Hyperuricemia, Cardiovascular Profile, and Comorbidity in Older Men and Women: The Pro. VA Study

Hyperuricemia (HU) is growing worldwide and associates with several medical conditions in the elderly. However, data about older people and possible gender differences are sparse. The aim of this study was to compare HU prevalence rates and association with relevant medical disorders in elderly subjects of both sexes. Pro. V.A. is a survey of 3099 individuals aged 65+, focusing on chronic diseases and disability. Uric acid (UA) levels were dichotomized using 6.0 mg/dL (females) and 7.0 mg/dL (males), and multivariate logistic regression models were used to estimate odds ratios (ORs) between HU and single comorbidity. HU prevalence was 21.5% in females and 15.8% in males. HU was associated with most anthropometric and laboratory variables in women, but not in men. After adjustment for age, body mass index, and renal function, HU was independently associated with the presence of cardiovascular diseases in both sexes. In women, HU was associated with hand osteoarthritis (OR = 1.52; 95% CI: 1.12-2.08) and edentulism (OR = 1.31; 95% CI: 1.01-1.71), while resulted protective for osteoporosis (OR = 0.69; 95% CI: 0.53-0.91). In men, HU was significantly related with knee osteoarthritis (OR = 1.72; 95% CI: 1.06-2.79) and chronic obstructive pulmonary disease (OR = 1.60; 95% CI: 1.04-2.45). The presence of >= 4 comorbidities was a stronger determinant of HU in men (OR = 2.54; 95% CI: 1.21-5.37) than in women (ns). Patterns of age-dependent UA increase are markedly different in men and women. HU prevalence is substantial and its association with other diseases is gender specific, connoting a peculiar clinical profile.