Association of ideal cardiovascular health metrics with serum uric acid, inflammation and atherogenic index of plasma: A population-based survey

  • Mohsen Mazidi
    Corresponding author.
    Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, China

    Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), Chaoyang, China
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  • Niki Katsiki
    Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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  • Dimitri P. Mikhailidis
    Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
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  • Maciej Banach
    Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland

    Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland

    Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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      • The link between inflammatory score, serum uric acid (SUA) and atherogenic index of plasma (AIP) with cardiovascular health (CVH) score was evaluated.
      • A negative association between SUA and CVH score was observed.
      • AIP was inversely related to CVH score.
      • Significant reductions in the odds of “high-risk atherosclerosis” and “CVD risk” were found across CVH categories.


      Background and aims

      We aimed to evaluate the link between inflammatory score [consisting of C-reactive protein (CRP) and white blood cells], serum uric acid (SUA) and atherogenic index of plasma (AIP) and the cardiovascular health (CVH) score.


      We used the cross-sectional National Health and Nutrition Examination Survey database. Statistical analyses accounted for the survey design and sample weights.


      Overall, there were 23,004 participants (mean age = 47.2 years, 46.5% males). Participants with an ideal CVH level had the highest ratio of poverty to income (3.62%, p < 0.001), as well as lower levels of CRP, SUA and AIP (p < 0.001 for all comparisons). In adjusted linear regression, a significant negative association was observed between inflammatory score (β = −0.052, p < 0.001), SUA (β = −0.041, p < 0.001) and AIP (β = −0.039, p < 0.001) and CVH score, i.e. participants with a better (greater) CVH score had a lower inflammatory score. Results from adjusted logistic regression showed reduction in the likelihood of “high-risk atherosclerosis” (defined as AIP ≥0.21) [intermediate: odds ratio (OR) = 0.90, 95% confidence interval (CI):0.85–0.95, ideal: OR = 0.81, 95%CI: 0.74–0.88] and “high CVD risk” (defined as CRP ≥3 mg/l) [intermediate: OR = 0.86, 95%CI:0.73–0.98, ideal: OR = 0.82, 95%CI:0.69–0.95] across the categories of CVH.


      Our findings highlight that CVH metrics were associated with inflammatory score, SUA and AIP. Furthermore, participants with a better CVH score had a lower CVD risk. These results reinforce the importance of implementing healthy behaviours as proposed by the American Heart Association. If confirmed in clinical trials, this knowledge may have implications for CVD prevention and management.


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