Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Claudia Agabiti Rosei¹, Anna Paini¹, Giacomo Buso¹, Alessandro Maloberti^{2

3}, Cristina Giannattasio^{2

3}, Massimo Salvetti¹, Edoardo Casiglia⁴, Valerie Tikhonoff⁵, Fabio Angeli^{6

7}, Carlo Maria Barbagallo⁸, Michele Bombelli⁹, Federica Cappelli¹⁰, Rosario Cianci¹¹, Michele Ciccarelli¹², Arrigo Francesco Giuseppe Cicero^{13

14}, Massimo Cirillo¹⁵, Pietro Cirillo¹⁶, Raffaella Dell'Oro⁹, Lanfranco D'Elia¹⁷, Giovambattista Desideri¹⁸, Claudio Ferri¹⁹, Ferruccio Galletti¹⁷, Loreto Gesualdo¹⁶, Guido Grassi⁹, Guido Iaccarino¹², Luciano Lippa²⁰, Francesca Mallamaci²¹, Stefano Masi¹⁰, Maria Masulli¹⁷, Alberto Mazza²², Alessandro Mengozzi^{10

23

24}, Pietro Nazzaro²⁵, Paolo Palatini⁴, Gianfranco Parati^{26

27}, Roberto Pontremoli²⁸, Fosca Quarti-Trevano⁹, Marcello Rattazzi²⁹, Gianpaolo Reboldi³⁰, Giulia Rivasi³¹, Elisa Russo²⁸, Giuliano Tocci³², Andrea Ungar³¹, Paolo Verdecchia³³, Francesca Viazzi²⁸, Massimo Volpe^{32

34}, Agostino Virdis¹⁰, Maria Lorenza Muiesan¹, Claudio Borghi^{13

14}; Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension

Affiliations

¹ Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
² Cardiology IV, "A.De Gasperi's" Department, Niguarda Ca' Granda Hospital, 20162 Milan, Italy.
³ School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy.
⁴ Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy.
⁵ Department of Medicine, University of Padua, 35100 Padua, Italy.
⁶ Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
⁷ Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico Tradate, 21100 Varese, Italy.
⁸ Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy.
⁹ Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
¹⁰ Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
¹¹ Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
¹² Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80133 Naples, Italy.
¹³ Department Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy.
¹⁴ Heart-Chest-Vascular Department, IRCCS AOU of Bologna, 40126 Bologna, Italy.
¹⁵ Department of Public Health, "Federico II" University of Naples, 80133 Naples, Italy.
¹⁶ Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, 70122 Bari, Italy.
¹⁷ Department of Clinical Medicine and Surgery, "Federico II" University of Naples, 80133 Naples, Italy.
¹⁸ Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences Sapienza, University of Rome, 00161 Rome, Italy.
¹⁹ Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
²⁰ Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy.
²¹ CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy.
²² Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, Italy.
²³ Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, 8952 Schlieren, Switzerland.
²⁴ Sant'Anna School of Advanced Studies, Research University, 56127 Pisa, Italy.
²⁵ Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, Italy.
²⁶ Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Auxologico Italiano, Department of Cardiology, Institute San Luca Hospital, Piazzale Brescia, 20149 Milan, Italy.
²⁷ Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 20126 Milan, Italy.
²⁸ Department of Internal Medicine, University of Genoa, IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy.
²⁹ Department of Medicine-DIMED, University of Padova, Medicina Interna 1° Ca' Foncello University Hospital, 31100 Treviso, Italy.
³⁰ Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy.
³¹ Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy.
³² Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy.
³³ Hospital S. Maria della Misericordia, 06100 Perugia, Italy.
³⁴ IRCCS San.Raffaele, Via della Pisana, 00163, Rome, Italy.

PMID: 38921458
PMCID: PMC11205863
DOI: 10.3390/metabo14060323

Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Claudia Agabiti Rosei et al. Metabolites. 2024.

. 2024 Jun 7;14(6):323.

doi: 10.3390/metabo14060323.

Authors

Affiliations

¹ Department of Clinical and Experimental Sciences, University of Brescia, and ASST Spedali Civili Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
² Cardiology IV, "A.De Gasperi's" Department, Niguarda Ca' Granda Hospital, 20162 Milan, Italy.
³ School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy.
⁴ Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy.
⁵ Department of Medicine, University of Padua, 35100 Padua, Italy.
⁶ Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
⁷ Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico Tradate, 21100 Varese, Italy.
⁸ Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy.
⁹ Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
¹⁰ Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
¹¹ Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
¹² Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80133 Naples, Italy.
¹³ Department Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy.
¹⁴ Heart-Chest-Vascular Department, IRCCS AOU of Bologna, 40126 Bologna, Italy.
¹⁵ Department of Public Health, "Federico II" University of Naples, 80133 Naples, Italy.
¹⁶ Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, 70122 Bari, Italy.
¹⁷ Department of Clinical Medicine and Surgery, "Federico II" University of Naples, 80133 Naples, Italy.
¹⁸ Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences Sapienza, University of Rome, 00161 Rome, Italy.
¹⁹ Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
²⁰ Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy.
²¹ CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy.
²² Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, Italy.
²³ Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, 8952 Schlieren, Switzerland.
²⁴ Sant'Anna School of Advanced Studies, Research University, 56127 Pisa, Italy.
²⁵ Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, Italy.
²⁶ Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Auxologico Italiano, Department of Cardiology, Institute San Luca Hospital, Piazzale Brescia, 20149 Milan, Italy.
²⁷ Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 20126 Milan, Italy.
²⁸ Department of Internal Medicine, University of Genoa, IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy.
²⁹ Department of Medicine-DIMED, University of Padova, Medicina Interna 1° Ca' Foncello University Hospital, 31100 Treviso, Italy.
³⁰ Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy.
³¹ Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy.
³² Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy.
³³ Hospital S. Maria della Misericordia, 06100 Perugia, Italy.
³⁴ IRCCS San.Raffaele, Via della Pisana, 00163, Rome, Italy.

PMID: 38921458
PMCID: PMC11205863
DOI: 10.3390/metabo14060323

Abstract

High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study with carotid ultrasound and without previous cardiovascular diseases (CVD) (n = 6209), followed over 20 years, were included in the analysis. Hypertriglyceridemia (hTG) was defined as TG ≥ 150 mg/dL. Higher levels of SUA (hSUA) were defined as ≥5.6 mg/dL in men and 5.1 mg/dL in women. A carotid plaque was identified in 1742 subjects (28%). SUA and TG predicted carotid plaque (HR 1.09 [1.04-1.27], p < 0.001 and HR 1.25 [1.09-1.45], p < 0.001) in the whole population, independently of age, sex, diabetes, systolic blood pressure, HDL and LDL cholesterol and treatment. Four different groups were identified (normal SUA and TG, hSUA and normal TG, normal SUA and hTG, hSUA and hTG). The prevalence of plaque was progressively greater in subjects with normal SUA and TG (23%), hSUA and normal TG (31%), normal SUA and hTG (34%), and hSUA and hTG (38%) (Chi-square, 0.0001). Logistic regression analysis showed that hSUA and normal TG [HR 1.159 (1.002 to 1.341); p = 0.001], normal SUA and hTG [HR 1.305 (1.057 to 1.611); p = 0.001], and the combination of hUA and hTG [HR 1.539 (1.274 to 1.859); p = 0.001] were associated with a higher risk of plaque. Our findings demonstrate that SUA is independently associated with the presence of carotid plaque and suggest that the combination of hyperuricemia and hypertriglyceridemia is a stronger determinant of carotid plaque than hSUA or hTG taken as single risk factors. The association between SUA and CVD events may be explained in part by a direct association of UA with carotid plaques.

Keywords: HDL cholesterol; LDL cholesterol; cardiovascular risk; carotid plaques; serum uric acid; triglycerides.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

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Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Affiliations

Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Authors

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources

Miscellaneous