Association of ideal cardiovascular health metrics with serum uric acid, inflammation and atherogenic index of plasma: A population-based survey
Journal article, 2019

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

C-reactive protein

Atherogenic index of plasma

Cardiovascular health

Serum uric acid


Mohsen Mazidi

Chalmers, Biology and Biological Engineering, Food and Nutrition Science

Niki Katsiki

Aristotle University of Thessaloniki

Dimitri P. Mikhailidis

University College London (UCL)

Maciej Banach

University of Zielona Góra

Polish Mother’s Memorial Hospital Research Institute

Medical University of Lodz


0021-9150 (ISSN)

Vol. 284 44-49

Subject Categories


Public Health, Global Health, Social Medicine and Epidemiology

Nutrition and Dietetics





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