Factor associated with hyperuricemia development during a 25 years follow-up: the pamela study

Objective: HyperUricemia (HU) has been associated with future fatal and non fatal CV events as well as with hypertension and metabolic syndrome development. However, only few data exist regarding the change in Uric Acid (UA) and the development of HU during a population follow-up. In particular, no study analyzed the variations during a very long follow-up. The present study was aimed at evaluating the factors associated with UA changes and HU development during a 25-years follow-up in the PAMELA study. Both the classic cut-off for hyperuricemia and the newly one identified by the Uric Acid Right for Heart Health (URRAH) study were used to define HU. Design and method: We analyzed data collected in 561 subjects of the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study with available SUA who complete the 3rd wave study (mean follow-up time 25.2 ± 0.5 years). The classic cut-off of 6/7 mg/dL (females and males respectively) and URRAH one (5.1/5.6 mg/dL for females and males) were used for HU definitions. Results: Mean UA value during follow-up increase from 4.7 ± 1.1 to 5.0 ± 1.2 mg/dL (p < 0.001) with a mean increase of 0.3 ± 1.1 mg/dL. UA changes significanlty correlated with baseline UA (r = -0.39, p < 0.001) and creatinine (r = -0 - 21, p < 0.001). With the classic cut-off (6/7 mg/dL) 9.1% of the subjects develop HU and this was associated at the multivariate model with age, sex (male), baseline diastolic Blood Pressure (BP) (OR 1.038, p = 0.02) and UA (OR 2.62, p < 0.001). With the new URRAH cut-off 19.1% of the subjects develop HU. At the multivariate model variables associated were gender (male) and baseline 24h systolic BP (OR 1.05, p < 0.001), tryglicerides (OR 1.01, p = 0.01) and UA (4.99, p < 0.001). Conclusions: The present study provide evidence that in the PAMELA study during the 25 year follow-up there is a progressive increase in UA. Baseline UA is the most important factor associated with HU development. However, also age, gender, triglycerides and BP could help to identify subjects that most probably will develop HU.