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Metabolites
Special Issues
Exploring Uric Acid and Beyond
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Exploring Uric Acid and Beyond

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 3977

Special Issue Editors

Dr. Pietro Cirillo

E-Mail Website
Guest Editor
1. Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Aldo Moro, 70122 Bari, Italy
2. Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
Interests: diabetes; hypertension; uric acid; chronic kidney disease
Prof. Dr. Claudio Borghi

E-Mail Website
Guest Editor
Atherosclerosis and Metabolic Disease Study Center, University of Bologna, 40138 Bologna, Italy
Interests: cholesterol; hypertension; uric acid; cardiovascular risk factors; cardiovascular prevention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Serum uric acid (UA) is a clear and an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke, and heart failure. Moreover, a high UA level is a risk factor for the new onset and progression of chronic kidney disease (CKD). The relationship between hyperuricemia and CKD is bidirectional and intriguing; to address this, the Uric Acid Right for Heart Health (URRAH) project by the Working Group on Uric Acid and CV Risk of the Italian Society of Hypertension has tried to determine this intricated relationship. In the CKD field, the new therapeutic era of the sGLT2i, with its uricosuric effects, has allowed new stimulating research inputs into the management of the UA-CKD interplay. New and interesting insights into the correlation between hyperuricemia and metabolic derangement have been emerging from extended research papers that have clarified that the UA is a causative pathologic element of metabolic syndrome, diabetes, obesity, and dyslipidemia. The relationship between hyperuricemia and the immune system, with its role as a danger signal in immunity and inflammation, has been a growing research interest for our and other working groups. Despite the substantial number of publications on this topic, there are still some unanswered questions, such as the best cut-off to use to refine the CV risk, especially in CKD patients, when the correction of UA values for kidney function is needed. The aim of this Special Issue is to review the role of UA as a global risk factor in medicine, with particular attention to special subgroup populations, i.e., CKD, obese, and diabetic patients.

Dr. Pietro Cirillo
Prof. Dr. Claudio Borghi
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Metabolites is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • uric acid
  • cardiovascular risk
  • kidney disease
  • obesity
  • diabetes
  • lipid metabolism
  • immune programming

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Published Papers (2 papers)

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12 pages, 270 KiB  
Article
Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study
by Claudia Agabiti Rosei, Anna Paini, Giacomo Buso, Alessandro Maloberti, Cristina Giannattasio, Massimo Salvetti, Edoardo Casiglia, Valerie Tikhonoff, Fabio Angeli, Carlo Maria Barbagallo, Michele Bombelli, Federica Cappelli, Rosario Cianci, Michele Ciccarelli, Arrigo Francesco Giuseppe Cicero, Massimo Cirillo, Pietro Cirillo, Raffaella Dell’Oro, Lanfranco D’Elia, Giovambattista Desideri, Claudio Ferri, Ferruccio Galletti, Loreto Gesualdo, Guido Grassi, Guido Iaccarino, Luciano Lippa, Francesca Mallamaci, Stefano Masi, Maria Masulli, Alberto Mazza, Alessandro Mengozzi, Pietro Nazzaro, Paolo Palatini, Gianfranco Parati, Roberto Pontremoli, Fosca Quarti-Trevano, Marcello Rattazzi, Gianpaolo Reboldi, Giulia Rivasi, Elisa Russo, Giuliano Tocci, Andrea Ungar, Paolo Verdecchia, Francesca Viazzi, Massimo Volpe, Agostino Virdis, Maria Lorenza Muiesan and Claudio Borghiadd Show full author list remove Hide full author list
Metabolites 2024, 14(6), 323; https://doi.org/10.3390/metabo14060323 - 7 Jun 2024
Viewed by 1513
Abstract
High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study [...] Read more.
High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study with carotid ultrasound and without previous cardiovascular diseases (CVD) (n = 6209), followed over 20 years, were included in the analysis. Hypertriglyceridemia (hTG) was defined as TG ≥ 150 mg/dL. Higher levels of SUA (hSUA) were defined as ≥5.6 mg/dL in men and 5.1 mg/dL in women. A carotid plaque was identified in 1742 subjects (28%). SUA and TG predicted carotid plaque (HR 1.09 [1.04–1.27], p < 0.001 and HR 1.25 [1.09–1.45], p < 0.001) in the whole population, independently of age, sex, diabetes, systolic blood pressure, HDL and LDL cholesterol and treatment. Four different groups were identified (normal SUA and TG, hSUA and normal TG, normal SUA and hTG, hSUA and hTG). The prevalence of plaque was progressively greater in subjects with normal SUA and TG (23%), hSUA and normal TG (31%), normal SUA and hTG (34%), and hSUA and hTG (38%) (Chi-square, 0.0001). Logistic regression analysis showed that hSUA and normal TG [HR 1.159 (1.002 to 1.341); p = 0.001], normal SUA and hTG [HR 1.305 (1.057 to 1.611); p = 0.001], and the combination of hUA and hTG [HR 1.539 (1.274 to 1.859); p = 0.001] were associated with a higher risk of plaque. Our findings demonstrate that SUA is independently associated with the presence of carotid plaque and suggest that the combination of hyperuricemia and hypertriglyceridemia is a stronger determinant of carotid plaque than hSUA or hTG taken as single risk factors. The association between SUA and CVD events may be explained in part by a direct association of UA with carotid plaques. Full article
(This article belongs to the Special Issue Exploring Uric Acid and Beyond)
14 pages, 1926 KiB  
Article
Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project
by Lanfranco D’Elia, Maria Masulli, Pietro Cirillo, Agostino Virdis, Edoardo Casiglia, Valerie Tikhonoff, Fabio Angeli, Carlo Maria Barbagallo, Michele Bombelli, Federica Cappelli, Rosario Cianci, Michele Ciccarelli, Arrigo F. G. Cicero, Massimo Cirillo, Raffaella Dell’Oro, Giovambattista Desideri, Claudio Ferri, Loreto Gesualdo, Cristina Giannattasio, Guido Grassi, Guido Iaccarino, Luciano Lippa, Francesca Mallamaci, Alessandro Maloberti, Stefano Masi, Alberto Mazza, Alessandro Mengozzi, Maria Lorenza Muiesan, Pietro Nazzaro, Paolo Palatini, Gianfranco Parati, Roberto Pontremoli, Fosca Quarti-Trevano, Marcello Rattazzi, Gianpaolo Reboldi, Giulia Rivasi, Elisa Russo, Massimo Salvetti, Giuliano Tocci, Andrea Ungar, Paolo Verdecchia, Francesca Viazzi, Massimo Volpe, Claudio Borghi and Ferruccio Gallettiadd Show full author list remove Hide full author list
Metabolites 2024, 14(3), 164; https://doi.org/10.3390/metabo14030164 - 14 Mar 2024
Cited by 1 | Viewed by 1867
Abstract
Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the [...] Read more.
Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the URRAH (URic acid Right for heArt Health) Study has identified a cut-off value of this index to predict CV mortality at 5.35 Units. Therefore, given that no SUA/sCr ratio threshold for CV risk has been identified for patients with diabetes, we aimed to assess the relationship between this index and CV mortality and to validate this threshold in the URRAH subpopulation with diabetes; the URRAH participants with diabetes were studied (n = 2230). The risk of CV mortality was evaluated by the Kaplan–Meier estimator and Cox multivariate analysis. During a median follow-up of 9.2 years, 380 CV deaths occurred. A non-linear inverse association between baseline SUA/sCr ratio and risk of CV mortality was detected. In the whole sample, SUA/sCr ratio > 5.35 Units was not a significant predictor of CV mortality in diabetic patients. However, after stratification by kidney function, values > 5.35 Units were associated with a significantly higher mortality rate only in normal kidney function, while, in participants with overt kidney dysfunction, values of SUA/sCr ratio > 7.50 Units were associated with higher CV mortality. The SUA/sCr ratio threshold, previously proposed by the URRAH Study Group, is predictive of an increased risk of CV mortality in people with diabetes and preserved kidney function. While, in consideration of the strong association among kidney function, SUA, and CV mortality, a different cut-point was detected for diabetics with impaired kidney function. These data highlight the different predictive roles of SUA (and its interaction with kidney function) in CV risk, pointing out the difference in metabolic- and kidney-dependent SUA levels also in diabetic individuals. Full article
(This article belongs to the Special Issue Exploring Uric Acid and Beyond)
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