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. 2019 Sep 30;34(37):e237.
doi: 10.3346/jkms.2019.34.e237.

Increased Carotid Intima-Media Thickness (IMT) in Hyperuricemic Individuals May Be Explained by Hyperhomocysteinemia Associated with Renal Dysfunction: a Cross-Sectional Study

Ji Ho Park #  1 , Jung Soo Song #  1 , Sang Tae Choi  2
Affiliations

Increased Carotid Intima-Media Thickness (IMT) in Hyperuricemic Individuals May Be Explained by Hyperhomocysteinemia Associated with Renal Dysfunction: a Cross-Sectional Study

Ji Ho Park et al. J Korean Med Sci. .

Abstract

Background: Both hyperuricemia and hyperhomocysteinemia are known as main risk factors of cardiovascular diseases. There has been, however, no report on the relationship between carotid intima-media thickness (IMT) and homocysteine (Hcy) in hyperuricemic patients. This study aimed to investigate how hyperuricemia is associated with increased carotid IMT with a focus on hyperhomocysteinemia.

Methods: This cross-sectional study included 1,222 patients who visited the Chung-Ang University Hospital Health Promotion Center from January 2013 to December 2015. The serum Hcy levels were estimated with a competitive immunoassay using the direct chemiluminescence method. The carotid IMT was measured by B-mode carotid ultrasonography. The definition of hyperuricemia was a serum uric acid level > 7.0 mg/dL for men or > 5.6 mg/dL for women, and hyperhomocysteinemia was defined as serum levels > 15 μol/L.

Results: The hyperuricemic patients showed significantly higher serum Hcy levels and lower estimated glomerular filtration rate (eGFR) than did normouricemic patients (13.39 ± 4.42 vs. 11.69 ± 3.65 μol/L, P < 0.001; 85.16 ± 19.18 vs. 96.14 ± 16.63, P < 0.001, respectively). Serum Hcy level (odds ratio [OR], 1.050; 95% confidence interval [CI], 1.009-1.092) and fasting glucose level (OR, 1.018; 95% CI, 1.011-1.026) were independent risk factors for carotid plaque. In patients with hyperuricemia, the serum Hcy levels correlated with the eGFR (γ = -0.478, P < 0.001). The carotid IMT correlated with serum Hcy levels and eGFR (γ = 0.196, P = 0.008; γ = - 0.297, P < 0.001, respectively) but not with the serum lipid profile.

Conclusion: These results suggest that renal function impairment in hyperuricemic patients may worsen carotid IMT by increasing serum Hcy levels.

Keywords: Carotid IMT; Homocysteine; Hyperuricemia; Renal Function.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Comparison of the carotid IMT and Hcy levels between the hyperuricemic and normouricemic groups. (A) Carotid IMT values and (B) serum Hcy levels were significantly higher in hyperuricemic group than in normouricemic group.
IMT = intima-media thickness, Hcy = homocysteine.
Fig. 2
Fig. 2. Correlation between Hcy level and eGFR with carotid IMT in the hyperuricemic group. (A) Carotid IMT showed significant correlations with serum Hcy level and (B) eGFR.
Hcy = homocysteine, IMT = intima-media thickness, eGFR = estimated glomerular filtration rate.
Fig. 3
Fig. 3. The suggested mechanism of atherosclerosis in patients with hyperuricemia.
CVD = cardiovascular disease.
See this image and copyright information in PMC

Comment in

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