The Relationship between Serum Uric Acid Levels and Early Mortality in Chronic Obstructive Pulmonary Disease Cases during Exacerbation

Main Article Content

Omer Yüceer
Gökhan Büyükbayram
Fatma Sema Oymak


Chronic Obstructive Pulmonary Disease, Uric Acid, Uric Acid/Creatinine Ratio, Mortality


Aim: In this study, it was aimed to compare the levels of serum uric acid and uric acid/creatinine ratios in patients with COPD during an attack or in stable COPD, and to show whether serum uric acid and uric acid/creatinine ratios are associated with early mortality in COPD patients during an acute attack.

Materials and Methods: In this study, COPD acute attack (n=125) and stable COPD (n=30) patients were evaluated. The data of these patients were obtained from patient files and computer records. COPD diagnosis and severity assessment were made according to the GOLD 2006 guideline. Participants' age, gender, body mass index, pulmonary function test, arterial blood gas, uric acid, creatinine values ​​and comorbidity information were recorded in the previously prepared Case Data Form.

Results: It was determined that the uric acid (p˂0.001) and uric acid/creatinine (p˂0.001) levels of the patients in the acute attack group were significantly higher than the levels of the patients in the stable group. The attack group was divided into two subgroups according to certain cut-off points for uric acid (˃6 mg/dl for women and ˃7 mg/dl for men) and uric acid/creatinine ratio (median value 7.10). According to this categorization, it was determined that there was no statistically significant relationship between uric acid level (odds ratio 2.985 [95% confidence interval 0.618-14,151]) and early mortality risk.

Conclusion: The results of this study showed that the uric acid and uric acid/creatinine levels in the attack group were higher than the levels in the stable group, but these parameters were not associated with early mortality.


Download data is not yet available.
Abstract 170 | PDF Downloads 94


1. Vogelmeier, CF, Criner, GJ, Martinez, FJ., 2017. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary. Respirology 2017; 22: 575–601.
2. Ko, FW., Chan, KP., Hui, DS., Goddard, JR., Shaw, JG., Reid, DW., Yang, LA., 2016. Acute Exacerbation of COPD. Respirology;Https://
3. Zhang WZ, Gomi K, Mahjour SB, et al. Update in Chronic Obstructive Pulmonary Disease 2017. Am J Respir Crit Care. 2018; 197(12): 1534-1539.
4. Duffy SP, Criner GJ.,2019. Chronic Obstructive Pulmonary Disease: Evaluation and Management. Med Clin North Am. 2019; 103(3): 453-461.
5. Celli BR, MacNee W. ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932-4
6. Garcia-Pachon E, Padilla-Navas I, Shum C., 2007. Serum uric acid to creatinine ratio in patients with chronic obstructive pulmonary disease. Lung 2007;185:21-4.
7. Song, JU, Hwang, J, Ahn, JK., 2007. Serum uric acid is positively associated with pulmonary function in Korean health screening examinees. Mod Rheumatol 2017; 27: 1057–1065..
8. Kadowaki, T, Hamada, H, Yokoyama, A., 2007. Significance of serum uric acid in patients with chronic respiratory failure treated with non-invasive positive pressure ventilation. Intern Med 2007; 46: 691–697
9. Li, L, Wan, C, Wen, F ., 2014. An unexpected role for serum uric acid as a biomarker for severity of asthma exacerbation. Asian Pac J Allergy Immunol 2014; 32: 93–99.
10. Brandstatter A, Lamina C, Kiechl S, 2010. Sex and age interaction with genetic association of atherogenic uric acid concentrations. Atherosclerosis:210:474-8.
11. Brandstatter A, Kiechl S, Kollerits B, 2008. Sex-specific association of the putative fructose transporter SLC2A9 variants with uric acid levels is modified by BMI. Diabetes Care;3 1:1662-7.
12.Aida Y, Shibata Y, Osaka D, 2011. The relationship between serum uric acid and spirometric values in participants in a health check: the Takahata study. Int J Med Sci;8:470-8.
13. Kocak ND, Sasak G, Akturk UA, 2016. Serum uric acid levels and uric acid/creatinine ratios in stable chronic obstructive pulmonary disease (COPD) patients: are these parameters efficient predictors of patients at risk for exacerbation and/or severity of disease? Medical science monitor: İnternational Medical Journal of Experimental and Clinical Research. 2016;22:4169.
14.Kır,E.,2020. Serum ürik asit düzeyi ve ürik asit / kreatinin oranının KOAH şiddeti (stabil veya akut alevlenme) ve kor pulmonale gelişimi ile ilişkisi, 2020. Ondokuz Mayıs Üniversitesi / Tıp Fakültesi / Göğüs Hastalıkları Anabilim Dalı.
15. Matsuura F, Yamashita S,Nakamura T.,1998. Effect of visceral fat accumulation on uric acid metabolism in male obese subjects;visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneousfat obesity.Metabolısm 1998;47:929-33
16. Gabrielsen AM, Lund MB, Kongerud J.,2011. The relationship between anthropometric easures, blood gases, and lung function in morbidly obese white subjects. Obes Surg 2011;21:485-91.
17.Sarangi R., Varadhan N., Bahinipati J., Dhinakaran A., Anandara J., Ravichandran K., 2017. Serum Uric Acid in Chronic Obstructive Pulmonary Disease: A Hospital Based Case Control Study. J Clin Diagn Res. ;Sep; 11(9): BC09–BC13.
18. Kim, J., Yoo, JY., Kim, HS., 2019. Metabolic Syndrome in South Korean Patients with Chronıc Obstructıve Pulmonary Disease: A Focus on Gender Differences. https:// 10.1016/j.anr.2019.03.002

19.Eagan TM, Ueland T, Wagner PD, 2010. Systemic inflammatory markers in COPD: results from the Bergen COPD Cohort Study. Eur Respir J 2010;35:540-8.
20. Pinto-Plata V., Toso J., Lee K., 2007. Profiling serum biomarkers in patients with COPD:associations with clinical parameters. Thorax;62:595-601.
21. Hurst JR, Donaldson GC, Perera WR, 2006. Use of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006;174:867-74.
22. Wouters EF, Groenewegen KH, Dentener MA, 2007. Systemic inflammation in chronic obstructive pulmonary disease: the role of exacerbations. Proc Am Thorac Soc 2007;4:626-634.
23.He Z., Chen Y, Chen P, 2010. Local inflammation occurs before systemic inflammation in patients with COPD. Respirology 2010;15:478-84. 27.
24. Pizzini, A., Aichner, M., Sonnweber, T., Tancevski, I., Weiss, G., 2020. The Significance of iron deficiency and anemia in a real-life COPD cohort. İnternational Journal of Medical sciences.2020.17(4); 2232-2239.
25.Nikol, AH., Frise, MC., Cheng, H-Y., McGahey, A., McFadyen, BM., Harris-Wright, T., Bart, NK., Curtis, MK., Khandwala, S., O’Neill, DP., Pollard, KA., Hardinge, FM., Rahman, NM., Armitage, AE., Dorrington, KL., Drakesmith, H., Ratcliffe, PJ., Robbins, PA., 2015. A cross-sectional study of the prevalence and associations of iron deficiency in a cohort of patients with chronic obstructive pulmonary disease. Observational Study.BMJ Open. 2015:6; 5(7):e007911. Doi:10.1136/bmjopen-2015-007911.
26. Kaya Y., Çanakçı E., Botan Yıldırım B., Karataş A., Enginyurt Ö., Düğeroğlu H., Altaş H., 2017. Toplum Kökenli Pnömonili Hastalarda Ürik Asit Düzeyi ile Hastanede Yatış Süresi ve Mortalite Arasındaki İlişki. Klinik Tıp Aile Hekimliği Dergisi Cilt: 9 Sayı: 4 Temmuz – Ağustos.
27. Ko, FW., Hui, DS., 2012. Air pollution and chronic obstructive pulmonary disease.Respirology 2012;17:395-401.
28.Peckova L, Bandouchova H, Hilscherova K, et al. Biochemical responses of juvenile and adult Japanese quails to cyanobacterial biomass. Neuro Endocrinol Lett 2009;30 Suppl 1:199-204.

29.Mathru, M., Dries, DJ., Barnes, L., 1996. Tourniquet-induced exsanguination in patients requiring lower limb surgery. An ischemia-reperfusion model of oxidant and antioxidant metabolism. Anesthesiology. 84;14-22.
30. Hellsten Y, Tullson PC. Richter EA.,1997. Oxidation of urate in human skeletaI muscle during exercise. Free Radic Biol Med 1997;22:169-74.
31.Waring WS, Convery A, Mishra V, 2003. Uric acid reduces exercise-induced oxidative stress in healthy adults. Clin Sci (bond) 2003;105:425-30.
32. Haj Mouhamed D, Ezzaher A, Neffati F, 2011. Effect of cigarette smoking on plasma uric acid concentrations. Environ Health Prev Med 2011;16:307-12.