Serum Uric Acid in the PAMELA Study: Main Findings and Association with the Atherogenic Index of Plasma

Serum uric acid (SUA) overproduction, leading to hyperuricemia, represents a metabolic dysfunction of frequent detection in a number of diseases characterized by an elevated cardiovascular risk, such as metabolic syndrome, essential hypertension, dyslipidemia, obesity, and diabetes mellitus. Similar findings have been also reported for the Atherogenic Index of Plasma (AIP), i.e., a biomarker derived from the logarithmic transformation of the ratio between plasma triglycerides 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 in several indistinct aspects. The present paper, after briefly summarizing the main features of the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study, will review the main study results related to SUA as cardiovascular risk factors. It will also report the original data collected in the PAMELA study on (1) the association between SUA and AIP and (2) the relationships between AIP and normal and elevated blood pressure, metabolic profile, and target organ damage associated with hypertension.