Association between serum uric acid level and peripheral arterial disease

Background: Higher serum uric acid levels have been implicated in the development and progression of atherosclerotic cardiovascular disease. However, it is not clear whether serum uric acid levels are related to subclinical measures of cardiovascular disease, including peripheral arterial disease (PAD). We examined the association between increasing serum uric acid levels and PAD in the US general population. Methods: A cross-sectional study was conducted among 3987 National Health and Nutrition Examination Survey 1999 - 2002 participants aged >= 40 years, without clinical history of cardiovascular disease. Main outcome-of-interest was PAD defined as ankle-brachial index < 0.9 (n=229). Results: Higher serum uric acid levels were positively associated with PAD, independent of smoking, body mass index (BMI), hypertension, diabetes, serum total cholesterol, serum creatinine, and other confounders. Multivariable odds ratio (OR) [95 percent confidence intervals (CI)] comparing serum uric acid levels >= 75th percentile (>= 380.8 mu mol/L) to uric acid levels < 50th percentile (< 315.6 mu mol/L) was 1.62 (1.08 - 2.44), p-trend=0.015. This association persisted in separate analysis among men and women. Further, the results were consistent in subgroup analyses by categories of age, current smoking, BMI, and diabetes mellitus. Conclusions: Higher serum uric acid levels are associated with PAD in the US general population. These results suggest that PAD may be an important indicator of the reported association between higher serum uric acid levels and clinical cardiovascular disease. Future prospective studies are required to clarify the temporal nature of this relationship. (c) 2007 Elsevier Ireland Ltd. All rights reserved.