J Rheum Dis.  2017 Jun;24(3):127-130. 10.4078/jrd.2017.24.3.127.

Hyper-homocysteinemia Inducing Hyperuricemia: What are the Mechanisms?

Affiliations
  • 1Department of Internal Medicine, Second University of Naples, Naples, Italy. fulviocacciapuoti@gmail.com

Abstract

Hyperuricemia is related to metabolic syndrome, and is defined as an over-production or under-excretion of uric acid (UA), with increased UA serum concentration. Among other causes, Hyper-homocysteinemia (H-Hcy) can be responsible for hyperuricemia. The mechanisms underlying the association between these two conditions are unclear, but increased UA serum levels can be a consequence of renovascular atherosclerosis, with reduced UA excretion. An alternative hypothesis is the over-production of UA from adenosine (originating from S-adenosyl-homocysteine). Genetic polymorphism (C677T) of methylenetetrahydrofolate reductase (MTHFR) may contribute. A possible mechanism is purines biosyinthesis originating from this gene variant. However, the results obtained from several studies and meta-analyses of the relationship between H-Hcy and hyperuricemia are ambivalent, and broader research is needed.

Keyword

Uricemia; Uric acid; Homocysteine; MTHFR C677T polymorphism

MeSH Terms

Adenosine
Atherosclerosis
Homocysteine
Hyperuricemia*
Methylenetetrahydrofolate Reductase (NADPH2)
Polymorphism, Genetic
Purines
Uric Acid
Adenosine
Homocysteine
Methylenetetrahydrofolate Reductase (NADPH2)
Purines
Uric Acid

Figure

  • Figure 1. Synthesis of uric acid from adenosine mono-phosphate (AMP).


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