Hyperuricemia is significantly associated with increased vascular stiffness in asymptomatic healthy Korean women

Abstract

Purpose

Increased serum uric acid is a known risk factor for cardiovascular disease. Brachial-ankle pulse wave velocity (baPWV) is a simple index of arterial stiffness, while the coronary artery calcium score (CACS) derived from multidetector computed tomography is a good marker of coronary atherosclerosis. Patients with coronary artery stenosis have significantly elevated baPWV values. Therefore, we investigated the relationship between serum uric acid level and baPWV in asymptomatic subjects, taking into account confounding factors, including CACS.

Materials and Methods

Of 4894 patients who underwent baPWV measurement and coronary computed tomography angiography as part of a general health examination at Gangnam Severance Hospital from July 2006 through September 2013, 2720 healthy subjects were enrolled in this evaluation after exclusion of confounding factors. Serum uric acid level was divided into quartiles for men and women separately: men, Q1: 1.9-5.2, Q2: 5.21-5.9, Q3: 5.91-6.7, Q4: 6.71-12.1 mg/dL; women, Q1: 2.0-3.8, Q2: 3.81-4.3, Q3: 4.31-4.9, Q4: 4.91-8.7 mg/dL. High baPWV was defined as ≥1400 cm/s.

Results

The mean concentration of serum uric acid was found to be significantly lower in women than in men (4.37±0.91 vs. 5.94±1.15 mg/dL, p<0.001). Serum uric acid was significantly elevated in subjects with a high baPWV. After adjustment for age, systolic blood pressure, body mass index, estimated glomerular filtration rate, fasting blood sugar, high- and low-density lipoprotein cholesterol, smoking habits and CACS, serum uric acid was found to be related with high baPWV in women (OR=1.266, 95% CI 1.060-1.512; p=0.009). In multivariate logistic regression analysis, Q4 of serum uric acid was independently associated with high baPWV in women (OR=1.71, 95% CI 1.089-2.697; p<0.05). After adjustment for traditional cardiovascular risk factors and other confounding factors including CACS, serum uric acid was independently associated with baPWV in women by multiple linear regression analysis (β=10.167, 95% CI 0.654-19.680; p=0.036). Subgroup analyses showed that, in Korean women of median postmenopausal age (>50 years), the highest quartile of serum uric acid was associated with high baPWV, after adjustments for other risk factors (OR compared with lowest quartile=1.806, 95% CI=1.065-3.063; p=0.028).

Conclusion

Serum uric acid is associated with aggravation of arterial stiffness in healthy Korean women, but not in men.