Novel pathological implications of serum uric acid with cardiovascular disease risk in obesity

Aims: This cohort study intended to elucidate the association between serum uric acid (SUA) levels and car-diovascular disease events in Japanese patients with obesity.Methods: Altogether, 450 obese Japanese outpatients were enrolled in a multicenter prospective cohort Japan, the Japan Obesity and Metabolic Syndrome Study. Primary analysis regarding the measurements of cardiovas-cular risk factors, including SUA levels, and the occurrence of macrovascular complications was based on following the participants over a 5-year period.Results: Of the eligible patients, 335 (74.4%) were followed into the fifth year. During the study period, 15 coronary heart disease, 7 stroke, and 6 arteriosclerosis obliterans events occurred in 39 patients. The CVD incidence rate was 15.8 per 1000 person-years. In the analysis of adjusted models for traditional risk factors, hyperuricemia was a significant factor for the incidence of CVD events, especially in female obese patients. Additionally, we estimated the association between SUA levels and CVD events using cubic spline models, which showed a U-shaped association in both male and female patients.Conclusions: SUA is an effective predictor of CVD events in female obese patients and a risk factor for CVD incident in obese patients.