Key result
Persistent or new hyperuricemia linked to ~86% higher odds of cardiometabolic multimorbidity progression.
Why the study?
Hyperuricemia is prevalent and associated with individual cardiometabolic diseases, but its role in the development and progression of cardiometabolic multimorbidity (CMM) is unclear.
Does keeping or rising to hyperuricemia increase the risk of cardiometabolic multimorbidity progression in middle-aged and older adults?
Cohort (n=4,820)
Yes
Does keeping or rising to hyperuricemia increase the risk of cardiometabolic multimorbidity progression in middle-aged and older adults?
Odds Ratio: 1.86 (95% CI 1.29–2.68)
Absolute Event Rate: 10.6% vs 5.95%
p-value: p=<0.001
Persistent or worsening hyperuricemia is associated with a significantly increased risk of cardiometabolic multimorbidity progression, particularly incident cardiovascular disease following diabetes.
SUA rise or persistence to hyperuricemia was associated with CMM progression; leaves open whether monitoring alters multimorbidity trajectories.
Background: Hyperuricemia is prevalent and associated with individual cardiometabolic diseases, highlighting the potential role of serum uric acid (SUA) in the development and progression of cardiometabolic multimorbidity (CMM, the coexistence of diabetes, heart disease, or stroke). This study aimed to examine the role of SUA change in the progression of CMM. Methods: This prospective cohort study used data from the China Health and Retirement Longitudinal Study, included 4,820 participants aged 45 years or above with three complete surveys at 2011 (baseline), 2015, and 2018. SUA level at survey 2011 and 2015 was used to measure SUA change as keeping or rising to hyperuricemia, and keeping or declining to non-hyperuricemia. CMM progression was defined as the first report of CMM or additional report of cardiometabolic diseases during survey 2015 and 2018. We used logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of SUA change on CMM progression. Results: During the follow-up of around 7 years, 519 (10.8%) of the participants kept or rose to hyperuricemia from survey 2011 to 2015, and 311 (6.5%) experienced CMM progression from survey 2015 to 2018. Participants who kept or rose to hyperuricemia had 1.86 (95% CI, 1.29, 2.68) increased odds of CMM progression compared with those who kept or declined to non-hyperuricemia. Specifically, keeping or rising to hyperuricemia (vs. keeping or declining to non-hyperuricemia) was associated with 2.01 times higher odds (95% CI, 1.18, 3.43) of incident diabetes and 1.67 times higher odds (OR:1.67; 95% CI, 1.15, 2.43) of incident cardiovascular diseases following diabetes. Conclusion: Keeping or rising to hyperuricemia was associated with CMM progression, particularly with incident cardiovascular diseases following diabetes. These findings suggest that monitoring SUA change may provide innovative insights into the prevention of CMM, especially in the secondary prevention of CMM (i.e., preventing further progression to cardiovascular diseases among patients with diabetes).
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Li et al. (2022) conducted a cohort in Cardiometabolic multimorbidity (CMM) progression (n=4,820). Keeping or rising to hyperuricemia vs. Keeping or declining to non-hyperuricemia was evaluated on Progression of cardiometabolic multimorbidity (first report of CMM or additional report of cardiometabolic diseases) (OR 1.86, 95% CI 1.29, 2.68, p=<0.001). Keeping or rising to hyperuricemia was associated with an 86% increased odds (OR 1.86) of cardiometabolic multimorbidity progression compared with keeping or declining to non-hyperuricemia.
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