In my last article we learned how normal uric acid calculations are frequently corrupted. By including people with hyperuricemia. So now I’m going to investigate how this error is dealt with in six other uric acid studies.
In all six studies hyperuricemia was defined differently for men and for women. Now we’ve established that this is medically meaningless for gout. Because crystals form at the same uric acid levels in men and women. However, the studies here are all statistical investigations of disease risks relating to uric acid levels. So I’m not qualified to comment on the medical value. But I wish, for sanity’s sake, they had run the numbers with a genderless standard. If only for comparison.
Anyway, we don’t have that. Similarly, we don’t know another important factor. But I’ll list the studies before I consider that factor.
Normal Uric Acid and Hyperuricemia Studies
Note that most studies took the hyperuricemia limits as 7 mg/dL for men and 6 mg/dL for women. Though the first study used 7.5 mg/dL for men (rounded from 450 µmol/l).
1. Psoriatic Arthritis and Hyperuricemia
Hyperuricemia is common in patients with psoriatic arthritis. Especially in those with longer disease duration and obesity. Proper control of Hyperuricemia and metabolic diseases may play a preventive role in improving psoriatic arthritis outcomes.
2. Type 2 Diabetes and Hyperuricemia
Based on the clearance of uric acid, 90 patients with Hyperuricemia were divided into three types: synthesis-increased hyperuricemia, excretion-decreased hyperuricemia and mixed type of hyperuricemia.
The calculations for these three types are complicated. So I will deal with them separately.
Clinically, different types of hyperuricemia should receive individualized treatment according their own characteristics.
3. Kidney Transplants and Hyperuricemia
Elevated uric acid was influencing negatively kidney function and graft survival in recipient of older kidneys.
4. Bilirubin and Hyperuricemia
High serum indirect bilirubin level might be a protective factor for the progression of renal function in CKD patients with Hyperuricemia
5. Blood Pressure and Hyperuricemia
There was an inverse association between serum phosphate and the risk of new-onset hyperuricemia in hypertensive adults.
6. Pulse Pressure and Hyperuricemia
Both hyperuricemia and high pulse pressure were associated with heart failure hospitalization in this elderly population.
Normal Uric Acid and Hyperuricemia Summary
Importantly, all these studies include “normal uric acid”. Yet it is never defined clearly. Other than as being below the arbitrary cut-off for hyperuricemia. This total lack of logic is disappointing in published scientific reports. But symptomatic of the general lack of understanding about the true meaning of “normal uric acid”.
Finally, I refer back to the second important missing factor in all these reports. We do not know if risks discovered by these investigations are real links between diseases and high uric acid. Or if there is a separate factor that determines the disease. Because what happens if uric acid is treated? All these studies need to be repeated. Using groups of people who had high uric acid. But have had treatment to lower uric acid to safe levels.
Your Hyperuricemia and Normal Uric Acid
You can see that hyperuricemia is associated with several diseases besides gout. So if you suspect comorbidities, you must consult your doctor. Because you cannot assume that controlling uric acid will help these other disease. But always make sure you avoid the “normal uric acid” term. Otherwise, the confusion never ends.
Leave Normal Uric Acid and Hyperuricemia to learn more about all aspects of Uric Acid and Gout.
Normal Uric Acid and Hyperuricemia References
- AlJohani, Roa’A et al. “Characteristic and Outcome of Psoriatic Arthritis Patients with Hyperuricemia.” The Journal of rheumatology vol. 45,2 (2018): 213-217. doi:10.3899/jrheum.170384
- Gao, Zhongai et al. “Renal impairment markers in type 2 diabetes patients with different types of hyperuricemia.” Journal of diabetes investigation vol. 10,1 (2019): 118-123. doi:10.1111/jdi.12850
- Magott-Procelewska, M et al. “Kidney Transplantation From Old Deceased Donors: Impact of Uric Acid Level-A Quarter-Century of Experience in One Transplant Center.” Transplantation proceedings vol. 50,6 (2018): 1701-1704. doi:10.1016/j.transproceed.2018.02.127
- Li, Mengyuan et al. “Relationship between serum bilirubin levels s and the progression of renal function in patients with chronic kidney disease and hyperuricemia.” Clinica chimica acta; international journal of clinical chemistry vol. 486 (2018): 156-161. doi:10.1016/j.cca.2018.07.045
- Cao, Jingjing et al. “Serum Phosphate and the Risk of New-Onset Hyperuricemia in Hypertensive Patients.” Hypertension (Dallas, Tex. : 1979) vol. 74,1 (2019): 102-110. doi:10.1161/HYPERTENSIONAHA.119.12633
- Sung, Shih-Hsien et al. “Hyperuricemia and pulse pressure are predictive of incident heart failure in an elderly population.” International journal of cardiology vol. 300 (2020): 178-183. doi:10.1016/j.ijcard.2019.11.001
- Boss, Gerry R., and J. Edwin Seegmiller. “Hyperuricemia and gout: classification, complications and management.” New England Journal of Medicine 300, no. 26 (1979): 1459-1468.