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Chen W, Sun Q, Shen X, Zhu J, Wang Z, Peng Y. Relationship between serum uric acid and ventricular diastolic dysfunction in type 2 diabetes mellitus patients. Am J Transl Res 2025; 17:2057-2066. [PMID: 40226006 PMCID: PMC11982838 DOI: 10.62347/caiv7004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 02/09/2025] [Indexed: 04/15/2025]
Abstract
OBJECTIVE To investigate the correlation of serum uric acid (SUA) levels with ventricular diastolic dysfunction (DD) in the diabetic population. METHODS Clinical data from 702 patients with type 2 diabetes mellitus (T2DM), including 394 males and 308 females, were retrospectively analyzed in this study. The data included demographic characteristics, biochemical test results, and echocardiography findings. Univariate and multivariate logistic regression analyses were performed to assess the association between SUA and DD. Additionally, the diagnostic efficacies of SUA and the multivariate logistic regression model (Logit P) for DD were evaluated using receiver operating characteristic (ROC) curves. RESULTS Compared to T2DM patients with normal diastolic function, those with DD had a higher prevalence of hypertension, older age, longer diabetes duration, elevated levels of low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), blood urea nitrogen (BUN), SUA, and hemoglobin A1c (HbA1c), as well as lower levels of 1,5-anhydroglucitol (1,5-AG) and estimated glomerular filtration rate (eGFR) (P<0.05). As indicated by the Logistic regression analysis, gender, age, and SUA were independent risk factors for DD (P<0.05). Women had a 47.8% lower risk of DD compared to men [95% CI (0.318-0.718)]. The risk of DD increased by 6.8% for each one-year rise in age [OR 1.068, 95% CI (1.051-1.085)] and by 0.5% for each 1 mmol/L increase in SUA [OR 1.005, 95% CI (1.003-1.007)]. The regression model incorporating sex, age, and SUA exhibited an area under the curve (AUC) of 0.753 (95% CI 0.712-0.794) for diagnosing DD, with a sensitivity of 65.65% and specificity of 78.65%. CONCLUSIONS Gender, age, and SUA were independent factors influencing the development of DD in T2DM patients. Among them, SUA is the only modifiable factor. Early and long-term control of SUA levels is essential to reduce the risk of DD in T2DM patients.
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Affiliation(s)
- Weihong Chen
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
| | - Qin Sun
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
| | - Xinru Shen
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
| | - Jinlong Zhu
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
| | - Zhipeng Wang
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
| | - Yan Peng
- Department of Endocrinology, Ma'anshan People's Hospital Ma'anshan 243000, Anhui, China
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Kuang Joo L, Abd Mutalib NS, Abu Backer FM, Abdull Rasid NS, Samsuri H, Hashim ND. Auricular Gouty Tophi: A Rare Presentation in an Uncommon Site. Cureus 2025; 17:e81035. [PMID: 40264604 PMCID: PMC12013853 DOI: 10.7759/cureus.81035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2025] [Indexed: 04/24/2025] Open
Abstract
Unlike the intense redness and painful swollen joint seen in acute gouty arthritis, classically affecting the first metatarsophalangeal joint called podagra, painless gouty tophi nodules can be found in any soft tissue throughout the body. While they frequently affect areas like the toes, fingers, and olecranon bursae, it is rare to see monosodium urate crystal deposits in the facial region, particularly the ear. This case highlights a patient with uncontrolled hyperuricemia, presenting with an uncommon manifestation of gouty tophi on the auricle. The diagnosis of auricular gouty tophi should be the primary consideration in patients with a nodular auricular mass, whitish material, uncontrolled hyperuricemia, and multiple gouty tophi. Although clinical history, examination findings, and biochemical investigations provide important diagnostic clues, definitive confirmation necessitates surgical excision and histopathological analysis.
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Affiliation(s)
- Lee Kuang Joo
- Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Nor Shahida Abd Mutalib
- Otorhinolaryngology - Head and Neck Surgery, Hospital Sultan Abdul Halim, Sungai Petani, MYS
| | | | | | - Hawairy Samsuri
- Otorhinolaryngology - Head and Neck Surgery, Hospital Sultan Abdul Halim, Sungai Petani, MYS
| | - Noor Dina Hashim
- Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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Wu X, Xu Z, Yang X, Li J, Feng Y. Left atrial size modify the association between uric acid and atrial fibrillation in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2024; 34:1559-1570. [PMID: 38658225 DOI: 10.1016/j.numecd.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS The potential influence of left atrial size on the relationship between uric acid and atrial fibrillation has not been fully investigated. This study aims to evaluate the interaction effect of left atrial size on the association between uric acid and atrial fibrillation in patients with coronary artery disease. METHODS AND RESULTS This retrospective cohort study, conducted from January 2018 to October 2022, included 2004 patients undergoing Drug-Eluting Stent implantation for coronary artery disease. Utilizing logistic regression models with the product of left atrial enlargement (LAE) and uric acid, interaction effects were assessed. Among the participants, 383 had LAE, and 159 experienced atrial fibrillation. After adjusting for covariates, continuous uric acid levels were associated with an increased risk of atrial fibrillation in patients without LAE (OR:1.631, 95% CI: 1.284-2.072), but not in those with LAE (OR:1.069, 95% CI: 0.848-1.348). A significant interaction of uric acid levels was observed between groups with and without LAE (p = 0.046). Restricted cubic spline curves indicated a J-shaped relationship between uric acid and atrial fibrillation in the absence of LAE. However, the association between uric acid levels and atrial fibrillation in the LAE group remained unchanged with increasing uric acid levels. CONCLUSION The study suggested that left atrial size modified the association between uric acid and atrial fibrillation in patients with coronary artery disease. Uric acid serves as a potential biomarker for atrial fibrillation risk, especially in individuals without LAE.
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Affiliation(s)
- Xuefeng Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Cardiology, The First People's Hospital of Foshan, Foshan, China; Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhaoyan Xu
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Xili Yang
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Jianming Li
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Yingqing Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
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Bolognesi A, Bortolotti M, Battelli MG, Polito L. Gender Influence on XOR Activities and Related Pathologies: A Narrative Review. Antioxidants (Basel) 2024; 13:211. [PMID: 38397809 PMCID: PMC10885918 DOI: 10.3390/antiox13020211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Taking into account the patient's gender is the first step towards more precise and egalitarian medicine. The gender-related divergences observed in purine catabolism and their pathological consequences are good examples of gender medicine differences. Uric acid is produced by the activity of xanthine oxidoreductase (XOR). The serum levels of both XOR activity and uric acid differ physiologically between the genders, being higher in men than in women. Their higher levels have been associated with gout and hypertension, as well as with vascular, cardiac, renal, and metabolic diseases. The present review analyzes the gender-related differences in these pathological conditions in relation to increases in the serum levels of XOR and/or uric acid and the opportunity for gender-driven pharmacological treatment.
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Affiliation(s)
| | | | - Maria Giulia Battelli
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (M.B.); (L.P.)
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Dong G. Development and Challenges of Pre-Heart Failure with Preserved Ejection Fraction. Rev Cardiovasc Med 2023; 24:274. [PMID: 39076392 PMCID: PMC11270127 DOI: 10.31083/j.rcm2409274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2024] Open
Abstract
Pre-heart failure with preserved ejection fraction (Pre-HFpEF) is a critical link to the development of heart failure with preserved ejection fraction (HFpEF). Early recognition and early intervention of pre-HFpEF will halt the progression of HFpEF. This article addresses the concept proposal, development, and evolution of pre-HFpEF, the mechanisms and risks of pre-HFpEF, the screening methods to recognize pre-HFpEF, and the treatment of pre-HFpEF. Despite the challenges, we believe more focus on the topic will resolve more problems.
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Affiliation(s)
- Guoju Dong
- Department of Cardiovascular Internal Medicine, Xiyuan Hospital, Chinese
Academy of Traditional Chinese Medicine, 100091 Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan
Hospital, Chinese Academy of Traditional Chinese Medicine, 100091 Beijing, China
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Liu T, Zuo R, Song J, Wang J, Zhu Z, Sun L, Wang S, Li B, Pan Y, Wang B. Association of Serum Uric Acid Level with Risk of Abdominal Aortic Calcification: A Large Cross-Sectional Study. J Inflamm Res 2023; 16:1825-1836. [PMID: 37131410 PMCID: PMC10149063 DOI: 10.2147/jir.s404668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/15/2023] [Indexed: 05/04/2023] Open
Abstract
Objective The association between serum uric acid (sUA) and incident abdominal aortic calcification (AAC), and severe abdominal aortic calcification (SAAC) in the general population of the United States (US) is unclear. Therefore, this research aimed to investigate the association between sUA and the risk of AAC and SAAC. Methods Individuals from National Health and Nutrition Examination Survey (NHANES) database were analyzed cross-sectionally between 2013 and 2014. The restricted cubic spline (RCS), multivariable logistic regression model and subgroup analysis were utilized to evaluate the correlation between sUA and incident AAC, and SAAC. In addition, generalized additive models with smooth functions were employed to survey the relationship between sUA and the degree of AAC. Results This study included 3016 individuals from the NHANES database. According to the RCS plot, sUA levels were associated with the risk of AAC/SAAC in a U-shaped pattern in the US population. The degree of calcification decreased at first and then increased with the increase in the sUA level. Conclusion Close monitoring and adequate control of sUA levels in the US general population may reduce the risk of AAC and SAAC.
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Affiliation(s)
- Tao Liu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Ronghua Zuo
- Department of Anesthesiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China
| | - Jia Song
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Jia Wang
- Department of Nephrology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China
| | - Zhijian Zhu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Lifang Sun
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Shasha Wang
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Baoyin Li
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Yesheng Pan
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Bing Wang
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
- Correspondence: Bing Wang, Department of Cardiology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China, Email
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Serum Uric Acid Is Associated with the Progression of Left Ventricular Diastolic Dysfunction in Apparently Healthy Subjects. DISEASE MARKERS 2022; 2022:9927254. [PMID: 36284986 PMCID: PMC9588337 DOI: 10.1155/2022/9927254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/08/2022] [Indexed: 12/03/2022]
Abstract
Background Left ventricular (LV) diastolic dysfunction (LVDD) is the defining feature of heart failure with preserved ejection fraction (HFpEF) and predicts subsequent incident heart failure (HF) and all-cause mortality. Mounting evidence reveals that cardiometabolic risk factors play critical roles in the development of LVDD. In this study, we sought to investigate the relation between serum uric acid (SUA) level and the progression of LVDD in apparently healthy patients. Methods A total of 1082 apparently healthy subjects without diagnosed cardiovascular disease and LVDD were consecutively enrolled. SUA levels were measured, and repeat echocardiography and tissue Doppler imaging (TDI) were performed at baseline and during 1-year follow-up. Results By dividing the study population based on quartiles of SUA, we found subjects in higher quartiles had greater increases in TDI-derived early diastolic velocity (e′) and E (peak LV filling velocity)/e′ ratios during 1-year follow-up. After multivariate adjustment, high SUA persisted to be an independent predictor for the subsequent worsening of LVDD (odds ratio: 1.351 [95% CI 1.125~1.625], per 100 μmol/L SUA). Subgroup analysis suggested that the association between SUA and LVDD development was more pronounced in subjects without other cardiometabolic risk factors involved. Factor analysis demonstrated that high SUA was the major cardiometabolic attribute in patients with LVDD progression. Conclusion Our findings suggest that high SUA is an independent cardiometabolic risk factor for the progression of LVDD in apparently healthy subjects.
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Song Y, Kang ZW, Liu Y. Multiple gouty tophi in the head and neck with normal serum uric acid: A case report and review of literatures. World J Clin Cases 2022; 10:1373-1380. [PMID: 35211572 PMCID: PMC8855169 DOI: 10.12998/wjcc.v10.i4.1373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/30/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gouty tophus is rarely reported in the head and neck areas. To the best of our knowledge, this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid (SUA) levels.
CASE SUMMARY We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels. The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years, which was aggravated for 3 d. The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years. Resection of the nasal masses was performed. Cartilage from the right ear cavity was used to repair the nasal defects. The pathological report confirmed a nasal gouty tophus. No recurrence or deformity was found after a 1 year follow-up.
CONCLUSION Normal SUA cannot completely negate the diagnosis of gouty tophus, especially in some rare regions.
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Affiliation(s)
- Yang Song
- Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Zi-Wei Kang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Yan Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
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