engleski

INCREASED URIC ACID IN YOUNG ADULT MEN BORN AFTER INTRAUTERINE GROWTH RETARDATION

Objective: Intrauterine growth retardation (IUGR) has been associated with an increased incidence of adult cardiovascular disease (CV). Elevation of serum uric acid (UA) is related to vascular disfunction and hypertension. Our aim was to investigate whether UA have some influence on blood pressure and vascular function in young adult men born after IUGR. Design and method: A total of 95 healthy men (21.0+0.89 years) born small for gestational age (SGA) and 90 healthy men (21.5+1.02 years) born appropriate for gestational age (AGA) were enrolled. Anthropometric parameters, office and ambulatory blood pressure (BP), fasting blood glucose, lipid profile, eGFR, carotid intima media thickness (cIMT), pulse wave velocity (PWV), central blood pressure (cBP), aortic and brachial augmentation index (Aix) were determined in all participants. Birth parameters were obtained from medical records. Hyperuricemia was defined as UA >380 µmol/L. Results: SGA subjects had higher levels of UA compared to controls (342.5 vs. 308.7 ; p<0.001). SGA subjects with hyperuricemia had higher BMI and waist circumference (p<0.001), office systolic BP (p=0.047), cBP (p=0, 016), higher BP variability (p=0.021), lower eGFR (p=0, 007) and were prone to dyslipidaemia (p<0.001). These observations were not found in control group. There were no differences in cIMT, Aix, PWV between groups. There were positive correlations between UA and BMI, WC in both groups, and inverse with eGFR (p<0.001) in SGA group. When prematurity was taken into account UA positively correlated with BPvariability (p=0.003), cIMT (p=0.016) and negatively with birth weight (p=0.009). In multiple regression analysis, BMI was the key determinant of systolic BP (ß=0, 427, p<0, 001). Conclusion: Our results support findings of clustering of CV risk factors in young adult men born after IUGR with increased UA levels. No changes in vascular function regardig UA levels were observed. However, subtle changes in BP pattern were observed mainly influencing levels and variability of systolic blood pressure especially in preterm IUGR subjects which might be due to altered vasoconstriction in IUGR subjects with increased UA levels.

Intrauterine growth retardation, hyperuricaemia, blood pressure

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