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U-Shaped Association Between Serum Uric Acid Level and Risk of Mortality: A Cohort Study

Title
U-Shaped Association Between Serum Uric Acid Level and Risk of Mortality: A Cohort Study
Author
김인아
Keywords
ALL-CAUSE MORTALITY; CANCER-MORTALITY; CARDIOVASCULAR MORTALITY; ISCHEMIC-STROKE; KIDNEY-FUNCTION; FOLLOW-UP; URATE; HYPOURICEMIA; MANAGEMENT; DISEASE
Issue Date
2018-04
Publisher
WILEY
Citation
ARTHRITIS & RHEUMATOLOGY, v. 70, no. 7, page. 1122-1132
Abstract
Objective. In addition to the controversy regarding the association of hyperuricemia with cardiovascular disease (CVD) mortality, few studies have examined the impact of a low uric acid level on mortality. We undertook the present study to evaluate the relationship between both low and high uric acid levels and the risk of all-cause and cause-specific mortality in a large sample of Korean adults over a full range of uric acid levels.Methods. A cohort study was performed in 375,163 South Korean men and women who underwent health check-ups from 2002 to 2012. Vital status and cause of death were ascertained from the national death records. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for mortality outcomes were estimated using Cox proportional hazards regression analysis.Results. During a total of 2,060,721.9 person-years of follow-up, 2,020 participants died, with 287 CVD deaths and 963 cancer deaths. Low and high uric acid levels were associated with increased all-cause, CVD, and cancer mortality. The multivariable-adjusted HRs for all-cause mortality in the lowest uric acid categories (<3.5 mg/dl for men and <2.5 mg/dl for women) compared with the sex-specific reference category were 1.58 (95% CI 1.18-2.10) and 1.80 (95% CI 1.10-2.93), respectively. Corresponding HRs in the highest uric acid categories (>= 9.5 mg/dl for men and >= 8.5 mg/dl for women) were 2.39 (95% CI 1.57-3.66) and 3.77 (95% CI 1.17-12.17), respectively.Conclusion. In this large cohort study of men and women, both low and high uric acid levels were predictive of increased mortality, supporting a U-shaped association between serum uric acid levels and adverse health outcomes.
URI
https://onlinelibrary.wiley.com/doi/full/10.1002/art.40472http://repository.hanyang.ac.kr/handle/20.500.11754/118198
ISSN
2326-5191; 2326-5205
DOI
10.1002/art.40472
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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