Asymptomatic Hyperuricemia Without Comorbidities Predicts Cardiometabolic Diseases: Five-Year Japanese Cohort Study.
Level 3 - non-randomized controlled study
Prospective longitudinal cohort study with 5-year follow-up
PubMed 28396536 · doi:10.1161/HYPERTENSIONAHA.116.08998
What was done
A 5-year prospective cohort study analyzed 5,899 Japanese adults (mean age 47±10 years, 1,864 men, aged 30 to 85) examined at a Tokyo preventive medicine center in 2004 and re-evaluated in 2009. Individuals with baseline overweight/obesity, hypertension, diabetes mellitus, dyslipidemia, gout or hyperuricemia on medications, or chronic kidney disease (eGFR <60 mL/min per 1.73 m2) were excluded. Logistic and linear regression examined the relationship between baseline asymptomatic hyperuricemia (>7 mg/dL in men, ≥6 mg/dL in women) and 5-year incident cardiometabolic outcomes, adjusting for age, sex, smoking, drinking habits, baseline eGFR, and body mass index.
What was found
Compared with normouricemic individuals, subjects with hyperuricemia had significantly higher 5-year cumulative incidence of hypertension (14.9% versus 6.1%, P < 0.001), dyslipidemia (23.1% versus 15.5%, P < 0.001), chronic kidney disease (19.0% versus 10.7%, P < 0.001), and overweight/obesity (8.9% versus 3.0%, P < 0.001). Cumulative incidence of diabetes mellitus was 1.7% versus 0.9% (P = 0.087), showing a trend that did not reach statistical significance.
Why it matters
This study shows that asymptomatic hyperuricemia independently precedes and predicts multiple cardiometabolic diseases and renal impairment even in individuals completely free of baseline metabolic or renal comorbidities.
Limits
The study was restricted to Japanese adults at a single preventive health center, limiting generalizability to other ethnicities and settings. As an observational cohort design, it cannot prove causality or demonstrate that lowering uric acid prevents cardiometabolic disease. Specific adjusted effect sizes and confidence intervals were omitted from the abstract.
Cited by
- supports A study conducted in Japan on lean, healthy individuals without diabetes, hypertension, or elevated triglycerides found that high uric acid alone increased the risk for developing obesity, diabetes, hypertension, and chronic kidney disease over the following years.