Kidney Function, Nutritional Status, and the Left Ventricle Dysfunction Are Associated with Serum Uric Acid Levels in...

The aim of this study was to assess the role of potential factors explaining variability of serum uric acid (SUA) levels in patients with chronic heart failure with reduced ejection fraction (HFrEF) not receiving xanthine oxidase inhibitors and acetylsalicylic acid, with multivariate adaptive regression splines and fuzzy c-regression models.

Between 1998 and 2010, we prospectively enrolled 294 patients (44 females, 250 males; mean age 43.1±11.6 years) not receiving allopurinol or febuxostat, who underwent right ventricular endomyocardial biopsy due to unexplained HFrEF (duration of symptoms ≥6 months) with New York Heart Association functional class II and III and decreased left ventricular ejection fraction <40% in radionuclide study. The following factors were analyzed: left ventricular ejection fraction, concentrations of serum creatinine, high-sensitivity C-reactive protein, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), SUA, glucose, total cholesterol, HDL and LDL fractions of cholesterol, triglycerides, fibrate, D-dimers, and medication. Multivariate Adaptive Regression Splines, local polynomial smoothing with Epanechnikov kernel function as well as the Time Domain Constrained Fuzzy c-Regression Models were used.

SUA concentration variability was explained by BMI, eGFR values, serum NT-pro BNP levels and the use of thiazide diuretics. The SUA declined with eGFR and increased with BMI values, serum NT-proBNP levels and the use of thiazide diuretics. A weak negative correlation between log¹⁰(SUA) levels and the LVEF was found (r=-0.130; p<0.05).

Kidney function, nutritional status, the use of thiazide diuretics and the severity of left ventricle dysfunction reflected by serum NT-proBNP levels explain the serum uric acid levels variability in patients with HFrEF.