Association between serum uric acid, aortic, carotid and femoral stiffness: The Maastricht Study

José M.A. Wijnands, Annelies Boonen, Thomas T. van Sloten, Miranda T. Schram, Simone Sep, Annemarie Koster, Carla J.van der Kallen, Ronald M.A. Henry, Pieter C. Dagnelie, Coen D.A. Stehouwer, Sjef van der Linden, Ilja C.W. Arts

Objective:
Arterial stiffness may be a mechanism to explain the association between uric acid and cardiovascular disease. We aimed to analyse associations between plasma uric acid and regional and local arterial stiffness, and assess potential differences related to sex and glucose metabolism status.

Methods:
A cross-sectional study was performed in 614 adults (52.6% men; mean age 58.7±8.5 yrs.; 23.2% type 2 diabetes (by design)) from The Maastricht Study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV), distensibility and compliance coefficient of the carotid and femoral artery, and carotid artery Young’s elastic modulus (YEM).

Results:
Higher uric acid (per SD of 74 µmol/L) was associated with greater stiffness indicated by a significantly higher cfPWV [β=0.216 (95% CI: 0.061; 0.372) p=0.006] and lower carotid distensibility coefficient [β=-0.458 (95% CI: -0.841; -0.075) p=0.019] after adjustment for sex, age, and glucose metabolism status. Associations lost significance after adjusting for mean arterial pressure, BMI, waist, smoking status, heart rate, total:HDL cholesterol, triglycerides, eGFR, and lipid-lowering, anti-hypertensive, and diabetes medication. No associations were found between uric acid and carotid compliance coefficient, carotid YEM, or stiffness of the femoral artery. A significant (p=0.049) interaction with glucose metabolism status was found for the carotid distensibility coefficient, with a stronger association among individuals with normal glucose metabolism [β=-0.504 (95% CI:  1.098; 0.090) p=0.096] than among those with impaired glucose metabolism or type 2 diabetes. There was no interaction with sex.

Conclusion:
Uric acid was not significantly associated with stiffness of the aorta, or the carotid or femoral artery.