Serum Uric Acid Levels Are Associated with the Echogenic Features of Carotid Plaque Vulnerability in Elderly Patients with Atherosclerotic Disease

Author:

Mastroiacovo Daniela1,Ettorre Evaristo2,Mengozzi Alessandro345ORCID,Virdis Agostino3,Camerota Antonio6,Muselli Mario6,Necozione Stefano6,Bocale Raffaella7,Ferri Claudio6,Desideri Giovambattista6ORCID

Affiliation:

1. Angiology Unit, Medical Department, “SS. Filippo and Nicola” Hospital, 67051 L’Aquila, Italy

2. Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy

3. Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy

4. Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, Zurich University Hospital, University of Zurich, 8952 Schlieren, Switzerland

5. Institute of Life Sciences, Scuola Superiore Sant’Anna, 56126 Pisa, Italy

6. Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy

7. Division of Endocrine Surgery, Agostino Gemelli University Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Catholic University of the Sacred Heart, 00168 Rome, Italy

Abstract

Uric acid is a marker of inflammation and a risk factor for atherosclerosis that has been suggested to play a role in carotid plaque instability. Reduced atherosclerotic plaque echogenicity at ultrasound examination is associated with alarming histopathological features and inflammation. In this study, we investigated the relationship between serum uric acid (SUA) levels and echogenic patterns of plaque instability in elderly subjects with carotid atherosclerosis. Since uric acid metabolism largely depends on renal function, SUA levels were indexed for serum creatinine levels (SUA/SCr). We enrolled 108 patients aged 65 years or more (72.7 ± 5.9 years; 50 females and 58 males) who underwent carotid duplex ultrasound to evaluate plaque echogenicity by greyscale median (GSM). The regression analysis demonstrated a significant inverse association between the GSM and the SUA/SCr ratio (β: −0.567; 95% CI −0.751 to −0.384 and p < 0.0001). Stepwise multivariate regression showed that the SUA/SCr ratio explained 30.3% of GSM variability (β: −0.600; 95% CI −0.777/−0.424, p < 0.0001, and semi-partial correlation 0.303). After a mean period of 3.5 ± 0.5 years, 48 patients were reevaluated according to the same baseline study protocol. The regression analysis demonstrated a still significant inverse association between the GSM and the SUA/SCr ratio (β: −0.462; 95% CI −0.745 to −0.178 and p = 0.002). Stepwise multivariate regression showed that the SUA/SCr ratio explained 28.0% of GSM variability (coefficient −0.584, 95% CI −0.848/−0.319, p < 0.0001, and semi-partial R2 0.280). In conclusion, this study demonstrates that SUA levels indexed for serum creatinine are associated with the echogenic features of carotid plaque vulnerability in elderly patients with atherosclerotic disease. These data could suggest an influential role for uric acid metabolism in carotid plaque biology.

Publisher

MDPI AG

Subject

Molecular Biology,Biochemistry,Endocrinology, Diabetes and Metabolism

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