Hyperuricemia and Cardio-Metabolic Risks: What Does a Biochemical Study in Northern Algeria Reveal?

Year 2026, Volume: 30 Issue: 1 , 198 - 207 , 11.01.2026

Hadjer Daoudi , Guendouze Assia , Zeghdar Moufida , Rouabah Abdelkader , Rouabah Leila

https://doi.org/10.12991/jrespharm.1640517

https://izlik.org/JA49YZ37WG

Abstract

This study examines the relationship between serum uric acid levels and cardio-metabolic risk factors by comparing at-risk individuals with healthy controls. A cross-sectional study was conducted on 105 adults (20–65 years) in Ali Mendjeli, Constantine. Mean uric acid levels were 43.80±13.34 mg/dL in healthy individuals, 53.36±14.93 mg/dL in type 2 diabetics, and 52.73±17.16 mg/dL in both hypertensive and diabetic hypertensive patients. Men exhibited higher uric acid levels than women, except in hypertensive individuals. Levels increased with age in men (40–60 years) and postmenopausal women but declined after 50 in diabetics and hypertensives. A significant association was observed between uric acid and BMI, with levels rising from 41.71±13.77 mg/dL in normal-weight individuals to 56±9.48 mg/dL in those with morbid obesity (P < 0.01). Uric acid positively correlated with triglycerides in healthy subjects (p < 0.05; r=0.244) and showed strong correlations with total cholesterol, BMI (p < 0.005; r1=0.431; r2=0.431; r3=0.576), and LDL cholesterol (p < 0.05; r=0.316) in diabetics. In diabetic hypertensives, uric acid was associated with total cholesterol (p < 0.01; r=0.464) and showed a non-significant inverse correlation with HDL cholesterol. These findings highlight the strong link between elevated uric acid and cardiovascular risk factors, emphasizing its potential role in cardiovascular disease management. Further research is needed to explore underlying mechanisms and targeted interventions.

Keywords

determinants of cardiovascular disease , body weight index , hypertension , metabolic syndrome , insuline resistance-related diabetes , uric acid

References

• [1] World Health Organization. Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed on 1 February 2025).
• [2] Castelao JE, Gago-Dominguez M. Risk factors for cardiovascular disease in women: relationship to lipid peroxidation and oxidative stress. Med Hypotheses. 2008;71(1):39–44. https://doi.org/10.1016/j.mehy.2007.10.016
• [3] Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007; 356(23):2388-2398. https://doi.org/10.1056/NEJMsa053935
• [4] Schretlen DJ, Inscore AB, Vannorsdall TD, Kraut M, Pearlson GD, Gordon B, Jinnah HA. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007;69(14):1418-1423. https://doi.org/10.1212/01.wnl.0000277468.10236.f1
• [5] Siu YP, Leung KT, Tong MKH, Kwan TH. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47(1):51–59. https://doi.org/10.1053/j.ajkd.2005.10.006
• [6] Ding M, Viet NN, Gigante B, Lind V, Hammar N, Modig K. Elevated uric acid is associated with new-onset atrial fibrillation: results from the Swedish AMORIS cohort. J Am Heart Assoc. 2023; 12(3): e027089. https://doi.org/10.1161/JAHA.122.027089
• [7] Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension. 2003;42(3):247–52. https://doi.org/10.1161/01.HYP.0000085858.66548.59
• [8] Johnson RJ, Titte S, Cade JR, Rideout BA, Oliver WJ. Uric acid, evolution and primitive cultures. Semin Nephrol. 2005;25(1):3–8. https://doi.org/10.1016/j.semnephrol.2004.09.002
• [9] Freedman DS, Williamson DF, Gunter EW, Byers T. Relation of serum uric acid to mortality and ischemic heart disease: the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol. 1995;141(7):637–44. https://doi.org/10.1093/oxfordjournals.aje.a117479
• [10] Daoudi H. PhD Thesis. Uric acid and lipid profile in type 2 diabetics from the municipality of Constantine, Algeria. Department of Biology, University of Constantine 1, Constantine, Algeria, 2017.
• [11] Bachir Cherif A, Taleb A, Bouraghda A, Bouamra A, Debbih ND, Rabia S, et al. Hyperuricemia and cardiovascular risk in hypertensive patients at a specialized consultation in the Blida region (Algeria). Ann Cardiol Angeiol (Paris). 2015. S0003-3928(16)30220-7. https://doi.org/10.1016/j.ancard.2016.11.001
• [12] Kanbay M, Jensen T, Solak Y, Le M, Roncal-Jimenez C, Rivard C, et al. Uric acid in metabolic syndrome: from an innocent bystander to a central player. Eur J Intern Med. 2016;29:3–8. https://doi.org/10.1016/j.ejim.2015.11.026
• [13] Panoulas VF, Toms TE, Metsios GS, Stavropoulos-Kalinoglou A, Kosovitsas A, Milionis HJ, et al. Target organ damage in patients with rheumatoid arthritis: the role of blood pressure and heart rate. Atherosclerosis. 2010;209(1):255–60. https://doi.org/10.1016/j.atherosclerosis.2009.08.047
• [14] Kleber ME, Delgado G, Grammer TB, Silbernagel G, Huang J, Krämer BK, et al. Uric acid and cardiovascular events: a Mendelian randomization study. J Am Soc Nephrol. 2015;26(11):2831–8. https://doi.org/10.1681/ASN.2014070660
• [15] Mackenzie IS, Ford I, Walker A, et al., on behalf of the ALL-HEART study group. A multi-centre, prospective, randomised, open-label, blinded endpoint trial of the efficacy of allopurinol therapy in improving cardiovascular outcomes in patients with ischaemic heart disease: protocol of the ALLHEART study. BMJ Open. 2016;6(9):e013774. https://doi.org/10.1136/bmjopen-2016-013774
• [16] Dubreuil M, Zhu Y, Zhang Y, Seeger JD, Lu N, Rho YH, et al. Allopurinol initiation and all-cause mortality in the general population. Ann Rheum Dis. 2015;74(7):1368–72. https://doi.org/10.1136/annrheumdis-2014-205269
• [17] Sautin YY, Nakagawa T, Zharikov S, Johnson RJ. Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative/nitrosative stress. Am J Physiol Cell Physiol. 2007;293(2):C584–96. https://doi.org/10.1152/ajpcell.00600.2006
• [18] Saito Y, Tanaka A, Node K, Kobayashi Y. Uric acid and cardiovascular disease: a clinical review. J Cardiol. 2021;78(1):51–7. https://doi.org/10.1016/j.jjcc.2020.12.013
• [19] Alaya A, Nouri A, Belgith M, Saad H, Jouini R, Najjar MF. Changes in urinary stone composition in the Tunisian population: a retrospective study of 1,301 cases. Ann Lab Med. 2012;32(3):177–83. https://doi.org/10.3343/alm.2012.32.3.177
• [20] Chen H, Ding X, Li J, Wu Z, Wang Y, He H, et al. White blood cell count: an independent predictor of coronary heart disease risk in middle-aged and elderly population with hyperuricemia. Medicine (Baltimore). 2018; 97(51): e13729. https://doi.org/10.1097/MD.0000000000013729
• [21] Butt JH, Docherty KF, Claggett BL, Desai AS, Petersson M, Langkilde AM, et al. Association of dapagliflozin use with clinical outcomes and the introduction of uric acid-lowering therapy and colchicine in patients with heart failure with and without gout: a patient-level pooled meta-analysis of DAPA-HF and DELIVER. JAMA Cardiol. 2023; 8(4): 386-393. https://doi.org/10.1001/jamacardio.2022.5608
• [22] Tanaka K, Ogata S, Tanaka H, Omura K, Honda C, Hayakawa K. The relationship between body mass index and uric acid: a study on Japanese adult twins. Environ Health Prev Med. 2015; 20(5): 347-353. https://doi.org/10.1007/s12199-015-0473-3
• [23] Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuricemia: a reality in the Indian obese. Obes Surg. 2012; 22(6): 945-948. https://doi.org/10.1007/s11695-012-0655-7
• [24] Liu L, Lou S, Xu K, Meng Z, Zhang Q, Song K. Relationship between lifestyle choices and hyperuricemia in Chinese men and women. Clin Rheumatol. 2013; 32(2): 233-239. https://doi.org/10.1007/s10067-012-2108-z
• [25] Palmer TM, Nordestgaard BG, Benn M, Tybjærg-Hansen A, Smith GD, Lawlor DA, et al. Association of plasma uric acid with ischaemic heart disease and blood pressure: mendelian randomisation analysis of two large cohorts. BMJ. 2013; 347: f4262. https://doi.org/10.1136/bmj.f4262
• [26] Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K. Serum uric acid and the risk for hypertension and type 2 diabetes in Japanese men: the Osaka Health Survey. J Hypertens. 2001; 19(7): 1209-1215. https://doi.org/10.1097/00004872-200107000-00005
• [27] Sánchez-Lozada LG, Tapia E, López-Molina R, Nepomuceno T, Soto V, Avila-Casado C, et al. Effects of acute and chronic L-arginine treatment in experimental hyperuricemia. Am J Physiol Renal Physiol. 2007; 292(4): F1238-F1246. https://doi.org/10.1152/ajprenal.00164.2008
• [28] Lin D, Yao Z, Liu H, Wang Q, Xie L, Yang B, et al. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduct Target Ther. 2024; 9: 212. https://doi.org/10.1038/s41392-024-01916-y
• [29] Corry DB, Eslami P, Choi YJ, Lee SJ, Kang DH, Krotich E, et al. Uric acid stimulates monocyte chemoattractant protein-1 expression and recruitment of macrophages to renal tissue. J Am Soc Nephrol. 2008; 19(9): 1613-1620. https://doi.org/10.1681/ASN.2007101181
• [30] Kato M, Ohta H, Isaka Y, Kiyomoto H, Sato E, Ohashi Y, et al. Uric acid induces renal tubular injury via NADPH oxidase activation in a rat model of hyperuricemia. Am J Physiol Renal Physiol. 2014; 307(5): F544-F552. https://doi.org/10.1152/ajprenal.00491.2013
• [31] Quiroz Y, Pons H, Gordon KL, Rincón J, Chávez M, Parra G, et al. Mycophenolate mofetil prevents salt-sensitive hypertension resulting from nitric oxide synthesis inhibition. Am J Physiol Renal Physiol. 2001; 281(1): F38-F47. https://doi.org/10.1152/ajprenal.2001.281.1.F38
• [32] Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med. 2007; 120(5): 442-447. https://doi.org/10.1016/j.amjmed.2006.06.040
• [33] Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol. 2006; 290(3): F625-F631. https://doi.org/10.1152/ajprenal.00140.2005
• [34] Masuo K, Kawaguchi H, Mikami H, Ogihara T, Tuck ML. Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Hypertension. 2003; 42(4): 474-480. https://doi.org/10.1161/01.HYP.0000091371.53502.D3
• [35] Chien KL, Chen MF, Hsu HC, Chang WT, Su TC, Lee YT, et al. Plasma uric acid and the risk of type 2 diabetes in a Chinese community. Clin Chem. 2008; 54(2): 310-316. https://doi.org/10.1373/clinchem.2007.095190
• [36] Reungjui S, Roncal CA, Mu W, Srinivas TR, Sirivongs D, Johnson RJ, et al. Thiazide diuretics exacerbate fructose-induced metabolic syndrome. J Am Soc Nephrol. 2007; 18(10): 2724-2731. https://doi.org/10.1681/ASN.2007040416
• [37] Cook S, Hugli O, Egli M, Vollenweider P, Burcelin R, Nicod P, et al. Clustering of cardiovascular risk factors mimicking the human metabolic syndrome X in eNOS null mice. Swiss Med Wkly. 2003; 133(25-26): 360-363. https://doi.org/10.4414/smw.2003.10239
• [38] Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005; 67(5): 1739-1742. https://doi.org/10.1111/j.1523-1755.2005.00273.x
• [39] Mercuro G, Vitale C, Cerquetani E, Zoncu S, Deidda M, Fini M, et al. Effect of hyperuricemia upon endothelial function in patients at increased cardiovascular risk. Am J Cardiol. 2004; 94(7): 932-935. https://doi.org/10.1016/j.amjcard.2004.06.032
• [40] Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114(12): 1752-1761. https://doi.org/10.1172/JCI21625
• [41] Cheung KJ, Tzameli I, Pissios P, Rovira I, Gavrilova O, Ohtsubo T, et al. Xanthine oxidoreductase is a regulator of adipogenesis and PPARgamma activity. Cell Metab. 2007; 5(2): 115-128. https://doi.org/10.1016/j.cmet.2007.01.005