• NEWS . 23 Mar 2020
  • Swedish cohort shows gender differences in relation to hyperuricaemia and subclinical atherosclerosis

  • Hyperuricaemia is closely associated with cardiovascular disease (CVD), but whether this association is independent of traditional cardiovascular risk factors (CVRFs), and whether it is gender-dependent, remains unclear. In view of this, a sex-stratified, population-based cohort study set out to determine the relationship between serum urate (SU) concentration and subclinical atherosclerosis, as measured by the coronary artery calcification (CAC) score, common carotid intima-media thickness (CIMT) and carotid plaque score. This pilot cohort is part of the large population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) with 30,000 participants aged 50–64 years, which is aimed at improving CVD risk prediction.

    The cohort involved a total of 1,040 participants aged 50–64 years; 48.8% were male. Of these, 68 with self-reported previous history of CVD and three with gout were excluded. The CAC score was assessed with the Agatston method using computed tomography; CIMT and carotid plaques were quantified by ultrasound.

    No significant differences were seen between males and females with respect to age, body mass index (BMI), education level, smoking, physical activity, high-sensitivity C-reactive protein (hs-CRP), hypertension and dyslipidaemia. However, both CAC (score >0) and diabetes were twice as common in men as in women (58% vs 26% and 8% vs 4%, respectively). For both sexes, higher SU quartiles were associated with BMI, hs-CRP and the prevalence of hypertension; although in women, they were also associated with the prevalence of dyslipidaemia. After adjusting for CVRFs, the three upper quartiles of SU (>308 μmol/L) were linked to higher CAC scores in men but not in women. Neither CIMT nor carotid plaques showed any correlation to SU in either sex.

    Taken together, these results suggest that differences in the biological effects of SU exist between men and women, or that SU has varying effects on different vascular beds or during the different stages of the atherosclerotic process.

    Drivelegka P, et al. Association between serum level of urate and subclinical atherosclerosis: results from the SCAPIS Pilot. Arthritis Res Ther 2020;22:37.