Association between the hypertriglyceridemic waist phenotype and hyperuricemia: a cross-sectional study

Relationship Between Asymptomatic Hyperuricemia and the Hypertriglyceridemic-Waist Phenotype in Korean Adults: A Cross-Sectional Study

Purpose

Visceral fat accumulation can negatively affect uric acid metabolism in healthy adults. The hypertriglyceridemic-waist (HTGW) phenotype is a predictor of diabetes and cardiometabolic risk. This study aimed to investigate the association between the HTGW phenotype and asymptomatic hyperuricemia in Korean adults.

Patients and Methods

The study included 23,240 adults, aged 20-80 years who underwent comprehensive health examinations at a general hospital in Gyeonggi Province, Korea, from January 2020 to December 2022. The HTGW phenotype was defined as the simultaneous presence of elevated serum triglyceride (TG) levels and increased waist circumference (WC). The diagnostic capability of the HTGW phenotype for hyperuricemia and its association with the condition were assessed using the receiver operating characteristic (ROC) curve and logistic regression analysis.

Results

The prevalence of hyperuricemia in the HTGW phenotype was 3.44 times higher than that in the normal TG normal waist (NTNW) phenotype. Compared with those in the NTNW group, the hazard ratios for developing hyperuricemia in the HTGW group were 2.887 (2.566-3.249, P <0.001) for men and 7.341 (5.139-10.487, P <0.001) for women, and these values remained significant after adjusting for potential confounders. The stratified analysis revealed that the HTGW phenotype, coupled with diabetes, had the highest probability of developing asymptomatic hyperuricemia (2.55 times). ROC curve analysis revealed that the area under the curve values of the WC*TG index for hyperuricemia diagnosis were 0.702, 0.627, and 0.685 for all participants, men, and women, respectively.

Conclusion

Among Korean adults, the HTGW phenotype was closely related to hyperuricemia in both men and women and showed a particularly strong association in patients with diabetes. It may be used in combination with an indicator that can complement its accuracy for identifying individuals at high risk of hyperuricemia.

Sex-related differences in the hypertriglyceridemic-waist phenotype in association with hyperuricemia: a longitudinal cohort study

BACKGROUND

There is limited longitudinal evidence supporting the association between the hypertriglyceridemic-waist (HTGW) phenotype and hyperuricemia. This study aimed to examine the longitudinal relationship between hyperuricemia and the HTGW phenotype among males and females.

METHODS

A total of 5562 hyperuricemia-free participants aged 45 or over from the China Health and Retirement Longitudinal Study (mean age: 59.0) were followed for 4 years. The HTGW phenotype was defined as having elevated triglyceride levels and enlarged waist circumference (cutoffs for males: 2.0 mmol/L and 90 cm; females: 1.5 mmol/L and 85 cm). Hyperuricemia was determined by uric acid cutoffs (males: 7 mg/dl; females: 6 mg/dl. Multivariate logistic regression models were used to assess the association between the HTGW phenotype and hyperuricemia. The joint effect of the HTGW phenotype and sex on hyperuricemia was quantified, and the multiplicative interaction was assessed.

RESULTS

During the four-year follow-up, 549 (9.9%) incident hyperuricemia cases were ascertained. Compared with those with normal levels of triglycerides and waist circumference, participants with the HTGW phenotype had the highest risk of hyperuricemia (OR: 2.67; 95% CI: 1.95 to 3.66), followed by an OR of 1.96 (95% CI: 1.40 to 2.74) for only higher triglyceride levels and 1.39 (95% CI: 1.03 to 1.86) for only greater waist circumference. The association between HTGW and hyperuricemia was more prominent among females (OR = 2.36; 95% CI: 1.77 to 3.15) than males (OR = 1.29; 95% CI: 0.82 to 2.04), with evidence of a multiplicative interaction (P = 0.006).

CONCLUSIONS

Middle-aged and older females with the HTGW phenotype may at the highest risk of hyperuricemia. Future hyperuricemia prevention interventions should be primarily targeted for females with the HTGW phenotype.

A Randomized Trial on Resveratrol Supplement Affecting Lipid Profile and Other Metabolic Markers in Subjects with Dyslipidemia

Resveratrol is a polyphenol with a well-established beneficial effect on dyslipidemia and hyperuricemia in preclinical experiments. Nonetheless, its efficacy and dose-response relationship in clinical trials remains unclear. This study examined whether resveratrol supplement improves the serum lipid profile and other metabolic markers in a dose-response manner in individuals with dyslipidemia. A total of 168 subjects were randomly assigned to placebo (n = 43) and resveratrol treatment groups of 100 mg/d (n = 41), 300 mg/d (n = 43), and 600 mg/d (n = 41). Anthropometric and biochemical parameters were analyzed at baseline and 4 and 8 weeks. Resveratrol supplementation for 8 weeks did not significantly change the lipid profile compared with the placebo. However, a significant decrease of serum uric acid was observed at 8 weeks in 300 mg/d (-23.60 ± 61.53 μmol/L, p < 0.05) and 600 mg/d resveratrol groups (-24.37 ± 64.24 μmol/L, p < 0.01) compared to placebo (8.19 ± 44.60 μmol/L). Furthermore, xanthine oxidase (XO) activity decreased significantly in the 600 mg/d resveratrol group (-0.09 ± 0.29 U/mL, p < 0.05) compared with placebo (0.03 ± 0.20 U/mL) after 8 weeks. The reduction of uric acid and XO activity exhibited a dose-response relationship (p for trend, <0.05). Furthermore, a marked correlation was found between the changes in uric acid and XO activity in the resveratrol groups (r = 0.254, p < 0.01). Resveratrol (10 μmol/L) treatment to HepG2 cells significantly reduced the uric acid levels and intracellular XO activity. Nevertheless, we failed to detect significant differences in glucose, insulin, or oxidative stress biomarkers between the resveratrol groups and placebo. In conclusion, resveratrol supplementation for 8 weeks had no significant effect on lipid profile but decreased uric acid in a dose-response manner, possibly due to XO inhibition in subjects with dyslipidemia. The trial was registered on ClinicalTrials.gov (NCT04886297).

Hypertriglyceridemic waist phenotype is associated with left ventricular hypertrophy in Chinese hypertension patients

Left ventricular hypertrophy (LVH), the most common target organ damage in patients with hypertension, is closely related to excessive visceral adipose tissue (VAT) accumulation in the body. The hypertriglyceridemic waist (HTHW) phenotype can act as a surrogate marker of excessive VAT. However, the relationship between the HTHW phenotype and LVH in patients with hypertension remains unknown. The present study aimed to investigate whether the HTHW phenotype is associated with LVH, using echocardiography in a cross-sectional study involving 4470 middle-aged and older Chinese patients with hypertension. Logistic regression analysis revealed that patients with the HTHW phenotype were 1.52-fold more likely to experience LVH than those with normal triglyceride levels and normal waist circumference. This association was independent of age, sex, and other potentially confounding factors. In the stratified analysis, a stronger correlation was found among women, people of at least 70 years of age, and people with hyperuricemia. These results suggest that distinguishing the HTHW phenotype in patients with hypertension could serve as a simple and effective screening strategy for identifying people with a higher risk of developing LVH.

Association between metabolic obesity phenotype, transition of metabolic phenotypes and the risk of hyperuricemia in Chinese adults: A cohort study

Prospective evidence on the association of obesity and metabolic health status and its transition over time with the risk of hyperuricemia in the Chinese population is limited. This study aims to investigate the phenotypic transition characteristics of metabolic obesity in Chinese adults and its association with hyperuricemia. Using the China Health and Retirement Longitudinal Survey (CHARLS) survey data in 2011 and 2015, 6059 adults aged ≥ 18 years were selected as the research people. The participants' general information, living habits, blood sample testing, and blood uric acid testing data during follow-up were extracted. According to body weight and metabolic health status, obesity phenotypes were divided into: metabolically normal weight group (MHNW), metabolically normal overweight/obesity group (MHOWO); metabolically abnormal normal weight group (MUNW); metabolically abnormal overweight/obese group (MUHOWO). Multiple linear regression was used to evaluate the correlation between metabolic obesity phenotype and serum uric acid level, and logistic regression model was used to analyze the association of metabolic obesity phenotype and transition with the risk of hyperuricemia. The average age of all subjects was (58.62 ± 8.93) years old, and 42.1% were male. The MHOWO phenotype was present in 19.2% of the general population and 48.6% of the baseline who were overweight or obese population. During the 4-year follow-up period, only 10.7% of participants with MHNW at baseline converted to MHOWO. Among MHOWO participants, 21.2% converted to MUHOWO. MHOWO also increased the risk of hyperuricemia (OR, 1.57; 95% CI 1.15-2.13; P = .004), both in obese and normal-weight individuals, even when metabolic status changed from unhealthy to healthy. Risk of hyperuricemia was high among those who remained metabolically unhealthy but of normal weight (OR, 3.09; 95% CI 1.51-6.30; P = .001). MHOWO also increases the risk of hyperuricemia, and MHOWO remains stable or changes to MUHOWO, which increases the risk of hyperuricemia. Therefore, close attention should be paid to the transition of metabolic health status over time, and individualized prevention strategies should be focused on metabolically unhealthy and obese individuals.

Association of hypertriglyceridemic waist phenotype with non-alcoholic fatty liver disease: a cross-sectional study in a Chinese population

BACKGROUND

The aim of this study was to determine the association between hypertriglyceridemic waist (HTGW) phenotype and non-alcoholic fatty liver disease (NAFLD) in a middle- to older-aged Chinese population.

METHODS

In this cross-sectional study, a total of 9015 participants (age 40-79 years) were recruited and grouped into four phenotypes, as follows: NWNT: normal waist-normal triglyceride; NWET: normal waist-elevated triglycerides; EWNT: elevated waist-normal triglycerides; and hypertriglyceridemic waist (HTGW). Logistic regression analysis was carried out to assess the associations between HTGW phenotype and NAFLD. Receiver-operating characteristic (ROC) curves were drawn to evaluate the utility of waist circumference-triglyceride index (WTI) as a reference factor for screening for NAFLD.

RESULTS

HTGW phenotype had a higher prevalence of NAFLD (53.3%), diabetes (19.6%), and hypertension (79.8%) than the other three subgroups. After adjusting for age, sex, and BMI, HTGW phenotype was associated with NAFLD (odds ratio (OR) 6.12; 95% confidence interval (CI) 5.11-7.32). Further adjusted for potential confounders, the HTGW phenotype was still significantly associated with NAFLD (adjusted OR 5.18; 95% CI 4.30-6.23) regardless of gender. The subgroup analyses generally revealed similar associations across all subgroups. ROC curve analysis showed that when the maximum area under the curve was 0.748, the WTI was 90.1, and the corresponding sensitivity and specificity were 90.6 and 59.5%, respectively.

CONCLUSIONS

HTGW phenotype is strongly associated with NAFLD and can be used as a reference factor for NAFLD screening.

Association between hypertriglyceridemic-waist phenotype and cardiovascular disease: A cohort study and meta-analysis

Background

The association between hypertriglyceridemic-waist (HTGW) phenotype and cardiovascular disease (CVD) remains inconsistent and debatable. We aimed to prospectively investigate the relationship between HTGW phenotype and CVD.

Methods and results

We included 8,216 participants from the China Health and Retirement Longitudinal Study. Participants were categorized into four subgroups: NTNW: normal triglyceride levels and normal waist circumference; HTNW: high triglyceride levels and normal waist circumference; NTGW: normal triglyceride levels with enlarged waist circumference; HTGW: high triglyceride levels and enlarged waist circumference. A Cox proportional hazards model was applied to determine the association between HTGW phenotype and CVD. A meta-analysis was conducted to incorporate the results of the current study and the previous-related studies on the association of HTGW phenotype and CVD. In the present cohort study, compared to the NTNW phenotype, those with NTGW (Hazard ratios (HRs) 1.34, 95% confidence intervals (CIs) 1.16–1.55) and HTGW (HRs 1.37, 95% CIs 1.16–1.62) phenotype were significantly associated with CVD risk. The meta-analysis further confirmed the significant association between HTGW phenotype and CVD [the pooled relative risk for HTGW vs. NTNW was 1.39 (1.29–1.49)].

Conclusion

The HTGW phenotype was associated with the increased risk of CVD, independently of established risk factors. A simple assessment of HTGW phenotypes might help to identify individuals with a high risk of developing CVD.

Association between hypertriglyceridemic-waist phenotype and non-alcoholic fatty liver disease: a general population-based study

BACKGROUND

Hypertriglyceridemic-waist (HTGW) phenotype has been proposed as a practical tool for screening the risk of cardiovascular diseases and glycemic metabolic disease. This study sought to investigate the relationship between HTGW phenotype and non-alcoholic fatty liver disease (NAFLD).

METHODS

A total of 14,251 subjects who took part in health screening were enrolled in the study and NAFLD was diagnosed by abdominal ultrasound. According to triglyceride (TG) and waist circumference, the study population was divided into four phenotypes, in which HTGW phenotype was defined as TG ≥ 1.7 mmol/L and male waist circumference ≥ 90 cm or female waist circumference ≥ 80 cm. Multivariate logistic regression analysis was used to evaluate the relationship between HTGW phenotype and NAFLD.

RESULTS

In the current study, 2.43% of the subjects had HTGW phenotype, while the prevalence of NAFLD in subjects with HTGW phenotype was 77.81%. After full adjustment for covariates, compared with people with normal waist circumference and TG levels, the risk of NAFLD in people with normal TG levels but enlarged waist circumference increased by 39% [OR:1.39, 95%CI: 1.15, 1.68], in people with normal waist circumference but elevated TG levels increased by 96% [OR:1.96, 95%CI: 1.65, 2.33], and in subjects with HTGW phenotype increased by 160% [OR:2.60, 95%CI: 1.88, 3.58]. Additionally, further analysis suggested that there were significant interactions between age, height, BMI and NAFLD risk associated with TGW phenotypes. Receiver operating characteristic curves analysis suggested that the combination of TG and waist circumference further improved the diagnostic value for NAFLD.

CONCLUSIONS

HTGW phenotype is associated with NAFLD risk in the general population, which may be a novel and accessible indicator for NAFLD screening.

The association of hypertriglyceridemic waist phenotype with hypertension: A cross-sectional study in a Chinese middle aged-old population

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hypertension. We undertook a cross‐sectional study with a sample of 9015 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hypertension. The prevalence of hypertension was significantly higher in individuals with the HTGW phenotype, than in those with the normal waist normal triglyceride (NWNT) phenotype (89.9% vs 75.3%, respectively, P < .001). After adjusting for age, sex, BMI, current smoker, and current alcohol consumption, the HTGW phenotype was associated with hypertension (Odds Ratio (OR)1.53; 95% CI 1.25–1.87). After further adjustment for potential confounders, the HTGW phenotype was still significantly associated with hypertension (adjusted OR1.28; 95% CI 1.04‐1.58) regardless of sex. The subgroup analyses generally revealed similar associations across all subgroups. This study indicated that the HTGW phenotype was strongly associated with hypertension, and blood pressure should be clinically monitored in individuals with the HTGW phenotype. We suggested a combined use of hypertriglyceridemia waist phenotype in identifying participants who are at high risk of hypertension.

The Association Between Hypertriglyceridemic-Waist Phenotype and Chronic Kidney Disease in Patients with Type 2 Diabetes: A Cross-Sectional METAL Study

BACKGROUND

The aim of this study was measuring the association between the hypertriglyceridemic-waist (HTGW) phenotype and chronic kidney disease in a large type 2 diabetes population.

METHODS

A total of 4254 diabetic patients from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai (METAL) study were enrolled. The hypertriglyceridemic-waist (HTGW) phenotype was defined as the presence of an elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m² or urinary albumin creatinine ratio (uACR) more than 30 mg/g. Linear and multiple logistic regression models were used for measuring the association between HTGW phenotype and chronic kidney disease.

RESULTS

The prevalence of CKD was 29% and 35.8% in total participants and participants with HTGW phenotype, respectively. Subjects in the HTGW phenotype group were more likely to have CKD (OR 1.47, 95% CI: 1.11, 1.95) compared with subjects in the normal waist circumference and normal triglycerides (NTNW) group. HTGW phenotype was both associated with the increasing risk of decreased eGFR (OR 1.31, 95% CI: 1.02, 1.75) and elevated uACR (OR 1.57, 95% CI: 1.18, 2.11). Furthermore, the stratified analysis showed that the strongest positive association between HTGW phenotype and CKD presence was found in the subgroup of presence of hypertension. The associations were all fully adjusted for age, sex, BMI, current smoking, current drinking and other confounding factors.

CONCLUSION

Our study suggested a positive association between the HTGW phenotype and CKD in Chinese type 2 diabetes patients. Further prospective studies are needed to confirm our findings and to investigate the underlying biological mechanisms.

Hypertriglyceridemic waist phenotype: Association with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke

OBJECTIVE

To explore the relationship of hypertriglyceridemic waist phenotype (HTWP) with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke.

METHODS

The data for this study were collected from hospitalized patients within 72 h of acute ischemic stroke onset at the Department of Neurology of the Affiliated Hospital of Beihua University from 1 July 2020 to 30 June 2022. The initial neurological severity was assessed by the National Institute of Health Stroke Scale (NIHSS) on the day of admission: NIHSS <6 was defined as mild stroke, and NIHSS ≥6 as moderate to severe stroke. HTWP was defined by fasting serum triglycerides ≥1.7 mmol/L and waist circumference ≥90 cm in men and ≥80 cm in women. Differentiation of etiologic subtypes was based on the method reported in the Trial of Org 10 172 in Acute Stroke Treatment. Multivariate logistic regression analysis was used to analyze the association of HTWP with initial neurological severity and etiologic subtypes.

RESULTS

The study included 431 patients. Compared with the normal waist-normal blood triglyceride group, patients with HTWP had reduced risks of moderate to severe stroke [odds ratio (OR): 0.384, 95% confidence interval (CI): 0.170-0.869; P = 0.022]. In addition, the risk of small-artery occlusion stroke was 2.318 times higher in the HTWP group than in the normal triglyceride-normal waist (NWNT) group (OR: 2.318, 95% CI: 1.244-4.319; P = 0.008).

CONCLUSION

Initial neurological severity was less severe in patients with HTWP, and HTWP was associated with an increased risk of small-artery occlusion stroke.

Association between hyperuricemia and metabolic risk components in Korean women

The researchers evaluated the association between hyperuricemia and metabolic risk components in Korean women of reproductive and postmenopausal ages. The study data were collected from the Korea National Health and Nutrition Examination Survey 2016. Among a total of 4305 female participants, the data of 2958 women were analyzed. Of the 2958 participants, 57.6% (n = 1508) were of reproductive age. After adjusting for factors, hyperuricemia was significantly associated with abdominal obesity (OR 4.30, p = .046), high blood pressure (OR 3.23, p = .002), and hypertriglyceridemia (OR 3.08, p = .005) in reproductive women. In contrast, no metabolic risk was significantly associated with hyperuricemia in postmenopausal women.

Prevalence and Risk Factors Associated with Hyperuricemia in the Pearl River Delta, Guangdong Province, China

Background

In China, the prevalence of HUA in the Pearl River Delta (PRD) region of Guangdong Province has not been extensively investigated. Therefore, this study investigated the prevalence of HUA and its related factors among people aged 20–99 years in nine cities in the PRD.

Materials and Methods

We selected 6491 health check participants from 9 cities in the PRD and collected participants’ anthropometric and biochemical test results for a cross-sectional study. We included 6491 participants and assessed their blood pressure (BP), body mass index (BMI), total cholesterol (TC), triglycerides (TG), glucose (Glu) and serum uric acid (UA) to analyze the regional prevalence of HUA and its related factors. HUA was indicated when fasting serum UA level was >420 μmol/L in men and >360 μmol/L in women.

Results

Overall prevalence of HUA in our cohort was 34.05%; prevalence was higher in men than in women (41.53% vs 26.14%, P < 0.001). Characteristics associated with HUA were hypertension (odds ratio (OR), 5.506; 95% confidence interval (CI), 4.402–6.889), higher body mass index (BMI; OR: 1.746; 95% CI: 1.560–1.954), age 31–40 years (OR: 0.829; 95% CI: 0.706–0.973), age 61–70 years (OR: 1.434; 95% CI: 1.194–1.722) and age ≥71 years (OR: 1.742; 95% CI: 1.397–2.173). In all subjects, serum UA was positively correlated with Glu, TG and TC. After we adjusted for age, BMI and BP, multivariate logistic regression analysis showed that HUA risk factors were high TC (OR: 1.770; 95% CI: 1.459–2.147) and TG (OR: 1.961; 95% CI: 1.632–2.357) in men; and high Glu (OR: 1.508; 95% CI: 1.084–2.099), TC (OR: 1.341; 95% CI: 1.084–1.660) and TG (OR: 1.680; 95% CI: 1.290–2.187) in women.

Conclusion

The prevalence of HUA was relatively high in the PRD of Guangdong Province. Relevant governmental bodies should focus on early diagnosis, early treatment and early intervention.

Purification, identification, and computational analysis of xanthine oxidase inhibitory peptides from kidney bean

Hyperuricemia is related to plenty of diseases, seriously damaging human health. Current clinical drugs used to treat hyperuricemia have many adverse effects. In this study, kidney bean hydrolysate (KBH) was found to exert high xanthine oxidase inhibitory (XOI) activity. Compared to KBH (50.31 ± 2.73%), XOI activities of three fractions (M_w <5 kDa, M_w <3 kDa, M_w  < 1 kDa) by ultrafiltration were higher and increased to 58.58 ± 3.57%, 59.34 ± 1.78%, and 55.05 ± 5.00%, respectively (P < 0.05). A total of 69 peptides were identified by HPLC-ESI-MS/MS and analyzed binding affinities with XO with the help of molecular docking. AVDSLVPIGR, DWYDIK, LDNLLR, ISPIPVLK, ISSLEMTR showed well binding affinities with XO and DWYDIK presented the highest XOI activity (68.63 ± 5.07%) among five synthetic peptides (P < 0.05). Additionally, visual analysis results indicated that DWYDIK was pushed into the hydrophobic channel and formed hydrogen bonds with pivotal amino acids of xanthine oxidase. Overall, KBH could be a promising candidate as anti- hyperuricemia functional food. PRACTICAL APPLICATION: This research initially revealed that kidney bean peptides could significantly inhibit the activity of xanthine oxidase, indicating kidney bean peptides could be a treatment for hyperuricemia. Kidney bean peptides may have commercial potentials as a safer alternative with few side effects to drugs.

Association of hypertriglyceridemic waist phenotype with renal function impairment: a cross-sectional study in a population of Chinese adults

Background

Hypertriglyceridemic waist (HTGW) phenotype has been suggested as a risk factor for chronic kidney disease (CKD). However, there is limited evidence on the relationship of triglyceride waist phenotypes with estimated glomerular filtration rate (eGFR) status and severity. Our aim was to explore the associations of triglyceride waist phenotypes with reduced eGFR and various decreased eGFR stages among Chinese adults.

Methods

A population-based, cross-sectional study was conducted among Chinese participants aged 20–74 years from June 2016 to December 2017 in Shanghai, China. An eGFR value below 60 mL/min/1.73 m² was defined as decreased eGFR. HTGW phenotype was defined as triglyceride (TG) ≥1.7 mmol/L and a waist circumference (WC) of ≥90 cm for men and ≥ 80 cm for women. We examined the association of triglyceride waist phenotypes with decreased eGFR risk using the weighted logistic regression models.

Results

A total of 31,296 adults were included in this study. Compared with normal TG level/normal WC (NTNW) phenotype, normal TG level/enlarged WC (NTGW) and elevated TG level/enlarged WC (HTGW) phenotypes were associated with the increased risk of decreased eGFR. Multivariable-adjusted ORs (95% CI) associated with NTGW, elevated TG level/normal WC (HTNW), and HTGW phenotypes were 1.75 (1.41–2.18), 1.29 (0.99–1.68), and 1.99 (1.54–2.58), respectively. These associations between triglyceride waist phenotypes and decreased eGFR risk remained across almost all the subgroups, including sex, age, BMI, T2DM, and hypertension. HTGW phenotype was consistently positively associated with the risk of mildly and moderately decreased eGFR, but not with severely decreased eGFR risk.

Conclusions

HTGW was consistently associated with the increased risk of decreased eGFR and various decreased eGFR stages, except for severely decreased eGFR. Further prospective studies are warranted to confirm our findings and to investigate the underlying biological mechanisms.

Bioactive Compounds from Plant-Based Functional Foods: A Promising Choice for the Prevention and Management of Hyperuricemia

Hyperuricemia is a common metabolic disease that is caused by high serum uric acid levels. It is considered to be closely associated with the development of many chronic diseases, such as obesity, hypertension, hyperlipemia, diabetes, and cardiovascular disorders. While pharmaceutical drugs have been shown to exhibit serious side effects, and bioactive compounds from plant-based functional foods have been demonstrated to be active in the treatment of hyperuricemia with only minimal side effects. Indeed, previous reports have revealed the significant impact of bioactive compounds from plant-based functional foods on hyperuricemia. This review focuses on plant-based functional foods that exhibit a hypouricemic function and discusses the different bioactive compounds and their pharmacological effects. More specifically, the bioactive compounds of plant-based functional foods are divided into six categories, namely flavonoids, phenolic acids, alkaloids, saponins, polysaccharides, and others. In addition, the mechanism by which these bioactive compounds exhibit a hypouricemic effect is summarized into three classes, namely the inhibition of uric acid production, improved renal uric acid elimination, and improved intestinal uric acid secretion. Overall, this current and comprehensive review examines the use of bioactive compounds from plant-based functional foods as natural remedies for the management of hyperuricemia.

Effects and Mechanisms of Dendrobium officinalis Six Nostrum for Treatment of Hyperuricemia with Hyperlipidemia

Objectives. Hyperuricemia (HUA) is a disease caused by increased production of uric acid (UA) or reduced excretion of UA in the body. Results of an epidemiological survey show that 60% of patients with HUA have hyperlipidemia (HPA). Dendrobium officinalis (DOF) six nostrum (DOS) is based on the theory of traditional Chinese medicine for the transformation of the traditional Chinese nostrum Si Miao Wan. In this article, we aim to discuss the efficacy and mechanism of DOS in reducing UA and regulating lipid metabolism. The rat model of HUA with HPA was induced by potassium oxonate (PO) combined with high-fat sorghum feed. We monitored the serum UA and blood lipids. Liver xanthine oxidase (XOD), adenosine deaminase (ADA), lipoprotein lipase (LPL), and fatty acid-binding protein (FABP1) activities were measured by enzyme-linked immunosorbent assay (ELISA) after the last administration of DOS. We performed a histopathological examination of rat kidney and intestine. Immunohistochemistry (IHC) was used to detect the expression of renal inflammatory proteins NLRP3 / Caspase-1 and intestinal inflammatory proteins TLR4 / NLRP3. We used western blot for measurement of liver hypoxanthine-guanine phosphoribosyl transferase (HPRT1) protein expression and renal PDZ domain protein kidney 1 (PDZK1) protein expression. DOS administration significantly reduced serum UA, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-c) level, and improved liver steatosis in the model rat. At the same time, DOS treatment effectively inhibited liver XOD and ADA, increased the level of liver HPRT1, and reduced the production of UA. Additional studies had shown that DOS can restore normal UA excretion function in the intestine and kidney and regulated liver lipids metabolism. IHC and histopathological sections showed that DOS reduced the level of kidney, intestinal inflammatory body (NLRP3, Caspase-1, and TLR4), improved inflammation of the kidney and intestinal tract in rats. DOS is a promising drug that can effectively reduce serum UA and lipid level in the model rat. The mechanism of action may be related to inhibition of UA production, promotion of UA excretion, regulation of lipids metabolism, and anti-inflammatory response.

Triglycerides and Total Cholesterol Concentrations in Association with Hyperuricemia in Chinese Adults in Qingdao, China

Objective

To assess the association between triglycerides (TG), total cholesterol (TC) and hyperuricemia (HUA) in the general Chinese population.

Methods

A population-based cross-sectional survey included 9680 participants aged 35–74 years in 2006 and 2009 in Qingdao, China. TG, TC and uric acid (UA) were measured. The logistic regression model was performed to estimate the association between TG, TC, and HUA with an odds ratio (OR) and 95% confidence intervals (CI). Meanwhile, age stratification analysis (<55 years group and ≥55 years group) was performed to evaluate whether age potentially affects the association between TG, TC and HUA using multivariable logistic regression.

Results

Higher TG and TC showed significantly increased HUA prevalence in both men and women (P_trend all <0.05). Multivariate logistic regression indicated that borderline high TG (OR: 1.68, 95% CI: 1.31, 2.15 and HTG (OR: 2.98, 95% CI: 2.39, 3.72) indicated increased risk for HUA in men, and borderline high TG (OR: 2.09; 95% CI: 1.68,2.62); HTG (OR: 3.62; 95% CI: 2.90,4.51), borderline high TC (OR: 2.09, 95% CI: 1.68, 2.62) and HTC (OR: 3.62, 95% CI: 2.90, 4.51) showed significant association with HUA in women after adjusted age, school years, marital status, geographic division, personal monthly income, BMI and HDL-C. Age stratification analyses demonstrated that the association between TG and HUA was stronger in males aged ≥55 years and female aged <55 years, and the association between TC and HUA was stronger in both gender aged <55 years.

Conclusion

This large cross-sectional study focusing on the association between single indictor of blood lipid as exposure and HUA as outcome on the east coast of China for the first time. From a sample of Chinese adults, this study demonstrated that elevated TG in men and women and TC in women were associated with increased HUA prevalence.

Prediction model of artificial neural network for the risk of hyperuricemia incorporating dietary risk factors in a Chinese adult study

Background

Risk of hyperuricemia (HU) has been shown to be strongly associated with dietary factors. However, there is scarce evidence on prediction models incorporating dietary factors to estimate the risk of HU.

Objective

The aim of this study was to develop a prediction model to predict the risk of HU in Chinese adults based on dietary information.

Design

Our study was based on a cross-sectional survey, which recruited 1,488 community residents aged 18 to 60 years in Beijing from October 2010 to January 2011. The eligible participants were randomly divided into a training set (n₁ = 992) and a validation set (n₂ = 496) in the ratio of 2:1. We developed the prediction model in three stages. We first used a logistic regression model (LRM) based on the training set to select a set of dietary risk factors which were related to the risk of HU. Artificial neural network (ANN) was then used to construct the prediction model using the training set. Finally, we used receiver operating characteristic (ROC) curve analysis to assess the accuracy of the prediction model using training and validation sets.

Results

In the training set, the mean age of participants with and without HU was 39.3 (standard deviation [SD]: 9.65) and 38.2 (SD: 9.38) years, respectively. Patients with HU consisted of 101 males (77.7%) and 29 females (22.3%). The LRM found that food frequency (vegetables [odds ratio (OR) = 0.73], meat [0.72], eggs [0.80], plant oil [0.78], tea [0.51], eating habits (breakfast [OR = 1.28]), and the salty cooking style (OR = 1.33) were associated with risk of HU. In the ANN analysis, we selected a three-layer back propagation neural network (BPNN) model with 14, 3, and 1 neuron in the input, hidden, and output layers, respectively, as the best prediction model. The areas under the ROC of the training and validation sets were 0.827 and 0.814, respectively. HU would occur when the incidence probability is greater than 0.128. The indicators of accuracy, sensitivity, specificity, and Yuden Index suggested that the ANN model in our study is successful and valuable.

Conclusions

This study suggests that the ANN model could be used to predict the risk of HU in Chinese adults. Further prospective studies are needed to improve the accuracy and to generalize the use of model.

APOE polymorphism is associated with blood lipid and serum uric acid metabolism in hypertension or coronary heart disease in a Chinese population

Aim: To explore the association of APOE polymorphism (rs7412:526C>T and rs429358:388T>C) with glucose, lipid and serum uric acid (UA) metabolism in patients with hypertension or coronary heart disease (CHD). Methods: A total of 544 patients with hypertension or CHD were selected for this study from March 2017 to January 2018. According to the APOE genotypes (excluding the E2/E4 genotype), the subjects were divided into three groups (E2/E2+E2/E3 genotypes, E3/E3 genotype [the wild-type] and E3/E4+E4/E4 genotypes) and the difference of metabolism among the three groups was compared. Results: There were significant differences in total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), high-density lipoprotein and serum UA levels among the three groups. Compared with APOE E3 homozygote, APOE E4 carriers possessed higher TC, triglycerides and LDL levels, whereas APOE E2 carriers had higher high-density lipoprotein level, lower TC and LDL levels. Furthermore, multivariate logistic regression analysis found that setting E3/E3 genotype as the reference group, the carriers of APOE E4 allele (E3/E4+E4/E4 genotypes) were significantly related to hypertriglyceridemia, and APOE E2 allele (E2/E2+E2/E3 genotypes) was significantly correlated with hyperuricemia. Conclusion: APOE polymorphism was associated with blood lipid and serum UA metabolism in patients with hypertension or CHD. Compared with APOE E3 homozygote, APOE E4 allele was related to elevated triglycerides, and APOE E2 allele was correlated with increased serum UA level.

Hypertriglyceridaemic waist is associated with hyperuricaemia and metabolic syndrome in rheumatoid arthritis patients

BACKGROUND

/Aim: The hypertriglyceridaemic waist (HTGW) phenotype has been described and suggested in general population as a cardiovascular risk marker. The aim of the present study was to evaluate the HTGW phenotype as a marker related to HUC and MetS in rheumatoid arthritis (RA).

MATERIALS AND METHODS

This was a cross-sectional study was designed in 250 RA Mexicans patients. The HTGW phenotype was defined as elevated waist circumference and elevated triglyceride concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype, HUC and MetS in its traditional NCEP/ATPIII versions and modified (HTGWm and MetSm).

RESULTS

The prevalence of HTGW and HTGWm it was 20.4% and 32%, respectively. All patients with HTGW presented MetS (P < 0.001), and in a multivariate model, the HTGW phenotype was the marker most closely related to HUC in comparison to components of MetS.

CONCLUSION

The HTGW may represent a marker for screening of cardiometabolic risk in RA patients, so in clinical practice can be implemented as a low-cost marker in the evaluation of the patient regardless of clinical characteristics of disease.

Lipid-lowering and antioxidative effects ofApium graveolensL. root flavonoid extracts

Apium graveolensL. root flavone extract can improve hyperlipidemia induced by high-fat emulsion diet in rats.

Metabolic Syndrome, and Particularly the Hypertriglyceridemic-Waist Phenotype, Increases Breast Cancer Risk, and Adiponectin Is a Potential Mechanism: A Case-Control Study in Chinese Women

Objective: To investigate the association between metabolic syndrome and breast cancer and to elucidate the potential mechanism underlying this association. Patients and Methods: Based on baseline data drawn from 21 hospitals in 11 provinces of China, we performed a case-control study among 1,127 women (595 cases and 532 controls), divided into premenopausal, and postmenopausal subgroups. Student's t test, Pearson's χ² test, and logistic regression analyses were performed to ascertain the association between breast cancer and metabolic syndrome, including all of its components. In addition, we attempted to clarify the potential role of adiponectin in this association. Results: Among the components of metabolic syndrome, abnormal waist circumference was the component that markedly increased breast cancer risk in premenopausal women (OR 1.447, 95% CI 1.043-2.006). Metabolic syndrome with clusters of special risk factors showed an association with breast cancer risk. Among all these components of metabolic syndrome, the hypertriglyceridemic-waist (HW) phenotype significantly increased breast cancer risk (OR 1.56, 95% CI 1.02-2.39), regardless of menopausal status, rendering it a strong predictor of breast cancer. Total adiponectin levels and high-molecular-weight adiponectin were reversely associated with metabolic syndrome. In addition, total adiponectin levels among breast cancer patients were much lower than among controls (6.67 ± 3.05 vs. 8.01 ± 4.18, p = 0.014) only in the HW phenotype subgroup. Furthermore, the HW phenotype was associated with increased risk of estrogen receptor/progesterone receptor-positive (ER+/PR+) and -negative (ER-/PR-) breast cancer, with a 51% (OR 1.51, 95% CI 1.03-2.21) and 69% (OR 1.69, 95% CI 1.05-2.72) increase, respectively. However, there was no significant association between the HW phenotype and the ER+/PR- subtype. These results suggested that low adiponectin levels may be a mechanism that explains the association between the HW phenotype and breast cancer risk. Conclusion: Metabolic syndrome with special cluster factors is related to breast cancer risk; in particular, the HW phenotype can be regarded as a strong predictor of breast cancer. As an important factor involved in fat metabolism, adiponectin may strongly predict metabolic syndrome, especially the HW phenotype and breast cancer. Further research into this mechanism and epidemiological studies are needed. This study provides new evidence for the role of a healthy lifestyle in preventing breast cancer.

Association between the Hypertriglyceridemic Waist Phenotype and Prediabetes in Chinese Adults Aged 40 Years and Older

OBJECTIVE

To investigate the association between the hypertriglyceridemic waist (HTGW) phenotype and prediabetes in Chinese adults aged 40 years and older.

METHODS

12757 adults (4101 men and 8656 women) without diabetes or cardiovascular and cerebrovascular diseases, free of using lipid-modified agents, were enrolled in this cross-sectional study. The HTGW phenotype was defined as elevated serum triglyceride concentrations and enlarged waist circumference. A two-hour post 75 g oral glucose tolerance test was performed in all participants. Multiple logistic regression analysis was used to evaluate the relationship of the HTGW phenotype with prediabetes.

RESULTS

Individuals with the HTGW phenotype had a higher adjusted odds ratio (OR: 1.70; 95% CI: 1.48-1.95) of prediabetes than those without the phenotype. There existed a strong relationship of the HTGW phenotype with impaired glucose tolerance (IGT) (OR: 1.83; 95% CI: 1.57-2.13), but not with impaired fasting glucose (IFG) (OR: 0.87; 95% CI: 0.65-1.17). Only women with the HTGW phenotype are significantly associated with the combined IFG and IGT (OR: 1.83; 95% CI: 1.28-2.62).

CONCLUSIONS

The HTGW phenotype was a useful risk indicator and a practical screening tool to benefit in the early diagnosis and intervention for prediabetes, particularly for IGT and the combined IFG and IGT.

Neck Circumference, a Novel Indicator for Hyperuricemia

Background: Waist circumference has been correlated with the risk of hyperuricemia. Whether neck circumference is also associated with hyperuricemia has not been assessed. This study aimed to investigate whether neck circumference is associated with hyperuricemia.

Methods: This study population from Beijing is part of the larger China-wide Risk Evaluation of Cancers in Chinese Diabetic Individuals: a lONgitudinal (REACTION) study. For this Beijing sub-center cross-sectional study, a total of 8971 subjects were recruited. Gender-specific multivariable-adjusted regression analyses were conducted to analyze the association of neck circumference and waist circumference with hyperuricemia and the association of neck circumference with serum uric acid levels in the non-hyperuricemia population.

Results: After adjusting for confounding variables, regression analyses showed that neck circumference was positively associated with hyperuricemia [OR, 2.61 (1.86–3.67) for males and 3.27 (2.53–4.22) for females] in both genders; further, neck circumference was also positively associated with serum uric acid levels in non-hyperuricemia subjects [b, 2.58 (1.76–3.39) for males and 4.27 (3.70–4.84) for females] in both genders. Additionally, we demonstrated that neck circumference was similar to waist circumference in terms of the strength of association (OR, 3.03 for waist circumference vs. 2.61 for neck circumference in males, and 3.50 vs. 3.27 for females) with hyperuricemia and the ability to predict hyperuricemia (AUC, 0.63 for waist circumference vs. 0.61 for neck circumference in males, and 0.66 vs. 0.66 in females).

Conclusion: Neck circumference is positively and independently associated with hyperuricemia in both genders and is also associated with serum uric acid levels in the non-hyperuricemia population.

A Trivalent Enzymatic System for Uricolytic Therapy of HPRT Deficiency and Lesch-Nyhan Disease

PURPOSE

Because of the evolutionary loss of the uricolytic pathway, humans accumulate poorly soluble urate as the final product of purine catabolism. Restoration of uricolysis through enzyme therapy is a promising treatment for severe hyperuricemia caused by deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT). To this end, we studied the effect of PEG conjugation on the activity and stability of the enzymatic complement required for conversion of urate into the more soluble (S)-allantoin.

METHODS

We produced in recombinant form three zebrafish enzymes required in the uricolytic pathway. We carried out a systematic study of the effect of PEGylation on the function and stability of the three enzymes by varying PEG length, chemistry and degree of conjugation. We assayed in vitro the uricolytic activity of the PEGylated enzymatic triad.

RESULTS

We defined conditions that allow PEGylated enzymes to retain native-like enzymatic activity even after lyophilization or prolonged storage. A combination of the three enzymes in an appropriate ratio allowed efficient conversion of urate to (S)-allantoin with no accumulation of intermediate metabolites.

CONCLUSIONS

Pharmaceutical restoration of the uricolytic pathway is a viable approach for the treatment of severe hyperuricemia.