Serum uric acid levels threshold for mortality in diabetic individuals: The URic acid Right for heArt Health (URRAH) project.

All-cause mortality Cardiovascular mortality Diabetes mellitus Diagnostic thresholds Hyperuricemia Serum uric acid

Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
05 2022
Historique:
received: 16 11 2021
revised: 20 01 2022
accepted: 24 01 2022
pubmed: 15 3 2022
medline: 19 4 2022
entrez: 14 3 2022
Statut: ppublish

Résumé

The URRAH (URic acid Right for heArt Health) Study has identified cut-off values of serum uric acid (SUA) predictive of total mortality at 4.7 mg/dl, and cardiovascular (CV) mortality at 5.6 mg/dl. Our aim was to validate these SUA thresholds in people with diabetes. The URRAH subpopulation of people with diabetes was studied. All-cause and CV deaths were evaluated at the end of follow-up. A total of 2570 diabetic subjects were studied. During a median follow-up of 107 months, 744 deaths occurred. In the multivariate Cox regression analyses adjusted for several confounders, subjects with SUA ≥5.6 mg/dl had higher risk of total (HR: 1.23, 95%CI: 1.04-1.47) and CV mortality (HR:1.31, 95%CI:1.03-1.66), than those with SUA <5.6 mg/dl. Increased all-cause mortality risk was shown in participants with SUA ≥4.7 mg/dl vs SUA below 4.7 mg/dl, but not statistically significant after adjustment for all confounders. SUA thresholds previously proposed by the URRAH study group are predictive of total and CV mortality also in people with diabetes. The threshold of 5.6 mg/dl can predict both total and CV mortality, and so is candidate to be a clinical cut-off for the definition of hyperuricemia in patients with diabetes.

Sections du résumé

BACKGROUND AND AIM
The URRAH (URic acid Right for heArt Health) Study has identified cut-off values of serum uric acid (SUA) predictive of total mortality at 4.7 mg/dl, and cardiovascular (CV) mortality at 5.6 mg/dl. Our aim was to validate these SUA thresholds in people with diabetes.
METHODS AND RESULTS
The URRAH subpopulation of people with diabetes was studied. All-cause and CV deaths were evaluated at the end of follow-up. A total of 2570 diabetic subjects were studied. During a median follow-up of 107 months, 744 deaths occurred. In the multivariate Cox regression analyses adjusted for several confounders, subjects with SUA ≥5.6 mg/dl had higher risk of total (HR: 1.23, 95%CI: 1.04-1.47) and CV mortality (HR:1.31, 95%CI:1.03-1.66), than those with SUA <5.6 mg/dl. Increased all-cause mortality risk was shown in participants with SUA ≥4.7 mg/dl vs SUA below 4.7 mg/dl, but not statistically significant after adjustment for all confounders.
CONCLUSIONS
SUA thresholds previously proposed by the URRAH study group are predictive of total and CV mortality also in people with diabetes. The threshold of 5.6 mg/dl can predict both total and CV mortality, and so is candidate to be a clinical cut-off for the definition of hyperuricemia in patients with diabetes.

Identifiants

pubmed: 35282979
pii: S0939-4753(22)00045-X
doi: 10.1016/j.numecd.2022.01.028
pii:
doi:

Substances chimiques

Uric Acid 268B43MJ25

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1245-1252

Informations de copyright

Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors declare no conflicts of interest.

Auteurs

Maria Masulli (M)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.

Lanfranco D'Elia (L)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.

Fabio Angeli (F)

Department of Medicine and Surgery, University of Insubria, Varese, Italy and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS Tradate, Varese, Italy.

Carlo M Barbagallo (CM)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.

Giancarlo Bilancio (G)

Department "Scuola Medica Salernitana", Baronissi, SA, University of Salerno.

Michele Bombelli (M)

Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Berardino Bruno (B)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Edoardo Casiglia (E)

Studium Patavinum, Department of Medicine, University of Padua, Padua, Italy.

Rosario Cianci (R)

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Arrigo F G Cicero (AFG)

Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy.

Massimo Cirillo (M)

Department of Public Health, "Federico II" University of Naples, Naples, Italy.

Pietro Cirillo (P)

Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy.

Raffaella Dell'Oro (R)

Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Giovambattista Desideri (G)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Claudio Ferri (C)

Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

Loreto Gesualdo (L)

Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy.

Cristina Giannattasio (C)

Cardiology IV, "A.De Gasperi's" Department, Niguarda Ca' Granda Hospital, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.

Guido Grassi (G)

Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Guido Iaccarino (G)

Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Naples, Italy.

Luciano Lippa (L)

Italian Society of General Medicine, Avezzano, L'Aquila, Italy.

Francesca Mallamaci (F)

CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, Reggio Calabria, Italy.

Alessandro Maloberti (A)

Cardiology IV, "A.De Gasperi's" Department, Niguarda Ca' Granda Hospital, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.

Stefano Masi (S)

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Alberto Mazza (A)

Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, Rovigo, Italy.

Alessandro Mengozzi (A)

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Maria Lorenza Muiesan (ML)

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Pietro Nazzaro (P)

Department of Biomedical Science and Oncology, University of Bari, Bari, Italy.

Paolo Palatini (P)

Studium Patavinum, Department of Medicine, University of Padua, Padua, Italy.

Gianfranco Parati (G)

Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.

Roberto Pontremoli (R)

Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Fosca Quarti-Trevano (F)

Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Marcello Rattazzi (M)

Studium Patavinum, Department of Medicine, University of Padua, Padua, Italy; Medicina Interna I, Ca' Foncello University Hospital, Treviso, Italy.

Gianpaolo Reboldi (G)

Department of Medicine and Centro di Ricerca Clinica e Traslazionale (CERICLET), University of Perugia, Perugia, Italy.

Giulia Rivasi (G)

Department of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy.

Massimo Salvetti (M)

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Valerie Tikhonoff (V)

Department of Medicine, University of Padua, Padua, Italy.

Giuliano Tocci (G)

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.

Andrea Ungar (A)

Department of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy.

Paolo Verdecchia (P)

Hospital S. Maria Della Misericordia, Perugia, Italy.

Francesca Viazzi (F)

Department of Internal Medicine, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Agostino Virdis (A)

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Massimo Volpe (M)

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.

Claudio Borghi (C)

Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy.

Ferruccio Galletti (F)

Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy. Electronic address: galletti@unina.it.

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