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Association between serum uric acid, aortic, carotid and femoral stiffness among adults aged 40–75 years without and with type 2 diabetes mellitus

The Maastricht Study

Wijnands, José M.A.a,b; Boonen, Anneliesa,b; van Sloten, Thomas T.c,d,e; Schram, Miranda T.c,d; Sep, Simone J.S.c,d; Koster, Annemarieb,f; van der Kallen, Carla J.H.c,d; Henry, Ronald M.A.c,d; Dagnelie, Pieter C.b,d,g; Stehouwer, Coen D.A.c,d; van der Linden, Sjefa,b; Arts, Ilja C.W.b,d,g

doi: 10.1097/HJH.0000000000000593
ORIGINAL PAPERS: Blood vessels

Objective: Arterial stiffness may be a mechanism to explain the association between uric acid and cardiovascular disease. We aimed to analyse associations between serum uric acid and regional and local arterial stiffness, and assess potential differences related to sex and glucose metabolism status.

Methods: A cross-sectional study was performed in 614 adults [52.6% men; mean age 58.7 ± 8.5 years; 23.2% type 2 diabetes mellitus (by design)] from The Maastricht Study. Arterial stiffness was assessed by carotid–femoral pulse wave velocity (cfPWV), distensibility, and compliance coefficient of the carotid and femoral artery, and carotid artery Young's elastic modulus.

Results: Higher uric acid (per SD of 74 μmol/l) was associated with greater stiffness indicated by a significantly higher cfPWV [β = 0.216 (95% confidence interval 0.061, 0.372); P = 0.006] and lower carotid distensibility coefficient [β = −0.633 (95% confidence interval −1.099, −0.166); P = 0.008] after adjustment for sex, age, and glucose metabolism status. Associations lost significance after adjusting for mean arterial pressure, BMI, waist, smoking status, heart rate, total : high-density lipoprotein cholesterol ratio, triglycerides, estimated glomerular filtration rate, use of lipid-lowering, antihypertensive, and diabetes medication, and use of secondary uricosurics. No associations were found between uric acid and carotid compliance coefficient, carotid Young's elastic modulus, or stiffness of the femoral artery. A significant interaction (P < 0.10) with glucose metabolism status was found for cfPWV. However, none of the stratified associations were significant. There was no interaction with sex.

Conclusion: Uric acid was not significantly associated with stiffness of the aorta, or the carotid or femoral artery among adults aged 40–75 years without and with type 2 diabetes mellitus.

aDepartment of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre

bCAPHRI School for Public Health and Primary Care, Maastricht University

cDepartment of Internal Medicine, Maastricht University Medical Centre

dCARIM School for Cardiovascular Diseases

eNUTRIM School for Nutrition, Toxicology and Metabolism

fDepartment of Social Medicine

gDepartment of Epidemiology, Maastricht University, Maastricht, the Netherlands

Correspondence to José M.A. Wijnands, MSc, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands.Tel: +31 43 3875026; fax: +31 43 3875006; e-mail:

Abbreviations: ΔD, distension; baPWV, brachial–ankle pulse wave velocity; cfPWV, carotid–femoral pulse wave velocity; cIMT, carotid intima–media thickness; D, arterial diameter; HR, heart rate; MAP, mean arterial pressure; PP, pulse pressure; YEM, Young's elastic modulus

Received 22 April, 2014

Revised 5 March, 2015

Accepted 5 March, 2015

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