Association between one-year change in serum urate level and risk of total and cardiovascular mortality in specific healthcheck participants : the J-SHC study

• Published in: Gout and Uric & Nucleic Acids Vol. 45; no. 2; pp. 123 - 129
• Main Authors: Kasahara, Masato, Tsuruya, Kazuhiko, Otaki, Yoichiro, Watanabe, Tsuyoshi, Narita, Ichiei, Kondo, Masahide, Iseki, Kunitoshi, Konta, Tsuneo, Asahi, Koichi, Yamagata, Kunihiro, Fujimoto, Shoichi, Shibagaki, Yugo, Moriyama, Toshiki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Gout and Uric & Nucleic Acids 20.12.2021; 一般社団法人 日本痛風・尿酸核酸学会
• Subjects: Cohort study; Mortality; Serum urate; コホート研究; 死亡; 血清尿酸
• ISSN: 2435-0095
• DOI: 10.14867/gnamtsunyo.45.2_123

This study examined the association between one-year changes in serum urate levels and the risk of all-cause and cardiovascular mortality in health checkup participants, using a nationwide database of specific health checkups. The subjects were 144,142 people (58,148 men and 85,994 women, mean age 65.3 years) who received specific health examinations in 2008 and 2009 and had sequential data on serum urate levels. The association between one-year change in serum urate level and risk of total and cardiovascular mortality was analyzed by Cox proportional hazard model adjusting for background factors (age, gender, smoking, alcohol consumption, BMI, eGFR, systolic blood pressure, HbA1c, triglycerides, LDL-C, HDL-C, medications (antihypertensive, antidiabetic, lipid-lowering), one-year change in these clinical parameters, and serum urate levels in 2008 and 2009). During the 7-year follow-up period, there were 1,206 total deaths (829 men and 377 women) and 234 cardiovascular deaths (161 men and 73 women). Cox proportional hazards analysis adjusted for background factors showed a significant increase in the hazard ratio (HR) of 1.77 (95% confidence interval [CI] 1.04-3.01) in the group of 2.0 or more decrease and HR of 2.73 (95% CI 1.57-4.72) in the group of 2 or more increase compared with the reference group (serum urate change: -0.9 to +0.9 mg/dL). This result suggests that a significant change in serum urate level during one year may be a risk of mortality independent of absolute serum urate level in the community population.