Hyperuricemia may impact role of HDL-C on carotid atherosclerosis, finds study

China: Hyperuricemia marks a pre-inflammatory state and impacts the role of HDL-C on carotid atherosclerosis, states an article published in Nutrition, Metabolism & Cardiovascular Diseases. Co-management of serum uric acid and HDL-C levels will help prevent atherosclerosis.

Globally, Atherosclerosis is a leading cause of vascular disease, with the highest morbidity and mortality. Serum uric acid (UA), the final product of purine metabolism, and high-density lipoprotein cholesterol (HDL-C) are positively and negatively associated with atherosclerosis, respectively. UA and HDL-C are involved in the balance of pro-inflammatory and anti-inflammatory processes in atherosclerosis. However, it is still unclear whether UA affects the role of HDL-C on atherosclerosis.

Xiangming Hu, Southern Medical University, China, and colleagues analyzed the effect of serum UA levels on the relationship between HDL-C and carotid atherosclerosis in patients with a high risk of ASCVD

The research team enrolled 1437 patients (992 men and 445 women) with multiple risk factors for atherosclerosis for this retrospective study. Patients were categorized into two groups, the normouricemia group and the hyperuricemia group, based on their baseline UA level. Multivariate logistic regression analysis and restricted cubic spline curves were used to assess the relationship between HDL-C and carotid atherosclerosis (abnormal carotid intima-media thickness [cIMT] and carotid artery plaque) at different UA levels. Compared to patients with normouricemia, patients with hyperuricemia were older and had a more extensive history of disease and unhealthy behavior

Study results show that,

• In the normouricemia group, multivariate-adjusted odds ratios for HDL-C were 0.55 for abnormal mean cIMT, 0.59 for abnormal maximum cIMT, and 0.53 for the occurrence of carotid artery plaque, while the correlation between each of these three indicators with HDL-C was not significant in those with hyperuricemia

• Spline regression models yielded similar results

• The effect of UA on the association between HDL-C and carotid atherosclerosis remained in the subset of patients with optimal low-density lipoprotein cholesterol.

Researchers concluded that the association between HDL-C and carotid atherosclerosis could be affected by different levels of serum uric acid and hyperuricemia potentially affects the relationship between HDL-C and inflammation markers in these patients. The study shows important clinical implications for a better understanding of the multifactorial effects in the development of atherosclerosis. Thus, maintaining serum UA is important for the prevention of atherosclerosis.

Despite several limitations, the study explored the relationship between UA levels, HDL-C and carotid atherosclerosis, paving the way for future research, the authors wrote.

Reference:

Xiangming Hu, Jieliang Liu, Wei Li, Chenyang Wang, Guang Li, Yingling Zhou, Haojian Dong, Elevated serum uric acid was associated with pre-inflammatory state and impacted the role of HDL-C on carotid atherosclerosis, Nutrition, Metabolism and Cardiovascular Diseases,2022, https://doi.org/10.1016/j.numecd.2022.03.026.