Biochemical and clinical correlates of hypouricemia in surgical and critically ill patients
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Ivo Giovannini
Abstract
Background: Changes in plasma uric acid concentration (UA, μmol/L) in postoperative and critical illness have pathophysiological and clinical relevance and may alter plasma antioxidant capacity. This issue is poorly understood because UA is simultaneously affected by multiple factors with impacts that have never been definitively characterized.
Methods: Data from 1050 measurements of UA and additional variables obtained in 151 patients were processed using regression analysis.
Results: The main direct correlate of UA was plasma creatinine (Cr), even in the absence of renal failure. UA was also related directly to sodium, glucose, cholesterol, albumin and other variables, and inversely to bilirubin. Postoperatively UA decreased, remaining related to preoperative UA and decreasing further with sepsis. In parenterally fed patients, UA was also inversely related to the amino acid dose. The following best fit explained three-quarters of its variability: UA=85.0(ln Cr, μmol/L)+0.6(preoperative UA)+4.3 (sodium, mmol/L)+5.4(glucose, mmol/L)−0.2(bilirubin, μmol/L)−28.9(amino acid dose, g/kg/day) −935.6; n=231, r2=0.74, p<0.0001. A contribution of extremely low UA to impaired plasma antioxidant capacity was suggested in severe sepsis.
Conclusions: These data show the combined effect of several factors on UA. The results may help to evaluate changes in UA in the clinical setting and pathophysiological events related to oxidative stress, and provide evidence of impaired plasma antioxidant capacity in severe sepsis.
Clin Chem Lab Med 2007;45:1207–10.
©2007 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- SIBioC 2007, 39th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology, Palacongressi Rimini (Italy), 2-5 October 2007
- Third “Biologie Prospective” Santorini Conference
- Application of leukocyte transcriptomes to assess systemic consequences of risk factors for cardiovascular disease
- Ghrelin variants influence development of body mass index and plasma levels of total cholesterol in dialyzed patients
- Evaluation of genetic predisposition to insulin resistance by nutrient-induced insulin output ratio (NIOR)
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