Uric Acid Abstracts 5

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Rate of conversion of isotopic glycine to uric acid in the normal and gouty human and how this is affected by vitamin E and folic acid
         (Bishop et al., 1955) Download

Is it time to revise the normal range of serum uric acid levels?
         (Desideri et al., 2014) Download
The actual reference range of serum uric acid has been assessed according to its variations among healthy individuals. i.e. those without clinical evidence of gout. By this approach, serum uric acid values between 3.5 and 7.2 mg/dL in adult males and postmenopausal women and between 2.6 and 6.0 mg/dL in premenopausal women have been identified as normal in many countries. However, this definition of normal range of serum uric acid in the general population is inevitably influenced by what we consider as "normal", since the absence of gout flares does not necessarily imply the absence of uric acid-related damage. Indeed, a growing body of evidence indicates that silent deposition of monosodium urate crystals as a result of hyperuricaemia may occur and lead to early destructive skeletal changes. In addition, a growing body of evidences demonstrates that uric acid might play a pathophysiological role in many "cardio-nephro-metabolic" disorders, which seems to be independent of the deposition of monosodium urate crystals, since it is evident also for serum uric acid concentrations below the saturation point for monosodium urate. Taken together, these findings strongly suggest to carefully reconsider the concept of "asymptomaticity" for chronic hyperuricemia and to consequently revise the normal range of serum uric acid levels also considering the progressive worldwide increase of circulating levels of uric acid, which could lead to a "shift to right" (i.e. toward higher values) of normal range. In the light of the new scientific knowledge on the pathophysiological role of uric acid in human disease, a threshold value < 6.0 mg/dL (< 360 micromol/L) seems to better identify true "healthy subjects" and should reasonably be considered for all subjects.


Hormonal aspects of human gout--excretion of adrenal hormone derivatives in gouty patients
            (Gregolini et al., 1983) Download
Forty-seven patients with gout, 28 of whom had not previously been treated with allopurinol, and 25 normal subjects, were examined for 24-h urinary excretion of the most important adrenal steroid derivatives. Results were submitted to statistical analysis and several variables have been taken in consideration. The untreated patients showed significantly higher values of uricemia, urinary uric acid, triglycerides, slightly higher values of androsterone, 11-oxo-androsterone + 11-oxo-etiocholanolone, dehydroepiandrosterone, and slightly lower values of 11-hydroxyandrosterone and pregnanetriol, in comparison to normal subjects. The different hormonal pattern seems to discriminate between patients with gout and normal subjects.

Effect of ACTH and sodium salicylate on the urinary uric acid: creatinine ratio, and circulating eosinophils in man
         (Marson, 1953) Download

Sodium salicylate and probenecid in the treatment of chronic gout; assessment of their relative effects in lowering serum uric acid levels
         (Marson, 1954) Download

Uric acid clearance in patients with gout and normal subjects
         (Snaith and Scott, 1971) Download


Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population.
            (Wallace et al., 2004) Download
OBJECTIVE: To determine whether the prevalence of gout and/or clinically significant hyperuricemia increased in a managed care population over 10 years. METHODS: The study was a descriptive analysis utilizing an administrative claims database to ascertain 10-year trends in prevalence of gout and/or hyperuricemia. Prevalence rates were calculated cross-sectionally for each year (1990-99) and expressed/compared as rates per 1000 enrollees. RESULTS: The prevalence of gout and/or hyperuricemia in the overall population increased by about 2 cases per 1000 enrollees over 10 years. In the > 75 year age group, rates increased from 21 per 1000 persons in 1990 to 41 per 1000 in 1999. In the 65-74 year age group, prevalence increased from between 21 and 24 per 1000 persons in the years 1990-92 to over 31 per 1000 during the years 1997-99. Prevalence rates in younger age groups (< 65 years) stayed consistently low during the years under study. There were sex differences in most age groups, with men having the greater burden of disease at every time point. CONCLUSION: Prevalence of gout and/or hyperuricemia in the overall study population increased during the 10-year period. When stratified by age, there were increases in prevalence among groups over age 65 in both sexes. Although gout prevalence increased in both sexes over the 10-year period, men still had most of the burden of disease. In ages younger than 65, men had 4 times higher prevalence than women (4:1 ratio), but in the older age groups (> 65), the gender gap narrowed to 1 woman to every 3 men with gout and/or hyperuricemia (3:1 ratio).

Study of the paradoxical effects of salicylate in low, intermediate and high dosage on the renal mechanisms for excretion of urate in man
         (Yu and Gutman, 1959) Download

 


References

Bishop, C., R. Rand, and J. H. Talbott (1955), ‘Rate of conversion of isotopic glycine to uric acid in the normal and gouty human and how this is affected by vitamin E and folic acid’, Metabolism, 4 (2), 174-82. PubMedID: 14355635
Desideri, G, et al. (2014), ‘Is it time to revise the normal range of serum uric acid levels?’, Eur Rev Med Pharmacol Sci, 18 (9), 1295-306. PubMedID: 24867507
Gregolini, L., et al. (1983), ‘Hormonal aspects of human gout--excretion of adrenal hormone derivatives in gouty patients’, Clin Chim Acta, 130 (3), 269-77. PubMedID: 6223725
Marson, F. G. (1953), ‘Effect of ACTH and sodium salicylate on the urinary uric acid: creatinine ratio, and circulating eosinophils in man’, Ann Rheum Dis, 12 (4), 296-300. PubMedID: 13125229
——— (1954), ‘Sodium salicylate and probenecid in the treatment of chronic gout; assessment of their relative effects in lowering serum uric acid levels’, Ann Rheum Dis, 13 (3), 233-45. PubMedID: 13198057
Snaith, M. L. and J. T. Scott (1971), ‘Uric acid clearance in patients with gout and normal subjects’, Ann Rheum Dis, 30 (3), 285-89. PubMedID: 5090245
Wallace, KL, et al. (2004), ‘Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population.’, J Rheumatol, 31 (8), 1582-87. PubMedID: 15290739
Yu, T. F. and A. B. Gutman (1959), ‘Study of the paradoxical effects of salicylate in low, intermediate and high dosage on the renal mechanisms for excretion of urate in man’, J Clin Invest, 38 (8), 1298-315. PubMedID: 13673086