Serum uric acid level and all-cause and cardiovascular mortality in Chinese elderly: A community-based cohort study in Shanghai

Background and aims The association between serum uric acid (SUA) and the all-cause and cardiovascular diseases (CVD) mortality remains controversial, but few studies based on the community population in Shanghai have been reported. We aimed to evaluate the association of SUA level with all-cause and CVD mortality in Chinese elderly based on a community-based cohort study in Shanghai of China. Methods and results A total of 12,071 eligible participants were included, with a cumulative follow-up period of 46,063.65 person-years and a median of 4.67 years. The time-dependent Cox regression model indicated that when SUA level was classified into quartile groups, no significant association was observed between SUA level and all-cause death in both men and women and between SUA level and CVD mortality in men. However, the HR (95%CI) between SUA groups and CVD death in women was 3.75 (1.49–9.43) for quartile 1, 3.66 (1.53–8.76) for quartile 2, and 2.98 (1.33–6.69) for quartile 4, respectively, when compared with the quartile 3 SUA level. A significant non-linear association was observed between SUA level and CVD death in elderly women. An increased risk of CVD death was observed among women with SUA level less than 4.30 mg/dL at the baseline, and a lower risk, among women with SUA level of 4.30–4.72 mg/dL at the baseline. Conclusion The non-linear association between SUA level and CVD mortality in elderly women suggests a potential benefit of controlling SUA level at4.30–4.72 mg/dL in elderly Chinese women.