Hyperuricemia increases the risk of cardiovascular mortality associated with very high HdL-cholesterol level.

Male Humans Female Cholesterol, HDL Cardiovascular Diseases / diagnosis Risk Factors Hyperuricemia / epidemiology Uric Acid Hypercholesterolemia Hyperlipidemias
Cardiovascular HDL-Cholesterol HURRAH Mortality 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:
02 2023
Historique:
received: 21 09 2022
revised: 07 11 2022
accepted: 28 11 2022
pubmed: 16 1 2023
medline: 15 2 2023
entrez: 15 1 2023
Statut: ppublish

Résumé

Whether the association between very high HDL-cholesterol levels and cardiovascular mortality (CVM) is modulated by some facilitating factors is unclear. Aim of the study was to investigate whether the risk of CVM associated with very high HDL-cholesterol is increased in subjects with hyperuricemia. Multivariable Cox analyses were made in 18,072 participants from the multicentre URRAH study stratified by sex and HDL-cholesterol category. During a median follow-up of 11.4 years there were 1307 cases of CVM. In multivariable Cox models a J-shaped association was found in the whole population, with the highest risk being present in the high HDL-cholesterol group [>80 mg/dL, adjusted hazard ratio (HR), 1.28; 95%CI, 1.02-1.61; p = 0.031)]. However, a sex-specific analysis revealed that this association was present only in women (HR, 1.34; 95%CI, 1.02-1.77; p = 0.034) but not in men. The risk of CVM related to high HDL-cholesterol was much greater in the women with high uric acid (>0.30 mmol/L, HR 1.61; 95%CI, 1.08-2.39) than in those with low uric acid (HR, 1.17; 95%CI, 0.80-1.72, p for interaction = 0.016). In women older than 70 years with hyperuricemia the risk related to high HDL-cholesterol was 1.83 (95%CI, 1.19-2.80, p < 0.005). Inclusion of BMI in the models weakened the strength of the associations. Our data indicate that very high HDL-cholesterol levels in women are associated with CVM in a J-shaped fashion. The risk of CVM is increased by concomitant hyperuricemia suggesting that a proinflammatory/oxidative state can enhance the detrimental cardiovascular effects associated with high HDL-cholesterol.

Sections du résumé

BACKGROUND AND AIMS
Whether the association between very high HDL-cholesterol levels and cardiovascular mortality (CVM) is modulated by some facilitating factors is unclear. Aim of the study was to investigate whether the risk of CVM associated with very high HDL-cholesterol is increased in subjects with hyperuricemia.
METHODS AND RESULTS
Multivariable Cox analyses were made in 18,072 participants from the multicentre URRAH study stratified by sex and HDL-cholesterol category. During a median follow-up of 11.4 years there were 1307 cases of CVM. In multivariable Cox models a J-shaped association was found in the whole population, with the highest risk being present in the high HDL-cholesterol group [>80 mg/dL, adjusted hazard ratio (HR), 1.28; 95%CI, 1.02-1.61; p = 0.031)]. However, a sex-specific analysis revealed that this association was present only in women (HR, 1.34; 95%CI, 1.02-1.77; p = 0.034) but not in men. The risk of CVM related to high HDL-cholesterol was much greater in the women with high uric acid (>0.30 mmol/L, HR 1.61; 95%CI, 1.08-2.39) than in those with low uric acid (HR, 1.17; 95%CI, 0.80-1.72, p for interaction = 0.016). In women older than 70 years with hyperuricemia the risk related to high HDL-cholesterol was 1.83 (95%CI, 1.19-2.80, p < 0.005). Inclusion of BMI in the models weakened the strength of the associations.
CONCLUSION
Our data indicate that very high HDL-cholesterol levels in women are associated with CVM in a J-shaped fashion. The risk of CVM is increased by concomitant hyperuricemia suggesting that a proinflammatory/oxidative state can enhance the detrimental cardiovascular effects associated with high HDL-cholesterol.

Identifiants

DOI: 10.1016/j.numecd.2022.11.024 PMID: 36642602
pubmed: 36642602
pii: S0939-4753(22)00484-7
doi: 10.1016/j.numecd.2022.11.024
pii:
doi:

Substances chimiques

Cholesterol, HDL 0
Uric Acid 268B43MJ25

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

323-330

Commentaires et corrections

Type : CommentIn
Type : CommentIn

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 The authors declare that they have no conflict of interest.

Auteurs

Paolo Palatini (P)

Department of Medicine, Studium Patavinum, University of Padova, Padua, Italy. Electronic address: palatini@unipd.it.

Agostino Virdis (A)

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

Stefano Masi (S)

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

Alessandro Mengozzi (A)

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

Edoardo Casiglia (E)

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

Valerie Tikhonoff (V)

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

Arrigo F G Cicero (AFG)

Alma Mater Studiorum University of Bologna, Bologna, Italy.

Andrea Ungar (A)

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

Gianfranco Parati (G)

S. Luca Hospital, Istituto Auxologico Italiano & University of Milan-Bicocca, Milan, Italy.

Giulia Rivasi (G)

Department of Medical and Surgical Science, University of Perugia, Perugia, Italy; Department of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Italy.

Massimo Salvetti (M)

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

Carlo M Barbagallo (CM)

Biomedical Department of Internal Medicine and Specialistics, University of Palermo, Palermo, Italy.

Michele Bombelli (M)

Department of Cardiovascular, Neural and Metabolic Sciences, Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Raffaella Dell'Oro (R)

Department of Cardiovascular, Neural and Metabolic Sciences, 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.

Luciano Lippa (L)

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

Lanfranco D'Elia (L)

Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Naples, Italy.

Maria Masulli (M)

Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Naples, Italy.

Paolo Verdecchia (P)

Hospital S. Maria della Misericordia, Perugia, Italy.

Gianpaolo Reboldi (G)

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

Fabio Angeli (F)

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

Francesca Mallamaci (F)

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

Massimo Cirillo (M)

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

Marcello Rattazzi (M)

Department of Medicine - DIMED, University of Padova, Medicina Interna 1, Ca' Foncello University Hospital, Treviso, Italy.

Pietro Cirillo (P)

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

Loreto Gesualdo (L)

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

Alberto Mazza (A)

Department of Internal Medicine, Hypertension Unit, General Hospital, Rovigo, Italy.

Cristina Giannattasio (C)

Cardiology IV, 'A. De Gasperis' Department, Niguarda Ca' Granda Hospital, Health Science Department, Milano-Bicocca University, Milano, Italy.

Alessandro Maloberti (A)

Cardiology IV, 'A. De Gasperis' Department, Niguarda Ca' Granda Hospital, Health Science Department, Milano-Bicocca University, Milano, 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; IRCCS Neuromed, Pozzilli (IS), 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; IRCCS Neuromed, Pozzilli (IS), Italy.

Guido Iaccarino (G)

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

Pietro Nazzaro (P)

Department of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari Medical School, Bari, Italy.

Ferruccio Galletti (F)

Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Naples, Italy.

Claudio Ferri (C)

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

Giovambattista Desideri (G)

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

Francesca Viazzi (F)

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

Roberto Pontremoli (R)

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

Maria Lorenza Muiesan (ML)

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

Guido Grassi (G)

Department of Cardiovascular, Neural and Metabolic Sciences, Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Claudio Borghi (C)

Alma Mater Studiorum University of Bologna, Bologna, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Hyperuricemia increases the risk of...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Lipoprotéines › Lipoprotéines HDL › Cholestérol HDL › Hyperuricemia increases the risk of...
questionsmedicales.fr › Maladies cardiovasculaires › Hyperuricemia increases the risk of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Hyperuricemia increases the risk of...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Hyperuricémie › Hyperuricemia increases the risk of...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Purines › Purinones › Xanthines › Acide urique › Hyperuricemia increases the risk of...
questionsmedicales.fr › Maladies métaboliques et nutritionnelles › Maladies métaboliques › Troubles du métabolisme lipidique › Dyslipidémies › Hyperlipidémies › Hypercholestérolémie › Hyperuricemia increases the risk of...
questionsmedicales.fr › Maladies métaboliques et nutritionnelles › Maladies métaboliques › Troubles du métabolisme lipidique › Dyslipidémies › Hyperlipidémies › Hyperuricemia increases the risk of...