Gender, body mass index, and PPARγ polymorphism are good indicators in hyperuricemia prediction for Han Chinese

The elevated visceral adiposity index increases the risk of hyperuricemia in Chinese hypertensive patients: A cross-sectional study

Background

Uncertainty still remained about the relationship between visceral adiposity index (VAI) and hyperuricemia. The aim of this study was to investigate whether VAI was an independent risk factor for hyperuricemia in hypertensive Chinese patients.

Methods

A cross-sectional study including 13176 hypertensive participants (6478 males) recruited from Wuyuan County, Jiangxi province, was conducted. All patients received anthropometric measurements, completed questionnaires and provided blood samples for biochemical testing. VAI was calculated by waist circumference, BMI, triglyceride and high-density lipoprotein cholesterol. Hyperuricemia was defined as serum uric acid ≥ 7 mg/dL in men and ≥ 6 mg/dL in women.

Results

Overall, the average level of uric acid was 7.8 ± 2.0 mg/dL in males and 6.34 ± 1.78 in females and prevalence of hyperuricemia was 61.4% and 51.30%, respectively. In multivariate logistic regression analysis, the risk of hyperuricemia increased 1.77 times and 1.88 times with the increase of ln VAI in males (OR:1.77, 95% CI: 1.62, 1.94) and females (OR:1.88, 95% CI: 1.73, 2.04). For males, compared to quartile 1, the risk of hyperuricemia in the second, third and the forth quartile of visceral adiposity index were 1.34 (95% CI: 1.14, 1.57),1.82(95% CI: 1.54, 2.14) and 2.97 (95% CI: 2.48, 3.57). For females, compared to quartile 1, the risk of hyperuricemia in the second, third and the forth quartile of visceral adiposity index were 1.48 (95% CI: 1.28, 1.72), 1.99 (95% CI: 1.71, 2.32) and 2.92 (95% CI: 2.50, 3.42).

Conclusions

This study found that VAI was an independent risk factor for hyperuricemia among hypertensive patients, which may provide some strategies for reducing the level of uric acid.

Haplotype of ESR1 and PPARD Genes Is Associated with Higher Anthropometric Changes in Han Chinese Obesity by Adjusting Dietary Factors-An 18-Month Follow-Up

The obesity genetic effect may play a major role in obesogenic environment. A combined case-control and an 18-month follow-up were carried out, including a total of 311 controls and 118 obese cases. All participants were aged in the range of 20-55 y/o. The body mass index (BMI) of obese cases and normal controls was in the range of 27.0-34.9 and 18.5-23.9 kg/m², respectively. The rs712221 on Estrogen receptor1 (ESR1) and rs2016520 on Peroxisome proliferator-activated receptor delta (PPARD) showed significant associations with obesity. The TT (odds ratio (OR): 2.42; 95% confidence interval (CI): 1.46-4.01) and TT/TC (OR: 2.80; 95% CI: 1.14-6.85) genotypes on rs712221 and rs2016520 had significantly higher obesity risks, respectively. Moreover, the synergic effect of these two risk SNPs (2-RGH) exhibited an almost geometrical increase in obesity risk (OR: 7.00; 95% CI: 2.23-21.99). Obese individuals with 2-RGH had apparently higher changes in BMI increase, body weight gain and dietary fiber intake but a lower total energy intake within the 18-month follow-up.

Early-life exposure to the Chinese famine and risk of hyperuricaemia in adult females in Qingdao

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.

Associaton of Retinol Binding Protein 4 (RBP4) Levels With Hyperuricemia: A Cross-Sectional Study in a Chinese Population

BACKGROUND

There are few studies on predictive biomarkers for hyperuricemia, and the predictive value of these biomarkers tends to be poor. Additionally, no reports have described the predictive value of retinol binding protein 4 (RBP4) for hyperuricemia.

PURPOSE

This study was performed to evaluate the value of RBP4 for predicting the risk of hyperuricemia in a general population, determine whether RBP4 could be used alone or in combination with other factors to predict the risk of hyperuricemia in the general population, and establish an optimum predictive model.

METHODS

We conducted a population-based cross-sectional survey in 2018, involving a questionnaire, physical examination, and laboratory testing. We enrolled 2303 individuals by stratified random sampling, and 2075 were included in the data analysis after applying the eligibility criteria.

RESULTS

Serum RBP4 level had a highly significant association with hyperuricemia (P<0.001). After adjusting for potential confounders, logistic regression indicated that the risk of hyperuricemia was highest in the highest RBP4 quartile (odds ratio: 7.9, 95% confidence interval [CI]: 4.18-14.84, compared to the lowest quartile). The area under the receiver operating characteristic (ROC) curve (AUC) for RBP4 was 0.749 (95% CI: 0.725-0.774, P<0.001), which was higher than that for all the other predictors assessed. The optimum model for predicting hyperuricemia in the general population consisted of RBP4, sex (male), body mass index, serum creatinine, high-sensitivity C-reactive protein, fasting blood glucose, insulin, and alcohol consumption. The AUC was 0.804 (95% CI: 0.782-0.826, P<0.001).

CONCLUSIONS

RBP4 is strongly associated with hyperuricemia, and its predictive value was higher than that of traditional predictors.

A simple prediction model of hyperuricemia for use in a rural setting

Currently, the most widely used screening methods for hyperuricemia (HUA) involves invasive laboratory tests, which are lacking in many rural hospitals in China. This study explored the use of non-invasive physical examinations to construct a simple prediction model for HUA, in order to reduce the economic burden and invasive operations such as blood sampling, and provide some help for the health management of people in poor areas with backward medical resources. Data of 9252 adults from April to June 2017 in the Affiliated Hospital of Guilin Medical College were collected and divided randomly into a training set (n = 6364) and a validation set (n = 2888) at a ratio of 7:3. In the training set, non-invasive physical examination indicators of age, gender, body mass index (BMI) and prevalence of hypertension were included for logistic regression analysis, and a nomogram model was established. The classification and regression tree (CART) algorithm of the decision tree model was used to build a classification tree model. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analyses (DCA) were used to test the distinction, accuracy and clinical applicability of the two models. The results showed age, gender, BMI and prevalence of hypertension were all related to the occurrence of HUA. The area under the ROC curve (AUC) of the nomogram model was 0.806 and 0.791 in training set and validation set, respectively. The AUC of the classification tree model was 0.802 and 0.794 in the two sets, respectively, but were not statistically different. The calibration curves and DCAs of the two models performed well on accuracy and clinical practicality, which suggested these models may be suitable to predict HUA for rural setting.

Early-life exposure to the Chinese famine of 1959-61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study

Background

Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood.

Methods

The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression.

Results

The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95% CI: 1.06–1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (P for interaction = 0.042). Compared with unexposed and BMI < 24 kg/m² participants, the OR (95%CI) of hyperuricemia was 3.66 (2.13–6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (P for interaction = 0.054).

Conclusion

Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.

Uric acid level changes after bariatric surgery in obese subjects with type 2 diabetes mellitus

Background

The purpose of the study was to investigate the incidence of hyperuricemia (HU) in obese subjects with type 2 diabetes mellitus (T2DM) before and after Roux-en-Y gastric bypass (RYGB), to describe the impact of this therapy in reducing uric acid levels, and its possible mechanism. This study was performed by cooperation with the First affiliated hospital of Soochow University and the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, department of general surgery.

Methods

A retrospective study was performed. From February 2015 to December 2017, we evaluated 147 obese patients with T2DM. Blood samples and other clinical data were drawn before and postoperative (1, 3, 6, 12 months after RYGB). All obese patients with T2DM underwent laparoscopic Roux-en-Y gastric bypass surgery (LRYGB). Different gender with HU were compared before and after surgery.

Results

A total of 147 patients received LRYGB (75 were female, 72 were male), and 48 patients with HU (22 were female, 26 were male). Four women and 2 men were lost to follow-up, they were excepted from this study. No patients with HU lost to follow-up. There's an intuitive downward trend about uric acid levels both in men and women, with men from 497.9 µmol/L before surgery to 371.5 µmol/L 1 year after surgery, P=0.000; women from 432.3 to 354.1 µmol/L, P=0.002. The proportion of HU changed with men from 37.1% (26/70) before surgery to 12.9% (9/70) one year after surgery, women from 31.0% (22/71) to 14.1% (10/71). The results of binary logistic regression analysis confirmed that triglycerides were clinical predictors for HU remission (P=0.004). No major late surgical complications were reported.

Conclusions

Our data showed that, bariatric surgery was effective to decrease the levels of serum uric acid (SUA) in obese patients with T2DM. Compared with traditional drug treatment, this shows a possible treatment of HU by RYGB. The remission of HU was associated with the decreased triglyceride levels in obese patients with T2DM, independent of BMI. The potential role of triglycerides in the remission of HU merits further study.

Using Blood Indexes to Predict Overweight Statuses: An Extreme Learning Machine-Based Approach

The number of the overweight people continues to rise across the world. Studies have shown that being overweight can increase health risks, such as high blood pressure, diabetes mellitus, coronary heart disease, and certain forms of cancer. Therefore, identifying the overweight status in people is critical to prevent and decrease health risks. This study explores a new technique that uses blood and biochemical measurements to recognize the overweight condition. A new machine learning technique, an extreme learning machine, was developed to accurately detect the overweight status from a pool of 225 overweight and 251 healthy subjects. The group included 179 males and 297 females. The detection method was rigorously evaluated against the real-life dataset for accuracy, sensitivity, specificity, and AUC (area under the receiver operating characteristic (ROC) curve) criterion. Additionally, the feature selection was investigated to identify correlating factors for the overweight status. The results demonstrate that there are significant differences in blood and biochemical indexes between healthy and overweight people (p-value < 0.01). According to the feature selection, the most important correlated indexes are creatinine, hemoglobin, hematokrit, uric Acid, red blood cells, high density lipoprotein, alanine transaminase, triglyceride, and γ-glutamyl transpeptidase. These are consistent with the results of Spearman test analysis. The proposed method holds promise as a new, accurate method for identifying the overweight status in subjects.