Serum Uric Acid Levels and Subclinical Atherosclerosis: Results From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

• Published in: Current problems in cardiology 2023-03, Vol.48 (3), p.101525-101525, Article 101525
• Main Authors: Mello, Filipe M., Bensenor, Isabela M., Santos, Itamar S., Bittencourt, Marcio S., Lotufo, Paulo A., Fuller, Ricardo
• Format: Article
• Language: English
• Subjects: Adult; Atherosclerosis - diagnosis; Atherosclerosis - epidemiology; Brazil - epidemiology; Carotid Intima-Media Thickness; Female; Humans; Longitudinal Studies; Male; Middle Aged; Risk Factors; Uric Acid
• ISSN: 0146-2806; 1535-6280
• DOI: 10.1016/j.cpcardiol.2022.101525

•Controversy remains as to whether serum uric acid is associated with arteriopathy or not.•Coronary artery calcium and carotid intima-media thickness markers of subclinical atherosclerosis.•Large population of apparently healthy individuals submitted to CAC and cIMT measurements.•Serum uric acid independently associated with cIMT but not to CAC. High serum uric acid (sUA) has been associated with coronary artery calcium (CAC) and increased carotid intima-media thickness (cIMT) in people at high cardiovascular risk. However, association is unclear in apparently healthy individuals. Our study aims to evaluate association between sUA and subclinical atherosclerosis measures: CAC and increased cIMT, in apparently healthy adults enrolled in ELSA-Brasil. A total of 4096 participants without previous coronary artery disease, stroke, and use of urate-lowering drugs, underwent CAC and cIMT assessment. All analyses were stratified by sex. Serum uric acid categorized by quintiles was the exposure variable. Thorough cardiovascular risk factor evaluation was performed, and association between sUA quintiles and CAC and cIMT was analyzed by linear regression using ln(CAC + 1) and cIMT, both as continuous variables. Median age of the sample was 49.0 (44.0-56.0) years (women: 55.1%; 59.1% were white). Mean values of sUA were 6.5 ± 1.4 mg/dL for men, and 4.9 ± 1.2 mg/dL for women. The highest quintile (Q5) of sUA was independently associated with cIMT in women (beta-coefficient: 0.022; 95% CI: 0.007-0.036; P = 0.003) and men (beta-coefficient: 0.020; 95% CI: 0.002-0.038; P = 0.032). Regarding CAC, no association was found: men's Q5 (beta-coefficient: -0.142; 95% CI: -0.436 to 0.153; P = 0.347) and women's Q5 (beta-coefficient: 0.046; 95% CI: -0.152 to 0.245; P = 0.647). In this cohort, the highest sUA quintiles were independently associated with cIMT in both women and men. No association was found between sUA and the presence of CAC.