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Internal and Emergency Medicine

, Volume 7, Issue 1, pp 5–8 | Cite as

Uric acid: a starring role in the intricate scenario of metabolic syndrome with cardio-renal damage?

  • Davide Stellato
  • Luigi Francesco Morrone
  • Chiara Di Giorgio
  • Loreto Gesualdo
IM - REVIEW

Abstract

Elevated uric acid levels are a common finding in patients with metabolic syndrome and in those with cardiovascular and renal disease, but the meaning of this elevation is still unclear. In patients with chronic kidney diseases, it could merely reflect the reduction in glomerular filtration rate: but uric acid levels are known to be elevated in people, also in younger ones, prior to the development of hypertension or renal disease, independently of several risk factors. Multiple potential mechanisms suggest a causative role for uric acid in vascular disease. Uric acid has been shown to be involved in metabolic pathways that lead to oxidative stress, endothelial disfunction, and to a vascular and systemic inflammatory response. Moreover, the elevation in uric acid levels observed after fructose ingestion, with a consequent reduction in nitric oxide, may lead to a reduced glucose uptake in the skeletal muscle, hyperinsulinemia, and insulin resistance. Besides these bench research data, also clinical studies showed the beneficial effects of lowering uric acid therapies on several markers of cardiovascular and renal disease. To date, however, there is no evidence indicating that such therapies, that are not free of risk, may reduce cardiovascular events; so that to manage our prescriptions, we need larger, prospective, interventional data.

Keywords

Uric acid  Oxidative stress  Endothelial disfunction  Inflammatory response 

Notes

Conflict of interest

None.

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Copyright information

© SIMI 2011

Authors and Affiliations

  • Davide Stellato
    • 1
  • Luigi Francesco Morrone
    • 1
  • Chiara Di Giorgio
    • 2
  • Loreto Gesualdo
    • 2
  1. 1.Struttura Complessa di Nefrologia e DialisiAzienda Ospedaliera RummoBeneventoItaly
  2. 2.Struttura Complessa di Nefrologia, Dialisi e TrapiantoAzienda Ospedaliero-Universitaria “OO.RR.”FoggiaItaly

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