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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2025-01-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-025-02440-w |
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| author | 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) |
| author_facet | 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) |
| author_sort | Elisa Russo |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4ad352f5fff04315b31b5e8975299260 |
| institution | Kabale University |
| issn | 1476-511X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Lipids in Health and Disease |
| spelling | doaj-art-4ad352f5fff04315b31b5e89752992602025-01-26T12:50:35ZengBMCLipids in Health and Disease1476-511X2025-01-0124111110.1186/s12944-025-02440-wPredictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH studyElisa Russo0Francesca Viazzi1Roberto Pontremoli2Fabio Angeli3Carlo Maria Barbagallo4Bruno Berardino5Michele Bombelli6Federica Cappelli7Edoardo Casiglia8Rosario Cianci9Michele Ciccarelli10Arrigo F. G. Cicero11Massimo Cirillo12Pietro Cirillo13Lanfranco D’Elia14Giovambattista Desideri15Claudio Ferri16Ferruccio Galletti17Loreto Gesualdo18Cristina Giannattasio19Guido Grassi20Guido Iaccarino21Egidio Imbalzano22Luciano Lippa23Francesca Mallamaci24Alessandro Maloberti25Stefano Masi26Maria Masulli27Alberto Mazza28Alessandro Mengozzi29Maria Lorenza Muiesan30Pietro Nazzaro31Paolo Palatini32Gianfranco Parati33Fosca Quarti-Trevano34Marcello Rattazzi35Gianpaolo Reboldi36Giulia Rivasi37Massimo Salvetti38Valerie Tikhonoff39Giuliano Tocci40Andrea Ungar41Paolo Verdecchia42Agostino Virdis43Massimo Volpe44Claudio Borghi45Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA)Dipartimento Di Medicina Interna E Specialita Mediche, Università Degli Studi Di GenovaDipartimento Di Medicina Interna E Specialita Mediche, Università Degli Studi Di GenovaDipartimento Di Medicina Interna E Specialita Mediche, Università Degli Studi Di GenovaUniversità Degli Studi Dell’InsubriaDipartimento Di Promozione Della Salute, Materno-Infantile, Di Medicina Interna E Specialistica “G. D’Alessandro” (PROMISE), Università Degli Studi Di PalermoUniversità Degli Studi Dell’Aquila Dipartimento Di Medicina Clinica Sanità Pubblica Scienze Della Vita E Dell’AmbienteDipartimento Di Medicina E Chirurgia, Università Milano-BicoccaDipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di PisaDipartimento Di Medicina, Università Degli Studi Di PadovaDipartimento Di Medicina Traslazionale E Di Precisione, Università Degli Studi Di Roma La SapienzaDipartimento Di Medicina Chirurgia E Odontoiatria Scuola Medica Salernitana, Università Degli Studi Di SalernoDipartimento Di Scienze Mediche E Chirurgiche, Università Degli Studi Di BolognaDipartimento Di Medicina Chirurgia E Odontoiatria - Scuola Medica Salernitana, Università Degli Studi Di SalernoDipartimento Dell’Emergenza E Dei Trapianti Di Organi, Università Degli Studi Di Bari Aldo MoroDipartimento Di Medicina Clinica E Chirurgia, Università Degli Studi Di Napoli Federico IIDipartimento Di Scienze Cliniche Internistiche Anestesiologiche E Cardiovascolari, Università Degli Studi Di Roma La SapienzaUniversità Degli Studi Dell’Aquila Dipartimento Di Medicina Clinica Sanità Pubblica Scienze Della Vita E Dell’AmbienteDipartimento Di Medicina Clinica E Chirurgia, Università Degli Studi Di Napoli Federico IIDipartimento Dell’Emergenza E Dei Trapianti Di Organi, Università Degli Studi Di Bari Aldo MoroASST Grande Ospedale Metropolitano Niguarda De Gasperis Cardio CenterScuola Di Medicina E Chirurgia, Università Degli Studi Di Milano-BicoccaDipartimento Di Medicina Clinica E Chirurgia, Università Degli Studi Di Napoli Federico IIDipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di MessinaSocietà Italiana Medici Di Medicina GeneraleAzienda Ospedaliera Bianchi-Melacrino-MorelliASST Grande Ospedale Metropolitano Niguarda De Gasperis Cardio CenterDipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di PisaDipartimento Di Medicina Clinica E Chirurgia, Università Degli Studi Di Napoli Federico IIOspedale Santa Maria Della MisericordiaDipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di PisaDipartimento Di Scienze Cliniche E Sperimentali, Università Degli Studi Di BresciaDipartimento Di Medicina Di Precisione E Rigenerativa E Area Jonica, Università Degli Studi Di Bari Aldo MoroDipartimento Di Medicina, Università Degli Studi Di PadovaIstituto Auxologico Italiano Istituto Scientifico San LucaScuola Di Medicina E Chirurgia, Università Degli Studi Di Milano-BicoccaDepartment of Medicine-DIMED, Medicina Interna 1°, Ca’ Foncello, Università Di PadovaDipartimento Di Medicina E Chirurgia, Università Degli Studi Di PerugiaAzienda Ospedaliero Universitària CareggiDipartimento Di Scienze Cliniche E Sperimentali, Università Degli Studi Di BresciaDipartimento Di Medicina, Università Degli Studi Di PadovaDipartimento Di Medicina Clinica E Molecolare, Università Degli Studi Di Roma La SapienzaAzienda Ospedaliero Universitària CareggiAzienda Ospedaliera Di PerugiaDipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di PisaDipartimento Di Medicina Clinica E Molecolare, Università Degli Studi Di Roma La SapienzaDipartimento Di Scienze Mediche E Chirurgiche, Università Degli Studi Di BolognaAbstract 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.https://doi.org/10.1186/s12944-025-02440-wTG/HDL-C ratioTriglyceridesInsulin-resistanceUric acidKidney functionCardiovascular mortality |
| spellingShingle | 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) Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study Lipids in Health and Disease TG/HDL-C ratio Triglycerides Insulin-resistance Uric acid Kidney function Cardiovascular mortality |
| title | Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study |
| title_full | Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study |
| title_fullStr | Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study |
| title_full_unstemmed | Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study |
| title_short | Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study |
| title_sort | predictive value of tg hdl c and gfr adjusted uric acid levels on cardiovascular mortality the urrah study |
| topic | TG/HDL-C ratio Triglycerides Insulin-resistance Uric acid Kidney function Cardiovascular mortality |
| url | https://doi.org/10.1186/s12944-025-02440-w |
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