Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: Insights from the I-DEMAND study F. Viazzi a, *, D. Garneri a , G. Leoncini a , A. Gonnella a , M.L. Muiesan b , E. Ambrosioni c , F.V. Costa c , G. Leonetti d , A.C. Pessina e , B. Trimarco f , M. Volpe g,h , E. Agabiti Rosei b , G. Deferrari a , R. Pontremoli a a Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy b Department of Internal Medicine, University of Brescia, Brescia, Italy c Department of Internal Medicine, University of Bologna, Bologna, Italy d Istituto Auxologico Italiano, Ospedale S. Luca, Milan, Italy e Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy f Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy g Cardiology Division, Department of Clinical and Molecular Medicine, University of Rome ‘Sapienza’, Rome, Italy h IRCCS Neuromed, Pozzilli (IS), Italy Received 9 October 2013; received in revised form 7 January 2014; accepted 22 January 2014 Available online --- KEYWORDS Uric acid; Hypertension; Metabolic syndrome; Cardiovascular risk; Chronic kidney disease Abstract Background and aims: The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensive patients with a high prevalence of diabetes. Methods and results: A total of 2429 patients (mean age 62  11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73 m 2 or as the presence of microalbuminuria (albumin-to-creat- inine ratio 2.5 mg/mmol in men and 3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respec- tively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95% CI 1.03 e1.18; P Z 0.0060; OR 1.28, 95% CI 1.15 e1.42; P < 0.0001). These associations were stronger in patients without diabetes and with normal renal function. Conclusions: Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensive patients under specialist care. Intervention trials are needed to inves- tigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk. ª 2014 Elsevier B.V. All rights reserved. * Corresponding author. Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera, Universitaria San Martino-IST, Genoa, Viale Benedetto XV, 6 CAP 16132, Italy. Tel./fax: þ39 (0) 10 3538932. E-mail address: francesca.viazzi@unige.it (F. Viazzi). Please cite this article in press as: Viazzi F, et al., Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: Insights from the I-DEMAND study, Nutrition, Metabolism & Cardiovascular Diseases (2014), http://dx.doi.org/10.1016/j.numecd.2014.01.018 0939-4753/$ - see front matter ª 2014 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.numecd.2014.01.018 Nutrition, Metabolism & Cardiovascular Diseases (2014) xx,1e 7 Available online at www.sciencedirect.com Nutrition, Metabolism & Cardiovascular Diseases journal homepage: www.elsevier.com/locate/nmcd