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Hyperuricemia is independently associated with endothelial dysfunction in postmenopausal women but not in premenopausal women
  1. Tatsuya Maruhashi1,
  2. Ayumu Nakashima2,
  3. Junko Soga1,
  4. Noritaka Fujimura1,
  5. Naomi Idei1,
  6. Shinsuke Mikami1,
  7. Yumiko Iwamoto1,
  8. Masato Kajikawa1,
  9. Takeshi Matsumoto1,
  10. Takayuki Hidaka1,
  11. Yasuki Kihara1,
  12. Kazuaki Chayama3,
  13. Chikara Goto4,
  14. Kensuke Noma5,
  15. Hirofumi Tomiyama6,
  16. Bonpei Takase7,
  17. Akira Yamashina6,
  18. Yukihito Higashi2,5
  1. 1Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
  2. 2Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan
  3. 3Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
  4. 4Hirohsima International University, Hiroshima, Japan
  5. 5Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  6. 6The Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
  7. 7Division of Biomedical Engineering, National Defense Medical College Research Institute, Tokorozawa, Japan
  1. Correspondence to Professor Yukihito Higashi; yhigashi{at}


Objectives The purpose of this study was to determine the relationships between uric acid, endothelial function and cardiovascular risk factors and to investigate whether menopausal status was associated with the relationship between uric acid and endothelial function in women.

Design Cross-sectional study.

Setting 3 general hospitals in Japan.

Participants 749 Japanese women aged 30–74 years recruited from people who underwent health-screening examinations with agreement for measurement of vascular function.

Measures We measured serum concentrations of uric acid and flow-mediated vasodilation (FMD). Percentage of FMD (peak diameter−baseline diameter/baseline diameter) was used for analysis. Endothelial dysfunction was defined as FMD ≤4.90%, division point for the lowest tertile and the middle tertile of FMD. Menopause women were defined as participants without menstruation for over 1 year or participants with a history of hysterectomy or bilateral oophorectomy.

Results Of the 749 participants, 368 (49.1%) were premenopausal women and 381 (50.9%) were postmenopausal women. Age, body mass index, systolic blood pressure, total cholesterol, triglycerides, glucose, estimated glomerular filtration rate and Framingham risk score were significantly correlated with serum uric acid level. FMD showed a gradual decrease in accordance with the serum uric acid level in the entire study population (<4 mg/dL, 6.85±3.65%; 4 to <5 mg/dL, 6.79±3.60%; 5 to <6 mg/dL, 6.24±3.58%; ≥6 mg/dL, 5.27±3.18%; p=0.01). Multivariate analysis revealed that uric acid was a significantly independent risk factor for endothelial dysfunction in postmenopausal women (OR 1.23, 95% CI 1.01 to 1.50), but not in premenopausal women.

Conclusions These findings suggest that uric acid can be used as a risk marker of endothelial dysfunction in a female population, and particularly as an independent risk factor in postmenopausal women but not in premenopausal women.

Registration number of the study UMIN000003409.

  • Vascular Medicine
  • Pathology

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