Association of Serum Uric Acid Levels with Peripheral Arterial Disease

Abstract

Peripheral arterial disease (PAD) is a chronic progressive disorder that results from accumulation of atherosclerotic plaques in the walls of arterial tree especially those of the lower limb leading to gradual narrowing of their lumens with eventual obstruction& limb loss if not treated. (1) Several factors have been implicated in that process. Along with traditional risk factors of atherosclerosis (DM, Dyslipidemia, Hypertension, CKD), other factors exist as elevated Fibrinogen, D-dimer, hyperhomocysteinemia, CRP…….etc. Generally Uric Acid (UA) has been accused for the initiation& progression of atherosclerosis in various arterial segments. Moreover, it showed significant correlation with markers of peripheral arterial stiffness in multiple clinical trials. It is thought to accumulate in the arterial wall& induce inflammation& activation of Xanthine Oxidoreductase enzyme. (5) Symptoms of PAD vary according to the site& degree of obstruction. In the lower limbs symptoms range from a symptomatic, exercise induced Intermittent Claudications(IC), Rest Pain to Critical Limb Ischemia (CLI), Ischemic Ulcers, Gangrene& Amputation. (3) Carotid stenosis manifests as symptoms of Transient Ischemic Attacks (TIA), Stroke syndromes or a symptomatic silent infarction (33).