Association between uric acid and carotid atherosclerosis in elderly persons

Objective Several cohort studies have shown a link between serum uric acid (SUA) and subsequent cardiovascular disease. However, such an association did not remain significant after adjusting for concomitant risk factors for atherosclerosis in some studies. Thus, the role of SUA as an independent risk factor remains controversial. We therefore investigated the association between SUA and sclerotic lesions of common carotid atherosclerosis. Patients and Methods We evaluated sclerotic lesions of the common carotid arterial intima-media thickness (IMT) by ultrasonography in 398 men aged 74 8 (range, 60-97) years and 521 women aged 75 8 (range, 60-104) years. To investigate the relation between SUA and various factors, all subjects were divided into three groups based on the tertile of SUA. Results Stepwise multiple linear regression analysis using IMT as an objective variable, adjusted by various risk factors as explanatory variables showed that SUA [B, 0.0099; 95% confidence interval (0), 0.0022-0.01751 was a significant independent contributing factor along with known risk factors such as age, sex, smoking status, systolic blood pressure, diastolic blood pressure, antihypertensive drug use, HDL-cholesterol, and LDLcholesterol. Multiple logistic regression analysis for carotid IMT as a tertile of SUA and dependent variables showed that the adjusted odds ratio was 1.25 (95% CI, 0.87-1.78) for those in the middle tertile (4.2-5.5 mg/dl), and 1.66 (95% CI, 1.16-2.39) for those in the highest tertile (5.6-14.1 mg/dl) compared to that for subjects in the lowest tertile of SUA levels (0.51-4.1 mg/dl). Conclusion We suggest that SUA is a risk factor or marker for ultrasonographically determined IMT.