Increased Carotid Intima-Media Thickness (IMT) in Hyperuricemic Individuals May Be Explained by Hyperhomocysteinemia Associated with Renal Dysfunction: a Cross-Sectional Study

• Published in: Journal of Korean medical science Vol. 34; no. 37; pp. e237 - 10
• Main Authors: Park, Ji Ho, Song, Jung Soo, Choi, Sang Tae
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 30.09.2019; 대한의학회
• Subjects: Carotid Arteries - diagnostic imaging; Carotid Arteries - physiology; Carotid Intima-Media Thickness; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Homocysteine - blood; Humans; Hyperhomocysteinemia - complications; Hyperhomocysteinemia - diagnosis; Hyperuricemia - physiopathology; Kidney Diseases - diagnosis; Kidney Diseases - etiology; Male; Middle Aged; Original; Risk Factors; Ultrasonography; 의학일반; Hyperuricemia; Homocysteine; Renal Function; Carotid IMT
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2019.34.e237

Both hyperuricemia and hyperhomocysteinemia are known as main risk factors of cardiovascular diseases. There has been, however, no report on the relationship between carotid intima-media thickness (IMT) and homocysteine (Hcy) in hyperuricemic patients. This study aimed to investigate how hyperuricemia is associated with increased carotid IMT with a focus on hyperhomocysteinemia. This cross-sectional study included 1,222 patients who visited the Chung-Ang University Hospital Health Promotion Center from January 2013 to December 2015. The serum Hcy levels were estimated with a competitive immunoassay using the direct chemiluminescence method. The carotid IMT was measured by B-mode carotid ultrasonography. The definition of hyperuricemia was a serum uric acid level > 7.0 mg/dL for men or > 5.6 mg/dL for women, and hyperhomocysteinemia was defined as serum levels > 15 μol/L. The hyperuricemic patients showed significantly higher serum Hcy levels and lower estimated glomerular filtration rate (eGFR) than did normouricemic patients (13.39 ± 4.42 vs. 11.69 ± 3.65 μol/L, P < 0.001; 85.16 ± 19.18 vs. 96.14 ± 16.63, < 0.001, respectively). Serum Hcy level (odds ratio [OR], 1.050; 95% confidence interval [CI], 1.009-1.092) and fasting glucose level (OR, 1.018; 95% CI, 1.011-1.026) were independent risk factors for carotid plaque. In patients with hyperuricemia, the serum Hcy levels correlated with the eGFR (γ = -0.478, < 0.001). The carotid IMT correlated with serum Hcy levels and eGFR (γ = 0.196, = 0.008; γ = - 0.297, < 0.001, respectively) but not with the serum lipid profile. These results suggest that renal function impairment in hyperuricemic patients may worsen carotid IMT by increasing serum Hcy levels.