurrence rates from the lowest SUA quartile to the highest SUA quartile were 16.0%, 26.4%, 28.3%, and 29.3% respectively （P=0.014）. After adjustment for gender, body mass index （BMI）, hypertension, serum levels of high sensitivity C-reactive protein （hsCRP）, triglyceride （TG）, left atrial diameter （LA）, estimated glomerular filtration rate （eGFR）, and SUA, there was an increased risk of recurrence in subjects in the highest SUA quartile compared with those in the lowest quartile （hazard ratio 2.804, 95% confidence interval 1.466-5.362, P=0.002）. Following multivariate Logistical analysis, SUA was found to be an independent predictor of recurrence （hazard ratio 1.613, 95% confidence interval 1.601-1.625, P=0.014）. Conclusion In a retrospective study of patients with paroxysmal AF undergoing catheter ablation, elevated preoperative SUA levels were associated with a hiaher rate of recurrence of AF.展开更多
Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is ...Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid(UA) generation inhibitor in the 1950 s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target forvascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted.展开更多
Background Studies have shown that increased levels of serum uric acid （SUA） are associated with atrial fibrillation （AF）. However, less is known about the prognostic value of SUA levels for AF in patients with ch...Background Studies have shown that increased levels of serum uric acid （SUA） are associated with atrial fibrillation （AF）. However, less is known about the prognostic value of SUA levels for AF in patients with chronic heart failure （CHF）. The aim of the study was to examine the prognostic value of SUA levels for AF in patients with CHF. Methods Sixteen thousand six hundred and eighty-one patients diagnosed with CHF from 12 hospitals were analyzed. Patients were categorized into AF group and non-AF group, death group, and survival group according to the results of the patients＇ medical records and follow-up. Univariate and multivariate Cox proportional hazards analyses were performed to examine the risk of AF. The sensitivity and specificity of SUA level in predicting the prognosis were examined by multivariate Cox models and receiver operating characteristic （ROC） curves. Results The results of univariate predictors in overall patients showed that the higher SUA level was associated with AF. SUA level （HR, 1.084; 95% CI, 1.017-1.144; P 〈0.001）, diuretics （HR, 1.549; 95% CI, 1.246-1.854; P 〈0.001）, and New York Heart Association （NYHA） （HR, 1.237; 95% CI, 1.168-1.306; P 〈0.001） function class were the independent risk factors for AF. The sensitivity and specificity of the models were 29.6% and 83.8% respectively for predicting AF. When SUA level was added to these models, it remained significant （Wald Z2, 1494.88; P 〈0.001 for AF）; 58.8% （95% CI, 57.7%-60.0%） of the observed results were concordant with the separate model. Conclusion Higher SUA level is associated strongly with AF in patients with CHF. SUA level can increase the sensitivity and specificity in predicting AF.展开更多
Background Recently, some studies had shown that elevated serum uric acid （SUA） itself may increase the risk for development of renal disease in patients with diabetes. This study aimed to explore whether SUA was a ...Background Recently, some studies had shown that elevated serum uric acid （SUA） itself may increase the risk for development of renal disease in patients with diabetes. This study aimed to explore whether SUA was a predictor of microalbuminuria and impaired renal function in type 2 diabetes in Chinese patients. Methods This cross-sectional study included 2108 type 2 diabetic patients. Kidney function was estimated using the simplified modification of diet in renal disease （MDRD） equation to obtain estimated glomerular filtration rate. The urine samples were obtained for measuring the albumin-to-creatinine ratio （ACR）. Results According to the ACR level, these patients were divided into two groups, normal ACR （NA） and non-normal ACR （non-NA）. Both SUA and creatinine were significantly higher in the non-NA group than those in the NA group （（318.89±107.52） vs. （283.44±88.64） pmol/L, and （95.08±53.24） vs. （79.63±18.20） μmol/L, respectively）. Logistic regression analysis showed that diabetic duration, systolic blood pressure, creatinine and SUA were the independent predictors of albuminuria. Furthermore, to identify the factors associated with renal function, these patients were divided into two groups according to the MDRD level （MDRD〈90 or MDRD〉90）. Both SUA and creatinine were significantly higher in the lower MDRD group than those in the higher MDRD group （（301.90±96.46） vs. （264.07±84.74） μmol/L, and （89.10±31.00） vs. （66.37±11.15） μmol/L, respectively）. Logistic regression analysis showed that only age and SUA were the independent predictors of MDRD. Conclusion High-normal SUA was associated with albuminuria and impaired glomerular filtration rate in Chinese type 2 diabetic patients.展开更多
Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinica...Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus （DM） was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent （DES）. Methods A total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group （n = 74） and the non-ISR group （n = 294）. The independent predictors of ISR in patients with DM were explored by multivariate Cox＇s proportional hazards regression models. Results A total of 368 patients （260 women and 108 men） with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients （20.11%） by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol （VLDL-C）, triglyceride （TG） and uric acid （UA） levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lo展开更多
Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels w...Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels with adverse cardiovascular events and deaths in an elderly population affected by advanced atherosclerosis. Methods Two hundred and seventy six elderly patients affected by advanced atherosclerosis （217 males and 59 females; aged 71.2 ±7.8 years） were included. All patients were assessed for history of cardiovascular disease, cancer, obesity and traditional risk factors. Patients were followed for approximately 31 ±11 months. Major events were recorded during follow-up, defined as myocardial infarction, cerebral isehemia, myocardial and/or peripheral revascularization and death. Results Mean SUA level was 5.47 ±1.43 mg/dL; then we further divided the population in two groups, according to the median value （5.36 mg/dL）. During a median follow up of 31 months （5 to 49 months）, 66 cardiovascular events, 9 fatal cardiovascular events and 14 cancer-related deaths have occurred. The patients with increased SUA level presented a higher significant incidence of total cardiovascular events （HR： 1.867, P = 0.014, 95% CI： 1.134-3.074）, The same patients showed a significant increased risk of cancer-related death （HR： 4.335, P = 0.025, 95% CI： 1.204-15.606）. Conclusions Increased SUA levels are independently and significantly associated with risk of cardiovascular events and cancer related death in a population of mainly elderly patients affected by peripheral vasculopathy.展开更多
AIM: To investigate the effect of rosuvastatin monotherapy on non-alcoholic steatohepatitis(NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form NASH.METHODS: Th...AIM: To investigate the effect of rosuvastatin monotherapy on non-alcoholic steatohepatitis(NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form NASH.METHODS: This prospective study included 20 biopsy proven patients with NASH, metabolic syndrome(Met S) and dyslipidaemia. Biochemical parameters of the blood of the patients and an ultrasonography of the liver were performed at baseline. Then patients receivedlifestyle advice and were treated for a 12 mo period with rosuvastatin(10 mg/d) monotherapy. Patients were re-evaluated during the study at 3 mo intervals, during which biochemical parameters of the blood were measured including liver enzymes. A repeat biopsy and ultrasonography of the liver were performed at the end of the study in all 20 patients. Changes in liver enzymes, fasting plasma glucose, serum creatinine, serum uric acid(SUA), high sensitivity C reactive protein(hs CRP) and lipid profile were assessed every 3 mo. The primary endpoint was the resolution of NASH and the secondary endpoints were the changes in liver enzyme and lipid values.RESULTS: The repeat liver biopsy and ultrasonography showed complete resolution of NASH in 19 patients, while the 20 th, which had no improvement but no deterioration either, developed arterial hypertension and substantial rise in triglyceride levels during the study, probably due to changes in lifestyle including alcohol abuse. Serum alanine transaminase, aspartate transaminase, and γ-glutamyl transpeptidase were normalised by the 3rd treatment month(ANOVA P < 0.001), while alkaline phosphatase activities by the 6th treatment month(ANOVA, P = 0.01). Fasting plasma glucose and glycated haemoglobin were significantly reduced(P < 0.001). Lipid values were normalised by the 3rd treatment month. No patient had Met S by the 9th treatment month. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function should be attributed solely to rosuvastatin treatme展开更多
Background Serum uric acid （UA）, the final product of purine degradation, has been proposed to be a marker for the severity and a possible predictor of mortality in patients with pulmonary arterial hypertension （PA...Background Serum uric acid （UA）, the final product of purine degradation, has been proposed to be a marker for the severity and a possible predictor of mortality in patients with pulmonary arterial hypertension （PAH）. The objectives of this study were to elucidate whether serum UA level correlates with the clinical features and the hemodynamic variables in Chinese patients with PAH and to compare the difference of the correlates in patients associated with different etiologies. Methods Serum UA was assessed in 228 patients with three types of PAH （idiopathic PAH （IPAH）, congenital heart disease related PAH （CHD-PAH） and connective tissue disease related PAH （CTD-PAH）） together with other clinical features. After the individualized treatment for at least 6 months, the UA levels and clinical features were re-evaluated in 88 patients. Results Serum UA was significantly elevated in patients with PAH compared with age-matched control subjects （（350.40±108.73） μmol/L vs （266.91±81.38） μmol/L）, P 〈0.001）. Serum UA negatively correlated with cardiac output and mixed venous saturation （SvO2） in all three types of PAH （all P 〈0.05）, positively correlated with the size of right ventricle in IPAH （P=0.002） and CTD-PAH （P=0.013） patients and with pulmonary vascular resistance just in CTD-PAH patients （P=0.001）. Serum UA significantly decreased from （365.80±120.46） μmol/L to （333.67±117.56） μmol/L in 88 patients （P=0.006） with vasodilator therapy for at least 6 months, accompanied with a reduction in pulmonary vascular resistance from （15.13±6.96） Woods unit to （12.00±5.04） Woods unit （P=0.001） and an increase in cardiac output from （2.63±0.98） L/min to （3.08±1.04） L/min （P=0.005）. Conclusions Serum UA increases in proportion to the clinical severity of all the three types of PAH, especially the CTD-PAH had a stronger correlations compared with IPAH and CHD-PAH. The serum UA levels also could partly reflect the respons展开更多
Uric acid is the end product of purine catabolism and its plasma levels are maintained below its maximum solubility in water(6–7 mg/dl).The plasma levels are tightly regulated as the balance between the rate of produ...Uric acid is the end product of purine catabolism and its plasma levels are maintained below its maximum solubility in water(6–7 mg/dl).The plasma levels are tightly regulated as the balance between the rate of production and the rate of excretion,the latter occurring in urine(kidney),bile(liver)and feces(intestinal tract).Reabsorption in kidney is also an important component of this process.Both excretion and reabsorption are mediated by specific transporters.Disruption of the balance between production and excretion leads to hyperuricemia,which increases the risk of uric acid crystallization as monosodium urate with subsequent deposition of the crystals in joints causing gouty arthritis.Loss-of-function mutations in the transporters that mediate uric acid excretion are associated with gout.The ATP-Binding Cassette exporter ABCG2 is important in uric acid excretion at all three sites:kidney(urine),liver(bile),and intestine(feces).Mutations in this transporter cause gout and these mutations occur at significant prevalence in general population.However,mutations that are most prevalent result only in partial loss of transport function.Therefore,if the expression of these partially defective transporters could be induced,the increased number of the transporter molecules would compensate for the mutation-associated decrease in transport function and hence increase uric acid excretion.As such,pharmacologic agents with ability to induce the expression of ABCG2 represent potentially a novel class of drugs for treatment of gouty arthritis.展开更多
Recent studies have shown that the abnormal accumulation of endogenous formaldehyde could be a critical factor in age-related cognitive decline. The aim of this study was to estimate the correlation between uric forma...Recent studies have shown that the abnormal accumulation of endogenous formaldehyde could be a critical factor in age-related cognitive decline. The aim of this study was to estimate the correlation between uric formaldehyde and general cognitive abilities in a community-based elderly population, and to measure the extent and direction in which the correlation varied with demographic characteristics. Using a double-blind design, formaldehyde in human urine was analyzed by high-performance liquid chromatography （n = 604）, and general cognitive abilities were measured using the Montreal Cognitive Assessment （MoCA）. Demographic characteristics, in terms of age, gender, residential region, and education were taken into consideration. We found that uric formaldehyde levels were inversely correlated with the MoCA score, and the concentration varied with demographic features： higher odds of a high formaldehyde level occurred among the less educated and those living in old urban or rural areas. In cytological experiments, the level of cellular formaldehyde released into the medium increased as SH-SY5Y and BV2 cells were incubated for three days. Formaldehyde in excess impairedthe processes of N2a cells and neurites of primary cultured rat hippocampal cells. However, removal of formaldehyde markedly rescued and regenerated the processes of N2a cells. These results demonstrated a negative correlation between the endogenous formaldehyde and general cognitive abilities. High formaldehyde levels could be a risk factor for cognitive impairment in older adults, and could be developed as a non-invasive marker for detection and monitoring of age-related cognitive impairment.展开更多
Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the ris...Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.展开更多
Background The association between increased serum uric acid （SUA） levels and cardiovascular risk has been debated for decades. Several large studies have provided conflicting results regarding the clinical signific...Background The association between increased serum uric acid （SUA） levels and cardiovascular risk has been debated for decades. Several large studies have provided conflicting results regarding the clinical significance of elevated SUA levels in cardiovascular disease （CVD） or cerebrovascular disease. The aim of this study was to investigate the relationship between SUA and CVD and all-cause mortality and their potential diagnostic value. Methods A total of 3570 in-patients ranging in age from 56 to 95 years （mean （67.36_＋11.36） years） were selected from 20 hospitals in Beijing and Shanghai. A carefully designed questionnaire was used to gather baseline data of each patient All patients were divided into two main groups according to their SUA levels： high SUA and normal SUA groups. Serum indices and other important parameters were measured. Results Compared with normal SUA group, high SUA group had significant difference in systolic blood pressure （SBP）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, body mass index （BMI）, and age （P 〈0.05 or P 〈0.01）. High SUA prevailed in female and patients with history of essential hypertension, while history of smoking and diabetes showed no significant difference between two groups. All-cause and CVD mortality occurred more frequently in high SUA group than in normal SUA group. In the accumulative survival analysis, high SUA group had lower survival rate than normal SUA group both in CVD and all-cause mortality. COX regression analysis indicated that the history of smoking, age and high SUA were independent risk factors for the development of CVD. Conclusions These preliminary observations suggest that patients with high SUA levels would face higher risk of mortality. SUA measurement may be applied as a routine predictor for clinical assessment.展开更多
A patented kinetic uricase method was evaluated for serum uric acid assay. Initial absorbance of the reaction mixture before uricase action （A0） was obtained by correcting the absorbance at 293 nm measured before th...A patented kinetic uricase method was evaluated for serum uric acid assay. Initial absorbance of the reaction mixture before uricase action （A0） was obtained by correcting the absorbance at 293 nm measured before the addition of uricase solution, and background absorbance （Ab） was predicted by an integrated method. Uric acid concentration in reaction solution was calculated from AA, the difference between A0 and Ab, using the absorptivity preset for uric acid. This kinetic uricase method exhibited CV〈4.3% and recovery of 100%. Lipids, bilirubin, hemoglobin, ascorbic acid, reduced glutathione and xanthine 〈0.32 mmol/L in serum had no significant effects. △A linearly responded to 1.2 to 37.5 μmol/L uric acid in reaction solution containing 15 μl serum. The slope of linear response was consistent with the absorptivity preset for uric acid while the intercept was consistent with that for serum alone. Uric acid concentrations in clinic sera by different uricase methods positively correlated to each other. By Bland-Altman analysis, this kinetic uricase method accorded with that by quantifying the total change of UV absorbance on the completion of uricase reaction. These results demonstrated that this kinetic uricase method is reliable for serum uric acid assay with enhanced resistance to both xanthine and other common errors, wider range of linear response and much lower cost.展开更多
Objective:To develop the missing link between hyperuricemia and hypertension.Methods:The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department.Hyperten...Objective:To develop the missing link between hyperuricemia and hypertension.Methods:The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department.Hypertension was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National Committee.Totally 205newly diagnosed and untreated essential hypertensive cases and age-sex matched nonnotensive controls were enrolled in the study.The potential confounding factors of hyperuricemia and hypertension in both cases and controls were controlled.Uric acid levels in all participants were analyzed.Results:Renal function between newly diagnosed hypertensive cases and nonnotensive healthy controls were adjusted.The mean serum uric acid observed in newly diagnosed hypertensive cases and in nonnotensive healthy controls were(290.05±87.03)μmol/L and(245.24±09.38)μmol/L respectively.A total of 59(28.8%)participants of cases and 28(13.7%)participants of controls had hyperuricemia(odds ratio 2.555(95%CI:1.549-4.213),P<0.00l).Conclusions:The mean serum uric acid leveb and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.展开更多
Objective： To explore the effect of Compound Tufuling Granules （复方土茯苓颗粒, CTG） on regulating glucose transporter 9 （GLUT9） expression in the kidney to influence the uric acid excretion by the kidney and ser...Objective： To explore the effect of Compound Tufuling Granules （复方土茯苓颗粒, CTG） on regulating glucose transporter 9 （GLUT9） expression in the kidney to influence the uric acid excretion by the kidney and serum uric acid （SUA） level in hyperuricemia mice. Methods： Sixty Kunming male mice were randomly divided into the control group, model group, benzbromarone group, and CTG high-, middle- and low- dose groups. The yeast extract and uricase inhibition method were used to build hyperuricemia model, and the corresponding drugs were administrated on the 7th day. On the 21st day the 24-h urine was collected, on the 22rid day the blood was collected, the SUA level was detected by uricase colorimetry, and the mRNA and protein expressions of GLUT9 were detected by quantitative real-time polymerase chain reaction and Western blot, respectively. Results： Compared with the model group, the levels of SUA and the mRNA and protein expressions of GLUT9 were significantly decreased, and the fraction excretion of uric acid （FEUA） was significantly increased in the CTG groups and benzbromarone group （all P〈0.05）. There was no significant difference in the above indicators between the CTG high-dose group and benzbromarone group （P〉0.05）. SUA is positively related to the GLUT9 mRNA and protein expressions in the kidney （P〈0.05 or P〈0.01）. Conclusions： CTG can significantly reduce the SUA and increase the FEUA. In addition, CTG can effectively inhibit the mRNA and protein expressions of GLUT9 in the kidney of hyperuricemia mice to inhibit the uric acid re-absorption, promote uric acid excretion and reduce SUA.展开更多
基金This work was supported by grants from the National High Technology Research and Development Program of China （No.2007AA022460）,the State Key Development Program for Basic Research of China （No.2011CB510000）,and the National Natural Science Foundation of China （No.81071032）.
文摘Background Uric acid （UA） is suspected to play a neuro-protective role in Parkinson＇s disease （PD）.This study aimed to evaluate whether the serum UA level was associated with the disease progression of PD in a relatively large population of Chinese patients.Methods Serum UA levels were measured from 411 Chinese PD patients and 396 age-matched controls; following the uric acid colorimetric method,the serum creatinine （Scr） levels were also measured to reduce the bias caused by possible differences in renal excretion function.The disease progression was scored by Hoehn and Yahr （H＆Y） scales and disease durations; PD group was divided into 3 subgroups according to H＆Y scales.Independent-samples ttest was performed to analyze the differences between PD group and control group.Multiple analysis of covariance was performed to analyze the differences between PD subgroups.Spearman rank-correlation was performed to evaluate the associations between serum UA or Scr level and disease progression.Results PD patients were found to have significantly lower levels of serum UA than controls （（243.38±78.91） vs.（282.97±90.80） pmol/L,P〈0.01）.As the disease progression,the serum UA levels were gradually reduced.There was a significantly inverse correlation of UA levels with H＆Y scales （Rs=-0.429,P 〈0.01） and disease duration （Rs=-0.284,P 〈0.01） in PD patients of both females and males.No significant difference of the Scr level between PD patients and controls was found （（70.01±14.70） vs.（69.84±16.46） μmol/L）,and the Scr level was not involved in disease progression.Conclusion Lower serum UA levels may possess a higher risk of PD,which may be a potential useful biomarker to indicate the progression of PD.
文摘INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.
文摘Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease(CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.Methods Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores(low Syntax score group: Syntax score ≤10.0; moderate Syntax score group: 10.0 <Syntax score ≤18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events(MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group(n=251, with SUA <416 μmol/L for men and SUA <357 μmol/L for women) and high SUA group(n=96, with SUA ≥416 μmol/L for men and SUA ≥357 μmol/L for women). All participants were followed for a mean of 22.0 months(1–75 months, interquartile range: 28 months) for major adverse cardiovascular events(MACEs), including all-cause death, recurrent nonfatal myocardial infarction(re-MI) and recurrent percutaneous coronary intervention(re-PCI). Results A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group((392.3±81.6) μmol/L vs.(329.9±71.0) μmol/L, P <0.001;(392.3±81.6) μmol/L vs.(311.4±64.7) μmol/L, P <0.001). The SUA level was positively correlated not only with the Syntax score(r=0.421, P <0.001; 95% CI: 0.333–0.512), but also with the number of diseased vessels(r=0.298, P <0.001; 95% CI: 0.194–0.396). After multip
文摘Background Previous studies have demonstrated that serum uric acid （UA） is an independent predictor of incident type 2 diabetes mellitus （T2DM） in general populations. This study aimed to investigate specific characteristics of UA and its relationship between UA and blood glucose and other risk factors in the Chinese population.Methods A total of 946 subjects were included in this study. UA, glucose, insulin, fractional excretion of UA （FEua）,creatinine clearance rate （Ccr）, hemoglobin A1c （HbA1c）, fructosamine （FA）, blood pressure and lipids were studied and also reexamined after the patients underwent two weeks of combined therapeutics.Results UA levels were the highest in subjects with impaired glucose regulation （IGR）, followed by subjects with normoglycemia （NGT） and finally by subjects with T2DM. The level of the 2-hour postprandial insulin and the area under the curve for insulin （AUCins） showed a similar tendency. The UA levels initially increased with increasing fasting blood glucose （FBG） and postprandial blood glucose （PPBG） levels, up to 7 mmol/L and 10 mmol/L, respectively, and thereafter decreased at higher FBG and PPBG levels. Compared with subjects in the lower serum UA quartile, subjects in the upper quartile of serum UA levels had higher weights, triglyceride levels, and creatinine levels as well as lower Ccr and FEua levels. Compared with women＇s group, UA levels were higher, and FEua levels were lower in men＇s group. Sex,body mass index （BMI）, mean arterial blood pressure （MAP）, serum triglycerides （TG）, FA and Ccr were independent correlation factors of UA. UA decreased and FEua increased after the patients underwent a combined treatment.Conclusions UA increased initially and then decreased as glucose levels increased from NGT to IGR and T2DM.Compared with NGT and T2DM, IGR subjects had higher SUA levels, which related to its high levels of insulin. Under T2DM, male gender, BMI, MAP, Ccr, TG and FA are independent correlation factors
文摘Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used blood urea nitrogen （BUN）,uric acid （UA）,and β2-microglobulin （β2-MG） remains to be explored.This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.Methods：Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled.The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes （KDIGO） criteria and classified by stage.Measurement data were analyzed using the t-test or Wilcoxon rank-sum test;enumerated data were analyzed using the Chi-square test or Fisher＇s exact test.Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic （ROC） curve analysis.Results：This study excluded 976 cases and analyzed 697 patients （578 men and 1 1 9 women）;the post-OLT AKI incidence was 0.409.Compared with the no-AKI group,the AKI group showed very significant differences in Model for End-stage Liver Disease score （14.74 ± 9.91 vs.11.07 ± 9.54,Z =5.404;P ＜ 0.001）,hepatic encephalopathy （45 [15.8％] vs.30 [7.3％],x2 =12.699;P ＜ 0.001）,hemofiltration （28 [9.8％] vs.0 [0.0％],x2 =42.171;P ＜ 0.001）,and 28-day mortality （23 [8.1％] vs.9 [2.2％],x2 13.323;P ＜0.001）.Moreover,mean values of Cr,BUN,UA,and β2-MG in the AKI group differed significantly at postoperative days 1,3,and 7 （all P ＜0.001）.ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 （sensitivity 80.1％,specificity 75.7％,cutoffvalue 88.23 μmol/L）,0.916 for Stage 2 （sensitivity 87.6％,specificity 82.6％,cutoff value 99.9 μmol/L）,and 0.972 for Stage 3 （sensitivity 94.1％,specificity 88.2％,cutoff value 122.90 μmol/L）.Conclusion：The sensitivity and specificity of serum Cr might be a high-value indicator for the diagno
基金This study was supported by grants from the Beijing Postdoctoral Work Foundation （No. 2012ZZ-40 and 2011ZZ-04）, National Science Foundation Council of China （No. 30971239 and 81070147）, and the Beijing Natural Science Foundation （No. 7101004）. Beijing Municipal Science ＆ Technology Commission （No. DI 1110700300000）.
文摘Background Recently there has been a great deal of interest in the role of serum uric acid （SUA） in atrial fibrillation （AF）. The objective of this study was to establish whether there is a relationship between levels of SUA and recurrence of paroxysmal AF after catheter ablation. Methods Three hundred and thirty patients diagnosed with paroxysmal AF were analyzed. Patients were categorized into quartiles on the basis of their pre-operative SUA measurement and follow-up, and Kaplan-Meier estimation with a Log-rank test was used for the analysis of the influence of SUA on the recurrence of AF. Pre-procedural clinical variables were correlated with the clinical outcome after ablation using multivariate Logistic analysis. A Cox proportional hazards model was used to estimate the relationship between SUA and the recurrence of AF. Results After a mean follow-up of （9.341＋3.667） （range 3.0-16.3） months, recurrence rates from the lowest SUA quartile to the highest SUA quartile were 16.0%, 26.4%, 28.3%, and 29.3% respectively （P=0.014）. After adjustment for gender, body mass index （BMI）, hypertension, serum levels of high sensitivity C-reactive protein （hsCRP）, triglyceride （TG）, left atrial diameter （LA）, estimated glomerular filtration rate （eGFR）, and SUA, there was an increased risk of recurrence in subjects in the highest SUA quartile compared with those in the lowest quartile （hazard ratio 2.804, 95% confidence interval 1.466-5.362, P=0.002）. Following multivariate Logistical analysis, SUA was found to be an independent predictor of recurrence （hazard ratio 1.613, 95% confidence interval 1.601-1.625, P=0.014）. Conclusion In a retrospective study of patients with paroxysmal AF undergoing catheter ablation, elevated preoperative SUA levels were associated with a hiaher rate of recurrence of AF.
文摘Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid(UA) generation inhibitor in the 1950 s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target forvascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted.
文摘Background Studies have shown that increased levels of serum uric acid （SUA） are associated with atrial fibrillation （AF）. However, less is known about the prognostic value of SUA levels for AF in patients with chronic heart failure （CHF）. The aim of the study was to examine the prognostic value of SUA levels for AF in patients with CHF. Methods Sixteen thousand six hundred and eighty-one patients diagnosed with CHF from 12 hospitals were analyzed. Patients were categorized into AF group and non-AF group, death group, and survival group according to the results of the patients＇ medical records and follow-up. Univariate and multivariate Cox proportional hazards analyses were performed to examine the risk of AF. The sensitivity and specificity of SUA level in predicting the prognosis were examined by multivariate Cox models and receiver operating characteristic （ROC） curves. Results The results of univariate predictors in overall patients showed that the higher SUA level was associated with AF. SUA level （HR, 1.084; 95% CI, 1.017-1.144; P 〈0.001）, diuretics （HR, 1.549; 95% CI, 1.246-1.854; P 〈0.001）, and New York Heart Association （NYHA） （HR, 1.237; 95% CI, 1.168-1.306; P 〈0.001） function class were the independent risk factors for AF. The sensitivity and specificity of the models were 29.6% and 83.8% respectively for predicting AF. When SUA level was added to these models, it remained significant （Wald Z2, 1494.88; P 〈0.001 for AF）; 58.8% （95% CI, 57.7%-60.0%） of the observed results were concordant with the separate model. Conclusion Higher SUA level is associated strongly with AF in patients with CHF. SUA level can increase the sensitivity and specificity in predicting AF.
文摘Background Recently, some studies had shown that elevated serum uric acid （SUA） itself may increase the risk for development of renal disease in patients with diabetes. This study aimed to explore whether SUA was a predictor of microalbuminuria and impaired renal function in type 2 diabetes in Chinese patients. Methods This cross-sectional study included 2108 type 2 diabetic patients. Kidney function was estimated using the simplified modification of diet in renal disease （MDRD） equation to obtain estimated glomerular filtration rate. The urine samples were obtained for measuring the albumin-to-creatinine ratio （ACR）. Results According to the ACR level, these patients were divided into two groups, normal ACR （NA） and non-normal ACR （non-NA）. Both SUA and creatinine were significantly higher in the non-NA group than those in the NA group （（318.89±107.52） vs. （283.44±88.64） pmol/L, and （95.08±53.24） vs. （79.63±18.20） μmol/L, respectively）. Logistic regression analysis showed that diabetic duration, systolic blood pressure, creatinine and SUA were the independent predictors of albuminuria. Furthermore, to identify the factors associated with renal function, these patients were divided into two groups according to the MDRD level （MDRD〈90 or MDRD〉90）. Both SUA and creatinine were significantly higher in the lower MDRD group than those in the higher MDRD group （（301.90±96.46） vs. （264.07±84.74） μmol/L, and （89.10±31.00） vs. （66.37±11.15） μmol/L, respectively）. Logistic regression analysis showed that only age and SUA were the independent predictors of MDRD. Conclusion High-normal SUA was associated with albuminuria and impaired glomerular filtration rate in Chinese type 2 diabetic patients.
文摘Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus （DM） was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent （DES）. Methods A total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group （n = 74） and the non-ISR group （n = 294）. The independent predictors of ISR in patients with DM were explored by multivariate Cox＇s proportional hazards regression models. Results A total of 368 patients （260 women and 108 men） with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients （20.11%） by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol （VLDL-C）, triglyceride （TG） and uric acid （UA） levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lo
文摘Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels with adverse cardiovascular events and deaths in an elderly population affected by advanced atherosclerosis. Methods Two hundred and seventy six elderly patients affected by advanced atherosclerosis （217 males and 59 females; aged 71.2 ±7.8 years） were included. All patients were assessed for history of cardiovascular disease, cancer, obesity and traditional risk factors. Patients were followed for approximately 31 ±11 months. Major events were recorded during follow-up, defined as myocardial infarction, cerebral isehemia, myocardial and/or peripheral revascularization and death. Results Mean SUA level was 5.47 ±1.43 mg/dL; then we further divided the population in two groups, according to the median value （5.36 mg/dL）. During a median follow up of 31 months （5 to 49 months）, 66 cardiovascular events, 9 fatal cardiovascular events and 14 cancer-related deaths have occurred. The patients with increased SUA level presented a higher significant incidence of total cardiovascular events （HR： 1.867, P = 0.014, 95% CI： 1.134-3.074）, The same patients showed a significant increased risk of cancer-related death （HR： 4.335, P = 0.025, 95% CI： 1.204-15.606）. Conclusions Increased SUA levels are independently and significantly associated with risk of cardiovascular events and cancer related death in a population of mainly elderly patients affected by peripheral vasculopathy.
文摘AIM: To investigate the effect of rosuvastatin monotherapy on non-alcoholic steatohepatitis(NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form NASH.METHODS: This prospective study included 20 biopsy proven patients with NASH, metabolic syndrome(Met S) and dyslipidaemia. Biochemical parameters of the blood of the patients and an ultrasonography of the liver were performed at baseline. Then patients receivedlifestyle advice and were treated for a 12 mo period with rosuvastatin(10 mg/d) monotherapy. Patients were re-evaluated during the study at 3 mo intervals, during which biochemical parameters of the blood were measured including liver enzymes. A repeat biopsy and ultrasonography of the liver were performed at the end of the study in all 20 patients. Changes in liver enzymes, fasting plasma glucose, serum creatinine, serum uric acid(SUA), high sensitivity C reactive protein(hs CRP) and lipid profile were assessed every 3 mo. The primary endpoint was the resolution of NASH and the secondary endpoints were the changes in liver enzyme and lipid values.RESULTS: The repeat liver biopsy and ultrasonography showed complete resolution of NASH in 19 patients, while the 20 th, which had no improvement but no deterioration either, developed arterial hypertension and substantial rise in triglyceride levels during the study, probably due to changes in lifestyle including alcohol abuse. Serum alanine transaminase, aspartate transaminase, and γ-glutamyl transpeptidase were normalised by the 3rd treatment month(ANOVA P < 0.001), while alkaline phosphatase activities by the 6th treatment month(ANOVA, P = 0.01). Fasting plasma glucose and glycated haemoglobin were significantly reduced(P < 0.001). Lipid values were normalised by the 3rd treatment month. No patient had Met S by the 9th treatment month. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function should be attributed solely to rosuvastatin treatme
文摘Background Serum uric acid （UA）, the final product of purine degradation, has been proposed to be a marker for the severity and a possible predictor of mortality in patients with pulmonary arterial hypertension （PAH）. The objectives of this study were to elucidate whether serum UA level correlates with the clinical features and the hemodynamic variables in Chinese patients with PAH and to compare the difference of the correlates in patients associated with different etiologies. Methods Serum UA was assessed in 228 patients with three types of PAH （idiopathic PAH （IPAH）, congenital heart disease related PAH （CHD-PAH） and connective tissue disease related PAH （CTD-PAH）） together with other clinical features. After the individualized treatment for at least 6 months, the UA levels and clinical features were re-evaluated in 88 patients. Results Serum UA was significantly elevated in patients with PAH compared with age-matched control subjects （（350.40±108.73） μmol/L vs （266.91±81.38） μmol/L）, P 〈0.001）. Serum UA negatively correlated with cardiac output and mixed venous saturation （SvO2） in all three types of PAH （all P 〈0.05）, positively correlated with the size of right ventricle in IPAH （P=0.002） and CTD-PAH （P=0.013） patients and with pulmonary vascular resistance just in CTD-PAH patients （P=0.001）. Serum UA significantly decreased from （365.80±120.46） μmol/L to （333.67±117.56） μmol/L in 88 patients （P=0.006） with vasodilator therapy for at least 6 months, accompanied with a reduction in pulmonary vascular resistance from （15.13±6.96） Woods unit to （12.00±5.04） Woods unit （P=0.001） and an increase in cardiac output from （2.63±0.98） L/min to （3.08±1.04） L/min （P=0.005）. Conclusions Serum UA increases in proportion to the clinical severity of all the three types of PAH, especially the CTD-PAH had a stronger correlations compared with IPAH and CHD-PAH. The serum UA levels also could partly reflect the respons
基金This work was supported by the National Institutes of Health grant R41 AR074854the Welch Endowed Chair in Biochemistry,Grant No.BI-0028,at Texas Tech University Health Sciences Center.
文摘Uric acid is the end product of purine catabolism and its plasma levels are maintained below its maximum solubility in water(6–7 mg/dl).The plasma levels are tightly regulated as the balance between the rate of production and the rate of excretion,the latter occurring in urine(kidney),bile(liver)and feces(intestinal tract).Reabsorption in kidney is also an important component of this process.Both excretion and reabsorption are mediated by specific transporters.Disruption of the balance between production and excretion leads to hyperuricemia,which increases the risk of uric acid crystallization as monosodium urate with subsequent deposition of the crystals in joints causing gouty arthritis.Loss-of-function mutations in the transporters that mediate uric acid excretion are associated with gout.The ATP-Binding Cassette exporter ABCG2 is important in uric acid excretion at all three sites:kidney(urine),liver(bile),and intestine(feces).Mutations in this transporter cause gout and these mutations occur at significant prevalence in general population.However,mutations that are most prevalent result only in partial loss of transport function.Therefore,if the expression of these partially defective transporters could be induced,the increased number of the transporter molecules would compensate for the mutation-associated decrease in transport function and hence increase uric acid excretion.As such,pharmacologic agents with ability to induce the expression of ABCG2 represent potentially a novel class of drugs for treatment of gouty arthritis.
基金supported by the National Basic Research Development Program(973 Program)of China(2012CB911004,2010CB912303)the National Science&Technology Pillar Program of China(2009BAI77B03)+2 种基金the National Natural Science Foundation of China(31271108,31070916,and 30911120494)the CAS/SAFEA International Partnership Program for Creative Research Team(Y2CX131003)the Knowledge Innovation Project of the Chinese Academy of Sciences,China(KSCX2-EWJ-256 and KSCX2-EW-J-8)
文摘Recent studies have shown that the abnormal accumulation of endogenous formaldehyde could be a critical factor in age-related cognitive decline. The aim of this study was to estimate the correlation between uric formaldehyde and general cognitive abilities in a community-based elderly population, and to measure the extent and direction in which the correlation varied with demographic characteristics. Using a double-blind design, formaldehyde in human urine was analyzed by high-performance liquid chromatography （n = 604）, and general cognitive abilities were measured using the Montreal Cognitive Assessment （MoCA）. Demographic characteristics, in terms of age, gender, residential region, and education were taken into consideration. We found that uric formaldehyde levels were inversely correlated with the MoCA score, and the concentration varied with demographic features： higher odds of a high formaldehyde level occurred among the less educated and those living in old urban or rural areas. In cytological experiments, the level of cellular formaldehyde released into the medium increased as SH-SY5Y and BV2 cells were incubated for three days. Formaldehyde in excess impairedthe processes of N2a cells and neurites of primary cultured rat hippocampal cells. However, removal of formaldehyde markedly rescued and regenerated the processes of N2a cells. These results demonstrated a negative correlation between the endogenous formaldehyde and general cognitive abilities. High formaldehyde levels could be a risk factor for cognitive impairment in older adults, and could be developed as a non-invasive marker for detection and monitoring of age-related cognitive impairment.
基金supported by Grants from the Ministry of Science and Technology of the People’s Republic of China[2016YFC1305202,2016YFC1305601,2016YFC0901201,2016YFC1304904]the National Natural Science Foundation of China[81670795]
文摘Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.
文摘Background The association between increased serum uric acid （SUA） levels and cardiovascular risk has been debated for decades. Several large studies have provided conflicting results regarding the clinical significance of elevated SUA levels in cardiovascular disease （CVD） or cerebrovascular disease. The aim of this study was to investigate the relationship between SUA and CVD and all-cause mortality and their potential diagnostic value. Methods A total of 3570 in-patients ranging in age from 56 to 95 years （mean （67.36_＋11.36） years） were selected from 20 hospitals in Beijing and Shanghai. A carefully designed questionnaire was used to gather baseline data of each patient All patients were divided into two main groups according to their SUA levels： high SUA and normal SUA groups. Serum indices and other important parameters were measured. Results Compared with normal SUA group, high SUA group had significant difference in systolic blood pressure （SBP）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, body mass index （BMI）, and age （P 〈0.05 or P 〈0.01）. High SUA prevailed in female and patients with history of essential hypertension, while history of smoking and diabetes showed no significant difference between two groups. All-cause and CVD mortality occurred more frequently in high SUA group than in normal SUA group. In the accumulative survival analysis, high SUA group had lower survival rate than normal SUA group both in CVD and all-cause mortality. COX regression analysis indicated that the history of smoking, age and high SUA were independent risk factors for the development of CVD. Conclusions These preliminary observations suggest that patients with high SUA levels would face higher risk of mortality. SUA measurement may be applied as a routine predictor for clinical assessment.
基金Project (No. 30200266) supported by the National Natural Science Foundation of China
文摘A patented kinetic uricase method was evaluated for serum uric acid assay. Initial absorbance of the reaction mixture before uricase action （A0） was obtained by correcting the absorbance at 293 nm measured before the addition of uricase solution, and background absorbance （Ab） was predicted by an integrated method. Uric acid concentration in reaction solution was calculated from AA, the difference between A0 and Ab, using the absorptivity preset for uric acid. This kinetic uricase method exhibited CV〈4.3% and recovery of 100%. Lipids, bilirubin, hemoglobin, ascorbic acid, reduced glutathione and xanthine 〈0.32 mmol/L in serum had no significant effects. △A linearly responded to 1.2 to 37.5 μmol/L uric acid in reaction solution containing 15 μl serum. The slope of linear response was consistent with the absorptivity preset for uric acid while the intercept was consistent with that for serum alone. Uric acid concentrations in clinic sera by different uricase methods positively correlated to each other. By Bland-Altman analysis, this kinetic uricase method accorded with that by quantifying the total change of UV absorbance on the completion of uricase reaction. These results demonstrated that this kinetic uricase method is reliable for serum uric acid assay with enhanced resistance to both xanthine and other common errors, wider range of linear response and much lower cost.
基金Supported by Department of Biochemistry,Institute of Medicine.Tribhuvan University Teaching Hospital,Kathmandu.Nepal(Grant No.30-956/2013CEA)
文摘Objective:To develop the missing link between hyperuricemia and hypertension.Methods:The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department.Hypertension was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National Committee.Totally 205newly diagnosed and untreated essential hypertensive cases and age-sex matched nonnotensive controls were enrolled in the study.The potential confounding factors of hyperuricemia and hypertension in both cases and controls were controlled.Uric acid levels in all participants were analyzed.Results:Renal function between newly diagnosed hypertensive cases and nonnotensive healthy controls were adjusted.The mean serum uric acid observed in newly diagnosed hypertensive cases and in nonnotensive healthy controls were(290.05±87.03)μmol/L and(245.24±09.38)μmol/L respectively.A total of 59(28.8%)participants of cases and 28(13.7%)participants of controls had hyperuricemia(odds ratio 2.555(95%CI:1.549-4.213),P<0.00l).Conclusions:The mean serum uric acid leveb and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.
基金Supported by the National Natural Science Foundation of China(No.81072915)Science and Technology Planning Project of Guangdong Province,China(No.2012A080201012)Natural Science Foundation of Guangdong Province,China(No.S2012010009032)
文摘Objective： To explore the effect of Compound Tufuling Granules （复方土茯苓颗粒, CTG） on regulating glucose transporter 9 （GLUT9） expression in the kidney to influence the uric acid excretion by the kidney and serum uric acid （SUA） level in hyperuricemia mice. Methods： Sixty Kunming male mice were randomly divided into the control group, model group, benzbromarone group, and CTG high-, middle- and low- dose groups. The yeast extract and uricase inhibition method were used to build hyperuricemia model, and the corresponding drugs were administrated on the 7th day. On the 21st day the 24-h urine was collected, on the 22rid day the blood was collected, the SUA level was detected by uricase colorimetry, and the mRNA and protein expressions of GLUT9 were detected by quantitative real-time polymerase chain reaction and Western blot, respectively. Results： Compared with the model group, the levels of SUA and the mRNA and protein expressions of GLUT9 were significantly decreased, and the fraction excretion of uric acid （FEUA） was significantly increased in the CTG groups and benzbromarone group （all P〈0.05）. There was no significant difference in the above indicators between the CTG high-dose group and benzbromarone group （P〉0.05）. SUA is positively related to the GLUT9 mRNA and protein expressions in the kidney （P〈0.05 or P〈0.01）. Conclusions： CTG can significantly reduce the SUA and increase the FEUA. In addition, CTG can effectively inhibit the mRNA and protein expressions of GLUT9 in the kidney of hyperuricemia mice to inhibit the uric acid re-absorption, promote uric acid excretion and reduce SUA.
