Salivary uric acid reactivity to discrimination stress and associations with cardiometabolic risk

Williams, S et al. (2022) APHA 2022 Annual Meeting and Expo

ABSTRACT: Background: Black and Latinx Americans are at disproportionate risk for cardiovascular disease (CVD) and metabolic syndrome. A well-documented pathway to these adverse health outcomes is psychosocial stress. Racism and racial discrimination are significant sources of stress for Black and Latinx Americans that potentially contribute to CVD. Salivary uric acid (sUA), a biomarker known to be associated with CVD and metabolic syndrome, has recently demonstrated stress reactivity.

Methods: We examined whether sUA showed reactivity related to a discrimination stressor and whether baseline sUA and sUA reactivity were associated with CVD and metabolic syndrome risk in 160 Black and Latinx adults. Saliva was collected before and after participants wrote about a personal experience of racial discrimination. Path analysis examined relationships between baseline sUA, sUA reactivity, BMI, and cardiometabolic outcomes (heart rate, systolic and diastolic blood pressure, and HbA1c).

Results: sUA showed reactivity to the discrimination stressor. There was an association between baseline sUA and systolic blood pressure, as well as sUA reactivity and heart rate and HbA1c. There was also an association between baseline sUA and outcomes of heart rate and HbA1c mediated by sUA reactivity, and between BMI and systolic blood pressure mediated by baseline sUA.

Conclusions: Results demonstrate that sUA is reactive to discrimination stress. Further, both higher baseline sUA and reactivity are linked with CVD and metabolic syndrome risk. These findings provide preliminary evidence suggesting that elevated uric acid levels may be a mechanism by which racism-based stress affects CVD and metabolic syndrome risk in Black and Latinx Americans.

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Keywords: saliva, uric acid, stress, discrimination stress, stress reactivity, metabolic syndrome, cardiovascular disease