Elevated serum uric acid was associated with pre-inflammatory state and impacted the role of HDL-C on carotid atherosclerosis

作者：Hu, Xiangming; Liu, Jieliang; Li, Wei; Wang, Chenyang; Li, Guang; Zhou, Yingling^*; Dong, Haojian^*

来源：Nutrition, Metabolism and Cardiovascular Diseases, 2022, 32(7): 1661-1669.

DOI：10.1016/j.numecd.2022.03.026

• Uric acid
• High-density lipoprotein cholesterol
• Atherosclerosis
• Inflammation

Background and aims: Uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) are positively and negatively associated with atherosclerosis, respectively. UA and HDL-C are involved in the balance of proinflammatory and anti-inflammatory processes in atherosclerosis. However, it is still unclear whether UA affects the effect of HDL-C on atherosclerosis. Methods and results: In this retrospective study, we enrolled 1437 patients with multiple risk factors for atherosclerosis. Patients were categorized into two groups according to their baseline UA level. Multivariate logistic regression analysis and restricted cubic spline curves were used to assess the relationship between HDL-C and carotid atherosclerosis (abnormal carotid intima-media thickness [cIMT] and carotid artery plaque) at different UA levels. Compared to patients with normouricemia, patients with hyperuricemia were older and had a more extensive history of disease and unhealthy behavior. In the normouricemia group, multivariate-adjusted odds ratios (95% CIs) for HDL-C were 0.55 (0.33-0.92) for abnormal mean cIMT, 0.59 (0.35-1.00) for abnormal maximum cIMT, and 0.53 (0.29-0.94) for the occurrence of carotid artery plaque, while the correlation between each of these three indicators with HDL-C were not significant in those with hyperuricemia. Spline regression models yielded similar results. The effect of UA on the association between HDL-C and carotid atherosclerosis remained in the subset of patients with optimal low-density lipoprotein cholesterol. Conclusion: Elevated UA marks a pre-inflammatory state and impacts the role of HDL-C on carotid atherosclerosis.(c) 2022 The Author(s). Published by Elsevier B.V. on behalf of 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. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

• 单位
  广东省人民医院; 广东省心血管病研究所; 南方医科大学