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Magnesium, Uric acid, Green tea, and Cocoa

July 2017

Uric acid

High serum uric acid level in adolescent depressive patients.

BACKGROUND: Depression disorder is a mental illness of high recurrence rate and its pathological mechanism is still unclear. 5-HT is the most widely studied neurotransmitter and high level of serum uric acid (SUA) can result from the increased oxygenolysis of nucleic acid. Aim of the present study is to explore the pathogenesis of adolescence depression through the study of SUA and 5-HT level in adolescent depressive patients. METHODS: The SUA of 152 adolescent depressive patients and normal adolescents were tested respectively and 5-HT levels among them were analyzed.RESULTS: The SUA level of cases (434.57±102.34µmol/L) was significantly higher than controls (330.18±62.59µmol/L), P<0.001; the 5-HT level of cases (20.86±4.58) was significantly lower than controls (24.03±5.76) (P<0.005) and had a significant negative correlation with SUA level (r=-0.49, P<0.01). LIMITATIONS: The sample size was relatively small and the patients were only male from General Hospital of Beijing Military Region. CONCLUSIONS: High level of SUA can be used as a biochemical index for the early diagnose of adolescence depression; adolescence depression may be due to DNA oxidative damage of neurons in brain.

J Affect Disord. 2015 Mar 15;174:464-6

Impact of Serum Uric Acid Levels on Coronary Plaque Stability Evaluated Using Integrated Backscatter Intravascular Ultrasound in Patients with Coronary Artery Disease.

AIM: Because the prevalence of hyperuricemia is lower in females than in males, the association between hyperuricemia and cardiovascular disease has been frequently reported in females. Increased serum uric acid levels are associated with the presence of cardiovascular risk factors such as hypertension, renal dysfunction, insulin resistance, and metabolic syndrome. However, it is controversial whether hyperuricemia is an independent risk factor for coronary artery disease in both the genders. The purpose of this study was to investigate the relationship between serum uric acid levels and coronary plaque components assessed using integrated backscatter intravascular ultrasound (IB-IVUS) in males and females. METHODS: In total, 385 patients (298 males and 87 females) who underwent percutaneous coronary intervention using IB-IVUS were divided into three groups in each gender according to their serum uric acid levels. We characterized tissue from coronary plaques in culprit lesions. RESULTS: Serum uric acid levels significantly correlated with percent lipid volume (r=0.37) and inversely correlated with percent fibrous volume (r=-0.35). Multivariate analysis showed that the uric acid level was independently associated with lipid-rich plaques (odds ratio 2.43, 95%, confidence interval 1.75-3.47). The prevalence of lipid-rich plaques increased with increasing uric acid levels in both genders. CONCLUSION: Increased serum uric acid levels were associated with larger lipid content plaques in both genders.

J Atheroscler Thromb. 2016 Aug 1;23(8):932-9

Association between serum uric acid and atrial fibrillation: a systematic review and meta-analysis.

BACKGROUND: Atrial fibrillation (AF) is mediated by oxidative stress, neurohormonal activation, and inflammatory activation. Serum uric acid (SUA) is a surrogate marker of oxidative stress. Xanthine oxidase produces SUA and is upregulated by inflammation and neurohormones. OBJECTIVE: To perform a meta-analysis to evaluate the evidence supporting an association between AF and SUA. METHODS: We searched the MEDLINE database (1966 to 2013) supplemented by manual searches of bibliographies of key relevant articles. We selected all cross-sectional and cohort studies in which SUA was measured and AF was reported. In cross-sectional studies, we calculated the pooled standardized mean difference of SUA between those with AF and those without AF. In cohort studies, we calculated the pooled relative risk with the corresponding 95% confidence interval (CI) for incident AF by using the random effects method. RESULTS: The search strategy yielded 40 studies, of which only 9 met our eligibility criteria. The 6 cross-sectional studies comprised 7,930 evaluable patients with a median prevalence of heart failure of 4% (IQR 0%-100%). The standardized mean difference of SUA for those with AF was 0.42 (95% CI 0.27-0.58) compared with those without AF. The 3 cohort studies evaluated 138,306 individuals without AF. The relative risk of having AF for those with high SUA was 1.67 (95% CI 1.23-2.27) compared with those with normal SUA. CONCLUSION: High SUA is associated with AF in both cross-sectional and cohort studies. It is unclear whether SUA represents a disease marker or a treatment target.

Heart Rhythm. 2014 Jul;11(7):1102-8

Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

The association between serum uric acid (SUA) and prehypertension was evaluated in a racially admixed sample of civil servants aged 35 to 74 years, enrolled (2008-2010) in the Brazilian Longitudinal Study of Health (ELSA-Brasil). Of the 15,105 patients who enrolled in the study, we analyzed 3,412 after excluding those who reported previous cardiovascular diseases, diabetes, or hypertension; were heavy drinkers; or had a body mass index (BMI) ≥ 35 kg/m(2). Among the men, logistic regression, adjusted for age, race, income, birth weight, salt intake, insulin resistance, BMI, and renal function revealed odds ratios (ORs) and 95% confidence intervals (CIs) of prehypertension from the bottom quartile (referent) to the top quartile of SUA levels as follows: 0.84 (95% CI, 0.61-1.38), 0.97 (0.71-1.34) and 1.44 (1.04-2.0; P for trend .01). Analyzing for 1-standard deviation of change in SUA, the ORs were 1.19 (1.06-1.32). This association persisted in the subgroup analysis consisting of patients who were white, overweight, with a high salt intake but with normal renal function, and without metabolic syndrome. No association was found among women. In conclusion, SUA levels were associated with prehypertension among men.

Angiology. 2016 Feb;67(2):180-6

Gender differences in the association between serum uric acid and prognosis in patients with acute coronary syndrome.

BACKGROUND: Increased levels of uric acid (UA) have been associated with cardiovascular disease. This association is generally stronger in women than men. However, gender differences in the prognostic value of UA in patients with acute coronary syndrome (ACS) are unknown. We investigated gender differences in the relationship between UA level and the prognosis in patients with ACS. METHOD: This was an observational analysis of patients with ACS undergoing percutaneous coronary intervention enrolled in the Ibaraki Cardiac Assessment Study (ICAS) registry. We analyzed 1,380 patients (330 women, 1050 men) with ACS who had information on UA. We assessed the association between UA and the incidence of major cardiovascular adverse events (MACE), defined as all-cause death, congestive heart failure, reinfarction, and stroke. Patients were divided according to gender-specific UA quartile. RESULTS: The mean UA level in women was significantly lower than that in men (4.9mg/dl vs 5.9mg/dl, p<0.001). After a median duration of follow-up period of 437 days (interquartile range 222-801 days), MACE had occurred in 186 (13%) patients [56 (17%) events in women; 130 (12%) events in men]. Kaplan-Meier analysis for MACE-free survival demonstrated that a higher quartile of UA was associated with MACE in both women and men (p<0.001, p=0.002, respectively). Multivariate Cox regression analysis revealed that the highest quartile of UA, as compared with the lowest quartile of UA, was an independent predictor of MACE in women [hazard ratio (HR), 2.84; 95% CI, 1.19-6.77; p=0.018] but not in men (HR, 1.32; 95% CI, 0.66-2.64; p=0.422). CONCLUSIONS: An increased level of UA was associated with MACE more strongly in women than in men with ACS. These results suggest that there are gender differences in the association of UA level with the prognosis in patients with ACS.

J Cardiol. 2016 Feb;67(2):170-6

The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction.

OBJECTIVES: Uric acid (UA) is a strong marker of cardiovascular disease. Therefore, we aimed to determine the relationship between serum UA levels and cardiovascular events in patients in the early period of their acute myocardial infarction. STUDY DESIGN: This retrospective study included 586 consecutive patients with ST-elevated myocardial infarction (STEMI) who were admitted to the hospital between March 2010 and February 2012. The study population was divided into two groups; the first group included hyperuricemic patients (n=107; uric acid level >6 mg/dl in women and >7 mg/dl in men), and the second group included patients with normal UA level (n=479). Multivariate analysis was used to demonstrate the predictive value of UA levels in groups. RESULTS: Patients in the hyperuricemic group were older (median 66 years vs. 60 years, p=0.001), and the ratio of female patients was higher (35.5% vs. 16.9%, p=0.001). Patients with hyperuricemia had a significantly higher incidence of in-hospital cardiovascular mortality than the normal group (15.9% vs. 3.1%, p<0.001). Advanced heart failure (class ≥ 3) was more frequent among hyperuricemic patients (17.8% vs. 8.8%, p=0.006). Age ≥ 70 years, chest pain duration >6 hours and hyperuricemia (hazard ratio (HR): 1.83, 95% confidence interval: 1.02-3.27; p=0.041) were found to be independent predictors of advanced heart failure. Hyperuricemia was found to be an independent predictor of in-hospital cardiovascular mortality in multivariate analyses (HR: 5.32, 95% confidence interval: 2.46-11.49; p=0.001). CONCLUSION: This study showed that a high serum UA level is an independent predictor of cardiovascular mortality and morbidity during the in-hospital period of STEMI.

Turk Kardiyol Dern Ars. 2014 Sep;42(6):501-8

Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population.

BACKGROUND: The association between serum uric acid (SUA) and left ventricular hypertrophy (LVH) is controversial and the ability of SUA in predicting incident LVH remains unsettled. Thus, we evaluated the relationship of SUA with new-onset echocardiographic LVH over a 10-year period in subjects of the general population enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study. METHODS: The study included 960 subjects with normal LV mass index (LVMI) at baseline echocardiographic evaluation and a readable echocardiogram at the end of follow-up. Cut-points for LVH were derived from reference values of the healthy fraction of the PAMELA population. RESULTS: Over a 10-year period, 258 participants (26.9%) progressed to LVH. The incidence of new-onset LVH increased from the lowest (23%) to intermediate (25%) and the highest baseline SUA tertile (32%). After adjusting for confounders (not including body mass index (BMI)), each 1 mg/dl increase in SUA entailed a 26% higher risk of incident LVH. Adjusted odd ratio of LVH risk in the highest SUA tertile was 96% higher than in the lowest tertile (odds ratio (OR) = 1.966, 95% CI = 1.158-3.339, P = 0.0123). Correction for BMI reduced the magnitude and statistical significance of ORs. CONCLUSIONS: The study shows that SUA is a predictor of long-term echocardiographic changes from normal LVMI to LVH in a community sample. Thus, life-style and pharmacologic measures aimed to reduce SUA levels may concur to preventing LVH development in the general population.

Am J Hypertens. 2017 Mar 1;30(3):279-285