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Rani L, Saini S, Thakur RS, Patel DK, Chowdhuri DK, Gautam NK. Single and combined effect of bisphenol A with high sucrose diet on the diabetic and renal tubular dysfunction phenotypes in Drosophila melanogaster. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 96:103977. [PMID: 36210596 DOI: 10.1016/j.etap.2022.103977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/08/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
In the present study, effect of exposure of bisphenol A (BPA) and combined exposure of BPA + HSD has been investigated on the glucose homeostasis and associated renal complications in Drosophila. Exposure of 1.0 mM BPA alone induced type 2 diabetes like condition (T2D) in adult male D. melanogaster via oxidative stress. Elevated TGF-β signaling was evident by increased expression of baboon (babo) in BPA exposed organism that stimulated the modulation of extracellular matrix (ECM) component collagen IV resulting in the fibrosis of the Malpighian tubules (MTs). Combined exposure of BPA + HSD (high sucrose diet) resulted in the increased magnitude of T2D and MTs dysfunction parameters. Taken together, the study illustrates that BPA has diabetogenic potential in exposed Drosophila that caused adverse effects on their MTs and combined exposure with BPA and HSD could aggravate the renal tubular dysfunction. The study further suggests the use of Drosophila model to study the environmental chemicals induced diabetes mediated renal dysfunction.
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Affiliation(s)
- Lavi Rani
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India; Embryotoxicology Laboratory, Environmental Toxicology Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), VishvigyanBhavan, 31, Mahatma Gandhi Marg, Lucknow 226 001, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201 002, Uttar Pradesh, India
| | - Sanjay Saini
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India; Embryotoxicology Laboratory, Environmental Toxicology Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), VishvigyanBhavan, 31, Mahatma Gandhi Marg, Lucknow 226 001, Uttar Pradesh, India
| | - Ravindra Singh Thakur
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201 002, Uttar Pradesh, India; Analytical Chemistry Laboratory, Regulatory Toxicology Group, CSIR-Indian Institute of Toxicology Research, Lucknow 226001, Uttar Pradesh, India
| | - Devendra Kumar Patel
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201 002, Uttar Pradesh, India; Analytical Chemistry Laboratory, Regulatory Toxicology Group, CSIR-Indian Institute of Toxicology Research, Lucknow 226001, Uttar Pradesh, India
| | - Debapratim Kar Chowdhuri
- Embryotoxicology Laboratory, Environmental Toxicology Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), VishvigyanBhavan, 31, Mahatma Gandhi Marg, Lucknow 226 001, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201 002, Uttar Pradesh, India.
| | - Naveen Kumar Gautam
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India.
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Spinal gout diagnosed by dual-energy CT: A case report. Radiol Case Rep 2022; 17:4135-4138. [PMID: 36105827 PMCID: PMC9465344 DOI: 10.1016/j.radcr.2022.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 12/27/2022] Open
Abstract
Axial gout is an atypical presentation of gout caused by monosodium urate deposition in the axial skeleton. Spinal gout presents nonspecifically and can be a difficult diagnosis. The diagnosis of gout is a clinical one, with imaging and labs providing supporting evidence. Current imaging modalities such as magnetic resonance, computed tomography, and X-ray can be nonspecific and lead to invasive procedures for diagnosis. Dual-energy computed tomography allows clear visualization of urate collection and is a valuable tool to make a confident diagnosis of spinal gout. Here, we present a case of a man with longstanding severe gout in which dual-energy computed tomography played a key role in diagnosis.
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103
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Cheremushkina EV, Eliseev MS. Hyperuricemia and gout: effects on bone and articular cartilage (literature review). OBESITY AND METABOLISM 2022. [DOI: 10.14341/omet12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Gout is a disease characterized by deposition of sodium monourate crystals in tissues which is the reason of inflammation among persons with hyperuricemia (HU). The prevalence of HU, which can be considered the first stage of gout formation, varies in different countries. Despite this, only a small number of persons with HU have been shown to develop symptoms of gout. Recent data suggest that HU is an independent risk factor for cartilage and bone damage. UA, both in the form of crystals and in a dissolved form, activates damage and potentiates cell death by releasing reactive oxygen species, activating the necroptosis pathway, neutrophil traps, synthesis of pro-inflammatory cytokines, and other pathogenetic mechanisms that cause the negative effects of HU and gout on articular cartilage and subchondral bone. The association of HU and osteoarthritis (OA) is well known and based on the common pathogenesis, but the direction of this relationship is still a debatable issue. The accumulated data suggest the need for a deeper study of the relationship of gout and asymptomatic HU with pathological processes leading to the development and progression of OA and disorders of bone metabolism.
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Wang J, Chen S, Zhao J, Liang J, Gao X, Gao Q, He S, Wang T. Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES. BMC Public Health 2022; 22:1981. [PMID: 36307786 PMCID: PMC9617335 DOI: 10.1186/s12889-022-14357-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Diet has long been hypothesized to play an important role in hyperuricemia, and weight gain is a factor that is strongly associated with the rise in serum urate. We aimed to clarify the mediating role of obesity in the relationship between diet and hyperuricemia and to determine whether a weight-loss diet is an effective way to prevent hyperuricemia. Methods This cross-sectional study analysed representative samples of United States (n = 20,081; NHANES 2007–2016) adults. Nutrient patterns were derived with two methods: principal component analysis (PCA) and reduced rank regression (RRR) with obesity. Logistic regression and multivariable linear regression were applied to analyse the association between nutrient patterns in obesity and hyperuricemia. Mediation analyses were used to determine whether four obesity indicators, including body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI) and lipid accumulation product index (LAP), mediated the relationship between nutrient patterns and hyperuricemia. Results PCA revealed three nutrient patterns (including “Low energy diet”, “Lower vitamin A, C, K pattern” and “Vitamin B group”), and only Vitamin B group had a total effect on hyperuricemia. RRR revealed one main nutrient pattern associated with obesity, which was characterized by High fat and low vitamin levels and was significantly associated with hyperuricemia. Mediation analysis showed that obesity mostly or even completely mediated the relationship between nutrient patterns and hyperuricemia, especially traditional obesity indicators, which played a key intermediary effect. The proportions of indirect effects for BMI and WC were as high as 53.34 and 59.69, respectively. Conclusions Our findings suggest that the direct effect of diet on hyperuricemia is weak, and obesity plays a critical mediating role in the relationship between diet and hyperuricemia, which confirms that a weight-loss diet such as a “Low fat and high vitamin diet” may be useful in preventing hyperuricemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14357-5.
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Bai R, Ying X, Shen J, Wu T, Lai X, Wang L, Yu M, Qi X, Mei Y. The visceral and liver fat are significantly associated with the prevalence of hyperuricemia among middle age and elderly people: A cross-sectional study in Chongqing, China. Front Nutr 2022; 9:961792. [PMID: 36313108 PMCID: PMC9613109 DOI: 10.3389/fnut.2022.961792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background The prevalence of hyperuricemia (HUA) has been increasing in recent years. HUA is a crucial risk factor for gout and an independent risk factor for cardiovascular diseases (CVDs). Identifying potentially modifiable factors of HUA is vital for preventing gout and even CVDs. This study aimed to explore the associations of fat distribution with HUA among middle-aged and elderly people in Chongqing, China. Materials and methods A cross-sectional study was conducted between July 2020 and September 2021. People who underwent quantitative computed tomography (QCT) scans were invited to participate in the study. A total of 3,683 individuals whose clinical characteristics and QCT-based fat distribution measurements included visceral fat area (VFA), subcutaneous fat area (SFA), and liver fat content (LFC) were well-recorded were included. HUA was defined as having a serum uric acid level greater than 420.0 μmol/L. Multivariate logistic regression models were used to evaluate the association between these adipose variables and HUA prevalence. Results The HUA prevalence was 25.6% (943/3,683), which was 39.6% (817/2,063) in men and 7.8% (126/1,620) in women. In the fully adjusted model (model 4), the comparison of the highest one with the lowest quartiles of adipose variables showed that the multivariable OR (95% confidence intervals) of HUA were 2.08 (1.36-3.16; P for trend = 0.001) for VFA, 0.89 (0.63-1.25; P for trend = 0.651) for SFA, and 1.83 (1.42-2.34; P for trend < 0.0001) for LFC. For VFA, the association was more evident in men than in women. Conclusion Higher VFA and LFC were significantly associated with the increased prevalence of HUA in middle-aged and elderly Chinese individuals. VFA and LFC may have a predictive effect on HUA. Controlling visceral and liver fat accumulation may be beneficial for middle-aged and older people. HUA can be prevented with specific effective healthy physical activity and balanced diet guidelines.
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Affiliation(s)
- Ruixue Bai
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xiuquan Ying
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jieqiang Shen
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Tingting Wu
- Department of Food and Nutrition, College of Medical and Life Sciences, Silla University, Busan, South Korea
| | - Xingyu Lai
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Lingyun Wang
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Meng Yu
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaoya Qi
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ying Mei
- Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Zhu B, Wang Y, Zhou W, Jin S, Shen Z, Zhang H, Zhang X, Ding X, Li Y. Trend dynamics of gout prevalence among the Chinese population, 1990-2019: A joinpoint and age-period-cohort analysis. Front Public Health 2022; 10:1008598. [PMID: 36311630 PMCID: PMC9602928 DOI: 10.3389/fpubh.2022.1008598] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023] Open
Abstract
Background The burden of gout is increasing worldwide, which places a heavy burden on society and healthcare systems. This study investigates the independent effects of age, period, and cohort on the gout prevalence from 1990 to 2019 in China, compares these effects by gender and then predicts the future burden of gout over the next decade. Methods The data were obtained from the Global Burden of Disease (GBD) study in 2019. Joinpoint regression model was employed to calculate the annual percentage change (APC) in gout prevalence, and the age-period-cohort analysis was utilized to estimate the independent effects of age, period, and cohort. ARIMA model was extended to predict the gout epidemic in 2020-2029. Results In 2019, there were 16.2 million cases of gout in China, with an age-standardized prevalence rate (ASPR) of 12.3‰ and 3.9‰ in men and women, respectively. During 1990-2019, the ASPR of gout was increasing significantly, with an average APC of 0.9%. The periods of 2014-2017 and 2001-2005 were "joinpoint" for men and women (APC: 6.3 and 5.6%). The age-period-cohort analyses revealed that the relative risk (RR) of developing gout increased with age, peaking at 70-74 years in men (RRage(70-74) = 162.9) and 75-79 years in women (RRage(75-79)=142.3). The period effect trended upward, with a more rapid increase in women (RRperiod(2019) = 2.31) than men (RRperiod(2019) = 2.23). The cohort effect generally peaked in the earlier cohort born in 1905-1909 for both sexes. Gout prevalence showed a strong positive correlation with the consumption of meat and aquatic products (rmeat = 0.966, raquaticproducts = 0.953). Within 2029, the ASPR of gout was projected to be 11.7‰ and 4.0‰ in men and women, respectively. Conclusion The prevalence of gout is increasing at an alarming rate in China; thus, it is necessary to provide targeted health education, regular screening, and accessible urate-lowering therapy healthcare to prevent and protect against gout in China, particularly in older women.
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Affiliation(s)
- Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yimei Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Weiran Zhou
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Shi Jin
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Han Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoyan Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China,*Correspondence: Xiaoqiang Ding
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China,Yang Li
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107
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Chang YS, Lin CY, Liu TY, Huang CM, Chung CC, Chen YC, Tsai FJ, Chang JG, Chang SJ. Polygenic risk score trend and new variants on chromosome 1 are associated with male gout in genome-wide association study. Arthritis Res Ther 2022; 24:229. [PMID: 36221101 PMCID: PMC9552457 DOI: 10.1186/s13075-022-02917-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background Gout is a highly hereditary disease, but not all those carrying well-known risk variants have developing gout attack even in hyperuricemia status. We performed a genome-wide association study (GWAS) and polygenic risk score (PRS) analysis to illustrate the new genetic architectures of gout and asymptomatic hyperuricemia (AH). Methods GWAS was performed to identify variants associated with gout/AH compared with normouricemia. The participants were males, enrolled from the Taiwan Biobank and China Medical University, and divided into discovery (n=39,594) and replication (n=891) cohorts for GWAS. For PRS analysis, the discovery cohort was grouped as base (n=21,814) and target (n=17,780) cohorts, and the score was estimated by grouping the polymorphisms into protective or not for the phenotypes in the base cohort. Results The genes ABCG2 and SLC2A9 were found as the major genetic factors governing gouty and AH, and even in those carrying the rs2231142 (ABCG2) wild-genotype. Surprisingly, variants on chromosome 1, such as rs7546668 (DNAJC16), rs10927807 (AGMAT), rs9286836 (NUDT17), rs4971100 (TRIM46), rs4072037 (MUC1), and rs2974935 (MTX1), showed significant associations with gout in both discovery and replication cohorts (all p-values < 1e−8). Concerning the PRS, the rates of gout and AH increased with increased quartile PRS in those SNPs having risk effects on the phenotypes; on the contrary, gout/AH rates decreased with increased quartile PRS in those protective SNPs. Conclusions We found new variants on chromosome 1 significantly relating to gout, and PRS predicts the risk of developing gout/AH more robustly based on the SNPs’ effect types on the trait. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02917-4.
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Affiliation(s)
- Ya-Sian Chang
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Yu Lin
- Graduate Institute of Clinical Medical Sciences, School of Medicine, China Medical University, Taichung, Taiwan.,Division of Laboratory Medicine, China Medical University Hsinchu Hospital, Zhubei City, Taiwan
| | - Ting-Yuan Liu
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chung-Ming Huang
- Graduate Institute of Integrated Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chin-Chun Chung
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chen
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - Jan-Gowth Chang
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan. .,Graduate Institute of Integrated Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
| | - Shun-Jen Chang
- Center for Precision Medicine and Epigenome Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan. .,Department of Kinesiology, Health and Leisure Studies, National University of Kaohsiung, No. 700, Kaohsiung University Road, Nanzih District, 81148, Kaohsiung, Taiwan.
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108
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Piao W, Zhao L, Yang Y, Fang H, Ju L, Cai S, Yu D. The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015-2017. Nutrients 2022; 14:nu14194095. [PMID: 36235748 PMCID: PMC9573360 DOI: 10.3390/nu14194095] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015–2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 μmol/L for male and 360 μmol/L for female. The Rao–Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China.
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de Almeida L, Devi S, Indramohan M, Huang QQ, Ratsimandresy RA, Pope RM, Dorfleutner A, Stehlik C. POP1 inhibits MSU-induced inflammasome activation and ameliorates gout. Front Immunol 2022; 13:912069. [PMID: 36225929 PMCID: PMC9550078 DOI: 10.3389/fimmu.2022.912069] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/06/2022] [Indexed: 01/13/2023] Open
Abstract
Canonical inflammasomes are innate immune protein scaffolds that enable the activation of inflammatory caspase-1, and subsequently the processing and release of interleukin (IL)-1β, IL-18, and danger signals, as well as the induction of pyroptotic cell death. Inflammasome assembly and activation occurs in response to sensing of infectious, sterile and self-derived molecular patterns by cytosolic pattern recognition receptors, including the Nod-like receptor NLRP3. While these responses are essential for host defense, excessive and uncontrolled NLRP3 inflammasome responses cause and contribute to a wide spectrum of inflammatory diseases, including gout. A key step in NLRP3 inflammasome assembly is the sequentially nucleated polymerization of Pyrin domain (PYD)- and caspase recruitment domain (CARD)-containing inflammasome components. NLRP3 triggers polymerization of the adaptor protein ASC through PYD-PYD interactions, but ASC polymerization then proceeds in a self-perpetuating manner and represents a point of no return, which culminates in the activation of caspase-1 by induced proximity. In humans, small PYD-only proteins (POPs) lacking an effector domain regulate this key process through competitive binding, but limited information exists on their physiological role during health and disease. Here we demonstrate that POP1 expression in macrophages is sufficient to dampen MSU crystal-mediated inflammatory responses in animal models of gout. Whether MSU crystals are administered into a subcutaneous airpouch or into the ankle joint, the presence of POP1 significantly reduces neutrophil infiltration. Also, airpouch exudates have much reduced IL-1β and ASC, which are typical pro-inflammatory indicators that can also be detected in synovial fluids of gout patients. Exogenous expression of POP1 in mouse and human macrophages also blocks MSU crystal-induced NLRP3 inflammasome assembly, resulting in reduced IL-1β and IL-18 secretion. Conversely, reduced POP1 expression in human macrophages enhances IL-1β secretion. We further determined that the mechanism for the POP1-mediated inhibition of NLRP3 inflammasome activation is through its interference with the crucial NLRP3 and ASC interaction within the inflammasome complex. Strikingly, administration of an engineered cell permeable version of POP1 was able to ameliorate MSU crystal-mediated inflammation in vivo, as measured by neutrophil infiltration. Overall, we demonstrate that POP1 may play a crucial role in regulating inflammatory responses in gout.
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Affiliation(s)
- Lucia de Almeida
- 1Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Savita Devi
- 2Department of Academic Pathology, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Mohanalaxmi Indramohan
- 2Department of Academic Pathology, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Qi-Quan Huang
- 1Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Rojo A. Ratsimandresy
- 2Department of Academic Pathology, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Richard M. Pope
- 1Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Andrea Dorfleutner
- 2Department of Academic Pathology, Cedars Sinai Medical Center, Los Angeles, CA, United States,3Department of Biomedical Sciences, Cedars Sinai Medical Center, Los Angeles, CA, United States,4The Kao Autoimmunity Institute, Cedars Sinai Medical Center, Los Angeles, CA, United States,*Correspondence: Andrea Dorfleutner, ; Christian Stehlik,
| | - Christian Stehlik
- 2Department of Academic Pathology, Cedars Sinai Medical Center, Los Angeles, CA, United States,3Department of Biomedical Sciences, Cedars Sinai Medical Center, Los Angeles, CA, United States,4The Kao Autoimmunity Institute, Cedars Sinai Medical Center, Los Angeles, CA, United States,5Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, United States,*Correspondence: Andrea Dorfleutner, ; Christian Stehlik,
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Long T, Liu L. Research Progress on the Relationship between Dietary Patterns and Hyperuricemia. Appl Bionics Biomech 2022; 2022:5658423. [PMID: 36164548 PMCID: PMC9509246 DOI: 10.1155/2022/5658423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
As the final metabolite of purine metabolism, uric acid is critically associated with human health. The serum uric acid level is regulated by diet and the metabolic capacity of the human body. The impaired control of uric acid metabolism and excretion is associated with the increased level of serum uric acid, which ultimately results in hyperuricemia. Hyperuricemia is the "fourth-highest" after hypertension, hyperglycemia, and hyperlipidemia. With progress made in the relationship between diet and hyperuricemia, different dietary patterns and lifestyles have been discussed, such as exercise, the amount intake of meat, seafood, supplements with omega-3 fatty acids, sugar-sweetened soft drinks and energy drinks, and lower-fat-containing foods as well as drinking beer, wine, and spirits in the present article. This study demonstrated that a lower risk of hyperuricemia is substantially correlated with higher baseline adherence to MeDiet, and plant polyphenols can combat hyperuricemia by blocking xanthine oxidase.
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Affiliation(s)
- Tian Long
- Department of Clinical Nutrition, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, Hubei 435000, China
| | - Liang Liu
- Department of Clinical Nutrition, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, Hubei 435000, China
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Wang C, Lu J, Sun W, Merriman TR, Dalbeth N, Wang Z, Wang X, Han L, Cui L, Li X, Ji A, Li H, Ji X, He Y, Li C, Liu Z. Profiling of Serum Oxylipins Identifies Distinct Spectrums and Potential Biomarkers in Young People with Very Early Onset Gout. Rheumatology (Oxford) 2022; 62:1972-1979. [PMID: 36111871 PMCID: PMC10152281 DOI: 10.1093/rheumatology/keac507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/01/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Oxylipins modulate inflammation via complex pathways. The oxylipin profile in gout remains unexplored. In this study, we systemically profiled oxylipins in young men and identified new oxylipin biomarkers for clinical use in differentiating gout from hyperuricemia.
Methods
Oxylipin profiling was performed in 90 men (30 very early onset gout, 30 asymptomatic HU (HU) and 30 normouricemia (NU), all aged <20 years) divided into discovery and validation sample sets. The dataset was analyzed based on orthogonal projection to latent structure-discriminant analysis (OPLS-DA). Correlation network and pathway enrichment were conducted to reveal potential oxylipin-involved pathways of gout. Candidate oxylipins were further evaluated and optimized in the validation cohort, and differential oxylipin biomarkers combined with or without serum urate were applied to construct diagnosis models.
Results
In discovery stage 21 differential oxylipins between the gout vs HU comparisons and 14 differential oxylipins between the gout vs NU comparisons were discovered. Correlation network analysis was performed and 14(S)-HDHA(14S-hydroxy-4Z, 7Z, 10Z, 12E, 16Z, 19Z-docosahexaenoic acid)was identified as a hub metabolite in both comparisons. Seven down-regulated oxylipins in gout vs HU group and five down-regulated oxylipins in gout vs NU group were validated. Diagnostic models were constructed with the above oxylipins, with 14(S)-HDHA alone acquiring area under the curve (AUC) 1 (95%CI, 1–1) in both comparisons.
Conclusion
Young men with very early onset gout have distinct oxylipin spectrums, especially those derived from AA (arachidonic acid), EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Differential oxylipins could serve as candidate serum biomarkers in differentiating gout from hyperuricemia.
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Affiliation(s)
- Can Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Jie Lu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Wenyan Sun
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
| | - Tony R Merriman
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- University of Alabama at Birmingham Division of Clinical Immunology and Rheumatology, , Birmingham, Alabama, United States
| | - Nicola Dalbeth
- University of Auckland Department of Medicine, , Auckland, New Zealand
| | - Zhongjun Wang
- the Affiliated Hospital of Qingdao University Department of Clinical Laboratory, , Qingdao, China
| | - Xuefeng Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Lin Han
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Lingling Cui
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Xinde Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Aichang Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
| | - Hailong Li
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
| | - Xiaopeng Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Yuwei He
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Changgui Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
| | - Zhen Liu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University , Qingdao, China
- Institute of Metabolic Diseases, Qingdao University , Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout , Qingdao, China
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Kutishenko NP, Martsevich SY, Zagrebelnyy AV, Lukina YV, Voronina VP, Dmitrieva NA, Lerman OV, Tolpygina SN, Blagodatskikh SV, Budaeva IV, Nekoshnova ES, Drapkina OM. Detection and Treatment of Hyperuricemia in Clinical Practice (According to the PROFILE Outpatient Registry). RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-08-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the frequency of detection of hyperuricemia (HU) in patients with high and very high cardiovascular risk and the frequency of prescribing drugs that lower serum uric acid (sUA) levels in real clinical practice.Material and methods: The general information of the study was based on the data of 2457 patients who were consistently included in the «PROFILE» registry until November 30, 2020: 1250 men (50.9%) and 1207 (49.1%) women. All patients with HU were selected (UA level ≥360 pmol/l in women, ≥420 pmol/l in men). At the stage of inclusion of the patient, data on MC indicators were available in 1777 (72.3%), upon re-examination - only 262 (33.2%) out of 790 patients who returned to the appointment.Results: The most common study of the level of sUA was performed in patients with gout (65.2%), with arterial hypertension (AH) and dyslipemia in 29.1% of cases, with diabetes mellitus (DM) - 30.1%, with impaired tolerance to glucose (IGT) - 40.2%, with other diseases, the proportion of patients with a known UA was even less. A positive relationship was found between the presence of AH and IGT with the frequency of UA control (p<0.001). In patients with AH, an increase in the level of sUA was detected significantly more often than in patients without AH (p<0.001), and less frequently in patients with DM and IGT (p<0.001 and p<0.01, respectively). The frequency of allopurinol prescribing was low: 49 (2%) patients received therapy, while of the 284 patients with HU, only 20 (7%) were prescribed allopurinol.Conclusion: in real clinical practice, only 29.1% of patients with AH and 20-25% of patients with other CVDs were monitored for sUA levels, every third patient had data on sUA levels at a repeat visit. In the presence of gout, the proportion of patients with current UA was higher (65%). For those with AH and IGT, positive correlations were found between the presence of the disease and control of sUA levels. A low frequency of prescribing drugs for the correction of HU was revealed.
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Affiliation(s)
- N. P. Kutishenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. Yu. Martsevich
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Zagrebelnyy
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. V. Lukina
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. P. Voronina
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. A. Dmitrieva
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Lerman
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. N. Tolpygina
- National Medical Research Center for Therapy and Preventive Medicine
| | | | - I. V. Budaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. S. Nekoshnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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113
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Zahoor H, Patel R, El-bahri J. Ulcerated Tophaceous Gout. Cureus 2022; 14:e28729. [PMID: 36204027 PMCID: PMC9528853 DOI: 10.7759/cureus.28729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 11/20/2022] Open
Abstract
Gout is a disease that occurs in response to the presence of monosodium urate (MSU) crystals typically within joints. Patients with gout may develop a chronic deposition of monosodium urate crystals within or around joints, cartilage, tendons, peri-articular, and subcutaneous tissue. This condition is termed “tophaceous gout.” Ulceration of the skin by tophi is very uncommon. Literature regarding the clinical course and the management of ulcerated tophi is limited and, therefore, treatment options are not well established. We hereby present a case of a 46-year-old male who presented to our facility with poorly controlled polyarticular tophaceous gout complicated by ulcerated tophi. Our hope is to contribute to the limited knowledge of this rare disease process and to contribute toward formulating the best management approach.
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114
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Haueisen Sander Diniz MDF, M R Beleigoli A, Isabel Rodrigues Galvão A, Weiss Telles R, Inês Schmidt M, B Duncan B, M Benseñor I, Luiz P Ribeiro A, Vidigal PG, Maria Barreto S. Serum uric acid is a predictive biomarker of incident metabolic syndrome at the Brazilian longitudinal study of adult Health (ELSA - Brasil). Diabetes Res Clin Pract 2022; 191:110046. [PMID: 36028067 DOI: 10.1016/j.diabres.2022.110046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/13/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
AIM To investigate whether serum uric acid (SUA) levels and hyperuricemia can be predictive biomarkers of incident metabolic syndrome(MS) among different body mass index(BMI) categories, and to investigate SUA cutoffs that best discriminate individuals with incident MS. METHODS We analyzed 7,789 participants without MS at baseline of ELSA-Brasil study. Logistic regression models were performed to evaluate associations between incident MS and SUA levels/hyperuricemia, expressed by odds ratios(ORs) and confidence intervals(95 % CI). RESULTS We found 1,646 incident MS cases after a median follow-up of 3.8[3.5-4.1] years. Incident MS was present among 8.3 % (n = 290) of participants with normal weight, 28.3 % (n = 850) with overweight, 39.8 % (n = 506) with obesity. Among incident MS participants of total sample, 33.0 % had hyperuricemia [SUA > 6.0 mg/dL (356.9 μmol/L)]. After all adjustments, SUA was independently prognostic of incident MS: for each 1 mg/dL increase in SUA the odds of incident MS were 45 % higher (OR1.45[CI95 %1.34-1.55 p <.01]). Associations were found for those presenting normal weight, overweight and obesity (OR1.43[CI95 %1.31-1.57 p <.01; OR1.22[CI95 %1.13-1.32 p <.01]; and OR1.16[CI95 %1.04-1.29 p <.05]) respectively. Hyperuricemia was independently associated with incident MS (OR1.88[CI95 %1.49-0.2.36 p <.01]). The SUA cut point level maximizing sensitivity and specificity in the discrimination of incident MS was 5.0 mg/dL. CONCLUSIONS SUA level is an independent predictive biomarker of incident MS at all BMI categories.
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Affiliation(s)
| | | | | | - Rosa Weiss Telles
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Inês Schmidt
- Postgraduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruce B Duncan
- Postgraduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Antônio Luiz P Ribeiro
- Telehealth Center and Cardiology Service, Hospital das Clínicas, and Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pedro G Vidigal
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sandhi Maria Barreto
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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115
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Zhang F, Wang H, Cui Y, Zhao L, Song R, Han M, Wang W, Zhang D, Shen X. Association between mixed dioxin exposure and hyperuricemia in U.S. adults: A comparison of three statistical models. CHEMOSPHERE 2022; 303:135134. [PMID: 35644240 DOI: 10.1016/j.chemosphere.2022.135134] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/08/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Previous studies on the relationship between dioxin exposures and hyperuricemia have usually been based on multi-chemical linear models. However, the complex nonlinear relationship and interaction between mixed dioxin exposures and hyperuricemia have seldom been studied. In this study, we applied three different statistical models to assess the joint effect of 12 dioxins on hyperuricemia. METHODS A total of 7 dioxin-like polychlorinated biphenyls (DL-PCBs), 3 polychlorinated dibenzo-p-dioxins (PCDDs), and 2 polychlorinated dibenzofurans (PCDFs) were measured in the serum of adults by the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2004. We fitted multivariable logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models to estimate the association of individual and mixed dioxin exposures with hyperuricemia. RESULTS Among the 1008 individuals included in our analysis, 20.04% had hyperuricemia. In the multivariable logistic regression established for each single dioxin, PCB28, PCB74, PCB105, PCB118, and 1,2,3,4,6,7,8-HPCDD were positively associated with hyperuricemia. With including all dioxins in the multivariable logistic regression model simultaneously, only PCB28 and 1,2,3,4,6,7,8-HPCDD were positively associated with hyperuricemia. In the WQS regression model, the WQS index was significantly associated (OR (95% CI): 2.32 (1.26, 4.28)) with hyperuricemia, and 1,2,3,4,6,7,8-HPCDD (weighted 0.22) had the largest contribution. In BKMR analysis, a significant positive association was found between mixed dioxin exposure and hyperuricemia when all dioxins were at their 60th percentile or above, compared to their 50th percentile. The univariate exposure-response function showed that PCB105 and PCB118 were positively associated with hyperuricemia. CONCLUSION By comparing the three statistical models, we concluded that the whole-body burden of 12 dioxins was significantly positively associated with hyperuricemia. PCB105, PCB118, and 1,2,3,4,6,7,8-HPCDD played the most important roles in hyperuricemia.
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Affiliation(s)
- Fan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Yixin Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Longzhu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Ruihan Song
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Miaomiao Han
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China
| | - Xiaoli Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, 266071, China.
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116
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She D, Wang Y, Liu J, Luo N, Feng S, Li Y, Xu J, Xie S, Zhu Y, Xue Y, Zhang Z. Changes in the prevalence of hyperuricemia in clients of health examination in Eastern China, 2009 to 2019. BMC Endocr Disord 2022; 22:202. [PMID: 35948906 PMCID: PMC9364534 DOI: 10.1186/s12902-022-01118-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the continuous improvement of people's living standards, the incidence of hyperuricemia (HUA) is increasing globally. The prevalence of HUA ranged in terms of region, race, and age. This study aims to investigate the changes in the prevalence of HUA in clients of health examination in Eastern China between 2009 and 2019. METHODS Chinese men and women aged 20-79 years (n = 4847 in the 2009 group and n = 12,188 in 2019 group) who had received health examinations were enrolled. Serum uric acid (UA) levels and biochemical parameters, including fasting blood-glucose (FBG), triglyceride (TG), total cholesterol (CHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine (Cr) and blood urea nitrogen (BUN) were evaluated. The prevalence of HUA in different age groups were measured, and the correlation of biochemical parameters with HUA were analyzed. RESULTS The prevalence of HUA was 18.7% in the 2019 group, which was significantly higher than that in 2009 (11.1%). In females, the prevalence of HUA was significantly higher in 2019 than 2009 for age groups of 20-29 and 30-39 years. In male population, 2019 participants had significantly higher age-specific prevalence for all age groups than 2009 participants. Young men aged 20-29 years became the main population of HUA in the 2019 participants, whereas middle-aged men aged 40-49 years had the highest prevalence of HUA in the 2009 participants. The prevalence rates of HUA in all BMI groups in 2019 participants were significantly higher than those in 2009 participants. Spearmen's correlation analysis and Logistic regression analysis indicated that BMI was positively correlated with HUA. The receiver-operating characteristic curve (ROC) analysis showed BMI > 24.48 kg/m2 and BMI > 23.84 kg/m2 displayed good capacities to discriminate the population with HUA from those without HUA in 2009 and 2019 participants, respectively. CONCLUSIONS In recent 10 years, the prevalence of HUA was increased rapidly in Chinese adults, especially in males. In 2019, the young male group (20-29 years old) replaced the middle-aged male group (40-49 years old) in 2009 as the leading age group for male HUA. BMI was positively correlated with HUA, and might be a potential risk factors to predict HUA.
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Affiliation(s)
- Dunmin She
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Yongliang Wang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Jing Liu
- Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Na Luo
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Shangyong Feng
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Ying Li
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Jin Xu
- Department of Information Center, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Shichun Xie
- Department of Information Center, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Yan Zhu
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Ying Xue
- Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
| | - Zhenwen Zhang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China.
- Department of Endocrinology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, Jiangsu, China.
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Guerrero-Romero F, Simental-Mendía LE. Hyperuricemia is Associated with the Presence of Metabolically Obese Normal-Weight and Metabolically Healthy Obese Phenotypes. Endocr Res 2022; 47:124-129. [PMID: 35918814 DOI: 10.1080/07435800.2022.2108049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is well-recognized that hyperuricemia is a common abnormality among individuals with metabolic syndrome. AIMS The objective of this study was to determine whether hyperuricemia is associated with the metabolically obese normal-weight (MONW) and metabolically healthy obese (MHO) phenotypes. METHODS Men and women equal or greater than 18 years of age were enrolled in a cross-sectional study. Normal-weight subjects were allocated into the MONW or healthy normal-weight (HNW) groups; while obese individuals were divided into the MHO and metabolically unhealthy obese (MUO) subgroups. MONW phenotype was defined by body mass index (BMI) <25.0 kg/m2 accompanied by at least one cardiovascular risk factor (hyperglycemia, elevated blood pressure, hypertriglyceridemia, and low high-density lipoprotein cholesterol), and MHO phenotype was considered in obese subjects (BMI ≥30 kg/m2) without metabolic abnormalities. RESULTS A total of 567 individuals were enrolled; of them, normal-weight subjects were allocated into the MONW (n = 101) and control (n = 72) groups, whereas obese individuals into the MHO (n = 61) and MUO (n = 333) groups. The multiple logistic regression analysis adjusted by age, gender, and body mass index revealed that hyperuricemia is significantly associated with MONW (OR = 5.14; 95% CI: 1.37-19.29) and MHO (OR = 0.34; 95% CI: 0.14-0.82) phenotypes. CONCLUSION Results of our study showed that hyperuricemia is associated with both MONW and MHO phenotypes.
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Affiliation(s)
- Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
| | - Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
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118
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Yong T, Liang D, Chen S, Xiao C, Gao X, Wu Q, Xie Y, Huang L, Hu H, Li X, Liu Y, Cai M. Caffeic acid phenethyl ester alleviated hypouricemia in hyperuricemic mice through inhibiting XOD and up-regulating OAT3. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 103:154256. [PMID: 35714456 DOI: 10.1016/j.phymed.2022.154256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hyperuricemia is characterized with high serum uric acids (SUAs) and directly causes suffering gout. Caffeic acid phenethyl ester (CAPE) is widely included in dietary plants and especially propolis of honey hives. HYPOTHESIS/PURPOSE Since CAPE exerts a property resembling a redox shuttle, the hypothesis is that it may suppress xanthine oxidase (XOD) and alleviate hyperuricemia. The aim is to unveil the hypouricemic effect of CAPE and the underlying mechanisms. METHODS By establishing a hyperuricemic model with potassium oxonate (PO) and hypoxanthine (HX) together, we investigated the hypouricecmic effect of CAPE. On this model, the expressions of key mRNAs and proteins, including glucose transporter 9 (GLUT9) and urate transporter 1 (URAT1), and the activity of XOD were assayed in vivo. Also, the inhibitory effect of CAPE against XOD was assayed in vitro through enzymatic activity tests and by molecular docking. RESULTS CAPE demonstrated a remarkable hypouricemic effect, which reduced the SUAs of hyperuricemic mice (401 ± 111 µmol/l) to 209 ± 56, 204 ± 65 and 154 ± 40 µmol/l (p < 0.01) at the doses of 15, 30 and 60 mg/kg respectively, depicting efficacies between 48 and 62% and approaching allopurinol's efficacy (52%). Serum parameters, body weights, inner organ coefficients, and H&E staining suggested that CAPE displayed no general toxicity and it alleviated the liver and kidney injuries caused by hyperuricemia. Mechanistically, CAPE decreased XOD activities significantly in vivo, presented an IC50 at 214.57 µM in vitro and depicted a favorable binding to XOD in molecular simulation, indicating that inhibiting XOD may be an underlying mechanism of CAPE against hyperuricemia. CAPE did decreased GLUT9 protein and down-regulated URAT1 mRNA and protein. In addition, CAPE up-regulated ATP binding cassette subfamily G member 2 (ABCG2) and organic anion transporter 3 (OAT3) mRNA and proteins in comparison with that of the hyperuricemic control. All above, CAPE may alleviate hyperuricmia through inhibiting XOD, decreasing GLUT9 and URAT1 and increasing ABCG2 and OAT3. CONCLUSION CAPE presented potent hypouricemic effect in hyperuricemic mice through inhibiting XOD activity and up-regulating OAT3. CAPE may be a promising treatment against hyperuricemia.
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Affiliation(s)
- Tianqiao Yong
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Danling Liang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
| | - Shaodan Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Chun Xiao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Xiong Gao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Qingping Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China.
| | - Yizhen Xie
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Longhua Huang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Huiping Hu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Xiangmin Li
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Yuancao Liu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Manjun Cai
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
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Hilsabeck TAU, Liu-Bryan R, Guo T, Wilson KA, Bose N, Raftery D, Beck JN, Lang S, Jin K, Nelson CS, Oron T, Stoller M, Promislow D, Brem RB, Terkeltaub R, Kapahi P. A fly GWAS for purine metabolites identifies human FAM214 homolog medusa, which acts in a conserved manner to enhance hyperuricemia-driven pathologies by modulating purine metabolism and the inflammatory response. GeroScience 2022; 44:2195-2211. [PMID: 35381951 PMCID: PMC9616999 DOI: 10.1007/s11357-022-00557-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/25/2022] [Indexed: 01/14/2023] Open
Abstract
Elevated serum urate (hyperuricemia) promotes crystalline monosodium urate tissue deposits and gout, with associated inflammation and increased mortality. To identify modifiers of uric acid pathologies, we performed a fly Genome-Wide Association Study (GWAS) on purine metabolites using the Drosophila Genetic Reference Panel strains. We tested the candidate genes using the Drosophila melanogaster model of hyperuricemia and uric acid crystallization ("concretion formation") in the kidney-like Malpighian tubule. Medusa (mda) activity increased urate levels and inflammatory response programming. Conversely, whole-body mda knockdown decreased purine synthesis precursor phosphoribosyl pyrophosphate, uric acid, and guanosine levels; limited formation of aggregated uric acid concretions; and was sufficient to rescue lifespan reduction in the fly hyperuricemia and gout model. Levels of mda homolog FAM214A were elevated in inflammatory M1- and reduced in anti-inflammatory M2-differentiated mouse bone marrow macrophages, and influenced intracellular uric acid levels in human HepG2 transformed hepatocytes. In conclusion, mda/FAM214A acts in a conserved manner to regulate purine metabolism, promotes disease driven by hyperuricemia and associated tissue inflammation, and provides a potential novel target for uric acid-driven pathologies.
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Affiliation(s)
- Tyler A U Hilsabeck
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
- Davis School of Gerontology, University of Southern California, University Park, Los Angeles, CA, 90007, USA
| | - Ru Liu-Bryan
- VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California San Diego, San Diego, CA, 92093, USA
| | - Tracy Guo
- VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California San Diego, San Diego, CA, 92093, USA
| | - Kenneth A Wilson
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Neelanjan Bose
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Daniel Raftery
- Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Jennifer N Beck
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Room A-632, San Francisco, CA, 94143, USA
| | - Sven Lang
- Department of Medical Biochemistry and Molecular Biology, Saarland University, Homburg, Germany
| | - Kelly Jin
- Allen Institute for Brain Science, Seattle, WA, 98109, USA
- Department of Pathology, University of Washington, Seattle, WA, 98195, USA
| | - Christopher S Nelson
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Tal Oron
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
| | - Marshall Stoller
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Room A-632, San Francisco, CA, 94143, USA
| | - Daniel Promislow
- Department of Pathology, University of Washington, Seattle, WA, 98195, USA
- Department of Biology, University of Washington, Seattle, WA, 98195, USA
| | - Rachel B Brem
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA
- Davis School of Gerontology, University of Southern California, University Park, Los Angeles, CA, 90007, USA
- Department of Plant and Microbial Biology, University of California, Berkeley, 111 Koshland Hall, Berkeley, CA, 94720, USA
| | - Robert Terkeltaub
- VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California San Diego, San Diego, CA, 92093, USA
| | - Pankaj Kapahi
- Buck Institute for Research On Aging, 8001 Redwood Blvd., Novato, CA, 94945, USA.
- Davis School of Gerontology, University of Southern California, University Park, Los Angeles, CA, 90007, USA.
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Room A-632, San Francisco, CA, 94143, USA.
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120
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Chen C, Wang J, Liang Z, Li M, Fu D, Zhang L, Yang X, Guo Y, Ge D, Liu Y, Sun B. Monosodium urate crystals with controlled shape and aspect ratio for elucidating the pathological progress of acute gout. BIOMATERIALS ADVANCES 2022; 139:213005. [PMID: 35882152 DOI: 10.1016/j.bioadv.2022.213005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/09/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
Gout is a self-limiting inflammatory arthritis mediated by the precipitation of monosodium urate (MSU) crystals that further activate the NLRP3 inflammasome and initiate a cascade of inflammatory events. However, the key physicochemical properties of MSU crystals that determine the acute phase of gout have not been fully identified. In this study, a library of engineered MSU crystals with well-controlled size and shape is designed to explore their proinflammatory potentials in mediating the pathological progress of gout. It is demonstrated that medium-sized long aspect ratio MSU crystals induce more prominent IL-1β production in vitro due to enhanced cellular uptake and the production of mitochondrial reactive oxygen species (mtROS). The characteristics of MSU crystals are also correlated with their inflammatory potentials in both acute peritonitis and arthritis models. Furthermore, 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) is demonstrated to inhibit MSU-induced oxidative burst by removing plasma membrane cholesterol. As a result, it attenuates the inflammatory responses both in vitro and in vivo. Additionally, antioxidant N-acetylcysteine (NAC) is shown to alleviate acute gouty symptom by suppressing oxidative stress. This study identifies the key physicochemical properties of MSU crystals that mediate the pathogenesis of gout, which sheds light on novel design strategies for the intervention of gout.
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Affiliation(s)
- Chen Chen
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China.; School of Bioengineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Jingyun Wang
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China.; School of Bioengineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Zhihui Liang
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China.; School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Min Li
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China.; School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Duo Fu
- School of Bioengineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Lei Zhang
- School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Xuecheng Yang
- School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Yiyang Guo
- School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Dan Ge
- School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Yang Liu
- School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China
| | - Bingbing Sun
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China.; School of Chemical Engineering, Dalian University of Technology, 2 Linggong Road, Dalian 116024, PR China..
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121
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Sivera F, Andres M, Dalbeth N. A glance into the future of gout. Ther Adv Musculoskelet Dis 2022; 14:1759720X221114098. [PMID: 35923650 PMCID: PMC9340313 DOI: 10.1177/1759720x221114098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/29/2022] [Indexed: 12/03/2022] Open
Abstract
Gout is characterized by monosodium urate (MSU) crystal deposits in and within joints. These deposits result from persistent hyperuricaemia and most typically lead to recurrent acute inflammatory episodes (gout flares). Even though some aspects of gout are well characterized, uncertainties remain; this upcoming decade should provide further insights into many of these uncertainties. Synovial fluid analysis allows for the identification of MSU crystals and unequivocal diagnosis. Non-invasive methods for diagnosis are being explored, such as Raman spectroscopy and imaging modalities. Both ultrasound and dual-energy computed tomography (DECT) allow the detection of MSU crystals; this not only provides a mean of diagnosis, but also has furthered gout knowledge defining the presence of a preclinical deposition in asymptomatic hyperuricaemia. Scientific consensus establishes the beginning of gout as the beginning of symptoms (usually the first flare), but the concept is currently under review. For effective long-term gout management, the main goal is to promote crystal dissolution treatment by reducing serum urate below 6 mg/dL (or 5 mg/dL if faster crystal dissolution is required). Current urate-lowering therapies' (ULTs) options are limited, with allopurinol and febuxostat being widely available, and probenecid, benzbromarone, and pegloticase available in some regions. New xanthine oxidase inhibitors and, especially, uricosurics inhibiting urate transporter URAT1 are under development; it is probable that the new decade will see a welcomed increase in the gout therapeutic armamentarium. Cardiovascular and renal comorbidities are common in gout patients. Studies determining whether optimal treatment of gout will positively impact these comorbidities are currently lacking, but will hopefully be forthcoming. Overall, the single change that will most impact gout management is greater uptake of international rheumatology society recommendations. Innovative strategies, such as nurse-led interventions based on these recommendations have recently demonstrated treatment success for people with gout.
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Affiliation(s)
- Francisca Sivera
- Rheumatology Unit, Hospital General
Universitario Elda, Ctra Sax s/n, Elda 03600, Alicante, Spain
- Department Medicine, Universidad Miguel
Hernandez, Elche, Spain
| | - Mariano Andres
- Department Medicine, Universidad Miguel
Hernandez, Elche, Spain
- Rheumatology Unit, Hospital General
Universitario Alicante, Alicante, Spain
- Alicante Institute of Sanitary and Biomedical
Research (ISABIAL), Alicante, Spain
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122
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Luo Q, Ding R, Chen L, Bu X, Xiao M, Liu X, Wu Y, Xu J, Tang W, Qiu J, Ding X, Tang X. The Association Between Spicy Food Intake and Risk of Hyperuricemia Among Chinese Adults. Front Public Health 2022; 10:919347. [PMID: 35874998 PMCID: PMC9298505 DOI: 10.3389/fpubh.2022.919347] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/03/2022] [Indexed: 12/20/2022] Open
Abstract
Hyperuricemia is associated with substantial health and economic burden all over the world. Dietary habits are an important influencing factor of hyperuricemia. This study aimed to investigate the relationship between spicy food intake and hyperuricemia based on a large population. A total of 22,125 individuals aged 30-79 were enrolled in China Multi-Ethnic Cohort (CMEC), Chongqing region. Spicy food intake information was collected by a standardized questionnaire. The association between spicy food intake and hyperuricemia was estimated by multivariable logistic regression models and multiple linear regression models. Additionally, we explored these relations in subgroups stratified by sex and age. Furthermore, sensitivity analyses were conducted to verify the stability of current findings. After controlling for potential confounders, compared with participants who never consumed spicy food and consumed less hot, participants who ate 3-5 days per week and very hot had the highest risk of hyperuricemia; the ORs (95% CIs) were 1.28 (1.09, 1.5) and 1.22 (0.92, 1.63), respectively. Additionally, the corresponding ORs (95% CIs) for each level increment in the frequency and degree of pungency in spicy food intake were 1.04 (1.01, 1.07) (P trend = 0.009) and 1.15 (1.04, 1.26) (P trend = 0.004). Further in sex-stratified and age-stratified analysis, similar positive associations were observed among men and those aged 30-59, but no significant association was found among women and those aged 60-79. In the linear regression models, 3-5 days per week and moderate pungency in spicy food intake were associated with 5.21 μmol/L (95% CI: 1.72, 8.70) and 4.69 μmol/L (95% CI: 1.93, 7.45) higher serum urate level. Results in further subgroup analysis were generally consistent with the logistic regression models. This study suggests that spicy food intake may be a risk factor for hyperuricemia, especially in men and younger people, and more studies are warranted to verify the causal associations.
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Affiliation(s)
- Qinwen Luo
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Rui Ding
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Liling Chen
- Chongqing Center for Disease Control and Prevention, Infectious Disease Control and Prevention Institute, Chongqing, China
| | - Xiaoqing Bu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Meng Xiao
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Xiang Liu
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yunyun Wu
- Chongqing Center for Disease Control and Prevention, Infectious Disease Control and Prevention Institute, Chongqing, China
| | - Jingru Xu
- Chongqing Center for Disease Control and Prevention, Infectious Disease Control and Prevention Institute, Chongqing, China
| | - Wenge Tang
- Chongqing Center for Disease Control and Prevention, Infectious Disease Control and Prevention Institute, Chongqing, China
| | - Jingfu Qiu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Xianbin Ding
- Chongqing Center for Disease Control and Prevention, Infectious Disease Control and Prevention Institute, Chongqing, China
| | - Xiaojun Tang
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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123
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Li S, Fu Y, Liu Y, Zhang X, Li H, Tian L, Zhuo L, Liu M, Cui J. Serum Uric Acid Levels and Nonalcoholic Fatty Liver Disease: A 2-Sample Bidirectional Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e3497-e3503. [PMID: 35363278 DOI: 10.1210/clinem/dgac190] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Observational studies have shown that nonalcoholic fatty liver disease (NAFLD) is highly correlated with serum uric acid (SUA). However, these studies have an inherent risk of bias due to reverse causality. Here, we perform a Mendelian randomization (MR) study to investigate causality between SUA and NAFLD. METHODS We performed a 2-sample bidirectional MR analysis using summary-level data from genome-wide association studies of SUA (with up to 110 347 individuals) and NAFLD (1483 cases and 17781 controls) in European populations. First, 13 single nucleotide polymorphisms (SNPs) associated with SUA were selected as instruments to estimate the causal effect of elevated SUA levels on the risk of NAFLD using the inverse-variance weighted (IVW) method. Then we performed MR with 3 SNPs as genetic instruments for NAFLD. To test the reliability, further sensitivity analyses were also conducted. RESULTS Our MR analyses demonstrated that NAFLD was associated with SUA levels (β = 0.032, P = 0.003). Similar results were obtained using other MR methods and in sensitivity analyses. Genetic predisposition to elevated SUA levels was not associated with NAFLD (IVW MR, odds ratio = 1.02, 95% CI: 0.90-1.15, P = 0.775). Similar results were obtained using other 4 pleiotropy robust MR methods and in sensitivity analyses, excluding 9 SNPs associated with potential confounders. CONCLUSIONS Our study supports the causal increased SUA levels by NAFLD, while our study does not confirm a causal association for SUA levels on risk of NAFLD. Further study is needed to interpret the potential mechanisms.
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Affiliation(s)
- Shiwei Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuhong Fu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Yue Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Xinxin Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Haijun Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Lei Tian
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Lin Zhuo
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingqiu Cui
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
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Akari S, Nakamura T, Furusawa K, Miyazaki Y, Kario K. The reality of treatment for hyperuricemia and gout in Japan: A historical cohort study using health insurance claims data. J Clin Hypertens (Greenwich) 2022; 24:1068-1075. [PMID: 35818841 PMCID: PMC9380143 DOI: 10.1111/jch.14539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
Hyperuricemia causes gout and has also been associated with metabolic syndrome and cardiovascular disease. Uric acid‐lowering drugs (ULDs) are used to reduce uric acid levels for the treatment of hyperuricemia and gout. However, there is a lack of robust and real‐world data on the history and treatment of patients with newly diagnosed hyperuricemia or gout in Japan. This retrospective, longitudinal, historical cohort study determined the characteristics of patients with hyperuricemia and/or gout, and prescription of, and adherence to, ULDs using data from the JMDC Claims Database. The primary evaluation population included 64 677 patients with newly diagnosed hyperuricemia and/or gout. Of these, only 26 501 (41.0%) had a prescription for ULDs at diagnosis. Even when ULDs were prescribed, the persistence rate of prescriptions declined over time, with a 54.4% persistence rate for ULDs at 12 months after the index diagnosis. In subgroups of patients with or without hypertension and diabetes, the rate of ULD prescription continuation was significantly higher in those with comorbidities than in those without (76.8% vs. 42.6% in those with vs. without hypertension, and 78.7% vs. 52.2% in those with vs. without diabetes). These finding suggest that therapeutic interventions to lower serum uric acid levels are under‐utilized for patients with newly diagnosed hyperuricemia and/or gout in Japan.
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Affiliation(s)
- Seigo Akari
- Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Aichi, Japan
| | - Takashi Nakamura
- Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Aichi, Japan
| | - Kenichi Furusawa
- Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Aichi, Japan
| | - Yuichi Miyazaki
- Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Aichi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Wien Klin Wochenschr 2022; 134:546-554. [PMID: 35817987 PMCID: PMC9300548 DOI: 10.1007/s00508-022-02054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/07/2022] [Indexed: 11/14/2022]
Abstract
Background Gout is the most frequent inflammatory joint disease in the western world and has a proven genetic background. Additionally, lifestyle factors like increasing life span and wealth, sufficient to excess nutritional status and a growing prevalence of obesity in the population, as well as e.g. alcohol consumption contribute to the rising incidence of hyperuricemia and gout. Apart from an adequate medication, medical advice on nutrition and lifestyle is an essential part of the management of gout patients, being at high risk of internal comorbidities. Objective In 2015, the ÖGR (Österreichische Gesellschaft für Rheumatologie und Rehabilitation) working group for osteoarthritis and crystal arthropathies already published nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Since then, a multitude of literature has been published addressing this topic, what required an update. Methods First, the authors performed a hierarchical literature search to screen the meanwhile published literature. Also considering references of the first publication, the relevant literature was selected, and the 2015 recommendations were either kept as published, reformulated or newly produced. Finally, the evidence level and the level of agreement with each recommendation were added. Results Following this process, ten recommendations were generated instead of the initial nine. Like in the original publication, a colored icon presentation was provided to complement the written text. Conclusion The Austrian nutrition and lifestyle recommendations for patients with gout and hyperuricemia were updated incorporating the most recent relevant literature, serving as education material for patients and updated information for physicians.
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Febuxostat Improves Uric Acid Levels and Renal Function in Patients with Chronic Kidney Disease and Hyperuricemia: A Meta-Analysis. Appl Bionics Biomech 2022; 2022:9704862. [PMID: 35847625 PMCID: PMC9286991 DOI: 10.1155/2022/9704862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/07/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Uric acid nephropathy, also known as hyperuricemia nephropathy or gouty nephropathy, is characterized by uric acid crystal deposition and inflammatory cell infiltration. Herein, we aimed to demonstrate the role of febuxostat on uric acid levels and renal function in patients with chronic kidney disease and hyperuricemia. Methods. Eight databases included were searched for clinical randomized controlled trials. Meanwhile, the confidence interval (CI) of either relative risk or mean difference was set to 95%. Besides, the heterogeneity of the research results is tested by
. Results. Ten studies were ultimately included in this meta-analysis. All of them were considered to be random controlled trials. 10 studies reported the serum uric acid of the test group and the control group, which was significantly lower (SMD: -146.44, 95% Cl: -195.96, -86.93, and
) than the control group, EGFR (SMD: 3.21, 95% Cl: 1.17, 5.25, and
), serum creatinine (SMD: -15.27, 95% Cl: -20.75, -9.79, and
), serum urea nitrogen (SMD: -2.37, 95% Cl: -3.31, -1.61, and
), and adverse reactions (OR: 0.74, 95% Cl: 0.32, 1.68, and
). Conclusion. The results of this study suggest that febuxostat may be effective in patients with CKD with HUA, as evidenced by serum uric acid, creatinine, urea nitrogen, and EGFR. However, large sample, multicenter, low risk of bias clinical studies, as well as basic medical research, are needed.
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Prevalence and risk factors of hyperuricemia and gout: a cross-sectional survey from 31 provinces in mainland China. J Transl Int Med 2022; 10:134-145. [PMID: 35959454 PMCID: PMC9328039 DOI: 10.2478/jtim-2022-0031] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and Objetives
Hyperuricemia (HUA) and gout seriously influence patients’ quality of life. The current study was performed to investigate the prevalence of HUA and gout and the related risk factors in Chinese adults.
Methods
Data were collected from the National Survey of Thyroid Disorders and Diabetes (the Thyroid Disease, Iodine Status, and Diabetes National Epidemiological survey [TIDE]), a cross-sectional investigation conducted during 2015–2017. Using a random, multistage, and stratified sampling strategy, a representative sample (78,130 participants aged 18 years and above) was selected from the general population in 31 provinces of mainland China. The weighted prevalence rates of HUA and gout were calculated, and the related risk factors were analyzed.
Results
The weighted prevalence rates of HUA and gout in Chinese adults were 17.7% and 3.2%, respectively. The prevalence of HUA in males linearly decreased with age, while the prevalence in females showed the opposite trend (both P for trend < 0.01). The prevalence rate of gout exhibited a rising tendency with age in both genders (both P for trend < 0.05). The HUA and gout prevalence rates in males were the highest in Han and Tibetan nationalities, respectively. Logistic regression analysis showed that the morbidities of HUA and gout were differentially associated with age, residence location, nationality, smoking, and other complicating metabolic diseases in the two genders.
Conclusions
There are relatively high prevalence rates of gout and HUA in China, which is currently a developing country. Reducing their burden has become an urgent issue for Chinese people.
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Topless R, Noorbaloochi S, Merriman TR, Singh JA. Change in serum urate level with urate-lowering therapy initiation associates in the immediate term with patient-reported outcomes in people with gout. Semin Arthritis Rheum 2022; 56:152057. [PMID: 35835008 DOI: 10.1016/j.semarthrit.2022.152057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/25/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the associations of changes in serum urate (SU) with health-related quality of life (HRQOL) in gout. METHODS We used the first 6-months of data from four interventional trials and one observational, open-label study of urate-lowering therapy (ULT) use. HRQOL were assessed at baseline and every 3-months, and SU was measured monthly. Primary outcome measures were Short-form 36 physical and mental component summary scores, Health Assessment Questionnaire Disability Index (HAQ-DI), Sheehan Disability Scale (SDS), Patient Global Assessment, and pain scores in the last week. Linear mixed models for each outcome were adjusted as appropriate for current SU, change in urate in the last month, number of flare-affected days in the last month, baseline BMI, age, comorbidities, sex, ethnicity, trial/study and treatment combination, and tophi status (fixed effects); subject, and the trial/study month were random effects. RESULTS Higher current SU correlated with reduced physical and mental HRQOL, and increased SDS and pain but not with HAQ-DI score. In the first 6-months of new/escalating ULT use, absolute change in SU levels associated with poorer outcomes on the HAQ-DI scale (β (95% CI) = 0.013 (0.007-0.019)) and poorer outcomes on SDS, SF-36 MCS, patient global and pain scales. Reduction of SU associated with poorer outcomes in all six measures. CONCLUSION High SU levels were associated with poorer HRQOL, pain and Sheehan disability score. Recent SU level fluctuations are associated with poorer outcomes, primarily driven by a reduction in SU. Clinical emphasis on slow rather than fast SU reduction and the routine use of effective, anti-inflammatory medications at ULT initiation/escalation may avoid short-term poor outcomes.
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Affiliation(s)
- Ruth Topless
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Siamak Noorbaloochi
- Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand; Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294, USA
| | - Jasvinder A Singh
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294, USA; Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL 35233, USA; Division of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
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Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries. J Clin Med 2022; 11:jcm11133749. [PMID: 35807031 PMCID: PMC9267449 DOI: 10.3390/jcm11133749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult patients who underwent thoracolumbar spine surgery between January 2009 and June 2021, and 128 patients who had a history of gouty arthritis were included. Baseline characteristics and operative details were compared between the flare-up and no-flare groups. Multivariate logistic regression was used to analyze predictors and construct a predictive model of postoperative flares. This model was validated using a receiver operating characteristic (ROC) curve analysis. Fifty-six patients (43.8%) had postsurgical gout flares. Multivariate analysis identified gout medication use (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.14−0.75; p = 0.009), smoking (OR, 3.23; 95% CI, 1.34−7.80; p = 0.009), preoperative hemoglobin level (OR, 0.68; 95% CI, 0.53−0.87; p = 0.002), and hemoglobin drop (OR, 1.93; 95% CI, 1.25−2.96; p = 0.003) as predictors for postsurgical flare. The area under the ROC curve was 0.801 (95% CI, 0.717−0.877; p < 0.001). The optimal cut-off point of probability greater than 0.453 predicted gout flare with a sensitivity of 76.8% and specificity of 73.2%. The prediction model may help identify patients at an increased risk of gout flare.
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Oku F, Hara A, Tsujiguchi H, Suzuki K, Pham KO, Suzuki F, Miyagi S, Nakamura M, Takazawa C, Sato K, Yanagisawa T, Kannon T, Tajima A, Nakamura H. Association between Dietary Fat Intake and Hyperuricemia in Men with Chronic Kidney Disease. Nutrients 2022; 14:nu14132637. [PMID: 35807818 PMCID: PMC9268322 DOI: 10.3390/nu14132637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 02/04/2023] Open
Abstract
Despite a close relationship between chronic kidney disease (CKD) and uric acid level, few studies have examined the relationship between uric acid level and fat intake by kidney function status. Therefore, we investigated the association between dietary fat intake and hyperuricemia with and without decreased kidney function in males living in Shika Town, Ishikawa Prefecture, Japan. This study included 361 males with a mean age of 60.7 years. Dietary fat and fatty acid intakes were evaluated using the brief-type self-administered diet history questionnaire. Reduced kidney function was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, while hyperuricemia was defined as a serum uric acid level >7.0 mg/dL. A two-way analysis of covariance showed that saturated fatty acid (p = 0.026), monounsaturated fatty acid (p = 0.014), and polyunsaturated fatty acid (p = 0.022) were significantly lower in the high uric acid group than in the normal uric acid group. In multiple logistic analysis stratified by renal function, lipid intake was negatively associated with hyperuricemia in the low eGFR group. These findings suggest that higher dietary lipid/fatty acid intake may be effective in the prevention and treatment of hyperuricemia in men with CKD.
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Affiliation(s)
- Fumika Oku
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
| | - Akinori Hara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
| | - Kim-Oanh Pham
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan;
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
| | - Chie Takazawa
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
| | - Kuniko Sato
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
| | - Toru Yanagisawa
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (F.O.); (A.H.); (H.T.); (C.T.); (K.S.); (T.Y.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (K.-O.P.); (F.S.); (M.N.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Correspondence: ; Tel.: +81-76-265-2218
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Sapankaew T, Thadanipon K, Ruenroengbun N, Chaiyakittisopon K, Ingsathit A, Numthavaj P, Chaiyakunapruk N, McKay G, Attia J, Thakkinstian A. Efficacy and safety of urate-lowering agents in asymptomatic hyperuricemia: systematic review and network meta-analysis of randomized controlled trials. BMC Nephrol 2022; 23:223. [PMID: 35739495 PMCID: PMC9229855 DOI: 10.1186/s12882-022-02850-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/13/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Asymptomatic hyperuricemia was found to be associated with increased cardiovascular disease risk but the potential benefits of urate-lowering therapy (ULT) remain controversial. We conducted a systematic review and network meta-analysis (NMA) with frequentist model to estimate the efficacy and safety of ULT in asymptomatic hyperuricemia. METHODS MEDLINE, Embase, and Scopus were searched without language restrictions. Randomized controlled trials (RCT) of adults with asymptomatic hyperuricemia were eligible if they compared any pair of ULTs (i.e., allopurinol, febuxostat, probenecid, benzbromarone, sulfinpyrazone, rasburicase, lesinurad, and topiroxostat) and placebo or no ULT, and had outcomes of interest, including composite renal events, major adverse cardiovascular events, serum urate levels, estimated glomerular filtration rate (eGFR), systolic blood pressure, and adverse events. RESULTS NMA with frequentist approach was applied to estimate relative treatment effects, i.e., risk ratio (RR) and mean difference (MD). A total of 23 RCTs were eligible. NMA identified beneficial effects of ULT on composite renal events and eGFR but not for other outcomes. Allopurinol and febuxostat had significantly lower composite renal events than placebo (RR 0.39, 95% confidence interval [CI] 0.23 to 0.66, and RR 0.68, 95% CI 0.46 to 0.99, respectively). Both treatments also resulted in significantly higher eGFR than placebo (MD 3.69 ml/min/1.73 m2, 95% CI 1.31 to 6.08, and MD 2.89 ml/min/1.73 m2, 95% CI 0.69 to 5.09, respectively). No evidence of inconsistency was identified. CONCLUSIONS Evidence suggests that allopurinol and febuxostat are the ULTs of choice in reducing composite renal events and improving renal function. TRIAL REGISTRATION This study was registered with PROSPERO: CRD42019145908. The date of the first registration was 12th November 2019.
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Affiliation(s)
- Tunlanut Sapankaew
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Narisa Ruenroengbun
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand
| | - Kamolpat Chaiyakittisopon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand
| | - Atiporn Ingsathit
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pawin Numthavaj
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Gareth McKay
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Yong T, Liang D, Xiao C, Huang L, Chen S, Xie Y, Gao X, Wu Q, Hu H, Li X, Liu Y, Cai M. Hypouricemic effect of 2,4-dihydroxybenzoic acid methyl ester in hyperuricemic mice through inhibiting XOD and down-regulating URAT1. Biomed Pharmacother 2022; 153:113303. [PMID: 35750011 DOI: 10.1016/j.biopha.2022.113303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/02/2022] Open
Abstract
In this paper, we reported the hypouricemic effect of 2,4-dihydroxybenzoic acid methyl ester (DAE), a component of Ganoderma applanatum, in hyperuricemic mice through inhibiting XOD and down-regulating URAT1. Computationally, DAE showed a high similarity to allopurinol and depicted a high affinity in docking to XOD. In vitro, DAE exhibited an inhibitory effect against XOD. Importantly, DAE demonstrated a remarkable hypouricemic effect, decreasing serum uric acids (SUAs) of hyperuricemic mice (407 ± 31 μmol/L) to 195 ± 23, 145 ± 33 and 134 ± 16 μmol/L (P < 0.01) at the doses of 20, 40, and 80 mg/kg with a dose-dependent manner and showing efficacies at 54-68 %, which were close to the efficacies of allopurinol (61 %) and benzbromarone (57 %). DAE depicted higher and negatively dose-independent urinary uric acids in comparison with that of the hyperuricemic control, implying DAE exerted an uricosuric effect and also a reduction effect on uric acid production. Unlike toxic allopurinol and benzbromarone, no general toxicity on body weights and no negative influence on liver, kidney, spleen and thymus were observed for DAE. Mechanistically, DAE inhibited XOD activities in vivo. Moreover, DAE up-regulated OAT1 and down-regulated GLUT9, URAT1 and CNT2. Overall, DAE may present a hypouricemic effect through inhibiting XOD and up-regulating OAT1 and down-regulating GLUT9, URAT1 and CNT2. This work provided novel insights into the hypouricemic effect of DAE and G. applanatum.
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Affiliation(s)
- Tianqiao Yong
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Danling Liang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China; Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
| | - Chun Xiao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Longhua Huang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China
| | - Shaodan Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Yizhen Xie
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Xiong Gao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Qingping Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China.
| | - Huiping Hu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Xiangmin Li
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Yuancao Liu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
| | - Manjun Cai
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application of the Ministry of Agriculture and Rural Affairs and State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, China; Guangdong Yuewei Edible Fungi Technology Co., Guangzhou 510663, China
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Effects of secukinumab and adalimumab on serum uric acid level in patients with plaque psoriasis. Chin Med J (Engl) 2022; 135:1438-1443. [PMID: 35838407 PMCID: PMC9481430 DOI: 10.1097/cm9.0000000000002130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic systemic inflammatory disease, and hyperuricemia is a common comorbidity in patients with psoriasis. However, there are limited reports on the relationship between serum uric acid levels and biological treatment efficacy. The purposes of this study were to compare the differences in serum uric acid levels between patients with psoriasis and healthy controls and analyze the risk of hyperuricemia. METHODS A total of 196 patients with psoriasis and 191 age- and sex-matched healthy controls were enrolled in this retrospective cohort study. One hundred and twenty-seven patients with severe psoriasis were treated with biologics. Sixty-eight patients received adalimumab, and 59 patients received secukinumab. Serum uric acid levels were measured at baseline, week 24, and week 48 of treatment. RESULTS Patients with psoriasis had higher serum uric acid levels than healthy controls (6.4 ± 1.7 mg/dL vs. 5.7 ± 1.5 mg/dL, P < 0.001). Hyperuricemia was found in 33.7% (66/196) of patients with psoriasis, which was significantly higher than that in healthy controls (13.1% [25/191], P < 0.001). Serum uric acid levels and hyperuricemia were not related to the severity of psoriasis ( P > 0.05). No significant changes in serum uric acid levels and hyperuricemia were observed following adalimumab treatment ( P > 0.05). The serum uric acid level in patients treated with secukinumab was 6.7 ± 1.6 mg/dL at week 24, which was not statistically different from that at baseline (6.6 ± 1.4 mg/dL, P = 0.885). Serum uric acid levels were significantly decreased at week 48 (6.3 ± 1.5 mg/dL vs. 6.6 ± 1.4 mg/dL, P = 0.007) in patients treated with secukinumab. Secukinumab had no significant effect on hyperuricemia either ( P > 0.05). CONCLUSIONS The serum uric acid levels and prevalence of hyperuricemia in patients with psoriasis were significantly higher than those in healthy controls. Secukinumab treatment for 48 weeks successfully decreased serum uric acid levels in patients with psoriasis, whereas adalimumab had no significant effect on serum uric acid levels.
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Early-life exposure to the Chinese famine and risk of hyperuricaemia in adult females in Qingdao. Br J Nutr 2022; 127:1639-1646. [PMID: 34284834 DOI: 10.1017/s0007114521002749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two population-based cross-sectional surveys involving randomly selected Chinese adults aged 35-74 years were conducted in Qingdao, China in 2006 and 2009. Nine thousand fifty-five subjects from the two surveys were grouped into four birth groups of fetal/infant exposed (born between 1 January 1959 and 31 December 1962), childhood exposed (born between 1 January 1950 and 31 December 1958), adolescence exposed (born between 1 January 1942 and 31 December 1949) and the unexposed (born before 1941 and after 1963). Multivariate logistic regression models were used to calculate the OR and 95 % CI of hyperuricaemia in different exposed groups. Overall, famine exposure in the fetal/infant period, childhood and adolescence was not associated with adulthood hyperuricaemia (all P > 0·05). In females, childhood exposed group (OR = 1·59, 95 % CI 1·25, 2·02) and adolescence exposed group (OR = 1·74, 95 % CI 1·30, 2·33) both had higher risks to have hyperuricaemia in adult. However, this difference was not found in fetal/infant exposed group. In males, no significant relation was observed in any famine exposed group (all P > 0·05). Exposure to famine in childhood and adolescence is associated with an increased risk of hyperuricaemia for adulthood of females, but not in males. Adequate nutrition during early life appears to be beneficial to prevent hyperuricaemia of adult females.
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Shu L, Yang M, Liu N, Liu Y, Sun H, Wang S, Zhang Y, Li Y, Yang X, Wang Y. Short Hexapeptide Optimized from Rice-Derived Peptide 1 Shows Promising Anti-hyperuricemia Activities. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:6679-6687. [PMID: 35608514 DOI: 10.1021/acs.jafc.2c00354] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Plant-derived peptides are a treasure trove for new-generation anti-hyperuricemia drugs. In the current study, we optimized a short hexapeptide rice-derived peptide 1 (RDP1)-M3 (AAAAGA) according to the anti-hyperuricemia RDP1 peptide identified from rice in our previous research. Results showed that RDP1-M3 exerted better hyperuricemia-alleviating and xanthine oxidase (XOD)-inhibiting potency in mice than RDP1. The biodistribution of RDP1-M3 was also analyzed. RDP1-M3 directly decreased XOD and uric acid levels in vivo and in vitro. In addition, RDP1-M3 reduced the expression of urate transporter 1 and glucose transporter 9, increased the level of organic anion transporter 1, reduced the expression of NOD-like receptor superfamily pyrin 3 inflammasomes, and reduced the levels of interleukin-1β and tumor necrosis factor-α of hyperuricemic mice. Thus, our results indicated that the optimized short hexapeptide RDP1-M3 may be a candidate drug for anti-hyperuricemia.
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Affiliation(s)
- Longjun Shu
- Key Laboratory of Chemistry in Ethnic Medicinal Resources & Key Laboratory of Natural Products Synthetic Biology of Ethnic Medicinal Endophytes, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, Yunnan 650504, China
| | - Meifeng Yang
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Naixin Liu
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Yixiang Liu
- Key Laboratory of Chemistry in Ethnic Medicinal Resources & Key Laboratory of Natural Products Synthetic Biology of Ethnic Medicinal Endophytes, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, Yunnan 650504, China
| | - Huiling Sun
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Siyu Wang
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Yue Zhang
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Yilin Li
- Key Laboratory of Chemistry in Ethnic Medicinal Resources & Key Laboratory of Natural Products Synthetic Biology of Ethnic Medicinal Endophytes, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, Yunnan 650504, China
| | - Xinwang Yang
- Department of Anatomy and Histology and Embryology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Ying Wang
- Key Laboratory of Chemistry in Ethnic Medicinal Resources & Key Laboratory of Natural Products Synthetic Biology of Ethnic Medicinal Endophytes, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, Yunnan 650504, China
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136
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Wang J, Chen Y, Chen S, Wang X, Zhai H, Xu C. Prevalence and risk factors of hyperuricaemia in non-obese Chinese: a single-centre cross-sectional study. BMJ Open 2022; 12:e048574. [PMID: 36691244 PMCID: PMC9171206 DOI: 10.1136/bmjopen-2020-048574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/22/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Hyperuricaemia is closely related to metabolic diseases and is receiving increasing attention from all over the world. This study aimed to investigate the prevalence and factors associated with hyperuricaemia in non-obese Chinese population. DESIGN Retrospective cross-sectional study. SETTING A large general hospital that can provide health check-ups in Hangzhou, China. PARTICIPANTS A total of 5731 apparently healthy Chinese adults (2349 men and 3382 women) who took their health check-ups during the year of 2019. EXCLUSION CRITERIA (1) those with body mass index ≥24 kg/m2; (2) those with incomplete anthropometric and biochemical data; (3) those with a history of malignancy and (4) those under urate-lowering treatment. PRIMARY AND SECONDARY OUTCOME MEASURES The prevalence and factors associated with hyperuricaemia in non-obese Chinese adults. RESULTS Of the 5731 non-obese subjects enrolled, 538 (9.4%) were identified as having hyperuricaemia, specifically 16.3% in men and 4.6% in women. The prevalence of hyperuricaemia markedly increased in women aged above 50 years. The prevalence of hyperuricaemia was significantly higher in metabolically unhealthy participants with normal weight than in metabolically healthy participants with normal weight. Participants with hyperuricaemia showed a higher prevalence of metabolic syndrome and fatty liver disease than participants with normouraemia. Age, waist circumference, estimated glomerular filtration rate, blood urea nitrogen, excessive drinking and fatty liver were associated with hyperuricaemia in both genders. CONCLUSION The prevalence of hyperuricaemia was 9.4% in non-obese Chinese adults. Non-obese participants with hyperuricaemia also showed multiple metabolic disorders. We suggest that clinicians pay attention to serum uric acid level in non-obese patients.
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Affiliation(s)
- Jinghua Wang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yishu Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shenghui Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinyu Wang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haoliang Zhai
- Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, Haining, China
| | - Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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137
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Ehren R, Habbig S, Krupka K, Ernst A, Bald M, König S, Murer L, Özçakar ZB, Pohl M, Babenko N, Spartà G, Staude H, Dello Strologo L, Szabó AJ, Tönshoff B, Weber LT. Prevalence and potential relevance of hyperuricemia in pediatric kidney transplant recipients-a CERTAIN registry analysis. Pediatr Transplant 2022; 26:e14265. [PMID: 35263498 DOI: 10.1111/petr.14265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/27/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asymptomatic hyperuricemia is frequently observed in pediatric kidney transplant recipients; symptomatic hyperuricemia, however, is a rare complication. Only few data are available in this patient population. We, therefore, investigated the prevalence of hyperuricemia and its association with kidney transplant function and blood pressure in a multicenter cohort of pediatric kidney transplant recipients. METHODS This is a retrospective, observational multicenter registry study. All pediatric kidney transplant recipients in the CERTAIN database with at least one documented serum uric acid level and a follow-up of 5 years posttransplant were eligible. We identified 151 patients with 395 measurements of serum uric acid. We calculated the prevalence of hyperuricemia, analyzed potential risk factors and clinical consequences such as elevated blood pressure and reduced estimated glomerular filtration rate (eGFR). Statistical analysis was performed using IBM SPSS Statistics 26. RESULTS One hundred and ten of 395 (27.8%) serum uric acid levels were above 416 µmol/L (7.0 mg/dL), defined as the upper limit of normal. Univariate analysis showed a significant (p = .026) inverse association of serum uric acid with eGFR overtime. There was no significant association of serum uric acid concentrations with body mass index (z-score), blood pressure (z-score), or sex. No episodes of gout were documented. CONCLUSION This study shows that hyperuricemia is present in a considerable number of patients sometime after pediatric kidney transplantation and is associated with lower eGFR. Whether hyperuricemia contributes to faster decline of graft function or to the overall cardiovascular risk of these patients remains to be elucidated.
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Affiliation(s)
- Rasmus Ehren
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sandra Habbig
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kai Krupka
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Angela Ernst
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Martin Bald
- Olga Children's Hospital, Clinic of Stuttgart, Stuttgart, Germany
| | - Sabine König
- Department of General Pediatrics, University Hospital Muenster, Muenster, Germany
| | - Luisa Murer
- Department of Woman's and Child's Health, Pediatric Nephrology Dialysis and Transplant Unit, Azienda Ospedaliera-University of Padova, Padova, Italy
| | - Zeynep Birsin Özçakar
- Division of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Michael Pohl
- KfH Kidney Center for Children and Adolescents, St. Georg Hospital, Leipzig, Germany
| | - Nadezhda Babenko
- National Medical Research Center for Children's Health, Organ Transplant Division, Moscow, Russian Federation
| | - Giuseppina Spartà
- Pediatric Nephrology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hagen Staude
- University Children's Hospital Rostock, Rostock, Germany
| | | | - Attila J Szabó
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.,MTA-SE (Hungarian Academy of Sciences - Semmelweis University) Pediatrics and Nephrology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Lutz T Weber
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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138
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He L, Li Z, Zhang Q, Chen Y, Gao Y, Chen T, Wang N, Jiang L, Fan Y. Evaluation of renal microperfusion in hyperuricemic nephropathy by Contrast-Enhanced Ultrasound imaging. Dis Model Mech 2022; 15:276106. [PMID: 35645166 PMCID: PMC9346517 DOI: 10.1242/dmm.049382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Diagnostic tools for the early detection of renal injury caused by hyperuricemia are still lacking. Here, we investigated whether contrast-enhanced ultrasound (CEUS) could be used as a diagnostic tool for hyperuricemic nephropathy (HN). In the HN rat model, CEUS detected a significant decline in renal cortical perfusion compared with that in control rats. Peak intensity (PI) values correlated significantly with serum KIM-1 levels and fibrosis scores in HN rats. An early decline in PI values was also observed in chronic kidney disease (CKD) stage 1 patients with HN compared with the controls (61.1±4.52 dB versus 65.80±7.10 dB) and correlated with renal function in the patients with HN. In contrast, an increase in time to reach PI values was detected in HN patients with stage 1 CKD (15.14±1.75 s versus 14.52±4.75 s) and was more pronounced in CKD stage 4 patients (67.32±3.29 s). CEUS was able to detect abnormal renal perfusion in early CKD with HN, which correlated with renal function decline, suggesting that CEUS could be used as a noninvasive tool for assessing renal function in patients with HN.
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Affiliation(s)
- Li He
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Ze Li
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Qunzi Zhang
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yini Chen
- Ultrasonic department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yihui Gao
- Ultrasonic department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Teng Chen
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Niansong Wang
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Lixin Jiang
- Ultrasonic department, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Ying Fan
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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139
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Wen Q, Tang X, Zhou Q, Chen W, Yu X. Clinicopathological Patterns and Outcomes in Patients with Lupus Nephritis and Hyperuricemia. J Clin Med 2022; 11:jcm11113075. [PMID: 35683463 PMCID: PMC9181739 DOI: 10.3390/jcm11113075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/21/2022] [Indexed: 12/04/2022] Open
Abstract
A limited number of large cohort studies have reported the clinicopathological characteristics and prognosis of patients with lupus nephritis (LN) and hyperuricemia (HUA). In this retrospective cohort study, 1297 LN patients were enrolled from January 1996 to December 2011 in the First Affiliated Hospital of Sun Yat-Sen University, and HUA occurred in 649 (50.04%) of these 1297 LN patients. Compared to patients without HUA, those with HUA presented with higher blood pressure and triglyceride levels, lower hemoglobin and serum albumin levels, worse renal function, more severe hematuria and proteinuria, higher lupus activity, and more positive antiphospholipid antibody. Pathologically, HUA cases presented more crescents, a higher degree of mesangial matrix, endothelial cell proliferation, and inflammatory cell infiltration. During the 52-month follow-up, the 5-year and 10-year incidence rates of renal endpoint events were 11.1% and 19.5% in the HUA group, and 8.3% and 13.8% in the non-HUA group, respectively (p = 0.073). In addition, the 5-year and 10-year mortality rates did not differ significantly between the HUA (12.0% and 18.2%) and non-HUA (12.2% and 17.5%) groups, respectively. This study verified that HUA was not an independent risk for poor clinical outcomes, and steroids that delay the deterioration of renal function did not affect the survival of these patients.
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Affiliation(s)
- Qiong Wen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
| | - Xueqing Tang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
- Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan 250014, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
- Correspondence: ; Tel./Fax: +86-020-87769673
| | - Xueqing Yu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; (Q.W.); (X.T.); (X.Y.)
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University), Guangzhou 510080, China
- Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China
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140
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Zhou J, Yuan Y, Xu P, Yi B, Chen H, Su W. Host-Population Microbial Diversity Scaling of Chinese Gut Microbiomes in Gout Patients. Evol Bioinform Online 2022; 18:11769343221095858. [PMID: 35586773 PMCID: PMC9109170 DOI: 10.1177/11769343221095858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
Gout is a prevalent chronic inflammatory disease that affects the life of tens of millions of people worldwide, and it typically presents as gout arthritis, gout stone, or even kidney damage. Research has revealed its connection with the gut microbiome, although exact mechanism is still unclear. Studies have shown the decline of microbiome diversity in gout patients and change of microbiome compositions between the gout patients and healthy controls. Nevertheless, how diversity changes across host individuals at a cohort (population) level has not been investigated to the best of our knowledge. Here we apply the diversity-area relationship (DAR), which is an extension to the classic SAR (species-area relationship) and establishes the power-function model between microbiome diversity and the number of individuals within cohort, to comparatively investigate diversity scaling (changes) of gut microbiome in gout patients and healthy controls. The DAR modeling with a study involving 83 subjects (41 gout patients) revealed that the potential number of microbial species in gout patients is only 70% of that in the healthy control (2790 vs 3900) although the difference may not be statistically significant. The other DAR parameters including diversity scaling and similarity parameters did not show statistically significant differences. We postulate that the high resilience of gut microbiome may explain the lack of significant gout-disease effects on gut microbial diversity at the population level. The lack of statistically significant difference between the gout patients and healthy controls at host population (cohort) level is different from the previous findings at individual level in the existing literature.
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Affiliation(s)
- Jieshang Zhou
- People's Hospital of Dingxi City, The Second Affiliated Hospital of Lanzhou University Medical School, Dingxi, China
| | - Yali Yuan
- People's Hospital of Dingxi City, The Second Affiliated Hospital of Lanzhou University Medical School, Dingxi, China.,College of Clinical Medicine, Lanzhou University Medical School, Lanzhou, China
| | - Pengli Xu
- College of Graduate Studies, Kunming Medical University, Kunming, China
| | - Bin Yi
- College of Mathematics, Honghe University, Mengzi, Yunnan, China
| | - Hongju Chen
- College of Mathematics, Honghe University, Mengzi, Yunnan, China
| | - Wei Su
- Department of Radiology, Affiliated Hospital of Yunnan University, Kunming, China
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141
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Sun J, Yue C, Liu Z, Li J, Kang W. The Association Between Total Percent Fat and Serum Uric Acid in Adults. Front Nutr 2022; 9:851280. [PMID: 35673358 PMCID: PMC9167424 DOI: 10.3389/fnut.2022.851280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/31/2022] [Indexed: 01/21/2023] Open
Abstract
Background Serum uric acid (SUA) has been proven to be closely associated with metabolic abnormalities, including obesity. This study aimed to investigate the detailed relationship between total percent fat (TPF) and SUA among adults. Methods Briefly, 23,715 adults aged 18–59 years in the National Health and Nutrition Examination Survey (NHANES) 1999–2018 were included in this study. Multivariable linear regression models were used to examine the association between TPF and SUA. Subgroup analyses stratified by sex and obesity status were also performed by multivariable linear regression. Then, fitted smoothing curves and generalized additive models were also applied to address the non-linear relationship between TPF and SUA. Finally, a recursive algorithm was used to calculate the inflection point in the non-linear relationship and a two-segment piecewise linear regression model was used to analyze the relationship between TPF and SUA on both sides of the inflection point. Results There were 15,808 (66.7%) obese individuals in all 23,715 participants. In the fully adjusted model, there was a positive association between TPF and SUA (β = 0.99, 95% CI: 0.73–1.26). Besides, this positive association remained statistically significant in subgroup analyses stratified by sex and obesity status. Interestingly, in males, the association of TPF and SUA was an inverted U-shaped curve (inflection point: 34.3%). Conclusion Our study revealed a significant positive relationship between TPF and SUA among adults and this association remained statistically significant when stratified by sex and obesity status, but the shape of the smoothing curve in males differed from that in females.
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Affiliation(s)
- Juan Sun
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenyang Yue
- Department of Biology, York University, Toronto, ON, Canada
| | - Zhen Liu
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Li
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Weiming Kang
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Weiming Kang,
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142
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Pugin B, Plüss S, Mujezinovic D, Nielsen RC, Lacroix C. Optimized UV-Spectrophotometric Assay to Screen Bacterial Uricase Activity Using Whole Cell Suspension. Front Microbiol 2022; 13:853735. [PMID: 35495677 PMCID: PMC9043897 DOI: 10.3389/fmicb.2022.853735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
Uricase catalyzes the conversion of uric acid into allantoin with concomitant reduction of molecular oxygen to hydrogen peroxide. In humans, uricase is not functional, thereby predisposing individuals to hyperuricemia, a metabolic disturbance associated with gout, chronic kidney disorders, and cardiovascular diseases. The efficacy of current therapies to treat hyperuricemia is limited, and novel approaches are therefore desired, for instance using uricase-expressing probiotic strains. Here, we evaluated UV-spectrophotometric and H2O2-based fluorescent assays to enable the rapid identification of uricase activity in a broad panel of lactobacilli, Bacillus, and Bifidobacterium species. We highlighted abiotic (medium composition and mode of sterilization) and biotic (H2O2-producing strains) factors impacting the measurements' accuracy, and reported on the stepwise optimization of a simple, fast, and robust high-throughput UV-spectrophotometric method to screen uricase activity using whole bacterial suspension, thereby assessing both cell-associated and extracellular activity. The validity of the optimized assay, based on the monitoring of uric acid degradation at 300 nm, was confirmed via liquid chromatography. Finally, a panel of 319 Qualified Presumption of Safety (QPS) strains of lactobacilli (18 species covering nine genera), Bacillus (three species), and Bifidobacterium (four species) were screened for uricase activity using the optimized method. All 319 strains, but the positive control Bacillus sp. DSM 1306, were uricase-negative, indicating that this activity is rare among these genera, especially in isolates from food or feces. Altogether, the UV-spectrophotometric high-throughput assay based on whole bacterial suspension reported here can be used to rapidly screen large microbial collections, by simultaneously detecting cell-associated and extracellular uricase activity, thereby accelerating the identification of uricolytic strains with therapeutic potential to treat hyperuricemia.
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Affiliation(s)
- Benoit Pugin
- Laboratory of Food Biotechnology, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Serafina Plüss
- Laboratory of Food Biotechnology, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Denisa Mujezinovic
- Laboratory of Food Biotechnology, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | | | - Christophe Lacroix
- Laboratory of Food Biotechnology, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
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Hong R, Huang J, Xu C, Zhang X, Mi F, Xu F, Wang Y, Feng Y, Yin J. Association of Sedentary Behavior and Physical Activity With Hyperuricemia and Sex Differences: Results From the China Multi-Ethnic Cohort Study. J Rheumatol 2022; 49:513-522. [PMID: 35169050 DOI: 10.3899/jrheum.211180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To determine the association of physical activity (PA) and sedentary time (ST; leisure and total ST), commuting mode with hyperuricemia in a multiethnic Chinese population, and to analyze the difference between sexes. METHODS Baseline data were analyzed from 22,094 participants from the China Multi-Ethnic Cohort study in the Yunnan region, China. PA and sedentary behavior were assessed through questionnaires. Hyperuricemia was defined as serum urate > 7.0 mg/dL among men and > 6.0 mg/dL among women. A restricted cubic spline (RCS) was created to model the possible nonlinear relationship of PA and ST with hyperuricemia. Logistic regression was used to estimate the odds ratio (OR) and 95% CI. RESULTS Hyperuricemia prevalence in the observed population was 15.5% (men 25.5%, women 10.7%). Compared to those with light PA, participants with moderate-to-vigorous PA had lower odds of hyperuricemia (adjusted ORs were 0.85 [95% CI 0.77-0.94] and 0.88 [95% CI 0.79-0.97]). However, RCS showed a U-shaped nonlinear relationship between PA and hyperuricemia, and a linear relationship between hyperuricemia prevalence and increasing ST. Total ST ≥ 4 hours/day increased the risk of hyperuricemia in women but not in men. Mode of transportation revealed that sedentary behavior increased the risk of hyperuricemia, but there were inconsistent results based on sex. CONCLUSION Moderate PA may be more beneficial in reducing the risk of hyperuricemia. Reducing ST may have a greater effect on preventing hyperuricemia in females than in males.
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Affiliation(s)
- Rudan Hong
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Juan Huang
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Chuanzhi Xu
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Xuehui Zhang
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Fei Mi
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Fang Xu
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Yanjiao Wang
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Yuemei Feng
- R. Hong, MMed, J. Huang, MMed, C. Xu, MMed, X. Zhang, BS Med, F. Mi, MD, F. Xu, MMed, Y. Wang, MD, Y. Feng, MD, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City
| | - Jianzhong Yin
- J. Yin, MMed, Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming City, and Baoshan College of Traditional Chinese Medicine, Baoshan, China
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Son KM, Kim JR, Park HA, Kim HA. Trends in hospital visits and healthcare costs of gout and seropositive rheumatoid arthritis in Korea from 2010 to 2017 using National Healthcare Claims. Korean J Intern Med 2022; 37:681-690. [PMID: 34695882 PMCID: PMC9082448 DOI: 10.3904/kjim.2020.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 03/03/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS We examined temporal trends in the rate of gout and seropositive rheumatoid arthritis (RA) hospital visits and healthcare costs in Korea. METHODS We conducted a serial cross-sectional analysis of Korean national healthcare claims. We calculated the annual increase in hospital visits (emergency department [ED] visits, outpatient visits, and hospitalizations) and total healthcare costs per visit. RESULTS From 2010 to 2017, the annual rates of ED visits, outpatient visits, and hospitalizations for gout increased from 6.28 to 21, from 638.38 to 1059.55, and from 12.37 to 15.6 per 100,000 persons, respectively. Before 2013, ED visits for gout were most common in patients over 70 years old, but they were most common in those aged between 30 and 49 years after 2013. The number of patients with ED visits, outpatient visits, and hospitalizations for RA from 2010 to 2017 increased from 1.25 to 1.87, from 219.04 to 307.49 and from 8.44 to 12.32 per 100,000 persons, respectively. However, there was no increase in the prevalence of ED visits for RA in any age group except for those older than 70 years. The cost per ED visit for gout significantly decreased from 496.3 to 273.6 US dollar during the study period. There was no significant change in the cost per ED visit for RA between 2010 and 2017. CONCLUSION There was a large increase in ED visits for gout during the study period. Further studies are needed to analyze the reason behind increased ED visits for gout and suggest ways on how to improve gout care.
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Affiliation(s)
- Kyeong Min Son
- Division of Rheumatology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Ju-Ryoung Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hang A Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- Correspondence to Hyun Ah Kim, M.D., Ph.D. Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea Tel: +82-31-380-1826 E-mail: , https://orcid.org/0000-0002-9318-7446
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145
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Lee Y, Hwang J, Desai SH, Li X, Jenkins C, Kopp JB, Winkler CA, Cho SK. Efficacy of Xanthine Oxidase Inhibitors in Lowering Serum Uric Acid in Chronic Kidney Disease: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11092468. [PMID: 35566594 PMCID: PMC9105680 DOI: 10.3390/jcm11092468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 02/05/2023] Open
Abstract
Objective: Current guidelines for gout recommend a treat-to-target approach with serum uric acid (SUA). However, there is little evidence for the dose-dependent effects of urate-lowering therapy (ULT). Herein, we analyzed the reported SUA-lowering effect and SUA target achievement differences for various doses of xanthine oxidase inhibitors. Methods: Approved ULT drugs were selected from the FDA Drug Database. We included prospective randomized controlled trials of ULT drugs from ClinicalTrials.gov, articles published in the journal “Drugs”, and Embase, a literature database. A meta-analysis was performed to determine the ability of different ULT drugs and doses to lower and maintain a target SUA < 6 mg/dL. Results: We identified 35 trials including 8172 patients with a baseline SUA of 8.92 mg/dL. The allopurinol, febuxostat, and topiroxostat showed dose-proportional SUA-lowering responses. Compared with allopurinol 300 mg daily, febuxostat 80 mg daily and 120 mg daily more effectively maintained SUA < 6 mg/dL. Conclusion: Allopurinol, febuxostat, and topiroxostat showed dose-proportional ability to lower and achieve a target SUA < 6 mg/dL. Significance and Innovations. We showed dose-dependent SUA lowering effects of allopurinol, febuxostat, and topiroxostat. Febuxostat is effective at ULT compared to allopurinol and could be potentially offered as an alternative agent when patients (1) have CKD, (2) have the human leukocyte antigen HLA-B*5801 allele, and (3) become refractory to allopurinol. Gradual allopurinol dose increase with a lower starting dose is needed in CKD.
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Affiliation(s)
- Yoojin Lee
- Molecular Genetic Epidemiology Section, Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702, USA; (Y.L.); (S.H.D.); (C.A.W.)
- Department of Pharmacology, Ajou University School of Medicine, Suwon 16499, Korea
| | - Jennifer Hwang
- Department of Internal Medicine, The Hospital of Central Connecticut, New Britain, CT 06052, USA;
| | - Shaan H. Desai
- Molecular Genetic Epidemiology Section, Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702, USA; (Y.L.); (S.H.D.); (C.A.W.)
- Howard University College of Medicine, Washington, DC 20059, USA
| | - Xiaobai Li
- Biostatistics and Clinical Epidemiology Service, National Institutes of Health, Bethesda, MD 20814, USA;
| | - Christopher Jenkins
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA;
| | - Jeffrey B. Kopp
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20814, USA;
| | - Cheryl A. Winkler
- Molecular Genetic Epidemiology Section, Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702, USA; (Y.L.); (S.H.D.); (C.A.W.)
| | - Sung Kweon Cho
- Molecular Genetic Epidemiology Section, Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702, USA; (Y.L.); (S.H.D.); (C.A.W.)
- Department of Pharmacology, Ajou University School of Medicine, Suwon 16499, Korea
- Correspondence: ; Tel.: +82-31-219-4506; Fax: +82-31-219-5069
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146
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Ghamri RA, Galai TA, Ismail RA, Aljuhani JM, Alotaibi DS, Aljahdali MA. Prevalence of hyperuricemia and the relationship between serum uric acid concentrations and lipid parameters among King Abdulaziz University Hospital patients. Niger J Clin Pract 2022; 25:439-447. [PMID: 35439902 DOI: 10.4103/njcp.njcp_1549_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Several studies have associated uric acid with dyslipidemia. However, no previous studies have examined patients without chronic illness. Aim : The aim of this study is to assess the relationship between serum uric acid concentration and lipid profile parameters and to estimate the prevalence of hyperuricemia in the city of Jeddah. Patients and Methods A retrospective study was conducted on 1206 patients who undergone laboratory blood testing over a 3-year period (2018-2020) at King Abdulaziz University Hospital, which was ethically approved. We used a predesigned checklist to collect data from electronic hospital records using Google Forms. Bivariate analysis, tables, and graphs were used to represent and identify the relationships between variables. A P value of <0.05 was considered significant. Results Our study revealed a prevalence of 12% for hyperuricemia in the study population. Males were more frequently affected than females (8.13% vs. 3.73%, respectively). There was no association between serum uric acid concentration and lipid profile parameters, including total cholesterol (P = 0.92), triglyceride (P = 0.42), high-density lipoprotein (P = 0.47), and low-density lipoprotein (P = 0.66). There was a strong association between serum uric acid concentration and high body mass index (P < 0.001), older age (P = 0.002), male sex (P < 0.001), and nationality (P < 0.001). Furthermore, there was an association between sex and mean erythrocyte sedimentation rate (P = 0.02) and mean triglyceride concentration (P = 0.02). Conclusion We observed a low prevalence of hyperuricemia, and our results indicate no association between serum uric acid concentration and lipid profile parameters.
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Affiliation(s)
- R A Ghamri
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - T A Galai
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - R A Ismail
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - J M Aljuhani
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - D S Alotaibi
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M A Aljahdali
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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147
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Han Y, Han K, Zhang Y, Zeng X. Serum 25-hydroxyvitamin D might be negatively associated with hyperuricemia in U.S. adults: an analysis of the National Health and Nutrition Examination Survey 2007-2014. J Endocrinol Invest 2022; 45:719-729. [PMID: 34435335 PMCID: PMC8918159 DOI: 10.1007/s40618-021-01637-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/11/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE The results of previous studies on the relationship between serum 25-hydroxyvitamin D [25(OH)D] and hyperuricemia are controversial. We hypothesized that serum 25(OH)D concentrations of U.S. adults would negatively correlate with the risk of hyperuricemia. METHOD Data came from the National Health and Nutrition Examination Survey 2007-2014 were used, after excluding those who met at least one of the exclusion criteria, a total of 9096 male individuals and 9500 female individuals aged 18 years or older were included. Binary logistic regression analysis and restricted cubic spline with fully adjusted confounding factors were applied to evaluate the association between serum 25(OH)D and hyperuricemia. We further performed stratified analysis and sensitivity analysis to minimize the influence of gender, metabolic syndrome, obesity and renal dysfunction on the above association. RESULTS We found a negative correlation between serum 25(OH)D and hyperuricemia. In the binary logistic regression analysis, compared with the highest serum 25(OH)D quartile [Q4: 25(OH)D > 77.10 nmol/L] group, the odds ratios (95% confidence intervals) in the lowest quartile [Q1: 25(OH)D ≤ 43.20 nmol/L] was 1.46 (1.22-1.75) in the fully adjusted model. Restricted cubic spline analysis showed L-shaped and non-linear relationships between 25(OH)D and hyperuricemia. In sensitivity analysis, after restricting to participants without significant renal dysfunction and obesity, the above association remained significant. After restricting to participants who were diagnosed as metabolic syndrome, above association remained significant in the fully adjusted model. In stratified analysis by gender, the association remained significant among males and females. CONCLUSIONS Serum 25(OH)D might be inversely associated with hyperuricemia in general U.S. adults. From our study, for people with unexplained hyperuricemia, screening for serum Vitamin D concentration might be necessary.
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Affiliation(s)
- Y Han
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - K Han
- Department of Critical Care Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China
| | - Y Zhang
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| | - X Zeng
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
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148
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Metabolic effects of a ketogenic diet in overweight/obese women with polycystic ovary syndrome with different uric acid levels: a prospective cohort study. Reprod Biomed Online 2022; 45:391-400. [DOI: 10.1016/j.rbmo.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 11/20/2022]
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149
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The Relationship between Alcohol Consumption and Gout: A Mendelian Randomization Study. Genes (Basel) 2022; 13:genes13040557. [PMID: 35456363 PMCID: PMC9028689 DOI: 10.3390/genes13040557] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/12/2022] [Accepted: 03/16/2022] [Indexed: 01/27/2023] Open
Abstract
Gout is a disease that manifests itself after decades of following a high-purine diet, with excessive alcohol consumption assumed to be one of the main contributors to the development of the disease. This study performs a Mendelian randomization (MR) analysis to determine whether alcohol consumption causally affects the risk of developing both hyperuricemia and gout. The results indicate that genetically predicted drinks consumed per week have no causal effect on neither the risk of gout (p = 0.35), nor serum uric acid levels (p = 0.73). For MR analysis in the other direction, genetic risk of gout was significantly associated with drinks per week (p = 0.03). Furthermore, the results of the MR analysis were verified in a cohort of individuals diagnosed with hyperuricemia and gout, comprising of alcohol-consuming and alcohol-abstaining subgroups. When split by alcohol status, the serum uric acid levels failed to show a significant difference in both gout (p = 0.92) and hyperuricemia (p = 0.23) subgroups. Overall, the results suggest that increased alcohol consumption does not play a causal role in the development of gout.
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150
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He H, Pan L, Ren X, Wang D, Du J, Cui Z, Zhao J, Wang H, Wang X, Liu F, Pa L, Peng X, Yu C, Wang Y, Shan G. Joint Effect of Beer, Spirits Intake, and Excess Adiposity on Hyperuricemia Among Chinese Male Adults: Evidence From the China National Health Survey. Front Nutr 2022; 9:806751. [PMID: 35273987 PMCID: PMC8902589 DOI: 10.3389/fnut.2022.806751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/04/2022] [Indexed: 12/22/2022] Open
Abstract
Alcohol intake and excess adiposity are associated with serum uric acid (SUA), but their interaction effect on hyperuricemia (HUA) remains unclear. Using data from the China National Health Survey (CNHS) (2012-2017), we analyzed the additive interaction of beer, spirits intake, excess adiposity [measured by body mass index (BMI), body fat percentage (BFP), and visceral fat index (VFI)] with HUA among male participants aged 20-80 from mainland China. The relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI) were calculated to assess the interaction effect on the additive scale. Both RERI and AP larger than 0 and SI larger than 1 indicate a positive additive interaction. Among 12,592 male participants, the mean SUA level was 367.1 ± 85.5 μmol/L and 24.1% were HUA. Overweight/obese men who were presently drinking spirits had an odds ratio (OR) of 3.20 (95%CI: 2.71-3.79) than the never drink group, with RERI, AP, and SI of 0.45 (95%CI: 0.08-0.81), 0.14 (95%CI: 0.03-0.25), and 1.25 (95%CI: 1.02-1.54), respectively. However, although combined exposures on beer intake and excess adiposity had the highest OR compared with no beer intake and nonobese participants, there was no additive interaction, with RERI, AP, and SI in the overweight/obesity and the beer intake group of 0.58 (-0.41-1.57), 0.17 (-0.08-0.41), and 1.30 (0.85-1.97), respectively. Other excess adiposity indexes revealed similar estimates. Our findings suggested that the exposures of both excess adiposity and alcohol drink could result in an additive interaction effect on HUA: the combined risk of excess adiposity with spirits intake but not with beer was greater than the sum of the effects among Chinese male adults.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ye Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
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