Background Hyperuricemia is closely associated to cardiovascular disease although it has not been defintively established whether it is a marker or a causative agent. Serum uric acid (sUa) is strongly linked to the metabolic syndrome, hypertension (HT), dyslipidemia (DL) and higher BMI and higher levels are seen in men compared to women. Coronary artery calcification (CAC) is associated with future risk of atherosclerotic CV events in addition to these traditional cardiovascular risk factors (CVRF). CACs are present in atherosclerotic arteries and can be quantified and scored non-invasively by computed tomography. The Swedish CArdioPulmonarybioImage Study (SCAPIS) extensively characterizes a Swedish cohort of 30 000 men and women aged between 50 and 64 years. A comprehensive pilot study in 1111 individuals was completed in 2012. In this pilot study we have examined the relation between CACs and sUa
Objectives Examine the association bewteen sUa and CAC in men and women seperately.
Methods In the SCAPIS pilot study we identified 1106 (552 males) individuals who were screened for traditional CVDRFs, such as HT, DL, diabetes mellitus (DM), smoking, physical activity (PA), educational level (EDU), BMI, high sensitive CRP (hsCRP). CACs, reflecting calcification of coronary arteries, was determined according to Agatston1. We measured sUa and related quartiles to CACs with multiple logistic regression analyses adjusting for traditional CVDRFs. CAC was defined positive if ≥1.
Results Age, BMI, smoking status, hsCRP, HT and DL showed no differences between sex while presence of CAC and diabetes was twice as common in men (Table 1). The three upper quartiles of sUa, (>306 μmol/L), all significantly (p<0.05) predicted presence of CACs in men even adjusting for HT, DL, DM, smoking, PA, EDU, BMI, hsCRP and age in multivariate logistic regression, but not in women (Table 2).
Conclusions Higher levels of sUa is associated with presence of CACs in men but not in women. This may merely reflect the earlier onset of atherosclerosis in men or possibly suggest biological differences in the effect of sUa on calcification of coronary arteries between sexes.
Agatston AS et al Quantification of coronary artery calcium using ultrafast computed tomography J Am Coll Cardiol 1990.
Disclosure of Interest None declared