Prothrombotic State and Cardiovascular Risk in Hyperuricaemic Individuals: Does Hyperglycaemia Play a Role? A Case-control Study

Abstract

ABSTRACT Introduction: The role of Hyperuricaemia (HU) in pathogenesis of cardiovascular disorders is debated. A number of hypothetical mechanisms that link HU to increased cardiovascular risk are researched. Aim: To evaluate the hypercoagulable state and cardiovascular risk in diabetic hyperuricaemics, nondiabetic hyperuricaemics in comparison to healthy controls, and to analyse whether chronic hyperglycaemia has a causal role in HU associated cardiovascular risk. Materials and Methods: A case-control study was conducted in which 60 known hyperuricaemic cases and 30 healthy controls were included in the study. Cases were further divided into nondiabetic hyperuricaemic and diabetic-hyperuricaemic subgroups. Routine blood biochemistry including high sensitivity C-Reactive Protein (hs-CRP), Plasminogen Activator Inhibitor-1 (PAI-1) and lipid profile was performed to assess endothelial function and hypercoagulability. Data were expressed as Mean±SEM. Results: Levels of hs-CRP and PAI-1 were significantly higher in diabetic hyperuricaemics (p<0.001) and nondiabetic hyperuricaemics (p<0.001) compared to controls. The difference was not significant between the hyperuricaemic subgroups. Serum Uric Acid (UA) levels showed a significantly positive correlation with hs-CRP (r=0.554, p<0.001) and PAI-1 (r=0.525, p=0.003) levels among the cases. Association between UA and glucose was not significant in diabetic hyperuricaemics (r=0.270, p=0.15). Conclusion: HU is associated with endothelial dysfunction and prothrombotic state leading to increased cardiovascular risk. Hyperglycaemia does not have a direct causal role in HU associated cardiovascular risk.

Keywords

• cardiovascular morbidity
• endothelial dysfunction
• hyperglycaemics