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Joint impact of serum urate, renal function, and genetic susceptibility on coronary heart disease and ischemic stroke

Huangda Guo1, Siyue Wang1, Hexiang Peng1

  • 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

Frontiers in Endocrinology
|December 29, 2025
PubMed

Insights

High serum urate levels increase cardiovascular disease (CVD) risk, especially when combined with poor kidney function or genetic predisposition. Managing urate is key for preventing CVD in at-risk individuals.

Area of Science:

  • Cardiovascular research
  • Nephrology
  • Genetics

Background:

  • The link between serum urate and cardiovascular disease (CVD) is known, but its interaction with renal function and genetic factors needs further investigation.
  • Understanding these combined effects is crucial for developing targeted CVD prevention strategies.

Purpose of the Study:

  • To examine the individual and combined associations of serum urate, renal function, and genetic risk with incident CVD.
  • To clarify the interplay between these factors in CVD development.

Main Methods:

  • Utilized UK Biobank data from 383,390 participants without baseline CVD.
  • Assessed serum urate, renal function (eGFR, albumin-creatinine ratio), and calculated genetic risk scores for coronary heart disease (CHD) and ischemic stroke (IS).
  • Employed Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD events over a median follow-up of 13.24 years.

Main Results:

  • Each standard deviation increase in serum urate correlated with increased risk for CVD, CHD, and IS.
  • Elevated serum urate combined with impaired renal function or high genetic risk significantly amplified CVD risk.
  • Individuals with poor renal function and high urate levels faced a threefold higher CVD risk compared to those with normal renal function and low urate.

Conclusions:

  • Serum urate management is critical for preventing CVD, particularly in individuals with renal impairment or genetic susceptibility.
  • The study highlights the synergistic effect of urate, renal function, and genetics on CVD risk.
Abstract

Keywords:
cardiovascular diseasescohort studygenetic riskrenal functionserum urate

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