Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease
Abstract
:1. Introduction
2. Subjects and Methods
2.1. Study Patients and Design
2.2. Evaluation of Cardiac Structure and Function
2.3. Assessment of baPWV and ABI
2.4. Collection of Demographic, Medical, and Laboratory Data
2.5. Reproducibility
2.6. Statistical Analysis
3. Results
3.1. Determinants of LAD > 47 mm, Observed/Predicted LVM > 128%, LVEF < 50%, ABI < 0.9, and baPWV > 1822 cm/s in the Study Patients
3.2. Correlation between UA and Echocardiographic Parameters
3.3. Determinants of LAD, Observed/Predicted LVM, LVEF, ABI, and baPWV in the Study Patients
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Lower Uric Acid (n = 217) | Higher Uric Acid (n = 201) | p |
---|---|---|---|
Age (year) | 65.6 ± 11.5 | 66.1 ± 13.9 | 0.665 |
Male gender (%) | 53.9 | 56.2 | 0.636 |
Diabetes mellitus (%) | 30.9 | 38.3 | 0.110 |
Coronary artery disease (%) | 20.2 | 19.5 | 0.861 |
Gout (%) | 8.8 | 18.9 | 0.003 |
Congestive heart failure (%) | 4.3 | 9.0 | 0.046 |
Systolic blood pressure (mmHg) | 141.2 ± 22.2 | 139.1 ± 20.8 | 0.300 |
Diastolic blood pressure (mmHg) | 78.2 ± 12.2 | 77.4 ± 12.5 | 0.537 |
Mean artery pressure (mmHg) | 99.2 ± 14.5 | 98.0 ± 14.2 | 0.385 |
ABI | 1.10 ± 0.15 | 1.10 ± 0.15 | 0.989 |
baPWV (cm/s) | 1903.2 ± 507.9 | 1869.7 ± 453.2 | 0.478 |
Laboratory parameters | |||
Uric acid (mg/dL) | 5.7 ± 1.0 | 9.0 ± 1.8 | < 0.001 |
Fasting glucose (mg/dL) | 114.1 ± 42.0 | 117.9 ± 48.3 | 0.429 |
Triglyceride (mg/dL) | 113 (82–169) | 128.5 (93.25–199.75) | 0.001 |
Total cholesterol (mg/dL) | 193.5 ± 42.1 | 188.1 ± 41.6 | 0.203 |
Hematocrit (%) | 39.0 ± 6.8 | 38.7 ± 7.2 | 0.707 |
eGFR (mL/min/1.73 m2) | 45.7 ± 14.1 | 38.8 ± 15.7 | < 0.001 |
Medications | |||
ACEI and/or ARB use (%) | 56.2 | 70.1 | 0.003 |
β-blocker use (%) | 39.3 | 49.8 | 0.033 |
Calcium channel blocker use (%) | 43.3 | 47.8 | 0.362 |
Diuretic use (%) | 23.0 | 43.5 | < 0.001 |
Hypouricemic agent use (%) | 7.4 | 11.4 | 0.157 |
Echocardiographic data | |||
LAD (mm) | 37.0 ± 6.5 | 39.6 ± 6.4 | < 0.001 |
Observed/predicted LVM (%) | 146.7 ± 46.1 | 161.6 ± 54.2 | < 0.001 |
LVEF | 64.1 ± 12.4 | 61.6 ± 14.0 | 0.055 |
Variables | Multivariable (Forward) | |
---|---|---|
OR (95% CI) | p | |
LAD > 47 mm | ||
Uric acid (per 1 mg/dL) | 1.329 (1.111–1.590) | 0.002 |
Observed/predicted LVM > 128% | ||
Diabetes mellitus | 1.934 (1.113–3.361) | 0.019 |
Mean artery pressure (per 1 mmHg) | 0.976 (0.958–0.994) | 0.009 |
Uric acid (per 1 mg/dL) | 1.198 (1.048–1.369) | 0.008 |
Diuretic use | 1.985 (1.099–3.586) | 0.023 |
LVEF < 50% | ||
Coronary artery disease | 2.564 (1.232–5.338) | 0.012 |
Congestive heart failure | 6.149 (2.069–18.275) | 0.001 |
Uric acid (per 1 mg/dL) | 1.316 (1.111–1.559) | 0.002 |
Fasting glucose (per 1 mg/dL) | 1.007 (1.001–1.014) | 0.032 |
Calcium channel blocker use | 0.203 (0.092–0.450) | < 0.001 |
Diuretic use | 2.167 (1.045–4.494) | 0.038 |
ABI < 0.9 | ||
Age (per 1 year) | 1.160 (1.094–1.231) | 0.032 |
Fasting glucose (per 1 mg/dL) | 1.011 (1.004–1.019) | 0.003 |
ACEI and/or ARB use | 4.013 (1.123–14.339) | 0.032 |
baPWV > 1822 cm/s | ||
Age (per 1 year) | 1.134 (1.097–1.172) | < 0.001 |
Diabetes mellitus | 3.152 (1.587–6.260) | 0.001 |
Congestive heart failure | 0.200 (0.058–0.683) | 0.010 |
Mean artery pressure (per 1 mmHg) | 1.132 (1.097–1.168) | < 0.001 |
Fasting glucose (per 1 mg/dL) | 1.013 (1.006–1.020) | < 0.001 |
Variables | Multivariable (Stepwise) | |
---|---|---|
Unstandardized Coefficient β (95% CI) | p | |
LAD (per 1 mm) | ||
Congestive heart failure | 4.118 (1.466, 6.771) | 0.002 |
Uric acid (per 1 mg/dL) | 0.767 (0.421, 1.113) | < 0.001 |
eGFR (per 1 mL/min/1.73 m2) | −0.064 (−0.112, −0.015) | 0.010 |
Observed/predicted LVM (per 1%) | ||
Age (per 1 year) | −0.435 (−0.800, −0.069) | 0.020 |
Congestive heart failure | 63.807 (44.646, 82.969) | < 0.001 |
Mean artery pressure (per 1 mmHg) | −0.539 (−0.881, −0.197) | 0.002 |
Uric acid (per 1 mg/dL) | 4.791 (2.471, 7.111) | < 0.001 |
Diuretic use | 11.522 (1.363, 21.680) | 0.026 |
LVEF (per 1%) | ||
Coronary artery disease | −4.297 (−7.563, −1.030) | 0.010 |
Congestive heart failure | −12.204 (−17.455, −6.953) | < 0.001 |
Uric acid (per 1 mg/dL) | −1.126 (−1.763,−0.489) | 0.001 |
Fasting glucose (per 1 mg/dL) | −0.043 (−0.072, −0.015) | 0.003 |
Calcium channel blocker use | 5.326 (2.722, 7.929) | < 0.001 |
ABI (per 0.1) | ||
Age (per 1 year) | −0.030 (−0.042, −0.019) | < 0.001 |
Coronary artery disease | −0.389 (−0.745, −0.033) | 0.032 |
Congestive heart failure | −1.169 (−1.745, −0.593) | < 0.001 |
baPWV (per 10 cm/s) | ||
Age (per 1 year) | 0.184 (0.155, 0.214) | < 0.001 |
Diabetes mellitus | 1.368 (0.478, 2.259) | 0.003 |
Congestive heart failure | −2.750 (−4.292, −1.208) | 0.001 |
Mean artery pressure (per 1 mmHg) | 0.173 (0.145, 0.201) | < 0.001 |
Fasting glucose (per 1 mg/dL) | 0.010 (0.001, 0.020) | 0.025 |
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Chiu, T.-H.; Wu, P.-Y.; Huang, J.-C.; Su, H.-M.; Chen, S.-C.; Chang, J.-M.; Chen, H.-C. Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease. Diagnostics 2020, 10, 514. https://doi.org/10.3390/diagnostics10080514
Chiu T-H, Wu P-Y, Huang J-C, Su H-M, Chen S-C, Chang J-M, Chen H-C. Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease. Diagnostics. 2020; 10(8):514. https://doi.org/10.3390/diagnostics10080514
Chicago/Turabian StyleChiu, Tai-Hua, Pei-Yu Wu, Jiun-Chi Huang, Ho-Ming Su, Szu-Chia Chen, Jer-Ming Chang, and Hung-Chun Chen. 2020. "Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease" Diagnostics 10, no. 8: 514. https://doi.org/10.3390/diagnostics10080514