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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Effect of uric acid on coronary microvascular endothelial function in women: association with eGFR and ADMA
So Kuwahata1, Shuichi Hamasaki, Sanemasa Ishida
1Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
Insights
High uric acid (UA) levels are linked to coronary endothelial dysfunction in women, potentially due to impaired renal function and increased asymmetric dimethylarginine (ADMA). This association was not observed in men.
Area of Science:
- Cardiovascular Medicine
- Renal Physiology
- Endocrinology
Background:
- Uric acid (UA) is increasingly recognized as a potential factor in cardiovascular disease.
- Endothelial dysfunction is a key early event in atherosclerosis.
- The role of UA in endothelial function, particularly its interaction with renal function and ADMA, requires further elucidation.
Purpose of the Study:
- To investigate the association between uric acid levels and coronary endothelial function.
- To examine the influence of uric acid on renal function, specifically estimated glomerular filtration rate (eGFR).
- To explore the relationship between uric acid, asymmetric dimethylarginine (ADMA), and endothelial function in both men and women.
Main Methods:
- A study involving 194 patients (119 men, 75 women) without coronary artery disease.
- Assessment of coronary endothelial function using coronary blood flow (CBF) changes induced by acetylcholine (ACh).
- Analysis of relationships between UA, eGFR, ADMA, and other clinical parameters using monovariate and stepwise regression.
Main Results:
- In women, higher UA and ADMA levels were correlated with reduced coronary blood flow response to ACh, while higher eGFR was associated with improved response.
- Uric acid was identified as the sole independent predictor of coronary endothelial function in women.
- In women, UA was inversely correlated with eGFR, and ADMA was positively correlated with UA and inversely with eGFR; these associations were not significant in men.
Conclusions:
- Elevated uric acid concentrations are associated with coronary microvascular endothelial dysfunction specifically in women.
- The interplay between serum UA, eGFR, and ADMA in women may contribute to impaired endothelial function in resistance coronary arteries.
- These sex-specific relationships suggest different pathophysiological mechanisms underlying endothelial dysfunction in men and women.
Aim:
The aim of this study was to investigate the role of uric acid (UA) in coronary endothelial function via its effects on renal function, other coronary risk factors and asymmetric dimethylarginine (ADMA) in men and women.
Methods:
The study population consisted of 194 consecutive patients (119 men and 75 women) without coronary artery disease. The relationships between UA and coronary endothelial function, estimated glomerular filtration rate (eGFR), ADMA or other biochemical or anthropometric parameters were investigated.
Results:
Monovariate analysis of female participants demonstrated that % change in coronary blood flow (CBF) induced by acetylcholine (ACh) was inversely correlated with UA, ADMA and age (r=-0.32, p<0.01; r=-0.31, p<0.05; r=-0.23, p<0.05, respectively), and positively correlated with eGFR (r=0.27, p<0.05). Stepwise regression analysis showed that UA was the only independent predictor of % change in CBF induced by ACh (F value 4.969, p<0.05). Similar analysis of male participants failed to show significant correlations of these variables except for age in monovariate analysis (r=-0.19, p<0.05). Meanwhile, UA was inversely correlated with eGFR in both men and in women (r=-0.25, p<0.01; r=-0.59, p<0.0001, respectively), and ADMA was positively correlated with UA and inversely correlated with eGFR (r=0.36, p<0.05; r=-0.42, p<0.01, respectively) in women but not in men.
Conclusion:
High concentrations of UA correlate with coronary endothelial microvascular dysfunction in women. Further, serum UA concentration is related to eGFR and ADMA only in women, which may result in impaired endothelial function in resistance coronary arteries in women but not in men.
