title: Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: insights from the I-DEMAND study.
abstract: OBJECTIVE
  The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensive patients with a high prevalence of diabetes.
  
  
  RESULTS
  A total of 2429 patients (mean age 62 ± 11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73 m(2) or as the presence of microalbuminuria (albumin-to-creatinine ratio ≥2.5 mg/mmol in men and ≥3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respectively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95% CI 1.03-1.18; P = 0.0060; OR 1.28, 95% CI 1.15-1.42; P < 0.0001). These associations were stronger in patients without diabetes and with normal renal function.
  
  
  CONCLUSIONS
  Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensive patients under specialist care. Intervention trials are needed to investigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk.
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy. Electronic address: francesca.viazzi@unige.it.
authors.forename: F
authors.initials: F
authors.lastname: Viazzi
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Garneri
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Leoncini
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gonnella
authors.affiliation: Department of Internal Medicine, University of Brescia, Brescia, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Muiesan
authors.affiliation: Department of Internal Medicine, University of Bologna, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ambrosioni
authors.affiliation: Department of Internal Medicine, University of Bologna, Bologna, Italy.
authors.forename: F V
authors.initials: FV
authors.lastname: Costa
authors.affiliation: Istituto Auxologico Italiano, Ospedale S. Luca, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Leonetti
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy.
authors.forename: A C
authors.initials: AC
authors.lastname: Pessina
authors.affiliation: Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Cardiology Division, Department of Clinical and Molecular Medicine, University of Rome 'Sapienza', Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: M
authors.initials: M
authors.lastname: Volpe
authors.affiliation: Department of Internal Medicine, University of Brescia, Brescia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Agabiti Rosei
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Deferrari
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D033461:Hyperuricemia / Q000097:blood / Q000453:epidemiology; D007558:Italy; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Cardiovascular risk; Chronic kidney disease; Hypertension; Metabolic syndrome; Uric acid