title: Uric acid as a risk factor for cardiovascular disease and mortality in overweight/obese individuals.
abstract: BACKGROUND
  The predictive value of serum uric acid (SUA) for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.
  
  
  METHODS
  The relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death) and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD). Cox models were used to assess the role of SUA as an independent risk factor.
  
  
  RESULTS
  9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death), and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20-2.10). In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72-1.36) nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08-2.12). No relationship was observed in men (HR: 1.06; 95% CI: 0.82-1.36).
  
  
  CONCLUSIONS
  SUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all-cause mortality in women.
authors.affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. helle.skak@gmail.com
authors.forename: Helle
authors.initials: H
authors.lastname: Skak-Nielsen
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Nick
authors.initials: N
authors.lastname: Finer
authors.forename: Ian D
authors.initials: ID
authors.lastname: Caterson
authors.forename: Luc
authors.initials: L
authors.lastname: Van Gaal
authors.forename: W Philip T
authors.initials: WP
authors.lastname: James
authors.forename: Aldo Pietro
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Arya M
authors.initials: AM
authors.lastname: Sharma
authors.forename: Walmir
authors.initials: W
authors.lastname: Coutinho
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000401:mortality*; D050177:Overweight / Q000097:blood* / Q000401:mortality*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D014527:Uric Acid