Horm Metab Res
DOI: 10.1055/a-2299-2914
Original Article: Endocrine Care
1
Department of Endocrinology, Affiliated Kunshan Hospital of Jiangsu
University, Kunshan, China
,
Menghuan Wu
2
Department of Cardiology, Xuyi People's Hospital, Xuyi,
China
,
Han Yan
3
Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu
University, Wujin Clinical College of Xuzhou Medical University, Changzhou,
China
,
Shao Zhong
1
Department of Endocrinology, Affiliated Kunshan Hospital of Jiangsu
University, Kunshan, China
,
Ruijun Xu
3
Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu
University, Wujin Clinical College of Xuzhou Medical University, Changzhou,
China
,
Zhiyong Zhao
3
Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu
University, Wujin Clinical College of Xuzhou Medical University, Changzhou,
China
,
Qichao Yang
3
Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu
University, Wujin Clinical College of Xuzhou Medical University, Changzhou,
China
› Author Affiliations
Funding Information
The Science and Technology Project of Changzhou Health Commission — WZ202226
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Abstract
Remnant cholesterol (RC) is closely related to metabolic diseases. Our study aims
to explore the relationship between RC and hyperuricemia. This cross-sectional
study included 14 568 adults aged 20 years or older from the National Health and
Nutrition Examination Survey (NHANES) conducted between 2007 and 2018 in the
United States. RC is calculated by subtracting high-density lipoprotein
cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) from total
cholesterol (TC). Hyperuricemia is defined by serum uric acid (SUA)
levels≥7 mg/dl in men and≥6 mg/dl in women. The independent association between
RC and hyperuricemia was evaluated. As the quartile range of RC levels
increases, the prevalence of hyperuricemia also rises (7.84% vs. 13.71% vs.
18.61% vs. 26.24%, p<0.001). After adjusting for confounding factors, the
fourth quartile of RC was associated with an increased risk of hyperuricemia
compared with the first quartile (OR=2.942, 95% CI 2.473–3.502, p<0.001).
Receiver Operating Characteristic (ROC) analysis shows that RC outperforms other
single lipid indices in hyperuricemia. Further Restricted Cubic Splines (RCS)
analysis suggests a nonlinear relationship between RC levels and hyperuricemia.
Elevated RC levels were found to be linked to hyperuricemia. Further studies on
RC hold promise for both preventing and addressing hyperuricemia.
Keywords
remnant cholesterol -
hyperuricemia -
NHANES -
population-based study -
nonlinear relationship
Publication History
Received: 06 March 2024
Accepted after revision: 03 April 2024
Accepted Manuscript online:
03 April 2024
Article published online:
02 May 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
References
1
Maiuolo J,
Oppedisano F,
Gratteri S.
et al.
Regulation of uric acid metabolism and excretion. Int J Cardiol 2016; 213: 8-14
2
Dehlin M,
Jacobsson L,
Roddy E.
Global epidemiology of gout: prevalence, incidence, treatment patterns and risk
factors. Nat Rev Rheumatol 2020; 16: 380-390
3
Stamp LK,
Chapman PT.
Gout and its comorbidities: implications for therapy. Rheumatology (Oxford) 2013; 52: 34-44
4
Crawley WT,
Jungels CG,
Stenmark KR.
et al.
U-shaped association of uric acid to overall-cause mortality and its impact on
clinical management of hyperuricemia. Redox Biol 2022; 51: 102271
5
Bardin T,
Richette P.
Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and
treatment options. BMC Med 2017; 15: 123
6
Oral A,
Sahin T,
Turker F.
et al.
Relationship between serum uric acid levels and nonalcoholic fatty liver disease
in non-obese patients. Medicina (Kaunas) 2019; 55: 600
7
Ahn JK.
Epidemiology and treatment-related concerns of gout and hyperuricemia in
Korean. J Rheum Dis 2023; 30: 88-98
8
Stürzebecher PE,
Katzmann JL,
Laufs U.
What is 'remnant cholesterol'?. Eur Heart J 2023; 44: 1446-1448
9
Wadström BN,
Wulff AB,
Pedersen KM.
et al.
Remnant cholesterol in the era of intensive lipid-lowering therapies. Eur Heart J 2023; 44: 3483
10
Mach F,
Baigent C,
Catapano AL.
et al.
2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid
modification to reduce cardiovascular risk. Eur Heart J 2020; 41: 111-188
11
Quispe R,
Martin SS,
Michos ED.
et al.
Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a
primary prevention study. Eur Heart J 2021; 42: 4324-4332
12
Hu X,
Liu Q,
Guo X.
et al.
The role of remnant cholesterol beyond low-density lipoprotein cholesterol in
diabetes mellitus. Cardiovasc Diabetol 2022; 21: 117
13
Chen J,
Su Y,
Su X.
et al.
Remnant cholesterol has a non-linear association with non-alcoholic fatty liver
disease. Diabetes Res Clin Pract 2023; 201: 110733
14
Zou Y,
Kuang M,
Zhong Y.
et al.
Remnant cholesterol can identify individuals at higher risk of metabolic
syndrome in the general population. Sci Rep 2023; 13: 5957
15
Zou Y,
Lan J,
Zhong Y.
et al.
Association of remnant cholesterol with nonalcoholic fatty liver disease: a
general population-based study. Lipids Health Dis 2021; 20: 139
16
Fang Y,
Mei W,
Wang C.
et al.
Dyslipidemia and hyperuricemia: a cross-sectional study of residents in Wuhu,
China. BMC Endocr Disord 2024; 24: 2
17
Feig DI,
Kang DH,
Johnson RJ.
Uric acid and cardiovascular risk. N Engl J Med 2008; 359: 1811-1821
18
Levey AS,
Stevens LA,
Schmid CH.
et al.
A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-612
19
Cheng J,
Sun J,
Yao K.
et al.
A variable selection method based on mutual information and variance inflation
factor. Spectrochim Acta A Mol Biomol Spectrosc 2022; 268: 120652
20
Sascău R,
Clement A,
Radu R.
et al.
Triglyceride-rich lipoproteins and their remnants as silent promoters of
atherosclerotic cardiovascular disease and other metabolic disorders: a
review. Nutrients 2021; 13: 1774
21
Jørgensen AB,
Frikke-Schmidt R,
West AS.
et al.
Genetically elevated non-fasting triglycerides and calculated remnant
cholesterol as causal risk factors for myocardial infarction. Eur Heart J 2013; 34: 1826-1833
22
Sandesara PB,
Virani SS,
Fazio S.
et al.
The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic
cardiovascular disease risk. Endocr Rev 2019; 40: 537-557
23
Huang H,
Xie J,
Zeng Y.
et al.
Remnant cholesterol independently Ppredicts the development of nonalcoholic
fatty liver disease. J Clin Endocrinol Metab 2023; 108: 2907-2915
24
Szili-Torok T,
Sokooti S,
Osté MCJ.
et al.
Remnant lipoprotein cholesterol is associated with incident new onset diabetes
after transplantation (NODAT) in renal transplant recipients: results of the
TransplantLines Biobank and cohort Studies. Cardiovasc Diabetol 2022; 21: 41
25
Pillinger MH,
Bangalore S,
Klein AB.
et al.
Cardiovascular disease and gout: real-world experience evaluating patient
characteristics, treatment patterns, and health care utilization. J Manag Care Spec Pharm 2017; 23: 677-683
26
Hu X,
Rong S,
Wang Q.
et al.
Association between plasma uric acid and insulin resistance in type 2 diabetes:
a Mendelian randomization analysis. Diabetes Res Clin Pract 2021; 171: 108542
27
Ohnishi H,
Saitoh S,
Takagi S.
et al.
Relationship between insulin-resistance and remnant-like particle
cholesterol. Atherosclerosis 2002; 164: 167-170
28
Shalaurova I,
Connelly MA,
Garvey WT.
et al.
Lipoprotein insulin resistance index: a lipoprotein particle-derived measure of
insulin resistance. Metab Syndr Relat Disord 2014; 12: 422-429
29
Garvey WT,
Kwon S,
Zheng D.
et al.
Effects of insulin resistance and type 2 diabetes on lipoprotein subclass
particle size and concentration determined by nuclear magnetic resonance. Diabetes 2003; 52: 453-462
30
Taskinen MR.
Diabetic dyslipidaemia: from basic research to clinical practice. Diabetologia 2003; 46: 733-749
31
Haas ME,
Attie AD,
Biddinger SB.
The regulation of ApoB metabolism by insulin. Trends Endocrinol Metab 2013; 24: 391-397
32
Song Y,
Liu J,
Zhao K.
et al.
Cholesterol-induced toxicity: an integrated view of the role of cholesterol in
multiple diseases. Cell Metab 2021; 33: 1911-1925
33
Conen D,
Wietlisbach V,
Bovet P.
et al.
Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular
risk factors in a developing country. BMC Public Health 2004; 4: 9
34
Deedwania PC,
Stone PH,
Fayyad RS.
et al.
Improvement in renal function and reduction in serum uric acid with intensive
statin therapy in older patients: a post hoc analysis of the SAGE trial. Drugs Aging 2015; 32: 1055-1065
35
Akbari A,
Razmi M,
Rafiee M.
et al
The effect of statin therapy on serum uric acid levels: a systematic review and
meta-analysis. Curr Med Chem 2023; DOI:
10.2174/0929867330666230207124516.
36
Zhou S,
Wu L,
Si H.
et al.
Longitudinal association between uric acid and incident sarcopenia. Nutrients 2023; 15: 3097
37
Tarantino G,
Sinatti G,
Citro V.
et al.
Sarcopenia, a condition shared by various diseases: can we alleviate or delay
the progression?. Intern Emerg Med 2023; 18: 1887-1895
38
Bi B,
Dong X,
Yan M.
et al.
Dyslipidemia is associated with sarcopenia of the elderly: a meta-analysis. BMC Geriatr 2024; 24: 181
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