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 5 – Correlations between serum levels of uric acid and biochemical variables, reactive hyperemia index and blood pressure (n = 149) Correlation Partial correlation* r p r p Anthropometric Parameters Body mass index (kg/m 2 ) 0.39 < 0.0001 0.30 0.0003 Waist circumference (cm) 0.43 < 0.0001 0.26 0.001 Metabolic Variables Glucose (mg/dL) 0.21 0.01 0.25 0.08 Insulin (µU/mL) 0.01 0.94 0.03 0.82 HOMA-IR 0.07 0.62 0.07 0.64 Total cholesterol (mg/dL) 0.22 0.01 0.14 0.10 HDL-cholesterol (mg/dL) -0.42 < 0.0001 -0.28 0.0007 LDL-cholesterol (mg/dL) 0.29 0.0003 0.19 0.02 Triglycerides (mg/dL) 0.35 < 0.0001 0.21 0.01 Inflammatory Profile Hs-CRP (mg/L) 0.11 0.23 0.16 0.10 Adiponectin (mg/mL) -0.40 0.0005 -0.25 0.03 Oxidative Stress Malondialdehyde(ng/mL) 0.28 0.04 0.31 0.03 Endothelial Function Reactive hyperemia index -0.27 0.01 -0.25 0.02 Blood Pressure Systolic BP (mmHg) 0.32 0.0001 0.16 0.06 Diastolic BP (mmHg) 0.24 0.003 0.16 0.11 HOMA-IR, homeostasis model assessment of insulin resistance; HDL: high density lipoprotein; LDL: low density lipoprotein; Hs-CRP: high-sensitivity C-reactive protein; BP: blood pressure. * After adjustment for age and sex (for the partial correlations with body mass index and waist circumference) or after adjustment for age, sex and body mass index (for the other variables). endothelial dysfunction through the reduction of nitric oxide bioavailability. 29 There is evidence that SUA can also decrease nitric oxide production via others mechanisms. 38 The strength of this study relies on the careful selection of participants, excluding individuals with characteristics that might influence SUA levels, as well as the metabolic and vascular markers evaluated here. For example, exclusions encompassed postmenopausal women and elderly, patients taking any type of medications (including diuretics), and those with hypertension, diabetes or chronic renal disease. 40 It is not clear whether increased SUA is a causative agent or is simply a marker of CVD. The present study provides the information that even in healthy young and middle aged adults SUA is directly associated with oxidative stress and with metabolic and vascular alterations that may increase the risk of CVD. The limitation of this study is the cross-sectional design, implying that causality is not likely to be determined. Conclusions The results obtained in this study suggest that in healthy young and middle-aged adults, higher serum levels of uric acid are associated with excessive body adiposity, worse lipid profile, oxidative stress, inflammation and impaired endothelial function. Author contributions Conception and design of the research: Ferreira TS, Fernandes JFR, Araújo LS, Nogueira LP, Leal PM, Antunes VP, Kaiser SE, Klein MRST; Acquisition of data: Ferreira TS, Fernandes JFR, Araújo LS, Nogueira LP, Leal PM, Antunes VP, Rodrigues MLG, Valença DCT; Analysis and interpretation of the data and Writing of the manuscript: Ferreira TS, Fernandes JFR, Araújo LS, Nogueira LP, Leal PM, Antunes VP, Rodrigues MLG, Valença DCT, Kaiser SE, Klein MRST; Statistical analysis: Kaiser SE, Klein MRST; Obtaining financing: Klein MRST; Critical revision of the manuscript for intellectual content: Ferreira TS, Fernandes JFR, Araújo LS, Kaiser SE, Klein MRST. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. 838