title: The Impact of Blood Pressure and Visceral Adiposity on the Association of Serum Uric Acid With Albuminuria in Adults Without Full Metabolic Syndrome.
abstract: The impact of metabolic phenotypes on the association of uricemia with urinary albumin/creatinine ratio (uACR) remains unresolved. We evaluated the association between serum uric acid and uACR in persons with 0, and 1-2 metabolic syndrome (MetS) components and determined the modification effects of visceral adiposity index (VAI), mean arterial pressure (MAP), and fasting glucose on this association.
  
  
  
  Using data from a cross-sectional survey of a representative Czech population aged 25-64 years (n = 3612), we analyzed 1,832 persons without decreased glomerular filtration rate <60ml/min/1.73 m2, diabetes, and MetS. MetS components were defined using the joint statement of the leading societies.
  
  
  
  Of the 1,832 selected participants, 64.1% (n = 1174) presented with 1-2 MetS components (age 46.3±11.2; men 51.7%), whereas 35.9% (n = 658) were free of any component (age 39.4±10.0; men 34.2 %). In fully adjusted multiple linear regression models for uricemia, uACR was an independent factor for increase in uric acid levels only in persons with 1-2 MetS components (standardized beta (Sβ) 0.048; P = 0.024); however, not in those without any component (Sβ 0.030; P = 0.264). Uric acid levels increased by the interaction of uACR with VAI (Sβ 0.06; P = 0.012), and of uACR with MAP (Sβ 0.05; P = 0.009). Finally, the association of uACR with uricemia was confined to persons whose VAI together with MAP were ≥the median of 1.35 and 98mm Hg, respectively (Sβ 0.190; P < 0.001).
  
  
  
  We demonstrated a strong modification effect of VAI and MAP on the association between uACR and uricemia, which suggests obesity-related hypertension as the underlying mechanism.
authors: Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic.|Montreal University Hospital Research Center, CHUM, Montréal, Canada.
authors: Alena
authors: A
authors: Krajcoviechova
authors: Montreal University Hospital Research Center, CHUM, Montréal, Canada.
authors: Johanne
authors: J
authors: Tremblay
authors: Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic.|Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Peter
authors: P
authors: Wohlfahrt
authors: Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic.
authors: Jan
authors: J
authors: Bruthans
authors: Montreal University Hospital Research Center, CHUM, Montréal, Canada.
authors: Muhmmad Ramzan
authors: MR
authors: Tahir
authors: Montreal University Hospital Research Center, CHUM, Montréal, Canada.
authors: Pavel
authors: P
authors: Hamet
authors: Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic.
authors: Renata
authors: R
authors: Cifkova
mesh_terms: D050154:Adiposity; D000328:Adult; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D033461:Hyperuricemia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid; D003404:Creatinine
keywords: albumin/creatinine ratio; blood pressure; hypertension; mean arterial pressure; metabolic syndrome; uric acid; visceral adiposity index.