TY - JOUR
T1 - Biochemical and clinical correlates of hypouricemia in surgical and critically
ill patients
AU - Giovannini, Ivo
AU - Chiarla, Carlo
AU - Giuliante, Felice
AU - Vellone, Maria
AU - Ardito, Francesco
AU - Pallavicini, Federico
AU - Nuzzo, Gennaro
PY - 2007
Y1 - 2007
N2 - Background: Changes in plasma uric acid concentration (UA, mu mol/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, mu mol/L)+0.6(preoperative UA)+4.3 (sodium, mmol/L)+5.4(glucose, mmol/L)-0.2(bilirubin, mu mol/L)-28.9(amino acid dose, g/kg/day) - 935.6; n = 23 1, r(2) =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.
AB - Background: Changes in plasma uric acid concentration (UA, mu mol/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, mu mol/L)+0.6(preoperative UA)+4.3 (sodium, mmol/L)+5.4(glucose, mmol/L)-0.2(bilirubin, mu mol/L)-28.9(amino acid dose, g/kg/day) - 935.6; n = 23 1, r(2) =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.
KW - Cholestasis
KW - Hypoalbuminemia
KW - Hypocholesterolemia
KW - Hypouricemia
KW - Parenteral amino acids
KW - Plasma antioxidant capacity
KW - Renal dysfunction
KW - Sepsis
KW - Surgical trauma
KW - Cholestasis
KW - Hypoalbuminemia
KW - Hypocholesterolemia
KW - Hypouricemia
KW - Parenteral amino acids
KW - Plasma antioxidant capacity
KW - Renal dysfunction
KW - Sepsis
KW - Surgical trauma
UR - http://hdl.handle.net/10807/14372
U2 - 10.1515/CCLM.2007.247
DO - 10.1515/CCLM.2007.247
M3 - Article
SN - 1434-6621
VL - 45
SP - 1207
EP - 1210
JO - Clinical Chemistry and Laboratory Medicine
JF - Clinical Chemistry and Laboratory Medicine
ER -