Mediating Effect of Metabolic Diseases on the Relationship between Hyperuricemia and Coronary Heart Disease

Published:November 15, 2022DOI:
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      • Elevated uric acid is an important risk factor for cardiovascular diseases.
      • Metabolic diseases may meditate the process from hyperuricemic prevalent to coronary heart disease incidence.
      • Control uric acid may benefit both metabolic diseases and cardiovascular diseases.


      Background and Aims

      Studies have shown that elevated serum uric acid (SUA) may increase the risk of coronary heart disease (CHD). However, it was still disputable how mediate effects between metabolic diseases and hyperuricemia affect the incidence of CHD. This study aimed to explore whether metabolic diseases may mediate the connection from hyperuricemia at baseline to the elevated incidence risk of CHD during follow-ups.

      Methods and Results

      Based on the Jinchang cohort, 48 001 subjects were followed for 9 years between June 2011 and December 2019. Multivariate-adjusted Cox regression models were applied to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). Significantly increased risks of CHD were observed in hyperuricemia (HR:1.46, 95%CI:1.28, 1.67) when compared with normouricemia population. The mediating effect model further demonstrated that metabolic diseases could mediate the association between hyperuricemia and CHD pathogenesis, partially for the combined metabolic diseases with mediation effects of 45.12%, 25.24% for hypertension, 28.58% for overweight or obese status, 29.05% for hypertriglyceridemia, 6.70% for hypercholesterolemia, 3.52% for low high density lipoprotein cholesterol (HDL-C), and 6.51% for high low density lipoprotein cholesterol (LDL-C), respectively.


      Hyperuricemia significantly increased the risk of incident CHD, and this association was partly mediated by metabolic diseases.



      CHD (Coronary heart disease), SUA (Serum uric acid), FPG (Fasting plasma glucose), BMI (Body mass index), HDL-C (High density lipoprotein cholesterol), LDL-C (Low density lipoprotein cholesterol), ICD-10 (International Classification of Diseases 10th revision), HR (Hazard ratio), CI (Confidence interval)
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