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Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care

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Abstract

Hyperuricemia is known to be associated with adverse outcomes in cardiovascular intensive care patients, but its mechanisms are unknown. A total of 569 emergency department patients were prospectively analyzed and assigned to intensive care (ICU group, n = 431) or other departments (n = 138). Uric acid (UA) levels were significantly higher in the intensive care patients (6.3 [5.1–7.6] mg/dl vs. 5.8 [4.6–6.8] mg/dL). The plasma xanthine oxidoreductase (XOR) activity in the ICU group (68.3 [21.2–359.5] pmol/h/mL) was also significantly higher than that in other departments (37.2 [15.1–93.6] pmol/h/mL). Intensive care patients were divided into three groups according to plasma XOR quartiles (Q1, low-XOR, Q2/Q3, normal-XOR, and Q4, high-XOR group). A multivariate logistic regression model showed that lactate (per 1.0 mmol/L increase, OR 1.326; 95%, CI 1.166–1.508, p < 0.001) and the Acute Physiology and Chronic Health Evaluation II score (per 1.0 point increase, OR 1.095, 95% CI 1.034–1.160, p = 0.002) were independently associated with the high-XOR group. In-hospital mortality was significantly higher in the high-XOR group (n = 28, 26.2%) than in the normal- (n = 11, 5.1%) and low- (n = 9, 8.3%) XOR groups. The high-XOR group (vs. normal-XOR group) was independently associated with the in-hospital mortality (OR 2.934; 95% CI 1.170–7.358; p = 0.022). Serum UA levels and plasma XOR activity were high in patients admitted to intensive care. The enhanced XOR activity may be one of the mechanisms under which hyperuricemia was associated with adverse outcomes in patients requiring cardiovascular intensive care.

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Acknowledgements

We are grateful to the staff of the ICU and medical records office at Chiba Hokusoh Hospital, Nippon Medical School, Japan, for collecting the medical data.

Funding

The authors declare that they have no competing sources of funding.

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Authors and Affiliations

  1. Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Yusaku Shibata, Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kazutaka Kiuchi, Kenichi Tani, Nobuaki Kobayashi, Noritake Hata & Kuniya Asai

  2. Department of Radioisotope and Chemical Analysis Center, Sanwa Kagaku Kenkyusho Co., Ltd, Mie, Japan

    Takayo Murase

  3. Department Pharmacological Study Group, Pharmaceutical Research Laboratories, Sanwa Kagaku Kenkyusho Co., Ltd, Mie, Japan

    Takashi Nakamura

  4. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Wataru Shimizu

Authors
  1. Yusaku Shibata
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  2. Akihiro Shirakabe
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  3. Hirotake Okazaki
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  4. Masato Matsushita
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  5. Hiroki Goda
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  6. Shota Shigihara
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  7. Kazuhiro Asano
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  8. Kazutaka Kiuchi
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  9. Kenichi Tani
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  10. Takayo Murase
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  11. Takashi Nakamura
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  12. Nobuaki Kobayashi
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  13. Noritake Hata
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  14. Kuniya Asai
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  15. Wataru Shimizu
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Contributions

YS AS participated in the conception and design; data collection, analysis, and interpretation; statistical analysis; and drafting of the manuscript. TM and TN measured the XOR activity. YS, AS, HO, MM, HG, SS, KK, KK, KT, NK, NH, KA and WS participated in the conception and design and data collection. All of the authors read and approved the final manuscript.

Corresponding author

Correspondence to Akihiro Shirakabe.

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Conflict of interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The research ethics committee of Nippon Medical School Chiba Hokusoh Hospital approved the study protocol.

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Shibata, Y., Shirakabe, A., Okazaki, H. et al. Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care. Heart Vessels 35, 1390–1400 (2020). https://doi.org/10.1007/s00380-020-01608-x

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  • DOI: https://doi.org/10.1007/s00380-020-01608-x

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