title: Longitudinal association between serum urate and subclinical atherosclerosis: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: OBJECTIVE
  The aim of the present study was to determine whether serum urate (sUA) concentration is positively associated with subclinical atherosclerosis, independent of body mass index (BMI), amongst generally healthy adults.
  
  
  METHODS
  The CARDIA study followed 5115 Black and White individuals aged 18-30 years in 1985-1986 (year 0). Subclinical atherosclerosis comprised coronary artery calcified plaque (CAC; years 15, 20 and 25), and maximum common carotid intima-media thickness (IMT; year 20). sUA (years 0, 10, 15 and 20) was modelled as gender-specific quartiles that were pooled. Discrete-time hazard regressions and generalized linear regressions were used for analyses.
  
  
  RESULTS
  Mean sUA concentration was lower in women than in men and increased with age. Adjusting for demographic and lifestyle factors, the highest versus lowest quartile of sUA at year 0 was associated with a 44% [95% confidence interval (CI) 20%, 73%] greater risk of CAC progression from years 15 to 25 (Ptrend  < 0.001), which was attenuated by adjustment for BMI at year 0 (Ptrend  = 0.45). A stronger association was found between sUA at year 15 and CAC progression at year 20 or 25 (hazard ratio 2.07, 95% CI 1.66, 2.58 for the highest versus lowest sUA quartile Ptrend  < 0.001), which was attenuated, but remained significant with additional adjustment for BMI at year 15 (Ptrend  = 0.01). A greater increment in sUA concentration from year 0 to year 15, independent of change in BMI, was related to a higher risk of CAC progression (Ptrend  < 0.001). Similar associations were found between sUA and IMT, but only in men.
  
  
  CONCLUSIONS
  sUA may be an early biomarker for subclinical atherosclerosis in young adults; starting in early middle age, sUA predicts subclinical atherosclerosis independently of BMI.
authors: Division of Epidemiology and Community Health, University of Minnesota-Twin Cities, Minneapolis, MN, USA; Nutritional Epidemiology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
authors: H
authors: H
authors: Wang
authors: D R
authors: DR
authors: Jacobs
authors: A L
authors: AL
authors: Gaffo
authors: M D
authors: MD
authors: Gross
authors: D C
authors: DC
authors: Goff
authors: J J
authors: JJ
authors: Carr
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: calcified plaque; intima-media thickness; subclinical atherosclerosis; urate; uric acid
references: N Engl J Med. 2008 Oct 23;359(17):1811-21
references: 18946066
references: J Rheumatol. 2011 Jan;38(1):111-7
references: 20889594
references: Metab Syndr Relat Disord. 2013 Jun;11(3):157-62
references: 23360433
references: Proc Natl Acad Sci U S A. 1981 Nov;78(11):6858-62
references: 6947260
references: Clin Chem. 1980 Feb;26(2):227-31
references: 7353268
references: Ann Epidemiol. 2000 Apr;10(3):136-43
references: 10813506
references: Am J Nephrol. 2005 Sep-Oct;25(5):425-33
references: 16113518
references: Stroke. 2006 Jun;37(6):1503-7
references: 16675740
references: J Rheumatol. 2009 Feb;36(2):378-84
references: 19012359
references: Diabetes Care. 2010 Nov;33(11):2471-3
references: 20798338
references: Methods Enzymol. 1986;129:101-23
references: 3724535
references: Atherosclerosis. 2009 Jan;202(1):11-7
references: 18585721
references: Ann Rheum Dis. 2013 Aug;72(8):1321-7
references: 22984170
references: J Clin Epidemiol. 1990;43(1):1-13
references: 1969463
references: Circulation. 2006 Dec 5;114(23):2508-16
references: 17130343
references: Circulation. 2009 Jan 27;119(3):382-9
references: 19139385
references: Circulation. 2002 Dec 17;106(25):3143-421
references: 12485966
references: Nephrology (Carlton). 2004 Dec;9(6):394-9
references: 15663643
references: Acta Endocrinol (Copenh). 1977 May;85(1):198-208
references: 577077
references: Atherosclerosis. 2009 Feb;202(2):623-31
references: 18602107
references: J Physiol. 2004 Mar 16;555(Pt 3):589-606
references: 14694147
references: Am J Med. 2005 Aug;118(8):816-26
references: 16084170
references: Arthritis Res Ther. 2011 Apr 18;13(2):R66
references: 21501486
references: Arthritis Rheum. 2009 Jul 15;61(7):885-92
references: 19565556
references: Atherosclerosis. 2012 Aug;223(2):497-503
references: 22749515
references: Free Radic Biol Med. 1993 Jun;14(6):615-31
references: 8325534
references: Hypertension. 2003 Jun;41(6):1287-93
references: 12743010
references: Arterioscler Thromb Vasc Biol. 1998 Jul;18(7):1119-23
references: 9672072
references: Circulation. 2002 Jul 9;106(2):221-6
references: 12105162
references: J Am Diet Assoc. 1991 Sep;91(9):1104-12
references: 1918764
references: Arthritis Res Ther. 2012 Jan 06;14(1):R4
references: 22225548
references: PLoS One. 2012;7(4):e36062
references: 22558327
references: Arthritis Care Res (Hoboken). 2010 Feb;62(2):170-80
references: 20191515
references: Med Sci Sports Exerc. 1993 Jan;25(1):81-91
references: 8423759
references: Tech Bull Regist Med Technol. 1966 Feb;36(2):21-5
references: 5908364
references: Am J Physiol. 1995 Jan;268(1 Pt 1):E1-5
references: 7840165
references: Arterioscler Thromb Vasc Biol. 2000 Jun;20(6):1622-9
references: 10845881
references: JAMA. 1993 Jul 21;270(3):354-9
references: 8315780
references: Curr Opin Rheumatol. 2011 Mar;23(2):174-7
references: 21178630
references: Am J Epidemiol. 1998 Nov 1;148(9):859-68
references: 9801016
references: Ann Intern Med. 2009 May 5;150(9):604-12
references: 19414839
references: Kidney Int. 2005 May;67(5):1739-42
references: 15840020
references: J Am Geriatr Soc. 2013 Mar;61(3):319-26
references: 23496291
references: Clin Chem. 2008 Apr;54(4):738-46
references: 18281420
references: JAMA. 2000 May 10;283(18):2404-10
references: 10815083
references: Radiology. 2005 Jan;234(1):35-43
references: 15618373
references: PLoS Med. 2005 Mar;2(3):e76
references: 15783260
references: Eur Heart J. 2006 May;27(10):1174-81
references: 16611671