الفهرس 
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Abstract
Menopause is one of the physiological stages in women’s life, during which women experience a series of physiological and psychological changes because of some complex processes such as disorder of endocrine system and/or dysregulation of neurological function. These changes, if not treated appropriately, may not only affect women’s health, but also may pose the life and work quality of the whole family at risk.
Women are known to have lower levels of serum uric acid (SUA) than men, which then increase with aging and with the onset of menopause until the levels roughly equal those of men in later years.
SUA increases as blood pressure rises, possibly due to reduced renal blood flow. Elevated UA is also associated with low-density lipoprotein (LDL) oxidation and subsequent vascular injury. Asymptomatic hyperuricemia may even precede the diagnosis and treatment of essential hypertension.
The carotid artery intima-media thickness (CAIMT) is easily, safely, reliably and inexpensively measured with B-mode ultrasound and its predictive value is increased when measured at multiple extracranial carotid sites. The normal intima-medial thickness of common carotid artery is 0.74 ± 0.14 mm. Some studies also indicated that CAIMT <0.8 mm is associated with normal healthy individuals, and a value at or above 1 mm is associated with atherosclerosis and a significantly increased CVD risk in any age group.
The CAIMT can be measured both from the near-wall and the far-wall of the carotid artery. In the far wall, it is usually easy to detect
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the media-adventitia interface, and this measurement location has been suggested as being more accurate.
SUA is associated with cardiovascular disease (CVD), however, it is still disputed whether this relationship is mediated by other risk factors such as obesity, dyslipidaemia, hypertension and insulin resistance.
Previous studies have indicated that there is significant difference in development of coronary artery disease (CAD) between premenopausal women and age-matched men, and such difference is not obvious between postmenopausal women and age-matched men.
In addition, estrogens, a group of important female hormones, have vasodilatation and anti-inflammatory functions. It has been shown that endogenous estrogens may play a protective role in the prevalence of CAD irrespective of sex.
The association between UA and CVD was largely ignored until the mid-1950s, when it was rediscovered. Since then, a number of epidemiologic studies have reported a relation between SUA levels and a wide variety of cardiovascular conditions, including: 1-hypertension, 2-metabolic syndrome, 3-coronary artery disease,4-cerebrovascular disease,5-vascular dementia, 6-preeclampsia, and kidney disease. The relation between UA and CVD is observed not only with frank hyperuricemia but also with UA levels considered to be in the normal to high range <5.2to 5.5 mg per deciliter.
Methodology:
Our study comprised a total of 100 healthy postmenopausal women from our outpatient department in Obstetrics and Gynecology
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Department, Menoufia University Hospitals from July 2013 to February 2015.
The study is a prospective observational study aimed at exploring the correlation between SUA and CAIMT and predictivity of SUA as a simple cheap screening test for early detection of CVD in postmenopausal ladies independently from other risk variables of metabolic syndrome (dyslipidemia, insulin resistance and obesity).
All participants were subjected to thorough history taking, complete medical examination, laboratory and radiological investigations including SUA and CAIMT measurement.
All participants were subjected to the same investigations after one year of follow up.
Results have been analyzed showing that our participant`s mean age was 54.24±6.30 years with range 45.0=66.10years. Menopausal years had a mean of 7.82±5.94 and range 1.0=20.0. All participants had normal blood pressure at baseline, after one year 28 participants from the whole population developed hypertension. They had high significance (P value <0.001)in relation to UA, CAIMT, and BMI. WC only of no significance value (P value 0.188).
Correlation between SUA and CAIMT pointed out a positive correlation (p value <0.001 ).
In those who developed hypertension (28%), SUA showed predictive value <0.001which was high significant, cut off point was 7.55. Sensitivity was 82% while when combined with CAIMT it become 100%. Specificity was 78%. Accuracy was 79% and become 70% when combined with CAIMT.