{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:51:29Z","timestamp":1793371889978,"version":"4.5.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,2,20]]},"abstract":"\n Background<\/jats:title>\n \n The link between elevated serum uric acid (\n SUA<\/jats:styled-content>\n ) levels and cardiovascular disease (\n CVD<\/jats:styled-content>\n )\u2013related mortality in the elderly population remains inconclusive. Nutritional status influences both\n SUA<\/jats:styled-content>\n and\n CVD<\/jats:styled-content>\n outcomes. Therefore, we investigated whether\n SUA<\/jats:styled-content>\n \u2010predicted mortality and the effect\u2010modifying roles of malnourishment in older people.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A longitudinal Taiwanese cohort including 127\u00a0771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1\u2010mg\/dL increment of\n SUA<\/jats:styled-content>\n . Low\n SUA<\/jats:styled-content>\n (<4\u00a0mg\/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index <98, serum albumin <38\u00a0g\/L, or body mass index <22\u00a0kg\/m\n 2<\/jats:sup>\n . Study outcomes were all\u2010cause and\n CVD<\/jats:styled-content>\n \u2010related mortality. Cox models were used to estimate hazard ratios (\n HRs<\/jats:styled-content>\n ) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow\u2010up of 5.8\u00a0years, there were 16\u00a0439 all\u2010cause and 3877\n CVD<\/jats:styled-content>\n \u2010related deaths. Compared with the reference\n SUA<\/jats:styled-content>\n strata of 4 to <5\u00a0mg\/dL, all\u2010cause mortality was significantly higher at\n SUA<\/jats:styled-content>\n <4\u00a0mg\/dL (\n HR<\/jats:styled-content>\n , 1.16; 95% confidence interval, 1.07\u20131.25) and \u22658\u00a0mg\/dL (\n HR<\/jats:styled-content>\n , 1.13; confidence interval, 1.06\u20131.21), with progressively elevated risks at both extremes. Similarly, increasingly higher\n CVD<\/jats:styled-content>\n \u2010related mortality was found at the SUA level <4\u00a0mg\/dL (\n HR<\/jats:styled-content>\n , 1.19; confidence interval, 1.00\u20131.40) and \u22657\u00a0mg\/dL (\n HR<\/jats:styled-content>\n , 1.17; confidence interval, 1.04\u20131.32). Remarkably, among the low\n SUA<\/jats:styled-content>\n (<4\u00a0mg\/dL) strata, only malnourished participants had greater all\u2010cause and\n CVD<\/jats:styled-content>\n \u2010related mortality. This modifying effect of malnourishment remained consistent across subgroups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n SUA<\/jats:styled-content>\n \u22658 or <4\u00a0mg\/dL independently predicts higher all\u2010cause and\n CVD<\/jats:styled-content>\n \u2010related mortality in the elderly, particularly in those with malnourishment.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007523","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T16:19:31Z","timestamp":1518452371000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":156,"title":["U\u2010Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All\u2010Cause Mortality in the Elderly: The Role of Malnourishment"],"prefix":"10.1161","volume":"7","author":[{"given":"Wei\u2010Cheng","family":"Tseng","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Faculty of Medicine, National Yang\u2010Ming University, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine, National Yang\u2010Ming University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung\u2010Tai","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Taipei City Hospital Heping\u2010Fuyou Branch, Taipei, Taiwan"},{"name":"Faculty of Medicine, National Yang\u2010Ming University, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine, National Yang\u2010Ming University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo\u2010Ming","family":"Ou","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Faculty of Medicine, National Yang\u2010Ming University, Taipei, Taiwan"},{"name":"Institute 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