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Increased Carotid Intima-Media Thickness (IMT) in Hyperuricemic Individuals May Be Explained by Hyperhomocysteinemia

Ji Ho Park1, Jung Soo Song1, Sang Tae Choi2

  • 1Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|September 28, 2019
PubMed

Insights

Hyperuricemia is linked to higher homocysteine levels and worsened carotid intima-media thickness (IMT), a marker of cardiovascular disease. Renal function impairment may exacerbate this relationship in hyperuricemic patients.

Area of Science:

  • Cardiovascular Disease Research
  • Metabolic Disorders
  • Nephrology

Background:

  • Hyperuricemia and hyperhomocysteinemia are established cardiovascular disease risk factors.
  • The relationship between carotid intima-media thickness (IMT) and homocysteine (Hcy) in hyperuricemic patients remains under-investigated.
  • This study explores the association between hyperuricemia, hyperhomocysteinemia, and carotid IMT.

Purpose of the Study:

  • To investigate the association between hyperuricemia and increased carotid IMT.
  • To examine the role of hyperhomocysteinemia in this association.
  • To identify risk factors for carotid plaque in hyperuricemic patients.

Main Methods:

  • A cross-sectional study of 1,222 patients from January 2013 to December 2015.
  • Serum Hcy levels measured by competitive immunoassay; carotid IMT assessed by B-mode ultrasonography.
  • Hyperuricemia defined as serum uric acid >7.0 mg/dL (men) or >5.6 mg/dL (women); hyperhomocysteinemia as serum Hcy >15 μmol/L.

Main Results:

  • Hyperuricemic patients had significantly higher serum Hcy levels and lower estimated glomerular filtration rate (eGFR) compared to normouricemic patients.
  • Serum Hcy level and fasting glucose were independent risk factors for carotid plaque.
  • In hyperuricemic patients, serum Hcy correlated with eGFR, and carotid IMT correlated with both serum Hcy and eGFR.

Conclusions:

  • Renal function impairment in hyperuricemic patients is associated with increased serum Hcy levels.
  • These findings suggest that impaired renal function may contribute to worsened carotid IMT in hyperuricemic individuals via elevated Hcy.
  • Serum Hcy and eGFR are significant predictors of carotid IMT in this population.
Abstract

Keywords:
Carotid IMTHomocysteineHyperuricemiaRenal Function

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