ABC | Volume 111, Nº6, December 2018

Original Article Ferreira et al Uric acid and cardiovascular risk factors Arq Bras Cardiol. 2018; 111(6):833-840 Table 2 – Comparison of participants’ usual dietary intake according to diagnosis of hyperuricemia Control group (n = 130) Hyperuricemia group (n = 19) p p* Energy (kcal/day) 1647.5 (1250.3 – 2099.0) 2212.2 (1543.4 – 2934.4) 0.02 0.77 Protein (g/day) 75.7 (63.5 – 93 9) 77.6 (67.1 – 112.8) 0.73 0.80 Carbohydrates (g/day) 196.0 (143.2 – 266.9) 296.2 (202.5 – 412.0) 0.01 0.49 Lipids (g/day) 60.3 (44.0 – 78.9) 75.9 (47.9 – 106.1) 0.23 0.71 Saturated fatty acids (g/day) 24.4 (18.4 – 31.0) 25.6 (14.9 – 29.5) 0.84 0.12 Poliunsaturated fatty acids (g/day) 7.1 (5.4 – 9.6) 8.8 (6.4 – 12.2) 0.15 0.75 Monounsaturated fatty acids (g/day) 11.1 (7.5 – 15.7) 7.0 (4.2 – 9.9) 0.01 0.12 Cholesterol (mg/day) 286.7 (207.1 – 425.0) 231.6 (152.8 – 417.7) 0.18 0.12 Fiber (g/day) 19.3 (14.9 – 25.4) 18.3 (12.7 – 19.6) 0.54 0.78 Calcium (mg/day) 706.6 (541.0 – 959.5) 773.1 (642.8 – 952.5) 0.46 0.55 Values as median (interquartile interval). p: Control group vs.Hyperuricemia group. p*: Control group vs.Hyperuricemia group, after adjustment for age, sex, and body mass index. Table 3 – Comparison of participants’ anthropometric parameters according to diagnosis of hyperuricemia Control group (n = 130) Hyperuricemia group (n = 19) p p* p** Body mass index (kg/m 2 ) 31.80 (26.26 – 34.42) 34.15 (33.36 – 37.19) 0.006 0.003 0.008 Men 32.30 (30.60 – 34.61) 36.53 (33.50 – 37.19) 0.03 0.04 - Women 31.68 (24.17 – 34.10) 33.90 (33.36 – 36.13) 0.04 0.05 - Waist circumference (cm) 98.75 (85.60 – 106.00) 105.60 (99.00 – 112.00) 0.05 0.03 0.12 Men 106.00 (102.50 – 114.50) 112.25 (106.00 – 113.00) 0.19 0.18 - Women 97.00 (82.50 – 103.50) 99.50 (96.50 – 106.00) 0.26 0.38 - Waist-to-hip ratio 0.89 (0.81 – 0.94) 0.89 (0.82 – 0.93) 0.76 0.70 0.69 Men 0.95 (0.93 – 0.96) 0.92 (0.89 – 0.95) 0.10 0.27 - Women 0.86 (0.79 – 0.92) 0.87 (0.82 – 0.93) 0.96 0.68 - Waist-to-height ratio 0.61 (0.55 – 0.65) 0.63 (0.59 – 0.66) 0.12 0.08 0.13 Men 0.62 (0.59 – 0.65) 0.64 (0.61 – 0.66) 0.46 0.36 - Women 0.60 (0.52 – 0.63) 0.63 (0.59 – 0.66) 0.22 0.32 - Values as median (interquartile interval). p: Control group vs.Hyperuricemia group. p*: Control group vs.Hyperuricemia group, after adjustment for age. p**: Control group vs.Hyperuricemia group, after adjustment for age and sex. compared to those without this condition, presented higher BMI, higher oxidative stress status, and worse endothelial function even after adjustments for potential confounders. In correlation analysis, after controlling for confounders, SUA levels were positively associated with BMI, WC, MDA, TG and LDL-cholesterol; and negatively correlated with HDL‑cholesterol, adiponectin and RHI. Previous cross-sectional studies have also observed a direct association between SUA and parameters of total and/or central body adiposity in individuals presenting different characteristics, such as obese postmenopausal women, 16 patients with type 2 diabetes 17,18 and individuals aged 18-70 years without type 1 or 2 diabetes. 3 Accordingly, epidemiological longitudinal studies carried out in the general population, reported an association of higher levels of SUA and an increased risk of overweight/obesity. 19 The mechanisms responsible for the relationship between elevated SUA and higher body adiposity are not completely understood. One possible explanation rests on the intake of fructose. The excessive consumption of fructose (via added sucrose or high-fructose corn syrup) stands as one of the dietary causes of hyperuricemia. 20 There is evidence that fructose causes intracellular ATP depletion, nucleotide turnover, and generation of uric acid. The fructose-induced uric acid generation causes mitochondrial oxidative stress which can in turn, favor fat accumulation. 21,22 Experimental studies also suggest that fructose intake may facilitate the development of overweight/obesity through other mechanisms, such as alteration in satiety and increase in food intake. 20,22 Conversely, there are studies indicating that adipose tissue possesses abundant xanthine oxidoreductase activity (similar to liver) and is capable of generating and secreting uric acid: a property which is enhanced in obesity. 23 836