Elevated Serum Uric Acid Is Associated with High Circulating Inflammatory Cytokines in the Population-Based Colaus Study

Background: The relation of serum uric acid (SUA) with systemic inflammation has been little explored in humans and results have been inconsistent. We analyzed the association between SUA and circulating levels of interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP). Methods and Findings: This cross-sectional population-based study conducted in Lausanne, Switzerland, included 6085 participants aged 35 to 75 years. SUA was measured using uricase-PAP method. Plasma TNF-alpha, IL-1 beta and IL-6 were measured by a multiplexed particle-based flow cytometric assay and hs-CRP by an immunometric assay. The median levels of SUA, IL-6, TNF-alpha, CRP and IL-1 beta were 355 mu mol/L, 1.46 pg/mL, 3.04 pg/mL, 1.2 mg/L and 0.34 pg/mL in men and 262 mu mol/L, 1.21 pg/mL, 2.74 pg/mL, 1.3 mg/L and 0.45 pg/mL in women, respectively. SUA correlated positively with IL-6, TNF-alpha and CRP and negatively with IL-1 beta (Spearman r: 0.04, 0.07, 0.20 and 0.05 in men, and 0.09, 0.13, 0.30 and 0.07 in women, respectively, P < 0.05). In multivariable analyses, SUA was associated positively with CRP (beta coefficient +/- SE = 0.35 +/- 0.02, P < 0.001), TNF-alpha (0.08 +/- 0.02, P < 0.001) and IL-6 (0.10 +/- 0.03, P < 0.001), and negatively with IL-1 beta (-0.07 +/- 0.03, P = 0.027). Upon further adjustment for body mass index, these associations were substantially attenuated. Conclusions: SUA was associated positively with IL-6, CRP and TNF-alpha and negatively with IL-1 beta, particularly in women. These results suggest that uric acid contributes to systemic inflammation in humans and are in line with experimental data showing that uric acid triggers sterile inflammation.