Uric acid: a starring role in the intricate scenario of metabolic syndrome with cardio-renal damage?

Elevated uric acid levels are a common finding in patients with metabolic syndrome and in those with cardiovascular and renal disease, but the meaning of this elevation is still unclear. In patients with chronic kidney diseases, it could merely reflect the reduction in glomerular filtration rate: bu...

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Bibliographic Details
Published in:Internal and emergency medicine 2012-02, Vol.7 (1), p.5-8
Main Authors: Stellato, Davide, Morrone, Luigi Francesco, Di Giorgio, Chiara, Gesualdo, Loreto
Format: Article
Language:English
Subjects:
Biomarkers - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - physiopathology
Female
Humans
Hyperuricemia - blood
Hyperuricemia - physiopathology
Im - Review
Internal Medicine
Male
Medicine
Medicine & Public Health
Metabolic Syndrome - blood
Metabolic Syndrome - physiopathology
Prognosis
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - physiopathology
Sensitivity and Specificity
Severity of Illness Index
Uric Acid - blood
Uric Acid - metabolism
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Summary:Elevated uric acid levels are a common finding in patients with metabolic syndrome and in those with cardiovascular and renal disease, but the meaning of this elevation is still unclear. In patients with chronic kidney diseases, it could merely reflect the reduction in glomerular filtration rate: but uric acid levels are known to be elevated in people, also in younger ones, prior to the development of hypertension or renal disease, independently of several risk factors. Multiple potential mechanisms suggest a causative role for uric acid in vascular disease. Uric acid has been shown to be involved in metabolic pathways that lead to oxidative stress, endothelial disfunction, and to a vascular and systemic inflammatory response. Moreover, the elevation in uric acid levels observed after fructose ingestion, with a consequent reduction in nitric oxide, may lead to a reduced glucose uptake in the skeletal muscle, hyperinsulinemia, and insulin resistance. Besides these bench research data, also clinical studies showed the beneficial effects of lowering uric acid therapies on several markers of cardiovascular and renal disease. To date, however, there is no evidence indicating that such therapies, that are not free of risk, may reduce cardiovascular events; so that to manage our prescriptions, we need larger, prospective, interventional data.
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-011-0642-3