Purine-rich foods, protein intake, and the prevalence of hyperuricemia: the Shanghai Men's Health Study

Hyperuricemia versus lifestyle in men and women of the Russian Federation population

Objective ― Analyzing gender-related specificities of hyperuricemia associations with lifestyle choices in the Russian Federation (RF) population. Material and Methods ― Cross-sectional survey was performed within the guidelines of the Russian national multicenter study ESSE-RF. The final sample size was 20781 people 25-64 years old. The effect of age, body mass index (BMI), diet, smoking status, and alcohol consumption on the incidence of hyperuricemia was evaluated. The analysis was carried out separately for men and women, using logistic regression. To build a model for predicting hyperuricemia, classification trees were used. Results ― Multidirectional associations of hyperuricemia were revealed both in women (with BMI, age, ‘Smart’ dietary pattern, alcohol consumption) and in men (with BMI, ‘smart’ dietary pattern, alcohol consumption, smoking status). The predictive accuracy of hyperuricemia incidence models was 60.4% in women vs. 65.7% in men. In both gender groups, BMI had the highest contribution to predicting the hyperuricemia incidence, while the next predictors, in terms of significance, differed among men and women. In women, the greatest impact, in decreasing order, was exerted by age, dietary patterns and drinking, whereas in men, by smoking status, dietary patterns and drinking. Conclusion ― In the RF population, there are multiple gender-specific associations of hyperuricemia with lifestyle choices, particularly nutrition, smoking and alcohol consumption.

Association between retinol intake and hyperuricaemia in adults

OBJECTIVE

Current evidences on the association between hyperuricaemia and retinol intake remain inconsistent. Furthermore, no known studies have investigated the relationship between hyperuricaemia and retinol intake from animal food and plant food separately. This study aimed to assess the relationship between different sources of retinol intake and risk of hyperuricaemia among US adults.

DESIGN

Univariate and multivariate weighted logistic regression models and restricted cubic spline models were used to assess the associations of total, animal-derived and plant-derived retinol intakes with the risk of hyperuricaemia. Dietary retinol was measured through two 24-h dietary recall interviews. Hyperuricaemia was defined as serum uric acid level ≥7·0 and ≥6·0 mg/dl in men and women, respectively.

SETTING

Data from the National Health and Nutrition Examination Survey 2009-2014 were used in this cross-sectional study.

PARTICIPANTS

Overall, 12 869 participants aged ≥20 years were included.

RESULTS

Compared with the lowest quintile, the multivariable OR of hyperuricaemia for the highest quintile intake of total, animal-derived and plant-derived retinol were 0·71 (95 % CI 0·52, 0·96), 0·76 (95 % CI 0·59, 0·96) and 0·92 (95 % CI 0·72, 1·17), respectively. The inverse association between dietary intake of total retinol and the risk of hyperuricaemia was observed in men. Dose-response analyses revealed a novel linear trend between the risk of hyperuricaemia and total, animal-derived retinol intake separately.

CONCLUSIONS

Our findings indicated that intakes of total and animal-derived retinol were negatively associated with hyperuricaemia in US adults.

Determination of total purine and purine base content of 80 food products to aid nutritional therapy for gout and hyperuricemia

The aim of this work is to facilitate the nutritional therapy of gout and hyperuricemia. In Japan, patients with gout or hyperuricemia are recommended to consume less than 400 mg of dietary purines per day. When receiving nutritional therapy for gout or hyperuricemia, purine-rich foods (>200 mg/100 g) should be eaten in even lower quantities. The purine content of foods reported in this study are as follows: noodles, 0.6-12.1 mg/100 g; bread, 4.4 mg/100 g; peas or seeds, 19.6-67.1 mg/100 g; dairy, 0.0-1.4 mg/100 g; Japanese vegetables, 0.9-47.1 mg/100 g; seasonings, 0.7-847.1 mg/100 g; meat or fish, 19.0-385.4 mg/100 g; fish milt, 375.4-559.8 mg/100 g; and supplements, 81.9-516.0 mg/100 g. Foods containing very large amounts of purine (>300 mg/100 g) included anchovy, cutlassfish (hairtail), cod milt, globefish milt, dried Chinese soup stock, dried yeast, a Euglena supplement, and a Lactobacillus supplement. When eating these high-purine food or supplements, the quantity taken at one meal should be limited, especially milt because they typically consumed amount of 20-30 g is equivalent to 75-168 mg total purines. This is 20%-40% of the recommended daily amount (400 mg/day) for patients with gout or hyperuricemia. Thus, these patients should restrict the amount of purine-rich foods they consume. Good dietary habits with a good balance of nutrients are recommended.

Short-Communication: Ingestion of a Nucleotide-Rich Mixed Meal Increases Serum Uric Acid Concentrations but Does Not Affect Postprandial Blood Glucose or Serum Insulin Responses in Young Adults

Circulating uric acid concentrations have been linked to various metabolic diseases. Consumption of large boluses of nucleotides increases serum uric acid concentrations. We investigated the effect of a nucleotide-rich mixed meal on postprandial circulating uric acid, glucose, and insulin responses. Ten healthy adults participated in a randomised, controlled, double-blind, crossover trial in which they consumed a mixed-meal containing either nucleotide-depleted mycoprotein (L-NU) or high-nucleotide mycoprotein (H-NU) on two separate visits. Blood samples were collected in the postabsorptive state and throughout a 24 h postprandial period, and were used to determine circulating uric acid, glucose, and insulin concentrations. Mixed meal ingestion had divergent effects on serum uric acid concentrations across conditions (time x condition interaction; P < 0.001), with L-NU decreasing transiently (from 45 to 240 min postprandially) by ~7% (from 279 ± 16 to 257 ± 14 µmol·L^-1) and H-NU resulting in a ~12% increase (from 284 ± 13 to 319 ± 12 µmol·L^-1 after 210 min), remaining elevated for 12 h and returning to baseline concentrations after 24 h. There were no differences between conditions in blood glucose or serum insulin responses, nor in indices of insulin sensitivity. The ingestion of a nucleotide-rich mixed-meal increases serum uric acid concentrations for ~12 h, but does not influence postprandial blood glucose or serum insulin concentrations.

Management of asymptomatic hyperuricemia: Integrated Diabetes & Endocrine Academy (IDEA) consensus statement

AIM

The definition and management of asymptomatic hyperuricemia has been an area of controversy for many decades. Debate persists regarding the benefit of treating all cases of asymptomatic hyperuricemia and hence, unsurprisingly there are no clear clinical practice guidelines from our country.

PARTICIPANTS

Ten members consisting of eminent physicians, endocrinologists, nephrologist and a rheumatologist were selected by the Integrated Diabetes & Endocrine Academy (IDEA) for a closed meeting with the aim to come to a consensus.

EVIDENCE

A literature search was performed using PubMed and Cochrane library following which published articles in indexed peer review journals were selected.

CONSENSUS PROCESS

Each participant voiced their opinion after reviewing the available data and a consensus was reached after three meetings by voting.

CONCLUSION

Recommendations were made on important areas such as definition, investigation and management of asymptomatic hyperuricemia.

Risk Factors For Hyperuricemia In Chinese Centenarians And Near-Centenarians

Purpose

Hyperuricemia is an important potential pathogenic factor for hypertension, cardiovascular disease and stroke. The current study aimed to investigate the prevalence of hyperuricemia and its relationship to lifestyle characteristics and dietary habits in centenarians and near-centenarians.

Patients and methods

In total, 966 centenarians and 788 near-centenarians were included. Community-based surveys were conducted to collect information about lifestyle. Blood examinations were performed using enzymatic assays. T-tests and χ2 tests were used to investigate significant indicators of hyperuricemia, and multivariate logistic regression was used to analyze the related risk factors. A comprehensive analysis of nineteen modifiable factors, including lifestyle characteristics, dietary habits, general characteristics and blood test indexes, was conducted.

Results

The prevalence of hyperuricemia was 29.02%. The percentage of men, waist circumference (WC), waist-hip ratio, estimated glomerular filtration rate (eGFR), levels of total protein (TP), alanine aminotransferase, aspartate aminotransferase, triglycerides, high-density lipoprotein cholesterol, serum homocysteine, serum uric acid, serum urea and serum creatinine, passive smoking, alcohol consumption, snoring, preference for fried flavors, and meat, seafood and vegetable consumption were significantly different between the hyperuricemia group and the normouricemia group (p<0.05). Multivariate logistic regression analysis showed that WC (OR=1.020), eGFR (OR=0.960), TP level (OR=1.038), serum urea level (OR=1.154), passive smoking (OR=2.589), snoring (OR=2.003), meat consumption (OR=2.506), seafood consumption (OR=1.422) and vegetable consumption (OR=0.521) were significantly associated with the risk of hyperuricemia (p<0.05).

Conclusion

Low eGFR and vegetable consumption, high WC, TP, and serum urea levels, passive smoking, snoring, and high meat and seafood consumption were independent risk factors for hyperuricemia. It is recommended that people at high risk for hyperuricemia should actively limit their intake of fried food, alcohol and purine-rich food, increase their intake of fresh vegetables, actively treat sleep apnea syndrome, avoid passive smoking, maintain a healthy WC and seek to improve their kidney and liver function.

Impact of a High Protein Intake on the Plasma Metabolome in Elderly Males: 10 Week Randomized Dietary Intervention

High protein diets may improve the maintenance of skeletal muscle mass in the elderly, although it remains less clear what broader impact such diets have on whole body metabolic regulation in the elderly. Non-targeted polar metabolomics analysis using HILIC HPLC-MS was used to profile the circulating plasma metabolome of elderly men (n = 31; 74.7 ± 4.0 years) who were randomized to consume for 10 weeks a diet designed to achieve either protein (RDA; 0.8·g⁻¹·kg⁻¹) or that doubled this recommend intake (2RDA; 1.6.g.kg⁻¹). A limited number of plasma metabolites (n = 24) were significantly differentially regulated by the diet. These included markers of protein anabolism, which increased by the 2RDA diet, including; urea, creatine, and glutarylcarnitine. Whilst in response to the RDA diet; glutamine, glutamic acid, and proline were increased, relative to the 2RDA diet (p < 0.05). Metaboanalyst identified six major metabolic pathways to be influenced by the quantity of protein intake, most notably the arginine and proline pathways. Doubling of the recommended protein intake in older males over 10 weeks exerted only a limited impact on circulating metabolites, as determined by LC-MS. This metabolomic response was almost entirely due to increased circulating abundances of metabolites potentially indicative of altered protein anabolism, without evidence of impact on pathways for metabolic health.

Trial Registration: This trial was registered on 3rd March 2016 at the Australia New Zealand Clinical Trial Registry (www.anzctr.org.au) at ACTRN 12616000310460.

Dietary Patterns, Exercise, and the Metabolic Syndrome Among Young People in Urban Pakistan (Lahore)

Background: Increasing urbanization, mechanization, and rural-to-urban migration has led to deranged sleeping patterns, surplus energy intake, and sedentary lifestyles in South Asian young people. This shift poses an insidious health risk for the development of metabolic syndrome (MetS). Early detection is needed because in the South Asian population, this syndrome carries an increased risk of comorbidities compared to people without the syndrome. This study was designed to elucidate the prevalence of MetS and its risk factors in young people in urban areas of Pakistan. Methods: A cross-sectional study was conducted in four undergraduate institutions in Lahore, Pakistan. Five hundred and nine young people participated, and each provided their informed consent for the collection of data on their demographic, physical, and biochemical characteristics along with information on their dietary, sleep, and physical activity habits. Results: Most participants reported consuming greater-than-recommended amounts of protein and smaller-than-recommended amounts of vegetables and fruits. The International Diabetes Federation criteria for MetS were fulfilled by 6.1% of the students. Hypertension (67.7%) and hypo-HDL-emia (64.5%) were the most common risk factors. More than 50% of the respondents slept fewer hours per day than recommended, and 33% had a sedentary lifestyle. Men, participants with a family history of metabolic illness and those with low physical activity levels had higher odds of a positive result on screening for MetS. Conclusions: The early detection of MetS and early identification of probable risk factors may make beneficial contributions to both public health and clinical interventions directed at high-risk individuals. Establishing and using cutoff values for modified waist circumference and specific body mass index in Asian populations may aid in early detection.

Epidemiology and prevalence of hyperuricemia among men and women in Chinese rural population: The Henan Rural Cohort Study

Objective: The aim of this study was to explore the latest prevalence of hyperuricemia and influencing factors in Chinese rural population.Methods: A survey was conducted from July 2015 to September 2017. A total of 38,855 (15,371 men and 23,484 women) subjects were recruited from the Henan Rural Cohort Study. Hyperuricemia was defined as a serum urate level of >7.0 mg/dL for men and >6.0 mg/dL for women. A meta-analysis of 19 studies that focused on hyperuricemia prevalence was performed to validate the result of the cross-sectional survey.Results: The crude and age-standardized prevalence of hyperuricemia was 10.24% and 12.60%, respectively. The prevalence of hyperuricemia decreased in men with increasing age, but the opposite trend was observed in women. The results of meta-analysis demonstrated that hyperuricemia prevalence in Chinese rural areas was 11.7%, consistent with the result of current survey. Multivariate logistic regression revealed that overweight or obesity, hypercholesterolemia, hypertriglyceridemia, hypoalphalipoproteinemia and high serum creatinine level could increase the risk of hyperuricemia, while high physical activity and fasting plasma glucose were associated with a lower risk of hyperuricemia in all participants.Conclusion: The latest prevalence of hyperuricemia is high in rural China and is associated with multiple factors, indicating that prevention and control strategies for hyperuricemia are needed urgently.

Effect of Inositol Hexaphosphate (IP6) on Serum Uric Acid in Hyperuricemic Subjects: a Randomized, Double-Blind, Placebo-Controlled, Crossover Study

Inositol hexaphosphate (IP₆), a food constituent with various health benefits, has been shown to suppress postprandial elevations of serum uric acid (SUA) levels in healthy adults by inhibiting purine nucleoside and base absorption. Here, we investigated the effect of repeated intake of IP₆ on fasting SUA levels in hyperuricemic subjects. This randomized double-blind placebo-controlled crossover design study included 31 asymptomatic hyperuricemic subjects (fasting SUA level > 7.0 but <9.0 mg/dL). Subjects ingested placebo or IP₆ drinks (600 mg twice daily) during two 2-week intervention periods with a 2-week washout period. The primary outcome was fasting SUA level; the secondary outcome was the urinary uric acid to creatinine ratio. Fasting SUA levels in the IP₆ group were lower than those in the placebo group (p < 0.05). The urinary uric acid to creatinine ratio did not change between the placebo and IP₆ groups (p > 0.05). This study showed that a 2-weeks supplementation period of 600 mg IP₆ twice daily can improve fasting SUA levels in hyperuricemic subjects.

Effect of phytic acid on postprandial serum uric acid level in healthy volunteers: a randomized, double-blind, crossover study

Phytic acid, a constituent of various plants, has been related to health benefits. Phytic acid has been shown to inhibit purine nucleotide metabolism in vitro and suppress elevation of plasma uric acid levels after purine administration in animal models. This study investigated the effect of phytic acid on postprandial serum uric acid (SUA) in humans. This randomized, double-blind, crossover design study included 48 healthy subjects with normal fasting SUA. Subjects consumed a control drink and a phytic acid drink with purine-rich food, and serum and urine uric acid levels were measured for 360 min after purine loading. Phytic acid lowered the incremental area under the curve (0-360 min) and incremental maximum concentration of SUA after purine loading (p < 0.05); tended to lower cumulative urinary uric acid excretion (0-360 min) after purine loading (p < 0.10); and suppressed postprandial SUA in this clinical study. Altogether, our findings suggest that phytic acid may play a beneficial role in controlling postprandial SUA.

Cross-sectional association between non-soy legume consumption, serum uric acid and hyperuricemia: the PREDIMED-Plus study

PURPOSE

To assess the association between the consumption of non-soy legumes and different subtypes of non-soy legumes and serum uric acid (SUA) or hyperuricemia in elderly individuals with overweight or obesity and metabolic syndrome.

METHODS

A cross-sectional analysis was conducted in the framework of the PREDIMED-Plus study. We included 6329 participants with information on non-soy legume consumption and SUA levels. Non-soy legume consumption was estimated using a semi-quantitative food frequency questionnaire. Linear regression models and Cox regression models were used to assess the associations between tertiles of non-soy legume consumption, different subtypes of non-soy legume consumption and SUA levels or hyperuricemia prevalence, respectively.

RESULTS

Individuals in the highest tertile (T3) of total non-soy legume, lentil and pea consumption, had 0.14 mg/dL, 0.19 mg/dL and 0.12 mg/dL lower SUA levels, respectively, compared to those in the lowest tertile (T1), which was considered the reference one. Chickpea and dry bean consumption showed no association. In multivariable models, participants located in the top tertile of total non-soy legumes [prevalence ratio (PR): 0.89; 95% CI 0.82-0.97; p trend = 0.01, lentils (PR: 0.89; 95% CI 0.82-0.97; p trend = 0.01), dry beans (PR: 0.91; 95% C: 0.84-0.99; p trend = 0.03) and peas (PR: 0.89; 95% CI 0.82-0.97; p trend = 0.01)] presented a lower prevalence of hyperuricemia (vs. the bottom tertile). Chickpea consumption was not associated with hyperuricemia prevalence.

CONCLUSIONS

In this study of elderly subjects with metabolic syndrome, we observed that despite being a purine-rich food, non-soy legumes were inversely associated with SUA levels and hyperuricemia prevalence.

TRIAL REGISTRATION

ISRCTN89898870. Registration date: 24 July 2014.

Uric Acid and Plant-Based Nutrition

Plant-based diets (PBDs) are associated with decreased risk of morbidity and mortality associated with important noncommunicable chronic diseases. Similar to animal-based food sources (e.g., meat, fish, and animal visceral organs), some plant-based food sources (e.g., certain soy legume products, sea vegetables, and brassica vegetables) also contain a high purine load. Suboptimally designed PBDs might consequently be associated with increased uric acid levels and gout development. Here, we review the available data on this topic, with a great majority of studies showing reduced risk of hyperuricemia and gout with vegetarian (especially lacto-vegetarian) PBDs. Additionally, type of ingested purines, fiber, vitamin C, and certain lifestyle factors work in concordance to reduce uric acid generation in PBDs. Recent limited data show that even with an exclusive PBD, uric acid concentrations remain in the normal range in short- and long-term dieters. The reasonable consumption of plant foods with a higher purine content as a part of PBDs may therefore be safely tolerated in normouricemic individuals, but additional data is needed in hyperuricemic individuals, especially those with chronic kidney disease.

Hypertriglyceridemia and hyperuricemia: a retrospective study of urban residents

Background

The aim of this study was to determine the association between hypertriglyceridemia and hyperuricemia (HUA).

Methods

The study was conducted in 3884 subjects who had not received medication enrolled as a baseline. Each participant received at least three annual health check-ups between 2011 and 2017. The risk of hyperuricemia was assessed in four Quartiles (Q1 to Q4) according to TG levels using multivariate-adjusted logistic regression models.

Results

The total incidence rate of HUA was 62.3/1000 person-years. In the univariate analysis, the risk of hyperuricemia in people with hypertriglyceridemia was 2.353 times that of normal triglycerides, with a 95% confidence interval of (2.011, 2.754), and the risk of hyperuricemia in men was 1.86 times of female, and the 95% confidence interval is (1.634, 2.177). After adjusting the potential confounders, the relative risk RR of TG at Q2 Q3 Q4 was 1.445 (95%CI:1.114, 1.901), 2.075 (1.611, 2.674), 2.972 (2.322, 3.804).

Conclusions

TG is an independent risk factor for hyperuricemia. As the level of TG increases, the risk of HUA increases.

Beneficial Effect of Dietary Fiber on Hyperuricemia in Rats and Humans: A Review

Hyperuricemia is recognized as a lifestyle-related disease and the prevalence is increasing in many parts of the world. Excessive intake of purines increases serum uric acid concentration and is thought to be one factor causative of hyperuricemia. Therefore, it is thought that prevention of hyperuricemia by dietary control may be very important. This is an article of our basic research regarding the role of dietary fiber in the suppression of hyperuricemia induced by dietary purines in rats; in addition, clinical research suggesting the possibility that dietary fiber intake has a beneficial effect on the prevention or suppression of hyperuricemia in humans is discussed. Our own studies reveal that the test dietary fiber significantly suppresses the elevation of serum uric acid concentration induced by dietary RNA (12.3-46.2%), adenosine-5'-monophosphate (9.5-23.2%), adenosine (10.7-20.4%), or adenine (16.3-38.9%) and suppresses experimental hyperuricemia in rats. The mechanism is presumed to be mediated by suppression of the digestion and/or absorption of dietary purines by dietary fiber. In clinical studies, intake of dietary fiber decreases serum uric acid concentrations. Reports of recent epidemiological studies indicate that higher levels of hyperuricemia increase the prevalence of its comorbidities (e.g., chronic kidney disease, obesity, hypertension, diabetes, and cardiovascular disease) and dietary fiber intake is associated with significantly lower risk for hyperuricemia and its comorbidities. We wish to emphasize the importance of recognizing the validity of increased dietary fiber intake as a preventive or suppressive method for hyperuricemia and its comorbidities.

The Demographic Diversity of Food Intake and Prevalence of Kidney Stone Diseases in the Indian Continent

Food intake plays a pivotal role in human growth, constituting 45% of the global economy and wellbeing in general. The consumption of a balanced diet is essential for overall good health, and a lack of equilibrium can lead to malnutrition, prenatal death, obesity, osteoporosis and bone fractures, coronary heart diseases (CHD), idiopathic hypercalciuria, diabetes, and many other conditions. CHD, osteoporosis, malnutrition, and obesity are extensively discussed in the literature, although there are fragmented findings in the realm of kidney stone diseases (KSD) and their correlation with food intake. KSD associated with hematuria and renal failure poses an increasing threat to healthcare infrastructures and the global economy, and its emergence in the Indian population is being linked to multi-factorial urological disorder resulting from several factors. In this realm, epidemiological, biochemical, and macroeconomic situations have been the focus of research, even though food intake is also of paramount importance. Hence, in this article, we review the corollary associations with the consumption of diverse foods and the role that these play in KSD in an Indian context.

Physiological consequences of biologic state and habitat dynamics on the critically endangered Yangtze finless porpoises (Neophocaena asiaeorientalis ssp. asiaeorientalis) dwelling in the wild and semi-natural environment

The objectives of this study were to investigate the effects of habitat and biological state on the physiology of critically endangered wild and semi-natural Yangtze Finless Porpoises (YFPs; Neophocaena asiaeorientalis ssp. asiaeorientalis) by measuring and comparing serum biochemical parameters. A total of 168 YFPs were sampled, 68 living in the semi-natural (Tian-E-Zhou Oxbow) and 98 living in the wild (Poyang Lake, PL) environment. The YFPs in the Tian-E-Zhou Oxbow were sampled from 2002 to 2015 and in the PL from 2009 to 2017. Each population was divided into Juvenile Male, Juvenile Female, Adult Male, Pregnant and Lactating Female life history categories. Overall, with location, 19/33 of the analytes and with season 18/33 of the analytes were significantly different. Similarly, within each location, 15/33 of the analytes changed with time in PL while only 8/33 changed with time in Tian-E-Zhou Oxbow, respectively. Finally, 15/33 of the analytes demonstrated significant differences between the different age and sex groups of animals. In our study, a significant variation, as well as an increasing and decreasing pattern of several parameters in both populations, suggest a worsening ecological environment of both habitats. This study will help in health assessment, improving conservation and management practices, a crucial requisite for biodiversity conservation.

Association of hyperuricemia with metabolic syndrome among university workers: sex and occupational differences

BACKGROUND

The relationship between metabolic syndrome (MetS) and hyperuricemia is not fully understood.

OBJECTIVE

To examine the association of hyperuricemia with MetS and the component of MetS that is mostly influenced by hyperuricemia among university workers.

METHODS

Anthropometric measurements, blood pressure, glucose, lipid profiles, renal function tests were measured in 1198 male and 1075 female (22-60 years old) workers on annual medical examination.

RESULTS

Hyperuricemia was 3-fold higher in males (odds ratio, OR, 2.938, 95% confidence interval, CI, 1.909-4.522, P<0.01) than females after adjustment for age, body mass index (BMI) and renal function. Overall, individuals with hyperuricemia were 3.9-fold likely to have MetS OR, 3.903; CI (2.439-6.245), P<0.01, and dyslipidemia, 2.5 times (OR, 2.501; 95% CI, 1.776-3.521, P<0.01) after adjustment for age, BMI, sex and renal function. However, no associations were found in individuals with hypertension (OR, 1.427; 95% CI, 0.996-2.205, P=0.052) and hyperglycemia (OR, 1.476; 95% CI, 0.989-2.202, P=0.057). Administrative work positively associated (OR, 1.895; 95% CI, 1.202-2.925, P<0.05) with hyperuricemia in males and not females.

CONCLUSION

Male workers with hyperuricemia, especially those working in administration were at risk of metabolic syndrome. It is important to screen, prevent and treat metabolic syndrome in individuals diagnosed with hyperuricemia at the workplace.

Folate, Vitamin B6 and Vitamin B12 Intake in Relation to Hyperuricemia

To assess the association between intake of folate, vitamin B6, and vitamin B12 with hyperuricemia (HU) among adults from the United States (US), we extracted relevant data from 24,975 US adults aged 20–85 years from the National Health and Nutrition Examination Survey (NHANES) in 2001–2014. All dietary intake was evaluated by 24-h dietary recalls. Multivariable logistic regression analysis was performed to explore the associations after adjustment for confounders. Compared to the lowest quintile (Q1), for males, adjusted odds ratios (ORs) of HU in Q2 to Q5 of folate (dietary folate equivalent, DFE) intake were 0.84 (95% CI, 0.73–0.96), 0.84 (0.73–0.97), 0.72 (0.62–0.84), and 0.64 (0.53–0.77), respectively (p for trend <0.0001). In females, adjusted ORs in Q2 to Q4 of folate (DFE) intake were 0.84 (95% CI, 0.71–0.99), 0.81 (0.68–0.96), and 0.82 (0.68–0.99), with a p for trend of 0.1475. Our findings indicated the intakes of total folate, folic acid, food folate, folate (DFE), vitamin B12, but not vitamin B6, were inversely related to the risk of HU in males. A lower risk of HU with higher intakes of total folate, food folate, and folate (DFE) was found in females, but with no association between intakes of folic acid, vitamin B6, B12, and the risk of HU for females.

Uric Acid and Cognitive Function in Older Individuals

Hyperuricemia has been recognized as an independent cardiovascular risk factor in epidemiological studies. However, uric acid can also exert beneficial functions due to its antioxidant properties, which may be particularly relevant in the context of neurodegenerative diseases. In this paper, we critically revise the evidence on the relationship between serum uric acid levels and cognitive function in older individuals, focusing on the etiology of cognitive impairment (Alzheimer’s disease, Parkinson’s dementia, and vascular dementia) and on the interactive connections between uric acid, dementia, and diet. Despite high heterogeneity in the existing studies, due to different characteristics of studied populations and methods of cognitive dysfunction assessment, we conclude that serum uric acid may modulate cognitive function in a different way according to the etiology of dementia. Current studies indeed demonstrate that uric acid may exert neuroprotective actions in Alzheimer’s disease and Parkinson’s dementia, with hypouricemia representing a risk factor for a quicker disease progression and a possible marker of malnutrition. Conversely, high serum uric acid may negatively influence the disease course in vascular dementia. Further studies are needed to clarify the physio-pathological role of uric acid in different dementia types, and its clinical-prognostic significance.

Association between Dietary Zinc Intake and Hyperuricemia among Adults in the United States

We aim to explore the associations between dietary zinc intake and hyperuricemia (HU) in United States (US) adults. 24,975 US adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2014 were stratified into quintiles based on zinc intake. All dietary intake measured through 24-h dietary recalls. Multivariable logistic regression analysis was performed to examine the association between zinc intake and HU after adjustment for possible confounders. For males, compared with respondents consuming less than 7.33 mg zinc daily, the adjusted odds ratios (ORs) were 0.83 (95% CI, 0.71, 0.97) among those consuming 10.26–13.54 mg zinc daily, 0.78 (95% CI, 0.63–0.96) among those consuming 18.50 mg or greater, and p for the trend was 0.0134. For females, compared with respondents consuming less than 5.38 mg zinc daily, the OR was 0.78 (95% CI, 0.63, 0.97) among those consuming 9.64–12.93 mg zinc daily, and p for the trend was 0.3024. Our findings indicated that dietary zinc intake is inversely associated with HU in US men and women, independent of some major confounding factors.

Lactobacillus gasseri PA-3 utilizes the purines GMP and guanosine and decreases their absorption in rats

Excessive intake of purine-rich foods elevates serum uric acid levels, making it a risk factor for hyperuricemia. We hypothesized that lactic acid bacteria ingested with food might utilize purines and contribute to their decreased absorption in the intestines, thereby preventing hyperuricemia. We previously reported that Lactobacillus gasseri PA-3 (PA-3) incorporates adenosine/inosine and related purines and that oral ingestion of PA-3 reduced the absorption of these purines in rats. However, it is unclear whether PA-3 also decreases the absorption of other purines, such as guanosine 5'-monophosphate (GMP) and guanosine. This study investigated whether PA-3 incorporates GMP and guanosine and reduces their absorption in rats. PA-3 incorporated both purines, with ¹⁴C-GMP uptake being greater than that of ¹⁴C-guanosine. Radioactivity in rat blood was significantly lower 30, 45, and 60 minutes after administration of ¹⁴C-GMP plus PA-3 than after administration of ¹⁴C-GMP alone and was significantly lower 15 minutes after administration of ¹⁴C-guanosine plus PA-3 than after administration of ¹⁴C-guanosine alone. PA-3 incorporates GMP and guanosine in vitro. Oral administration of PA-3 with GMP and guanosine reduces the intestinal absorption of these purines in vivo. These findings, together with those of previous studies, indicate that PA-3 reduces the absorption of major purines contained in foods. PA-3 may also attenuate the excessive absorption of dietary purines in humans, protecting these individuals against hyperuricemia.

Association of dietary patterns and hyperuricemia: a cross-sectional study of the Yi ethnic group in China

BACKGROUND

Diet plays an important role in the development of hyperuricemia (HUA), but evidence for association between overall dietary patterns and HUA is scarce and inconsistent. The present study aims to explore association of dietary patterns and HUA among the Yi ethnic group of China.

METHODS

This is a cross-sectional study involving people aged more than 18 years. Principal component factor analysis (PCFA) on food groups from a semi-quantitative 52-item food frequency questionnaire was applied to identify dietary patterns. HUA status was regressed on tertiles of factor scores to estimate prevalence ratio (PR) by using log-binomial model.

RESULTS

Of the 1,893 participants (18-96 years), 398 (21.0%) were diagnosed with HUA. Three dietary patterns were identified: 'plant-based', 'animal products', and 'mixed food'. The 'animal products' was characterized by high intake of fish, animal giblets, fresh meat, and wheat products. After adjustment for potential confounders, the highest tertile of 'animal products' pattern score was associated with higher prevalence of HUA when compared with the lowest tertile (PR: 1.34, 95% CI: 1.06-1.70). The other two patterns were not related to HUA.

CONCLUSIONS

'Animal products' dietary pattern was correlated with HUA among the Yi ethnic group of China.

Circulating uric acid levels and subsequent development of cancer in 493,281 individuals: findings from the AMORIS Study

Objectives

Serum uric acid has been suggested to be associated with cancer risk. We aimed to study the association between serum uric acid and cancer incidence in a large Swedish cohort.

Results

A positive association was found between uric acid levels and overall cancer risk, and results were similar with adjustment for glucose, triglycerides and BMI. Hazard ratio (HR) for overall cancer for the 4^th quartile of uric acid compared to the 1^st was 1.08 (95% CI: 1.05–1.11) in men and 1.12 (1.09 – 1.16) in women. Site-specific analysis showed a positive association between uric acid and risk of colorectal, hepatobiliary, kidney, non-melanoma skin, and other cancers in men and of head and neck and other cancers in women. An inverse association was observed for pulmonary and central nervous system (CNS) cancers in men and breast, lymphatic and haematological, and CNS malignancies in women.

Materials and Methods

We included 493,281 persons aged 20 years and older who had a measurement of serum uric acid and were cancer-free at baseline in the AMORIS study. Multivariable Cox proportional hazards regression was used to investigate sex-specific quartiles of serum uric acid in relation to cancer risk in men and women. Analysis was further adjusted for serum glucose, triglycerides and, where available, BMI. Site-specific analysis was performed for major cancers.

Conclusions

Altered uric acid levels were associated with risk of overall and some specific cancers, further indicating the potential role of uric acid metabolism in carcinogenesis.

TT genotype of rs2941484 in the human HNF4G gene is associated with hyperuricemia in Chinese Han men

The aim of the study is to investigate the association between the human hepatocyte nuclear factor 4 gamma (HNF4G) gene and hyperuricemia in Chinese Han population. A total of 414 hyperuricemia patients and 406 gender and age-matched normouricemic controls were enrolled. Four single nucleotide polymorphisms were genotyped as genetic markers for the human HNF4G gene (rs2977939, rs1805098, rs2941484, rs4735692). Data were analyzed for two separate groups: men and women. For rs2941484, the genotype distribution frequency in hyperuricemic subjects and was significantly different from that in normouricemic controls in men (P = 0.038). Meanwhile, in recessive model of rs2941484, the distribution frequency of TT genotype and CC+CT genotypes also differed significantly between the hyperuricemia men and normouricemic men (P = 0.011). For the other 3 SNPs in both men and women, there was no difference in the genotype and allele and distribution frequency between the hyperuricemia patients and normouricemic controls. In men, after adjustments for BMI, SBP, DBP, fasting glucose, total cholesterol, triglycerides, low density lipoprotein cholesterol and creatinine, the men with the TT genotype of rs2941484 were found to have significantly higher probability of suffering from hyperuricemia than the ones with CT and CC genotypes (OR = 2.170, P < 0.001). Therefore, TT genotype of rs2941484 in the human HNF4G gene might be a gender-specific genetic marker for hyperuricemia in Chinese Han men.

Dietary Magnesium Intake and Hyperuricemia among US Adults

To assess the association between dietary magnesium intake and hyperuricemia in United States (US) adults, we extracted 26,796 US adults aged 20–85 years from the National Health and Nutrition Examination Survey (NHANES) in 2001–2014. All dietary intake was measured through 24 h dietary recall method. Multivariable logistic regression analysis was performed to investigate the association between magnesium intake and hyperuricemia after adjusting for several important confounding variables. When compared to the lowest quintile (Q1), for male, adjusted odds ratios (ORs) of hyperuricemia in the second quintile (Q2) to the fifth quintile (Q5) of the magnesium intake were 0.83 (95% CI: 0.72–0.95), 0.74 (0.64–0.85), 0.78 (0.67–0.90), and 0.70 (0.58–0.84, p for trend = 0.0003), respectively. For female, OR was 0.75 (0.62–0.90) in the fourth quintile (Q4) (p for trend = 0.0242). As compared to Q4 of magnesium intake (contains recommended amount), the relative odds of hyperuricemia were increased by 1.29 times in Q1 (OR = 1.29, 1.11–1.50) in male. The ORs were 1.33 (1.11–1.61) in Q1, 1.27 (1.07–1.50) in Q2 in female. Our results indicated that increased magnesium intake was associated with decreased hyperuricemia risk. It also indicated the importance of recommended dietary allowance (RDA) of magnesium and the potential function of magnesium intake in the prevention of hyperuricemia.

The Dietary Fructose:Vitamin C Intake Ratio Is Associated with Hyperuricemia in African-American Adults

Background

A high fructose intake has been shown to be associated with increased serum urate concentration, whereas ascorbate (vitamin C) may lower serum urate by competing with urate for renal reabsorption.

Objective

We assessed the combined association, as the fructose:vitamin C intake ratio, and the separate associations of dietary fructose and vitamin C intakes on prevalent hyperuricemia.

Methods

We conducted cross-sectional analyses of dietary intakes of fructose and vitamin C and serum urate concentrations among Jackson Heart Study participants, a cohort of African Americans in Jackson, Mississippi, aged 21-91 y. In the analytic sample (n = 4576), multivariable logistic regression was used to examine the separate associations of dietary intakes of fructose and vitamin C and the fructose:vitamin C intake ratio with prevalent hyperuricemia (serum urate ≥7 mg/dL), after adjusting for age, sex, smoking, waist circumference, systolic blood pressure, estimated glomerular filtration rate, diuretic medication use, vitamin C supplement use, total energy intake, alcohol consumption, and dietary intake of animal protein. Analyses for individual dietary factors (vitamin C, fructose) were adjusted for the other dietary factor.

Results

In the fully adjusted model, there were 17% greater odds of hyperuricemia associated with a doubling of the fructose:vitamin C intake ratio (OR: 1.17; 95% CI: 1.08, 1.28), 20% greater odds associated with a doubling of fructose intake (OR: 1.20; 95% CI: 1.08, 1.34), and 13% lower odds associated with a doubling of vitamin C intake (OR: 0.87; 95% CI: 0.78, 0.97). Dietary fructose and the fructose:vitamin C intake ratio were more strongly associated with hyperuricemia among men than women (P-interaction ≤ 0.04).

Conclusion

Dietary intakes of fructose and vitamin C are associated with prevalent hyperuricemia in a community-based population of African Americans.

Novel treatment strategies for chronic kidney disease: insights from the animal kingdom

Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress. Biomimetic studies suggest that the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) offers protection in extreme environmental conditions and promotes longevity in the animal kingdom. Similarly, during months of fasting, immobilization and anuria, hibernating bears are protected from muscle wasting, azotaemia, thrombotic complications, organ damage and osteoporosis - features that are often associated with CKD. Improved understanding of the susceptibility and protective mechanisms of these animals and others could provide insights into novel strategies to prevent and treat several human diseases, such as CKD and ageing-associated complications. An integrated collaboration between nephrologists and experts from other fields, such as veterinarians, zoologists, biologists, anthropologists and ecologists, could introduce a novel approach for improving human health and help nephrologists to find novel treatment strategies for CKD.

Dietary patterns associated hyperuricemia among Chinese aged 45 to 59 years: An observational study

In our literature research, we have not found any study reporting the association between the major dietary patterns and the risk of hyperuricemia in a middle-aged Chinese population. Herein, the present study aimed to evaluate the association of dietary patterns with the risk of hyperuricemia in the city of Hangzhou, Zhejiang Province, East China. We included 1204 participants (743 males and 461 females) aged 45 to 59 years in the present cross-sectional study. Dietary intake was assessed using a semiquantitative food frequency questionnaire in 2014 to 2016. All biochemical data and anthropometric measurements were collected following standardized procedures. Dietary patterns were determined by using factor analysis. We examined the associations between major dietary patterns and hyperuricemia risk by log-binominal regression analysis, and the results are presented as prevalence ratio (PR) and confidence interval (CI). Three major dietary patterns were identified by means of factor analysis: traditional Chinese, meat food, and mixed food patterns. After controlling for potential confounders, subjects in the highest quartile of the traditional Chinese pattern scores had a lower PR for hyperuricemia (PR = 0.82; 95%CI: 0.426-0.922), in comparison to those from the lowest quartile, while compared with the lowest quartile of the meat food pattern, the highest quartile had a greater PR for hyperuricemia (PR = 1.48; 95%CI: 1.120-2.097). Besides, no association was observed between mixed food pattern and the risk of hyperuricemia.Our findings indicate that the traditional Chinese pattern is associated with a decreased risk of hyperuricemia, and the meat food pattern is associated with an increased risk of hyperuricemia, whereas the mixed food pattern shows no association with the risk of hyperuricemia. Further large prospective studies are warranted to confirm our findings.

Mycoprotein represents a bioavailable and insulinotropic non-animal-derived dietary protein source: a dose–response study

The anabolic potential of a dietary protein is determined by its ability to elicit postprandial rises in circulating essential amino acids and insulin. Minimal data exist regarding the bioavailability and insulinotropic effects of non-animal-derived protein sources. Mycoprotein is a sustainable and rich source of non-animal-derived dietary protein. We investigated the impact of mycoprotein ingestion, in a dose–response manner, on acute postprandial hyperaminoacidaemia and hyperinsulinaemia. In all, twelve healthy young men completed five experimental trials in a randomised, single-blind, cross-over design. During each trial, volunteers consumed a test drink containing either 20 g milk protein (MLK20) or a mass matched (not protein matched due to the fibre content) bolus of mycoprotein (20 g; MYC20), a protein matched bolus of mycoprotein (40 g; MYC40), 60 g (MYC60) or 80 g (MYC80) mycoprotein. Circulating amino acid, insulin and uric acid concentrations, and clinical chemistry profiles, were assessed in arterialised venous blood samples during a 4-h postprandial period. Mycoprotein ingestion resulted in slower but more sustained hyperinsulinaemia and hyperaminoacidaemia compared with milk when protein matched, with overall bioavailability equivalent between conditions (P>0·05). Increasing the dose of mycoprotein amplified these effects, with some evidence of a plateau at 60–80 g. Peak postprandial leucine concentrations were 201 (sem 24) (30 min), 118 (sem 10) (90 min), 150 (sem 14) (90 min), 173 (sem 23) (45 min) and 201 (sem 21 (90 min) µmol/l for MLK20, MYC20, MYC40, MYC60 and MYC80, respectively. Mycoprotein represents a bioavailable and insulinotropic dietary protein source. Consequently, mycoprotein may be a useful source of dietary protein to stimulate muscle protein synthesis rates.

Evaluation of purine utilization by Lactobacillus gasseri strains with potential to decrease the absorption of food-derived purines in the human intestine

It is well accepted that frequent and heavy intake of purine-rich foods causes elevation of serum uric acid levels, which is a risk factor of hyperuricemia. Reducing intestinal absorption of dietary purines may attenuate the elevation of serum uric acid levels and exacerbation of hyperuricemia. This reduction may be achieved by the ingestion of lactic acid bacteria that take up purines in the intestine. In this study, we investigated the degree of uptake and utilization of purines of three lactobacilli strains. Among them, Lactobacillus gasseri PA-3 (PA-3) showed the greatest incorporation of ¹⁴C-adenine. PA-3 also incorporated ¹⁴C-adenosine and ¹⁴C-AMP. Additionally, using defined growth medium, PA-3 demonstrated greater proliferation in the presence of these purines than in their absence. Although further investigation is required, ingestion of PA-3 may lower serum uric acid levels by reducing intestinal absorption of purines in humans.

Lactobacillus gasseri PA-3 Uses the Purines IMP, Inosine and Hypoxanthine and Reduces their Absorption in Rats

Excessive intake of purine-rich foods elevates serum levels of uric acid. Animal and fish meats contain high amounts of inosine and its related purines, and the reduction of taking those purines is crucial for the improvement of serum uric acid levels. We previously showed that Lactobacillus gasseri PA-3 (PA-3) incorporates adenosine and its related purines and that oral treatment with PA-3 reduced adenosine absorption in rats. This study investigated whether PA-3 also incorporates IMP (inosine 5′-monophosphate), inosine, and hypoxanthine, and whether it reduces their absorption in rats. PA-3 was incubated in vitro with radioisotope (RI)-labeled IMP, inosine, and hypoxanthine, and the incorporation of these compounds by PA-3 was evaluated. In addition, rats were orally administered PA-3 along with RI-labeled inosine 5′-monophosphate, inosine, or hypoxanthine, and the ability of PA-3 to attenuate the absorption of these purines was determined. PA-3 incorporated all three purines and displayed greater proliferation in the presence than in the absence of these purines. Oral administration of PA-3 to rats reduced the absorption of IMP, inosine, and hypoxanthine. These results indicate that PA-3 reduces the absorption of purines contained in foods and it is expected that PA-3 contributes attenuation of the excessive intake of dietary purines.

The consumption of fish cooked by different methods was related to the risk of hyperuricemia in Japanese adults: A 3-year follow-up study

BACKGROUND AND AIMS

Fish consumption is a recognized risk factor for elevated serum uric acid (UA) levels, hyperuricemia, and gout. However, the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia is unclear. Therefore, we aimed to investigate the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia in Japanese adults.

METHODS AND RESULTS

A 3-year follow-up study was conducted with 424 Japanese adults aged 29-74 years. Fish consumption was assessed using a validated self-administered dietary history questionnaire, and hyperuricemia was defined as serum UA ≥7 mg/dL in men and ≥6 mg/dL in women or the use of any anti-gout treatment. During the 3-year follow-up period, we documented 30 newly diagnosed cases of hyperuricemia. After adjusting for potential confounders, multivariate logistic regressions analysis revealed a significant positive relationship between the risk of hyperuricemia and raw (sashimi and sushi) or roasted fish consumption, but not boiled or fried fish consumption. The odds ratios (95% CI) for hyperuricemia with increasing raw fish consumption were 1.00 (reference), 2.51 (0.85, 7.39), and 3.46 (1.07, 11.14) (P for trend: 0.036). Similarly, the odds ratios (95% CI) with increasing roasted fish consumption were 1.00 (reference), 3.00 (0.75, 11.89), and 5.17 (1.30, 20.62) (P for trend: 0.018).

CONCLUSION

This 3-year follow-up study showed that the consumption of raw or roasted fish, but not boiled or fried fish, was related with a higher risk of hyperuricemia in Japanese adults.

Effect of Soy Sauce on Serum Uric Acid Levels in Hyperuricemic Rats and Identification of Flazin as a Potent Xanthine Oxidase Inhibitor

This is the first report on the ability of soy sauce to effectively reduce the serum uric acid levels and xanthine oxidase (XOD) activities of hyperuricemic rats. Soy sauce was partitioned sequentially into ethyl acetate and water fractions. The ethyl acetate fraction with strong XOD inhibition effect was purified further. On the basis of xanthine oxidase inhibitory (XOI) activity-guided purification, nine compounds including 3,4-dihydroxy ethyl cinnamate, diisobutyl terephthalate, harman, daidzein, flazin, catechol, thymine, genistein, and uracil were obtained. It was the first time that 3,4-dihydroxy ethyl cinnamate and diisobutyl terephthalate had been identified from soy sauce. Flazin with hydroxymethyl furan ketone group at C-1 and carboxyl at C-3 exhibited the strongest XOI activity (IC50 = 0.51 ± 0.05 mM). According to fluorescence quenching and molecular docking experiments, flazin could enter into the catalytic center of XOD to interact with Lys1045, Gln1194, and Arg912 mainly by hydrophobic forces and hydrogen bonds. Flazin, catechol, and genistein not only were potent XOD inhibitors but also held certain antioxidant activities. According to ADME (absorption, distribution, metabolism, and excretion) simulation in silico, flazin had good oral bioavailability in vivo.

Uric acid correlates to oxidation and inflammation in opposite directions in women

OBJECTIVE

To evaluate the association of uric acid (UA) levels with a panel of markers of oxidative stress and inflammation.

METHODS

Plasma UA levels, along with a panel of oxidative stress and inflammatory markers, were measured in 755 Chinese women.

RESULTS

Plasma UA levels were inversely associated with urinary levels of the oxidative stress marker F2-isoprostanes and positively correlated to levels of inflammatory markers, such as C-reactive protein and some proinflammatory cytokines (tumor necrosis factor-α and interleukin-6) in blood as well as prostaglandin E2 metabolites in urine.

CONCLUSIONS

Plasma UA levels correlate to oxidation and inflammation biomarkers in opposite directions in women.

Is Uric Acid a Missing Link between Previous Gestational Diabetes Mellitus and the Development of Type 2 Diabetes at a Later Time of Life?

INTRODUCTION

A high level of uric acid (UA) is a strong, independent risk factor for type 2 diabetes mellitus. The relationship between UA levels and the development of type 2 diabetes in women with previous gestational diabetes mellitus (pGDM) remains unclear. The aim of study was to evaluate the UA levels in pGDM women in relation to their current nutritional status and carbohydrate metabolism.

MATERIAL AND METHODS

199 women with pGDM diagnoses based on oral glucose tolerance tests (OGTTs) 5-12 years previously and a control group of 50 women without pGDM. The assessment included anthropometric parameters, body composition (Tanita SC-330S), current OGTT, insulin resistance index (HOMA-IR), β-cell function (HOMA-%B), HbA1c, lipids, and uric acid.

RESULTS

No differences between groups were found in terms of age, time from the index pregnancy, anthropometric parameters, lipids or creatinine levels. The incidences of overweight and obesity were similar. Carbohydrate abnormalities were more frequent in the pGDM group than the control group (43.2% vs 12.0% p<0.001). The women with pGDM had significantly higher fasting glucose, HbA1c, glucose and insulin levels in the OGTTs, but similar HOMA-IR values. Their UA levels were significantly higher (258±58 vs 230±50 μmol/L, p<0.005) and correlated with BMI and the severity of carbohydrate disorders. The normal weight and normoglycemic pGDM women also demonstrated higher UA levels than a similar control subgroup (232±48 vs 208±48 μmol/L, p<0.05). Multivariate analysis revealed significant correlations of UA level with BMI (β = 0.38, 95% CI 0.25-0.51, p<0.0001), creatinine level (β = 0.23, 95% CI 0.11-0.35, p<0.0005), triglycerides (β = 0.20, 95% CI 0.07-0.33, p<0.005) and family history of diabetes (β = 0.13, 95% CI 0.01-0.25, p<0.05). In logistic regression analysis, the association between higher UA level (defined as value ≥297 μmol/L) and presence of any carbohydrate metabolism disorder (IFG, IGT or diabetes) was statistically significant (odds ratio 3.62 [95% CI 1.8-7.3], p<0.001).

CONCLUSIONS

Higher UA levels may be associated with the development of type 2 diabetes in pGDM women, also in these with normal body weights.

Nonpharmacological Management of Gout and Hyperuricemia: Hints for Better Lifestyle

We reviewed lifestyle factors that influence serum uric acid levels and risk of gout flare, and how to improve their deleterious effects. Since obesity increases uric acid and weight gain increases gout risk, weight reduction by daily exercise and limiting intake of excess calories is recommended. However, strenuous exercise, which causes adenine nucleotide degradation; starvation, which decreases uric acid excretion; and dehydration may raise the level of uric acid in serum and trigger gout. Increased intake of purine-rich foods, such as meat and seafood, raise the level of uric acid in serum and is associated with increased risk of gout, whereas dairy products, especially low-fat types, are associated with a lower risk of gout. Also, heavy alcohol drinking raises the uric acid level and increases the risk of gout through adenine nucleotide degradation and lactate production. Sweet fruits and soft drinks containing fructose should be moderated, since fructose may raise uric acid and increase gout risk through uric acid production and/or decreased excretion. On the other hand, the Mediterranean diet is recommended for gout patients, since it may also help prevent hyperuricemia. Furthermore, coffee and vitamin C supplementation could be considered as preventive measures, as those can lower serum uric acid levels as well as the risk of gout.

The ratio of oxidized and reduced forms of selected antioxidants as a possible marker of oxidative stress in humans

Oxidative stress is an imbalance between reactive oxygen species exposure and the ability of organisms to detoxify the reactive intermediates and to repair the oxidative damage of biologically important molecules. Many clinical studies of oxidative stress unfortunately provide conflicting and contradictory results. The ability of antioxidant systems to adequately respond to oxidative stress can be used in laboratory diagnostics. In the present review, methods using the ratio of reduced and oxidized forms of uric acid, ascorbic acid, glutathione and coenzyme Q10 as suitable indicators of oxidative stress are discussed. From the mentioned publications it is evident that suitable sample preparation prior to analysis is crucial.

Gout: a review of nonmodifiable and modifiable risk factors

Gout is a common inflammatory arthritis triggered by the crystallization of uric acid within the joints. Gout affects millions worldwide and has an increasing prevalence. Recent research has been carried out to better qualify and quantify the risk factors predisposing individuals to gout. These can largely be broken into nonmodifiable risk factors, such as gender, age, race, and genetics, and modifiable risk factors, such as diet and lifestyle. Increasing knowledge of factors predisposing certain individuals to gout could potentially lead to improved preventive practices. This review summarizes the nonmodifiable and modifiable risk factors associated with development of gout.

Effects of chicory inulin on serum metabolites of uric acid, lipids, glucose, and abdominal fat deposition in quails induced by purine-rich diets

Inulin, a group of dietary fibers, is reported to improve the metabolic disorders. In the present study, we investigated the effects of chicory inulin on serum metabolites of uric acid (UA), lipids, glucose, and abdominal fat deposition in quail model induced by a purine-rich diet. In this study, 60 male French quails were randomly allocated to five groups: CON (control group), MOD (model group), BEN (benzbromarone-treated group), CHI-H (high-dosage chicory inulin-treated group), and CHI-L (low-dosage chicory inulin-treated group). The serum UA level was significantly increased in the model group from days 7 to 28, as well as triglyceride (TG) and free fatty acid (FFA) increased later in the experimental period. The abdominal fat ratio was increased on day 28. Benzbromarone can decrease UA levels on days 14 and 28. The high and low dosage of chicory inulin also decreased serum UA levels on days 7, 14, and 28. The abdominal fat ratio, activity, and protein of acetyl-CoA carboxylase (ACC) were decreased in chicory inulin-treated groups. The activities of xanthine oxidase (XOD) and fatty acid synthase (FAS) were increased in the model group and decreased in the benzbromarone and chicory inulin groups. This study evaluated a quail model of induced hyperuricemia with other metabolic disorders caused by a high-purine diet. The results indicated that a purine-rich diet might contribute to the development of hyperuricemia, hypertriglyceridemia, and abdominal obesity. Chicory inulin decreased serum UA, TG, and abdominal fat deposition in a quail model of hyperuricemia by altering the ACC protein expression and FAS and XOD activities.

Soy food consumption, cardiometabolic alterations and carotid intima-media thickness in Chinese adults

BACKGROUND AND AIM

The associations between soy food consumption, cardiometabolic disturbances and subclinical atherosclerosis remain controversial due to limited evidence. We examined the associations of habitual soy food consumption with cardiometabolic disturbances and carotid intima-media thickness (CIMT).

METHODS AND RESULTS

We included 2939 subjects (2135 women and 804 men) aged 50-75 years in this community-based cross-sectional study. Dietary data and other covariates were collected using interviewer-administered questionnaires. We determined CIMT in relation to each subject's common carotid artery, internal carotid artery, carotid bifurcation, blood lipids, glucose and urine acid, blood pressure and waist circumference. A logistic regression model was applied to estimate the odd ratios (ORs) and 95% confidence intervals (CIs), and linear regression was used to estimate the regression coefficient and 95% CIs. After adjusting for potential confounders, we found that greater consumption of soy protein (6.1 vs. 0.5 g/d) was inverse associated with the presence of elevated total cholesterol (TC), dyslipidemia, abdominal obesity and hyperuricemia in women, and with abdominal obesity in men, although no significant sex-soy interactions were observed (P: 0.145-0.985). The consumption of soy protein and isoflavones was inversely associated with the number of cardiometabolic disturbances among women, but not men. There were no significant associations of soy protein and isoflavones with CIMT thickening and other cardiometabolic disturbances.

CONCLUSION

Greater soy consumption was associated with a lower presence of elevated TC, dyslipidemia, hyperuricemia and less number of cardiometabolic disturbances components in women.

An old disease with new insights: Update on diagnosis and treatment of gout

Gout is an acute and chronic inflammatory disorder associated with high morbidity and impaired quality of life. There has been a substantial increase in the prevalence and incidence of gout in recent years. Novel diagnostic and therapeutic options have provided new insights into the pathogenesis and management of hyperuricemia and gout in the last decade. This clinical review aims to summarize the diagnostic process and management of acute and chronic gout.

Sweetened beverage consumption and the risk of hyperuricemia in Mexican adults: a cross-sectional study

BACKGROUND

The prevalence of hyperuricemia has doubled worldwide during the last few decades. The substantial increase in sweetened beverage (SB) consumption has also coincided with the secular trend of hyperuricemia. Recent studies do show that the consumption of SB can induce hyperuricemia. However, the association between SB and hyperuricemia remains unclear. The aim of this study was to evaluate the association between SB consumption and levels of uric acid in Mexican adults.

METHODS

We performed a cross-sectional analysis of data from selected adults participating in the baseline assessment of the Health Workers Cohort Study. A total of 6,705 participants of both sexes between ages 18 and 70 years were included. SB intake was estimated using a validated semi-quantitative food frequency questionnaire. Biochemical and anthropometric information was collected using standard procedures. Hyperuricemia was defined as uric acid levels ≥ 7.0 mg/dL in men and ≥ 5.8 mg/dL in women. The association of interest was assessed by multiple logistic regression models.

RESULTS

The odds ratios (OR) for hyperuricemia in men who consume 0.5-1 SB/day was 1.59 (95% CI; 1.05-2.40) and 2.29 (95% CI; 1.55-3.38) for those who consume ≥3 SB/day when compared to men who consume less than half a SB/day. In women, the OR for hyperuricemia for those who consume >1.0- < 3.0 SB/day was 1.33 (95% CI; 1.04-1.70) and 1.35 (95% CI; 1.04-1.75) for those who consume ≥3 SB/day when compared to women who consume less than half a SB/day, independent of other covariables. Men and women with high SB consumption and a body mass index (BMI) ≥ 25 Kg/m2 had greater risk for hyperuricemia than men and women with low SB consumption and normal BMI < 25 Kg/m2.

CONCLUSIONS

Our findings suggest that the consumption of SB is associated with an increased risk of hyperuricemia in Mexican adults. However, longitudinal research is needed to confirm the association between SB intake and hyperuricemia.

Serum uric acid levels in patients with Alzheimer's disease: a meta-analysis

Background

Serum uric acid (UA) could exert neuro-protective effects against Alzheimer's disease (AD) via its antioxidant capacities. Many studies investigated serum UA levels in AD patients, but to date, results from these observational studies are conflicting.

Methods

We conducted a meta-analysis to compare serum UA levels between AD patients and healthy controls by the random-effects model. Studies were identified by searching PubMed, ISI Web of Science, EMBASE, and the Cochrane library databases from 1966 through July 2013 using the Medical Subject Headings and keywords without restriction in languages. Only case-control studies were included if they had data on serum UA levels in AD patients and healthy controls. Begg's funnel plot and Egger's regression test were applied to assess the potential publication bias. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity.

Results

A total of 11 studies met the inclusion criteria including 2708 participants were abstracted. Serum UA levels were not significantly different in AD patients compared to healthy controls (standardized mean difference (SMD) = −0.50; 95% confidence interval (CI): −1.23 to 0.22). Little evidence of publication bias was observed. Sensitivity analyses showed that the combined SMD was consistent every time omitting any one study, except only one study which greatly influenced the overall results. Meta-regression showed that year of publication, race, sample size, and mean age were not significant sources of heterogeneity.

Conclusion

Our meta-analysis of case-control studies suggests that serum UA levels do not differ significantly in AD patients, but there may be a trend toward decreased UA in AD after an appropriate interpretation. More well-designed investigations are needed to demonstrate the potential change of serum UA levels in AD patients.