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Uric acid is a chemical which is created when the body breaks down an organic compound called purines. Purines can be exogenous or endogenous. Endogenous means purines are produced by the body, whereas exogenous purines come from items we consume.

The body usually dissolves uric acid in the blood, which then travels to the kidneys and is excreted through our urine. When the body creates an excessive amount of uric acid (also called hyperuricaemia) or is unable to remove sufficient amounts, this leads to illness and certain health conditions.

Image reference: Țăpoi, L., Șalaru, D.L., Sascău, R., & Stătescu, C. (2021). Uric acid - an emergent risk marker for thrombosis?


Gout is the most common inflammatory arthritis condition, which is caused by raised serum uric acid (SUA).

Symptoms

These common symptoms associated with gout affect one or more joints, mostly the big toe:

  • Pain
  • Swelling
  • Redness
  • Tenderness

Risk factors

The following are factors which increase uric acid levels:

  • Diet – includes liver, anchovies, mackerel, dried beans, red meat, shellfish, high sugar drinks, alcohol (mainly beer).
  • Being overweight – the body creates higher amounts of uric acid, making it more difficult for the kidneys to eliminate it.
  • Medical conditions – diabetes, metabolic syndrome, heart and kidney conditions.
  • Medications – low-dose aspirin, high blood pressure medication.
  • Family history.
  • Sex – occurs more often in males, however post-menopausal women have the same risk factor levels.

Uric acid and thrombosis

Research has found that raised uric acid levels is linked to compromised endothelial function, inflammatory response, prothrombotic state and thrombogenicity (the predisposition of a material to generate blood clotting when it comes into contact with the blood). Observational and experimental research studies have suggested that hyperuricaemia increases the risk of VTE.

The mechanisms involved with this association is thought to be the activation of the inflammation pathway which is provoked by elevated SUA. Inflammatory diseases, such as gout, are considered to increase the risk of VTE.

Information regarding normal uric acid values vary, with some suggesting a reading below 6.8 mg/dL is considered normal and above 8mg/dL is seen as very high and is indicative of hyperuricaemia. Ranges for males and females also vary.

Men – 3.4-7.0 mg/dL

Women – 2.4-6.0 mg/dL

Elevated SUA values may be associated with your risk of gout or similar related health conditions, however in respect to VTE risk, some research has provided different levels. Research from 2021 investigating the relationship between SUA and VTE found levels below 4.37 mg/dL were at a lower risk, and the groups which had values between 4.38-5.54 or ≥5.55 mg/dL had more than a 3-fold increased risk of VTE recurrence.


References