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Asymptomatic Hyperuricemia Without Comorbidities Predicts Cardiometabolic Diseases: Five-Year Japanese Cohort Study
Masanari Kuwabara1, Koichiro Niwa2, Ichiro Hisatome2
1From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., A.A.-H., P.B., T.J., Y.S., T.M., G.G., M.A.L., R.J.J.); Department of Cardiology, Toranomon Hospital, Tokyo, Japan (M.K., M.O.); Cardiovascular Center, St Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Future Basic Medicine, Nara Medical University, Kashihara, Japan (T.N.); and Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.). kuwamasa728@gmail.com.
Abstract:
Whether asymptomatic hyperuricemia in the absence of comorbidities increases the risk for cardiometabolic disorders and chronic kidney disease remains controversial. This study was conducted to clarify the association between asymptomatic hyperuricemia and cardiometabolic conditions. Subjects consisting of Japanese adults between 30 and 85 years of age were enrolled in the study at Center for Preventive Medicine, St Luke's International Hospital, Tokyo, and were available at enrollment (2004) and at 5-year follow-up (2009). Subjects were excluded if they were overweight or obese, hypertensive, diabetic, and dyslipidemic, had a history of gout or hyperuricemia on medications, or had chronic kidney disease as estimated glomerular filtration rate <60 mL/min per 1.73 m2 Linear and logistic regression analyses were used to examine the relationship between hyperuricemia and development of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and overweight/obesity (unadjusted and adjusted for age, sex, smoking, drinking habits, baseline estimated glomerular filtration rate, and body mass index). Five thousand eight hundred and ninety-nine subjects without comorbidities (mean age of 47±10 years, 1864 men) were followed for 5 years. Hyperuricemia (defined as >7 mg/dL in men and ≥6 mg/dL in women) was associated with increased cumulative incidence of hypertension (14.9% versus 6.1%; P<0.001), dyslipidemia (23.1% versus 15.5%; P<0.001), chronic kidney disease (19.0% versus 10.7%; P<0.001), and overweight/obesity (8.9% versus 3.0%; P<0.001), while diabetes mellitus (1.7% versus 0.9%; P=0.087) showed a trend but did not reach statistical significance. In conclusion, asymptomatic hyperuricemia carries a significant risk for developing cardiometabolic conditions in Japanese individual without comorbidities.