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The Impact of Blood Pressure and Visceral Adiposity on the Association of Serum Uric Acid With Albuminuria in Adults Without Full Metabolic Syndrome

Publication at First Faculty of Medicine |
2016

Abstract

BACKGROUND The impact of metabolic phenotypes on the association of uricemia with urinary albumin/creatinine ratio (uACR) remains unresolved. We evaluated the association between serum uric acid and uACR in persons with 0, and 1-2 metabolic syndrome (MetS) components and determined the modification effects of visceral adiposity index (VAI), mean arterial pressure (MAP), and fasting glucose on this association.

METHODS Using data from a cross-sectional survey of a representative Czech population aged 25-64 years (n = 3612), we analyzed 1,832 persons without decreased glomerular filtration rate <60 ml/min/1.73 m(2), diabetes, and MetS. MetS components were defined using the joint statement of the leading societies.

RESULTS Of the 1,832 selected participants, 64.1% (n = 1174) presented with 1-2 MetS components (age 46.3 +/- 11.2; men 51.7%), whereas 35.9% (n = 658) were free of any component (age 39.4 +/- 10.0; men 34.2 %). In fully adjusted multiple linear regression models for uricemia, uACR was an independent factor for increase in uric acid levels only in persons with 1-2 MetS components (standardized beta (S beta) 0.048; P = 0.024); however, not in those without any component (S beta 0.030; P = 0.264).

Uric acid levels increased by the interaction of uACR with VAI (S beta 0.06; P = 0.012), and of uACR with MAP (S beta 0.05; P = 0.009). Finally, the association of uACR with uricemia was confined to persons whose VAI together with MAP were = the median of 1.35 and 98 mm Hg, respectively (S beta 0.190; P < 0.001).

CONCLUSIONS We demonstrated a strong modification effect of VAI and MAP on the association between uACR and uricemia, which suggests obesity-related hypertension as the underlying mechanism.