Aspectos metabólicos y complicaciones de la hiperuricemia
Resumen
El resultado de observaciones epidemiológicas inicia en la actualidad una reevaluación del ácido úrico en diferentes enfermedades metabólicas, enfermedad cardiovascular y renal. El rol de la hiperuricemia como factor de riesgo cardiovascular independiente es difícil de evaluar aún en análisis de modelos multivariados, dado que existen resultados inconclusos e inconsistentes en la mayoría de los estudios. Esta dificultad se observa por la fuerte asociación del ácido úrico con otros factores clásicos de riesgo cardiovascular que no permiten diferenciar el riesgo. Durante muchos años se lo consideró una sustancia biológicamente inerte, pero posteriormente se encontró que tiene muchas propiedades biológicas que podrían ser beneficiosas o perjudiciales para los seres humanos. Existen en la actualidad una controversia sobre si su rol es protector por tener propiedades anti-oxidante o lesivo por sus propiedades pro-oxidantes en la placa arterioesclerótica y en tejido adiposo lo que podría determinar que no solo se trate de un marcador de riesgo, sino que conforme un factor causal en las enfermedades metabólicas como la diabetes mellitus, el síndrome metabólico, las enfermedades cardiovasculares y/o renales. En esta revisión hemos actualizado estos conceptos de manera de intentar esclarecer dicho rol, para en un futuro se pueda instituir normas, que actualmente no están establecidas, para decidir si se debe tratar la hiperuricemia, en qué casos, con que niveles de corte y cuáles serían sus objetivos terapéuticos en cada circunstancia.
Citas
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