Abstract:Aim To explore the association between cardiometabolic index and hyperuricemia risk in people over 45 years of age in China Health and Retirement Longitudinal Study. Methods Data from the China Health and Retirement Longitudinal Study in 2011 and 2015 were included in this prospective cohort study. The 2011 data were used as the baseline and the outcomes of hyperuricemia were followed up in 2015. The Cox proportional hazard model was used to analyze the association between cardiometabolic index and the risk of hyperuricemia. ROC curve was used to analyze the predictive value of cardiometabolic index for the risk of hyperuricemia. Results Among 3 002 subjects, after adjusting for relevant confounders, the risk of hyperuricemia in the highest cardiometabolic index group was 3.12 times (P＜0.001) that in the lowest cardiometabolic index group in males, and HR was 3.0,5%CI was 1.606～6.062; in females was 2.128 times (P＜0.05) that in the lowest cardiometabolic index group, respectively, and HR was 2.8,5%CI was 1.060～4.272; the risk of hyperuricemia increased with the increase of cardiometabolic index. ROC curve analysis showed that the curve of cardiometabolic index for predicting the risk of hyperuricemia was 0.618 (95%CI:0.580~0.656), the best cutoff value was 0.433, the sensitivity was 46.97%, and the specificity was 72.94%. Conclusions The cardiometabolic index is positively correlated with the risk of hyperuricemia. Maintaining a low cardiometabolic index is beneficial to prevent hyperuricemia. It is suggested that cardiometabolic index may be an identification factor of hyperuricemia.

Abstract:Gout is a common disease caused by the deposition of sodium urate crystals in joints or other tissues, and its incidence and prevalence are increasing year by year. Hyperuricemia is the most important risk factor for gout. In recent years, many epidemiological and empirical studies have confirmed that gout is closely related to the occurrence and death of cardiovascular diseases such as hypertension, coronary heart disease and myocardial infarction. Dual-energy CT, as a new non-invasive imaging modality, can specifically and quantitatively display urate crystals, and has become an effective tool for the diagnosis of gout in recent years, and some studies have found its clinical value in the diagnosis of cardiovascular damage in gout. This review analyzes the complex correlation between gout and cardiovascular diseases, and the advantages and application value of dual-energy CT in the diagnosis of cardiovascular damage in gout.

Abstract:Aim To explore the effect of hyperuricemia on the severity of coronary artery disease and clinical prognosis after percutaneous coronary intervention(PCI)of patients with acute coronary syndrome(ACS)and hypertension.Methods 422 patients were included who were diagnosed with ACS and hypertension after PCI. According to the diagnostic criteria of hyperuricemia, these patients were divided into hyperuricemia group (208 patients) and normal-level serum uric acid (UA) group (214 patients), and the general clinical characteristics, coronary angiography results and major adverse cardiovascular events within 1 year were analyzed. Univariate and multivariate Logistic regression models were used to explore the related risk factors of multi-vessel coronary artery disease and total MACE within 1 year. Furthermore, the serum UA levels of all patients were grouped according to the interquartile range to explore the dose-effect relationship between serum UA levels and total MACE within 1 year, severity of coronary artery disease. Spearman correlation analysis was used to analyze the correlation between serum UA level and Gensini score. With all-cause death as the ending event, Kaplan-Meier survival curve was used to describe the cumulative survival of two groups within 1 year (Log-rank test).Results Compared with normal-level serum uric acid group, multi-vessel coronary artery disease and non-criminal vascular occlusion were more common, and the Gensini scores were also higher in the hyperuricemia group (P＜0.05). Among the MACE that occurred within one year, the incidence of all-cause death, PCI or coronary artery bypass grafting (CABG) for myocardial infarction or angina pectoris, conservative medication treatment for myocardial infarction or angina pectoris, and total MACE were higher (P＜0.05). Univariate and multivariate Logistic regression analysis models showed that hyperuricemia was still an independent risk factor for total MACE within 1 year and multi-vessel coronary artery disease before and after adjusting for confounding factors (P＜0.05). The severity of coronary artery disease and the incidence of total MACE increased significantly with the increase of serum uric acid levels (P＜0.05). And the one-year all-cause death cumulative survival rate of hyperuricemia group decreased significantly(Log-rank test, P＝0.043) compared with patients with normal-level serum uric acid group. Conclusion Hyperuricemia is an independent risk factor for multi-vessel coronary artery disease and total MACE in patients with ACS and hypertension after PCI, and patients with hyperuricemia had a lower survival rate compared with patients with normal-level serum uric acid.

Abstract:Aim To evaluate the association between serum uric acid levels with chronic kidney disease (CKD) in middle-aged health checkup population. Methods In this cross-sectional study, 24095 subjects were included in the study. Blood pressure, body height and body mass were measured, blood lipid, blood glucose and renal function were measured. The relationship between the level of blood uric acid and chronic renal disease was observed. CKD was defined as estimated glomerular filtration rate (eGFR)＜60 mL/min/1.73 m2. Results The prevalence of hyperuricemia was 16.0%, the prevalence of hyperuricemia in males was significantly higher than in females (21.6% vs. 7.3%), meanwhile its prevalence increased with the age, especial in those postmenopausal female. Compared to the serum uric acid first quartile, the multivariate-adjusted odds for CKD of fourth quartiles were 6.30(95%CI was 4.84～8.19) in male and 9.08(95%CI was 6.27～13.14) in female. Conclusions The serum uric acid was age-related increase, especial in postmenopause female. The hyperuricemia was independent risk factor of CKD, the association of hyperuricemia and CKD in female was significantly robust in female than in male.

Abstract:Aim To explore the effects of epigallocatechin gallate (EGCG) on the inflammation of vascular endothelium in hyperuricemia rats. Methods Thirty-six male SD rats were divided into normal control group, model control group, EGCG low dose (EGCG-L) group, EGCG medium dose (EGCG-M) group, EGCG high dose (EGCG-H) group and allopurinol group. After five weeks, the expression of MCP-1, TNF-α, ICAM-1, ET-1 and eNOS in hyperuricemia rats were detected by RT-PCR, serum uric acid, creatinine, urea nitrogen and xanthine oxidase (XO) were determined. Results Compared with normal control group, the levels of serum uric acid and XO were increased in model control group (P＜0.01). Compared with model control group, the levels of serum uric acid and XO were significantly decreased in EGCG-L group, EGCG-M group, EGCG-H group and allopurinol group (P＜0.01). Compred with normal control group, the mRNA expression of MCP-1, TNF-α and ICAM-1 was markedly increased in model control group (P＜0.01). The expression of MCP-1 mRNA in EGCG-H group and allopurinol group was markedly decreased as compared with model control group (P<0.05). Compared with model control group, the expression of TNF-α, ICAM-1 mRNA was significantly decreased in EGCG-L group, EGCG-M group, EGCG-H group and allopurinol group (P＜0.01). The mRNA expression of ET-1 in EGCG-M group was also decreased significantly (P＜0.01). Conclusion EGCG attenuated serum uric acid and the inflammation of vascular endothelium in hyperuricemia rats.

Abstract:Aim To detect the correlation between hyperuricemia （HUA） and chronic heart failure. Methods We selected 422 patients with CHF （260 with HFpEF） and 134 patients without CHF hospitalized in Shengjing Hospital of China Medical University between February 2009 and January 2012. The correlation between HUA and CHF was analyzed with t inspection, χ2 inspection and Logistic analysis and the prognostic correlation between them was further explored through Follow-up studies. Results Serum UA in HFpEF and HFrEF group （374.54±144.30 μmol/L, 416.45±168.93 μmol/L） was significantly higher than non-heart failure group （299.71±114.36 μmol /L, P<0.05）.

Abstract:With the improvement of peoples living standards and diet, the incidences of hyperuricemia and artery atherosclerosis increase. Research revealed that the two diseases were closely related. But the mechanism on how hyperuricemia leads to atherosclerosis is not very clear yet. Hyperuricemia may facilitate the progress of atherosclerosis through these ways: the direct effect of soluble uric acid, urate crystals inflammatory reaction, and hypercholesterolemia which enhances the correlation between high uric acid and atherosclerosis. Reduction of blood uric acid could reduce the occurrence of atherosclerosis and improve the survival rate of patients with cardiovascular and cerebrovascular diseases. The improvement of the quality of long-term survival of patients undoubtedly has important clinical significance. Therefore, in-depth and extensive reseaches are necessary in elucidating the underlying mechanisms.

Abstract:Aim To explore the relationship between atherosclerosis and serum interleukin-10 (IL-10), adiponectin in type 2 diabetes patients with hyperuricemia. Methods The blood uric acid (UA), serum interleukin-10 (IL-10), adiponectin and other indicators were detected in type 2 diabetes patients with high uric acid and artery atherosclerosis sclerosis (65 cases, high uric acid group), type 2 diabetes patients with artery atherosclerosis sclerosis (68 cases, normal uric acid group), normal control group (30 cases), respectively. And the relationship between the above indexes and artery atherosclerosis were analysed. Results Serum IL-10 levels was significantly lower in high uric acid group, normal uric acid group than that in normal control group, and it was lower in high uric acid group than that in normal uric acid group Serum adiponectin levels was significantly lower in high uric acid group, normal uric acid group than that in normal control group, and it was lower in high uric acid group than that in normal uric acid group Correlation analysis showed that intima-media thickness (IMT) was negatively correlated with IL-10 and adiponectin, and positively correlated with homeostasis model assessment insulin resistance index (HOMA-IR), UA. Multiple linear stepwise regression analysis showed that IL-10, adiponectin, UA, triglyceride (TG), low density lipoprotein cholesterol (LDLC), HOMA-IR, systolic blood pressure (SBP) and dglycosylated hemoglobin (HbA1c) entered the regression equation. Conclusion Reduction of serum IL-10, adiponectin levels is closely related to insulin resistance, hyperuricemia, which participate in the development of diabetic atherosclerosis.

Abstract:AimTo discuss the role of endothelial dysfunction in the kidney damage induced by hyperuricemia.Methods36 male Wister rats were randomly divided into three groups, namely control group, hyperuricemia model group, benzbromarone treatment group(n=12).Application of Oteracil potassium(uricase inhibitor ) and high yeast feeding were used to establish the hyperuricemia model.In addition to the same treatment,the treatment group were added benzbromarone to control hypeuricemia.Control group were fed normal diet and tap water, at the weekend of 2,4,6, blood uric acid and creatinine level were tested.All rats were sacrificed at the end of 6 weeks, HE and Masson staining of renal organizations were applied to observe the pathological changes, and measure the interstitial fibrosis area.Endothelial nitric oxide synthase (eNOS), endothelin-1(ET-1) and hypoxia inducible factor-1α(HIF-1α) expressions in renal interstitial tubular were detected by immunohistochemistry.ResultsAfter 2 weeks the blood uric acid level in model group was higher than that of the control group and treatment group.At the end of 6 weeks, the serum creatinine level in the model group was much higher than that of the control group and the treatment group, there was no obvious difference between the two latter groups.The renal interstitial fibrosis was more serious than that of the normal control group and the treatment group.The nitric oxide synthase expression in the model group was significantly lower than that in the control group and treatment group, while both the endothelin-1 and hypoxia inducible factor-1α expression in the model group was significantly higher than that in the control group and treatment group.ConclusionHyperuricemia can reduce the sy-nthesis of nitric oxide synthase but increase the production of endothelin-1 in the renal interstitial vascular endothelial cells, thus affecting the endothelial function of renal interstitial vascular and leading to renal interstitial fibrosis through an mechanism of ischemia and hypoxia.

Abstract:Aim To investigate the value of hypertension with hyperuricemia for the assessment of the presence and severity of coronary artery disease(CAD). Methods The association between hyperuricemia with hypertension and the presence and severity of coronary artery disease was investigated in 662 patients with clinically suspected coronary artery disease.According to the incidence of hypertension and hyperuricemia all patients were divided into four groups.They were 91 cases of hypertension with hyperuricemia,259 cases of hypertensive patients.Hyperuricemia alone were 77 cases,and no disease of hyperuricemia and high blood pressure were 235 cases.All patients who underwent coronary angiography were divided into 458 cases of CAD group and 204 cases of non-CAD group based on the severity of coronary artery disease.Severity of coronary artery disease was evaluated using the Gensini score index. Results The serum uric acid levels(358.1±95.1 μmol/L) and the prevalence of hypertension(52.6%)and hyperuricemia(30.8%)were higher in CAD patients than those in without CAD(P<0.05).There were interactions between hyperuricemia and hypertension which were significant predictors for present of CAD.The Gensini scores of CAD patients who complicated with both hyperuricemia and hypertension were the highest.There was a linear trend between higher prevalence of hypertension with hyperuricemia and increasing numbers of disease vessel. Conlusion Serum uric acid in combination with hypertension may have some clinical significance in evaluating the degree and risk of coronary artery disease.