Korean J Fam Pract. 2018; 8(2): 169-174  https://doi.org/10.21215/kjfp.2018.8.2.169
The Relationship between Serum Uric Acid Level and Carotid Plaques in Healthy Adults
Ho-Joon Lee, Eun-Ki Kim*, Young-Jung Kim, Jong-Hwa Kuk, Jun Ko, Ju-Hwa Park
Department of Family Medicine, Hankook General Hospital, Cheongju, Korea
Eun-Ki Kim
Tel: +82-43-222-7000, Fax: +82-43-255-7007
E-mail: keunk7268@hanmail.net
ORCID: http://orcid.org/0000-0001-9100-9905
Received: March 9, 2017; Accepted: October 7, 2017; Published online: April 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Recent studies have reported that elevated serum uric acid level is related to cardiovascular disease. However, the association between uric acid and ischemic cerebrovascular disease has rarely been explored. Both diseases are on the rise and have risk factors and pathology similar to those of atherosclerosis. Positive carotid plaques seen on carotid sonography enable the diagnosis of systemic atherosclerosis. We have therefore studied the association between serum uric acid and carotid plaques.
Methods: We included 2,041 subjects who underwent carotid sonography, and excluded patients with ischemic stroke, myocardial infarction, hypertension, or diabetes. These patients had presented at a Korean general hospital between January 2014 and November 2016 for medical examination.
Results: Among 2,041 patients, 310 (15.19%) were diagnosed with positive carotid plaques and 372 (18.22%) had hyperuricemia (325 men and 47 women). We performed multiple logistic regression with serum uric acid and other risk factors for atherosclerosis. There was an elevated prevalence of carotid plaques among patients with a higher level of uric acid (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.50–1.88; P<0.0001). The relationship had a similar pattern when applied to the elderly group (OR, 1.15; 95% CI, 1.12–1.17; P<0.0001) and the group that had higher fasting blood glucose levels (OR, 1.01; 95% CI, 1.00–1.01; P=0.0023).
Conclusion: There is a statistically significant association between serum uric acid level and carotid plaques in adults without illness.
Keywords: Serum Uric Acid; Atherosclerosis; Carotid Plaques; Fasting Blood Glucose
References
  1. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008; 359: 1811-21.
    Pubmed KoreaMed CrossRef
  2. Davis NS. The cardio-vascular and renal relations and manifestations of gout. JAMA 1897; 29: 261-2.
    CrossRef
  3. Gertler MM, Garn SM, Levine SA. Serum uric acid in relation to age and physique in health and in coronary heart disease. Ann Intern Med 1951; 34:1421-31.
    Pubmed CrossRef
  4. Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA 2000; 283: 2404-10.
    Pubmed CrossRef
  5. Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension 2003; 42: 247-52.
    Pubmed KoreaMed CrossRef
  6. Nakagawa T, Tuttle KR, Short RA, Johnson RJ. Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome. Nat Clin Pract Nephrol 2005; 1: 80-6.
    Pubmed CrossRef
  7. Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 2004; 164: 1546-51.
    Pubmed CrossRef
  8. Johnson RJ, Rideout BA. Uric acid and diet--insights into the epidemic of cardiovascular disease. N Engl J Med 2004; 350: 1071-3.
    Pubmed CrossRef
  9. Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension 2001; 38: 1101-6.
    Pubmed CrossRef
  10. Ryu SY, Oh JG, Lee CG, Kim KS. Relationship of serum uric acid to cardiovascular risk factors in Korean male workers. Korean J Prev Med 2002; 35:214-20.
  11. Yoo TW, Sung KC, Shin HS, Kim BJ, Kim BS, Kang JH, et al. Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J 2005; 69: 928-33.
    Pubmed CrossRef
  12. Kim SM, Kim KM, Lee DJ, et al. Relationship between serum uric acid concentration and free fatty acid, cardiovascular risk factors and visceral fat. Korean J Obese 1997; 6: 51-8.
  13. Hwang SJ, Lee KE, Lee BH, Gwak JI, Yoo JH, Choi YH. Relationship between serum uric acid level and hypertension: a retrospective cohort study. Korean J Fam Med 2010; 31: 672-8.
    CrossRef
  14. Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 1993; 87(3 Suppl): II56-65.
    Pubmed
  15. Grobbee DE, Bots ML. Carotid artery intima-media thickness as an indicator of generalized atherosclerosis. J Intern Med 1994; 236: 567-73.
    CrossRef
  16. Cho DK, Kwon SU, Kim SW, Park JI, Lim SH, Lim SJ, et al. Risk factors and predictors for the progression of carotid atherosclerotic stenosis in Korean adults. Korean Circ J 2005; 35: 834-40.
    CrossRef
  17. Liu A, Yu Z, Wang N, Wang W. Carotid atherosclerosis is associated with hypertension in a hospital-based retrospective cohort. Int J Clin Exp Med 2015; 8: 21932-8.
    Pubmed KoreaMed
  18. Gnasso A, Carallo C, Irace C, Spagnuolo V, De Novara G, Mattioli PL, et al. Association between intima-media thickness and wall shear stress in common carotid arteries in healthy male subjects. Circulation 1996; 94: 3257-62.
    Pubmed CrossRef
  19. Gamero L, Levenson J, Armentano R, Graf S, Brandani L, Simon A, et al. Carotid wall inertial index increase is related to intima-media thickening in hypertensive patients. J Hypertens 1999; 17: 1825-9.
    Pubmed CrossRef
  20. Zhang AJ, Zhang AY, Zhong C. Carotid atherosclerosis in ischemic cerebrovascular patients. J Clin Med Res 2009; 1: 40-4.
    CrossRef
  21. Nikic P, Savic M, Jakovljevic V, Djuric D. Carotid atherosclerosis, coronary atherosclerosis and carotid intima-media thickness in patients with ischemic cerebral disease: Is there any link? Exp Clin Cardiol 2006; 11: 102-6.
    Pubmed KoreaMed
  22. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340: 14-22.
    Pubmed CrossRef
  23. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 1997; 96: 1432-7.
    Pubmed CrossRef
  24. Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb 1991; 11: 12459.
    CrossRef
  25. Touboul PJ, Elbaz A, Koller C, Lucas C, Adraï V, Chédru F, et al. Common carotid artery intima-media thickness and brain infarction : the Etude du Profil Génétique de l’Infarctus Cérébral (GENIC) case-control study. The GENIC Investigators. Circulation 2000; 102: 313-8.
    Pubmed CrossRef
  26. Ministry of Health and Welfare, Korea Center for Disease Control and Prevention. 2015 National Health Statistics (National Statistics No.117002, National Health and Nutrition Examination Survey) [Internet]. Cheonju: Korea Center for Disease Control and Prevention [cited 2017 Mar 9].
  27. Ministry of Health and Welfare, Korea Center for Disease Control and Prevention. New strategies of national system for cardio-cerebrovascular disease [Internet]. Cheonju: Korea Center for Disease Control and Prevention;2004 [cited 2017 Mar 9].
  28. Statistics Korea. Annual report on the cause of death statistics by provinces [Internet]. Daejeon: Statistics Korea; 2011 [cited 2017 Mar 9].
    Pubmed
  29. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 1995;273: 1421-8.
    Pubmed CrossRef
  30. Kim JH, Youn HJ, Hong EJ, Park CS, Lee JM, Lim SH, et al. Clinical significance of B-mode ultrasound of common carotid artery for prediction of severity of coronary artery disease: important parameters on hand measurement. Korean Circ J 2005; 35: 467-73.
    CrossRef


This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives