| Contributors: |
1., R.E.; Viazzi, F.; Pontremoli, R.; Angeli, F.; Barbagallo, C.; Berardino, B.; Bombelli, M.; Cappelli, F.; Casiglia, E.; Cianci, R.; Ciccarelli, M.; Cicero, A.; Cirillo, M.; Cirillo, P.; D'Elia, L.; Desideri, G.; Ferri, C.; Galletti, F.; Gesualdo, L.; Giannattasio, C.; Grassi, G.; Iaccarino, G.; Imbalzano, E.; Lippa, L.; Mallamaci, F.; Maloberti, A.; Masi, S.; Masulli, M.; Mazza, A.; Mengozzi, A.; Muiesan, M.; Nazzaro, P.; Palatini, P.; Parati, G.; Quarti-Trevano, F.; Rattazzi, M.; Reboldi, G.; Rivasi, G.; Salvetti, M.; Tikhonoff, V.; Tocci, G.; Ungar, A.; Verdecchia, P.; Virdis, A.; Volpe, M.; Borghi, C.; Working Group On Uric Acid And Cardiovascular Risk Of The Italian Society Of Hypertension, (. |
| Description: |
Background Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributes to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been proposed as an easily obtainable marker for IR. This research aimed to investigate the interaction between IR and glomerular filtration rate (GFR)-adjusted uricemia (SUA/GFR ratio) in determining CV risk in a large population cohort study. Methods Data from 18,694 subjects were analyzed from Uric acid Right foR heArt Healt (URRAH) database. The study evaluated the association between TG/HDL-C ratio and SUA/GFR ratio, as well as their impact on the development of outcomes during the follow-up study period. The primary endpoint was CV mortality. Results After a mean follow-up of 124 ± 64 months, 2,665 (14.2%) CV deaths occurred. The incidence of fatal and non-fatal CV events increased in parallel with the increase of TG/HDL-C quintiles. TG/HDL-C ratio showed a positive association with increasing of SUA/GFR ratio, even in non-diabetic patients. Multivariate analysis showed that the TG/HDL-C ratio increases the mortality risk even after adjustment for potential confounding factors. Finally, IR and GFR-adjusted hyperuricemia showed an additive effect on CV mortality. Conclusions Both IR and SUA/GFR ratio independently predict CV mortality, regardless of age, gender, BMI, diabetes, hypertension and statin use. The joint effect of the TG/HDL-C ratio and the elevated SUA/GFR ratio was greater than the presence of each single risk factor on CV mortality. This highlights the importance of monitoring these markers to better assess cardiovascular risk. |