Review Article: URIC ACID HOMEOSTASIS AND DISTURBANCES (original) (raw)

Uric acid profile in apparently healthy people and diabetics

European Journal of Chemistry, 2012

In recent times, hyperuricaemia has been widely diagnosed in individuals due to changes in lifestyle and as a result of disease conditions that lead to elevated levels of uric acid in the blood. Our present work is on determination of the levels of uric acid in healthy individuals and patients with type 2 diabetes mellitus. Prevalence of hyperuricaemia in relation to age, gender and disease condition was monitored. The results indicated that, levels of uric acid are much higher in subjects that have a combined case of hyperuricaemia and type 2 diabetes mellitus.

High plasma uric acid concentration: causes and consequences

Diabetology & Metabolic Syndrome, 2012

High plasma uric acid (UA) is a precipitating factor for gout and renal calculi as well as a strong risk factor for Metabolic Syndrome and cardiovascular disease. The main causes for higher plasma UA are either lower excretion, higher synthesis or both. Higher waist circumference and the BMI are associated with higher insulin resistance and leptin production, and both reduce uric acid excretion. The synthesis of fatty acids (tryglicerides) in the liver is associated with the de novo synthesis of purine, accelerating UA production. The role played by diet on hyperuricemia has not yet been fully clarified, but high intake of fructose-rich industrialized food and high alcohol intake (particularly beer) seem to influence uricemia. It is not known whether UA would be a causal factor or an antioxidant protective response. Most authors do not consider the UA as a risk factor, but presenting antioxidant function. UA contributes to > 50% of the antioxidant capacity of the blood. There is still no consensus if UA is a protective or a risk factor, however, it seems that acute elevation is a protective factor, whereas chronic elevation a risk for disease.

Inadequate uric acid referent values may cause "hyperuricemia" and overtreatment

Blood, heart and circulation, 2018

Aim: The current serum uric acid upper reference limits in Croatia are seemingly too low (337 µmol/l for women and 403 µmol/l), as in a pilot study we have found much higher values (at least 390 and 488 µmol/l, respectively). As low reference standards may stimulate overdiagnosis and overtreatment, these data motivated us for a larger sample investigation. Method: This cross-sectional, population-based study was conducted retrospectively (2013 data) in the archives of two accredited biochemistry laboratories in Split, Croatia (uricase method, Olympus analyzers). Assessed were consecutive, anonymized results from all adult individuals (≥18 years), stratified in percentiles by age and gender. Result: Among 1,565 results (844 female, 721 male) the prevalence of hyperuricemia, defined by the actual upper reference intervals in Croatia, steadily increases with age from 2% to over 30%, amounting at 40% in both genders after the age of 80 years. Conclusion: The actual upper reference interval limits for uric acid are too low, derived from samples that do not represent the actual southern Croatian population and do not include age stratification above 18 years. There is a need for new, higher, age and gender grounded limits of serum uric acid "normality" in a Mediterranean population.

Serum Uric Acid: A Risk Factor and a Target for Treatment?

Journal of the American Society of Nephrology, 2006

Serum uric acid was first noted to be associated with increased BP by Frederick Mohamed in the 1870s. Although the link was rediscovered periodically over the years, it generally was dismissed as a surrogate marker for decreased renal function that led to increased uric acid and increased risk for hypertension and cardiovascular (CV) disease. Recently, however, several lines of evidence suggest that increased serum uric acid may be a significant modifiable risk factor. Increased serum uric acid is associated with increased risk for future hypertension in several large longitudinal clinical trials as well as an independent risk factor for poor CV prognosis. Animal model experiments demonstrate that increased serum uric acid causes increased BP that initially is reversible but becomes irreversible, salt sensitive, and uric acid independent over time. The mechanisms include the direct action of uric acid on smooth muscle and vascular endothelial cells. Finally, in adolescents with new-onset essential hypertension, the prevalence of elevated serum uric acid is >90%, and preliminary clinical trial evidence suggests that agents that lower serum uric acid may lower BP in this select population. Although the investigations are still preliminary, serum uric acid represents a possible new and intriguing target for the reduction of morbidity and mortality associated with hypertension and CV disease.

Dietary, anthropometric, and biochemical determinants of uric acid in free-living adults

Nutrition Journal, 2013

Background: High plasma uric acid (UA) is a prerequisite for gout and is also associated with the metabolic syndrome and its components and consequently risk factors for cardiovascular diseases. Hence, the management of UA serum concentrations would be essential for the treatment and/or prevention of human diseases and, to that end, it is necessary to know what the main factors that control the uricemia increase. The aim of this study was to evaluate the main factors associated with higher uricemia values analyzing diet, body composition and biochemical markers.

The relationship between chronic kidney disease, uric acid, and dietary factors; an updated review

2017

Chronic kidney disease (CKD) is one of the important illnesses that several risk factors have been suggested for its incident and progression, including lifestyle, obesity, metabolic syndrome, diabetes mellitus, hypertension, family history of illness, and age more than 60 years. Recently, a large and growing body of literature has investigated the relation between serum uric acid (SUA) and CKD. Numerous studies have found that SUA is as a possible risk factor for CKD but other studies did not show. Therefore, whether hyperuricemia (HUA) is a marker of chronic renal failure or independent risk factors for CKD is controversial, while, the relationship between the high uric acid levels and CKD is more complex than a simple cause-and-effect association. Uric acid is the end-product oxidation of purine metabolism. Endogenous processes with high cell turnover and environmental factors such as diet and prescribed drugs are associated with uric acid levels. Previous studies have shown that...