Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study

Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study

Abstract Background Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributes to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipopr...

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Main Authors: Elisa Russo, Francesca Viazzi, Roberto Pontremoli, Fabio Angeli, Carlo Maria Barbagallo, Bruno Berardino, Michele Bombelli, Federica Cappelli, Edoardo Casiglia, Rosario Cianci, Michele Ciccarelli, Arrigo F. G. Cicero, Massimo Cirillo, Pietro Cirillo, Lanfranco D’Elia, Giovambattista Desideri, Claudio Ferri, Ferruccio Galletti, Loreto Gesualdo, Cristina Giannattasio, Guido Grassi, Guido Iaccarino, Egidio Imbalzano, Luciano Lippa, Francesca Mallamaci, Alessandro Maloberti, Stefano Masi, Maria Masulli, Alberto Mazza, Alessandro Mengozzi, Maria Lorenza Muiesan, Pietro Nazzaro, Paolo Palatini, Gianfranco Parati, Fosca Quarti-Trevano, Marcello Rattazzi, Gianpaolo Reboldi, Giulia Rivasi, Massimo Salvetti, Valerie Tikhonoff, Giuliano Tocci, Andrea Ungar, Paolo Verdecchia, Agostino Virdis, Massimo Volpe, Claudio Borghi, Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA)
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Lipids in Health and Disease
Subjects:
TG/HDL-C ratio
Triglycerides
Insulin-resistance
Uric acid
Kidney function
Cardiovascular mortality
Online Access:https://doi.org/10.1186/s12944-025-02440-w
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Summary:Abstract Background Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributes to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been proposed as an easily obtainable marker for IR. This research aimed to investigate the interaction between IR and glomerular filtration rate (GFR)-adjusted uricemia (SUA/GFR ratio) in determining CV risk in a large population cohort study. Methods Data from 18,694 subjects were analyzed from Uric acid Right foR heArt Healt (URRAH) database. The study evaluated the association between TG/HDL-C ratio and SUA/GFR ratio, as well as their impact on the development of outcomes during the follow-up study period. The primary endpoint was CV mortality. Results After a mean follow-up of 124 ± 64 months, 2,665 (14.2%) CV deaths occurred. The incidence of fatal and non-fatal CV events increased in parallel with the increase of TG/HDL-C quintiles. TG/HDL-C ratio showed a positive association with increasing of SUA/GFR ratio, even in non-diabetic patients. Multivariate analysis showed that the TG/HDL-C ratio increases the mortality risk even after adjustment for potential confounding factors. Finally, IR and GFR-adjusted hyperuricemia showed an additive effect on CV mortality. Conclusions Both IR and SUA/GFR ratio independently predict CV mortality, regardless of age, gender, BMI, diabetes, hypertension and statin use. The joint effect of the TG/HDL-C ratio and the elevated SUA/GFR ratio was greater than the presence of each single risk factor on CV mortality. This highlights the importance of monitoring these markers to better assess cardiovascular risk.
ISSN:1476-511X

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