Serum Uric Acid in the Pamela Study: Main Findings and Relationships with the Atherogenic Index of Plasma

Serum uric acid (SUA) overproduction, leading to hyperuricemia, has been found to be of common detection in a number of clinical conditions characterized by an elevated cardiovascular risk, namely metabolic syndrome, essential hypertension, dyslipidemia, obesity and diabetes mellitus. Similar findings have been also reported for the Atherogenic Index of Plasma (AIP), i.e., the logarithmic transformation of the ratio between plasma triglycerides value and high-density plasma lipoprotein cholesterol. Both SUA and AIP have been found to be sensitive predictors of fatal and non-fatal cardiovascular events and all-cause mortality, their association representing a highly sensitive marker potentiating the predictive value of each single factor. Although a number of studies have investigated the relationships between SUA and AIP, the association between these two metabolic variables still remains indistinct. The main features of this hypothetical relationship and their connection with an unique leading metabolic alteration represent elements of interest for cardiovascular pathophysiology worthy of clinical investigation. The present paper, after briefly summarizing the main features of the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study, will review the epidemiologcal and clinical relevance of SUA as cardiovascular risk factor, based on the findings reported in the context of the above mentioned clinical investigation. The paper will finally report the data on the association between UA and AIP found in the PAMELA study, comparing them to the findings of the published studies on the topic.