Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project
Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously,...
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MDPI AG
2024-03-01
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| Series: | Metabolites |
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| Online Access: | https://www.mdpi.com/2218-1989/14/3/164 |
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| author | Lanfranco D’Elia Maria Masulli Pietro Cirillo Agostino Virdis Edoardo Casiglia Valerie Tikhonoff Fabio Angeli Carlo Maria Barbagallo Michele Bombelli Federica Cappelli Rosario Cianci Michele Ciccarelli Arrigo F. G. Cicero Massimo Cirillo Raffaella Dell’Oro Giovambattista Desideri Claudio Ferri Loreto Gesualdo Cristina Giannattasio Guido Grassi Guido Iaccarino Luciano Lippa Francesca Mallamaci Alessandro Maloberti Stefano Masi Alberto Mazza Alessandro Mengozzi Maria Lorenza Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Roberto Pontremoli Fosca Quarti-Trevano Marcello Rattazzi Gianpaolo Reboldi Giulia Rivasi Elisa Russo Massimo Salvetti Giuliano Tocci Andrea Ungar Paolo Verdecchia Francesca Viazzi Massimo Volpe Claudio Borghi Ferruccio Galletti |
| author_facet | Lanfranco D’Elia Maria Masulli Pietro Cirillo Agostino Virdis Edoardo Casiglia Valerie Tikhonoff Fabio Angeli Carlo Maria Barbagallo Michele Bombelli Federica Cappelli Rosario Cianci Michele Ciccarelli Arrigo F. G. Cicero Massimo Cirillo Raffaella Dell’Oro Giovambattista Desideri Claudio Ferri Loreto Gesualdo Cristina Giannattasio Guido Grassi Guido Iaccarino Luciano Lippa Francesca Mallamaci Alessandro Maloberti Stefano Masi Alberto Mazza Alessandro Mengozzi Maria Lorenza Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Roberto Pontremoli Fosca Quarti-Trevano Marcello Rattazzi Gianpaolo Reboldi Giulia Rivasi Elisa Russo Massimo Salvetti Giuliano Tocci Andrea Ungar Paolo Verdecchia Francesca Viazzi Massimo Volpe Claudio Borghi Ferruccio Galletti |
| author_sort | Lanfranco D’Elia |
| collection | DOAJ |
| description | Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the URRAH (URic acid Right for heArt Health) Study has identified a cut-off value of this index to predict CV mortality at 5.35 Units. Therefore, given that no SUA/sCr ratio threshold for CV risk has been identified for patients with diabetes, we aimed to assess the relationship between this index and CV mortality and to validate this threshold in the URRAH subpopulation with diabetes; the URRAH participants with diabetes were studied (<i>n</i> = 2230). The risk of CV mortality was evaluated by the Kaplan–Meier estimator and Cox multivariate analysis. During a median follow-up of 9.2 years, 380 CV deaths occurred. A non-linear inverse association between baseline SUA/sCr ratio and risk of CV mortality was detected. In the whole sample, SUA/sCr ratio > 5.35 Units was not a significant predictor of CV mortality in diabetic patients. However, after stratification by kidney function, values > 5.35 Units were associated with a significantly higher mortality rate only in normal kidney function, while, in participants with overt kidney dysfunction, values of SUA/sCr ratio > 7.50 Units were associated with higher CV mortality. The SUA/sCr ratio threshold, previously proposed by the URRAH Study Group, is predictive of an increased risk of CV mortality in people with diabetes and preserved kidney function. While, in consideration of the strong association among kidney function, SUA, and CV mortality, a different cut-point was detected for diabetics with impaired kidney function. These data highlight the different predictive roles of SUA (and its interaction with kidney function) in CV risk, pointing out the difference in metabolic- and kidney-dependent SUA levels also in diabetic individuals. |
| first_indexed | 2024-04-24T18:01:52Z |
| format | Article |
| id | doaj.art-ac246d031b4048dd9e39db16d2184057 |
| institution | Directory Open Access Journal |
| issn | 2218-1989 |
| language | English |
| last_indexed | 2024-04-24T18:01:52Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Metabolites |
| spelling | doaj.art-ac246d031b4048dd9e39db16d21840572024-03-27T13:54:10ZengMDPI AGMetabolites2218-19892024-03-0114316410.3390/metabo14030164Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) ProjectLanfranco D’Elia0Maria Masulli1Pietro Cirillo2Agostino Virdis3Edoardo Casiglia4Valerie Tikhonoff5Fabio Angeli6Carlo Maria Barbagallo7Michele Bombelli8Federica Cappelli9Rosario Cianci10Michele Ciccarelli11Arrigo F. G. Cicero12Massimo Cirillo13Raffaella Dell’Oro14Giovambattista Desideri15Claudio Ferri16Loreto Gesualdo17Cristina Giannattasio18Guido Grassi19Guido Iaccarino20Luciano Lippa21Francesca Mallamaci22Alessandro Maloberti23Stefano Masi24Alberto Mazza25Alessandro Mengozzi26Maria Lorenza Muiesan27Pietro Nazzaro28Paolo Palatini29Gianfranco Parati30Roberto Pontremoli31Fosca Quarti-Trevano32Marcello Rattazzi33Gianpaolo Reboldi34Giulia Rivasi35Elisa Russo36Massimo Salvetti37Giuliano Tocci38Andrea Ungar39Paolo Verdecchia40Francesca Viazzi41Massimo Volpe42Claudio Borghi43Ferruccio Galletti44Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, ItalyNephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyStudium Patavinum, Department of Medicine, University of Padua, 35100 Padua, ItalyDepartment of Medicine, University of Padua, 35100 Padua, ItalyDepartment of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, ItalyBiomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, ItalyInternal Medicine, Pio XI Hospital of Desio, ASST Brianza, University of Milano-Bicocca, 20871 Vimercate, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Medicine and Surgery, University of Salerno, 84081 Salerno, ItalyHypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, ItalyDepartment of Public Health, “Federico II” University of Naples, 80131 Naples, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, ItalyDepartment of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, ItalyNephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, ItalyCardiology IV, “A.De Gasperi’s” Department, Niguarda Ca’ Granda Hospital, 20162 Milan, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, ItalyDepartment of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, ItalyItalian Society of General Medicine (SIMG), 67051 Avezzano, ItalyDepartment of Nephrology, Dialysis and Transplantation GOM “Bianchi-Melacrino-Morelli”, 89133 Reggio Calabria, ItalyCardiology IV, “A.De Gasperi’s” Department, Niguarda Ca’ Granda Hospital, 20162 Milan, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, ItalyStudium Patavinum, Department of Medicine, University of Padua, 35100 Padua, ItalySan Luca Hospital, IRCCS, Istituto Auxologico Italiano, 20149 Milan, ItalyDipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, 16132 Genova, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, ItalyMedicina Interna 1°, Ca’ Foncello, Department of Medicine—DIMED, University of Padova Hospital, 31100 Treviso, ItalyDepartment of Medicine and Surgery, University of Perugia, 06100 Perugia, ItalyDepartment of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, ItalyDipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, 16132 Genova, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Clinical and Molecular Medicine, University of Rome Sapienza, 00189 Rome, ItalyDepartment of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, ItalyHospital S. Maria della Misericordia, 06100 Perugia, ItalyDipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, 16132 Genova, ItalyDepartment of Clinical and Molecular Medicine, University of Rome Sapienza, 00189 Rome, ItalyHypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, ItalyDepartment of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, ItalySeveral studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the URRAH (URic acid Right for heArt Health) Study has identified a cut-off value of this index to predict CV mortality at 5.35 Units. Therefore, given that no SUA/sCr ratio threshold for CV risk has been identified for patients with diabetes, we aimed to assess the relationship between this index and CV mortality and to validate this threshold in the URRAH subpopulation with diabetes; the URRAH participants with diabetes were studied (<i>n</i> = 2230). The risk of CV mortality was evaluated by the Kaplan–Meier estimator and Cox multivariate analysis. During a median follow-up of 9.2 years, 380 CV deaths occurred. A non-linear inverse association between baseline SUA/sCr ratio and risk of CV mortality was detected. In the whole sample, SUA/sCr ratio > 5.35 Units was not a significant predictor of CV mortality in diabetic patients. However, after stratification by kidney function, values > 5.35 Units were associated with a significantly higher mortality rate only in normal kidney function, while, in participants with overt kidney dysfunction, values of SUA/sCr ratio > 7.50 Units were associated with higher CV mortality. The SUA/sCr ratio threshold, previously proposed by the URRAH Study Group, is predictive of an increased risk of CV mortality in people with diabetes and preserved kidney function. While, in consideration of the strong association among kidney function, SUA, and CV mortality, a different cut-point was detected for diabetics with impaired kidney function. These data highlight the different predictive roles of SUA (and its interaction with kidney function) in CV risk, pointing out the difference in metabolic- and kidney-dependent SUA levels also in diabetic individuals.https://www.mdpi.com/2218-1989/14/3/164uric acidcreatininecardiovasculardiabetes |
| spellingShingle | Lanfranco D’Elia Maria Masulli Pietro Cirillo Agostino Virdis Edoardo Casiglia Valerie Tikhonoff Fabio Angeli Carlo Maria Barbagallo Michele Bombelli Federica Cappelli Rosario Cianci Michele Ciccarelli Arrigo F. G. Cicero Massimo Cirillo Raffaella Dell’Oro Giovambattista Desideri Claudio Ferri Loreto Gesualdo Cristina Giannattasio Guido Grassi Guido Iaccarino Luciano Lippa Francesca Mallamaci Alessandro Maloberti Stefano Masi Alberto Mazza Alessandro Mengozzi Maria Lorenza Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Roberto Pontremoli Fosca Quarti-Trevano Marcello Rattazzi Gianpaolo Reboldi Giulia Rivasi Elisa Russo Massimo Salvetti Giuliano Tocci Andrea Ungar Paolo Verdecchia Francesca Viazzi Massimo Volpe Claudio Borghi Ferruccio Galletti Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project Metabolites uric acid creatinine cardiovascular diabetes |
| title | Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project |
| title_full | Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project |
| title_fullStr | Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project |
| title_full_unstemmed | Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project |
| title_short | Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project |
| title_sort | serum uric acid serum creatinine ratio and cardiovascular mortality in diabetic individuals the uric acid right for heart health urrah project |
| topic | uric acid creatinine cardiovascular diabetes |
| url | https://www.mdpi.com/2218-1989/14/3/164 |
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