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Gremke N, Griewing S, Kostev K, Wagner U, Kalder M. Association between gout and subsequent breast cancer: a retrospective cohort study including 67,598 primary care patients in Germany. Breast Cancer Res Treat 2023; 199:545-552. [PMID: 37071268 PMCID: PMC10175324 DOI: 10.1007/s10549-023-06944-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/05/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE The aim of this retrospective cohort study was to analyze the cumulative incidence of breast cancer following gout and to investigate the association between gout and subsequent breast cancer in 67,598 primary care patients in Germany. METHODS This study included adult female patients (≥ 18 years) with an initial diagnosis of gout in 1284 general practices in Germany between January 2005 and December 2020. Individuals without gout were matched to gout patients using propensity score matching based on average yearly consultation frequency during the follow-up period, diabetes, obesity, chronic bronchitis/COPD diagnoses, and diuretic therapy. The 10-year cumulative incidence of breast cancer in the cohorts with and without gout was also studied using Kaplan-Meier curves, which were then compared using the log-rank test. Finally, a univariable Cox regression analysis was conducted to assess the association between gout and breast cancer. RESULTS After up to 10 years of follow-up, 4.5% of gout and 3.7% of non-gout patients were diagnosed with breast cancer. A Cox regression analysis revealed a significant association between gout and subsequent breast cancer in the total population (HR: 1.17; 95% CI: 1.05-1.31). In the age-stratified analyses, gout was only strongly associated with subsequent breast cancer in the age group ≤ 50 (HR: 1.58; 95% CI: 1.10-2.27), but the association was not significant in women over 50 years old. CONCLUSION Taken together, the findings of our study provide evidence for the association between gout and subsequent breast cancer diagnosis, particularly in the youngest age group.
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Affiliation(s)
- Niklas Gremke
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
| | - Sebastian Griewing
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Karel Kostev
- IQVIA, Main Airport Center, Unterschweinstiege 2-14, 60549, Frankfurt, Germany
| | - Uwe Wagner
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
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Zhou W, Shan N, Wei J, Zhou Y, Men M. Cross-sectional and longitudinal associations between lipid accumulation product and hyperuricemia. Nutr Metab Cardiovasc Dis 2022; 32:2348-2355. [PMID: 35965249 DOI: 10.1016/j.numecd.2022.06.022] [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: 03/03/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Lipid accumulation product (LAP) is a novel, sex-specific, index-describing lipid over accumulation. Previous studies used baseline LAP for predicting hyperuricaemia; however, the relationship between them is unclear. We aimed to investigate the relationship between LAP and the risk of hyperuricaemia in the Central Chinese population. METHODS AND RESULTS This large-scale observational study comprised a cross-sectional population sample and a prospective cohort of 44,294 healthy subjects. This study examined the association between LAP and the risk of hyperuricaemia in the total sample and subgroups using multiple logistic regression analysis and multivariate cox proportional hazards model analysis. As a result, there was a dose-response relationship between LAP and the risk of hyperuricaemia. The prevalence of hyperuricaemia was 13.4% in the cross-sectional study. During 9 years of follow-up, hyperuricaemia occurred in 928 (19.8%) participants. The corresponding hazard ratios after multiple adjustments of hyperuricaemia in the second, third and fourth quartile were 1.34 (95% confidence interval [CI], 1.04-1.72), 2.01 (95% CI, 1.54-2.63), and 2.44 (95% CI, 1.80-3.30)-fold higher vs. the first quartile, respectively. Subgroup analyses showed that the association between LAP and the risk of hyperuricaemia was more pronounced in females, individuals≤49 years old and subjects with eGFR ≥60 ml/min/1.73 m2. CONCLUSION LAP was positively related to the risk of hyperuricaemia in the Central Chinese population, particularly in women, individuals≤49 years old and adults with relatively normal renal function. These findings suggested the potential of LAP as an independent risk indicator in preventing hyperuricaemia.
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Affiliation(s)
- Wei Zhou
- Health Management Center, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, 410008, China
| | - Nianchun Shan
- Department of Gynecology, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, 410008, China
| | - Yang Zhou
- Department of Nursing, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
| | - Meichao Men
- Health Management Center, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, 410008, China.
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Liu Y, Zhang WS, Tang ZH, Zhang SM, Qiu J. The potential influence of high uric acid exposure on surface and corrosion susceptibility of pure titanium. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:44. [PMID: 35575837 PMCID: PMC9110516 DOI: 10.1007/s10856-022-06667-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
This study investigated the corrosion susceptibility of pure titanium under uric acid exposure for 7 days based on surface analysis. The prepared pure titanium specimens, exposed to different concentrations of uric acid, were examined for surface microstructure, surface element composition and surface wettability using scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and static contact angle measurement, respectively. The corrosion behaviors of titanium specimens were measured by open-circuit potential (OCP), electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization. The titanium ion release from the prepared specimens, which were immersed in Hank's balanced salt solution (HBSS) containing different amount of uric acid, was measured by inductively coupled plasma atomic emission spectrometry (ICP-AES). More irregular pitting holes were observed on titanium surfaces exposed to a high concentration of uric acid, and XPS analyses revealed that the amount of titanium dioxide (TiO2) decreased. Titanium surfaces pre-treated with high uric acid became more hydrophobic. Furthermore, the results of OCP and potentiodynamic polarization tests showed increased corrosion susceptibility of titanium samples, while EIS data indicated more active corrosion behavior of titanium materials. The high concentration of uric acid also induced titanium ion release. High concentration of uric acid negatively influenced the surface characteristics and corrosion properties of titanium materials, which destroyed the titanium oxide film barrier. High uric acid exposure increased corrosion susceptibility of pure titanium specimens and accelerated titanium ion release. Graphical abstract.
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Affiliation(s)
- Yao Liu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Wen-Si Zhang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Ze-Hua Tang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Song-Mei Zhang
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Jing Qiu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.
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Which Clusters of Metabolic Syndrome Are the Most Associated with Serum Uric Acid? Medicina (B Aires) 2022; 58:medicina58020297. [PMID: 35208620 PMCID: PMC8879816 DOI: 10.3390/medicina58020297] [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: 01/21/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/21/2023] Open
Abstract
Background and Objectives: Metabolic syndrome is defined as three or more of five components; therefore, there are 16 possible different clusters of metabolic risk factors that are under one diagnosis of metabolic syndrome. In this study, we evaluated the different clusters of metabolic syndrome (MetS) across serum uric acid (SUA) quartiles and analyzed the association of these clusters with SUA levels, respectively, in both men and women. Materials and Methods: A total of 606 subjects were recruited to a cross-sectional study from the ongoing Lithuanian High Cardiovascular Risk primary prevention program (LitHiR). All of the study subjects were diagnosed with MetS (according to the 2005 National Cholesterol Education Program Adult Treatment Panel III MetS definition). Results: In the middle-aged population of patients with MetS living in Lithuania, a high proportion of hyperuricaemia was detected—35.5% (95% Cl 31.7% to 39.4%). For women possessing all five MetS components, the chances of having hyperuricaemia are 2.807 higher than for women with three risk factors (p < 0.001). However, men do not have a statistically significantly higher chance of having hyperuricaemia, depending on the number of MetS components in our population. Using multivariable models, the statistically significant chance of having hyperuricaemia was observed only in women possessing all five MetS components (OR = 2.386, p < 0.0001), compared to any other of 15 MetS clusters. After adjustment for age and sex, the chance of having hyperuricaemia for individuals with the cluster of all five MetS components, compared to any other of 15 MetS clusters, remained (OR = 1.982, p = 0.001). Also, a lower probability (OR = 0.653, p = 0.039) of having hyperuricaemia was observed for individuals having the combination of abnormal plasma glucose, blood pressure, and waist circumference. Conclusions: Patients with the clustering of all five metabolic syndrome components are at higher risk for having hyperuricaemia than patients with any other combination of MetS clusters. This risk is even higher for women. It could be beneficial for patients presented with all five MetS components to be screened for SUA concentration in the primary CVD prevention program.
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He H, Pan L, Liu F, Ren X, Cui Z, Pa L, Zhao J, Wang D, Du J, Wang H, Wang X, Peng X, Yu C, Wang Y, Shan G. The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey. Front Endocrinol (Lausanne) 2022; 13:879384. [PMID: 35757401 PMCID: PMC9226682 DOI: 10.3389/fendo.2022.879384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/21/2022] [Indexed: 12/22/2022] Open
Abstract
Reproductive factors have been demonstrated to be associated with hyperuricemia. Body composition is an essential determinant influencing serum uric acid (SUA), but it is largely unknown whether increased SUA was influenced by changed body composition during the menopausal transition. As a secondary analysis of China National Health Survey from 2012-to 2017, this study included 18,997 women aged 20 to 80. Menarche age and menopause information were collected by questionnaire interview. Body mass index (BMI), body fat percentage (BFP), fat mass index (FMI), and fat-free mass index (FFMI) were used as body composition indexes. Hyperuricemia was defined as SUA higher than 360μmol/L (approximately 6 mg/dl). Mediation analysis was performed to explore the direct and indirect effects of menopause on hyperuricemia. A 1:2 age-matched case-control data set (n=6202) was designed to control age-related confounders and was used in multivariable analyses. After adjustment of covariates, postmenopausal women had 14.08 (10.89-17.27) μmol/L higher SUA than their premenopausal counterparts. Overweight/obesity and higher levels of BFP, FMI, and FFMI were all found to be positively associated with hyperuricemia. The mediation analysis showed that the total effect of menopause on hyperuricemia was positive, but was substantially mediated by body composition indexes. Forty-five percent of the total effect can be attributed to the indirect effect mediated by BMI (OR for the natural indirect effect (NIE): 1.09, 95%CI: 1.04-1.13), and over 80% mediated by BFP (OR for NIE: 1.23, 95%CI: 1.16-1.29). However, FFMI did not present the mediated role in the association (OR for NIE: 0.99, 95%CI: 0.96-1.02). The findings revealed that body composition, especially the fat mass indexes, significantly mediated the association between menopause and hyperuricemia. The role of body composition as mediator constitutes clinical and public health significance that should be recognized and considered in healthcare for women experiencing their menopause transition.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & 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 & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, 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
| | - 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
| | - 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 & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ye Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
- *Correspondence: Guangliang Shan,
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Association between female reproductive factors and gout: a nationwide population-based cohort study of 1 million postmenopausal women. Arthritis Res Ther 2021; 23:304. [PMID: 34915918 PMCID: PMC8675498 DOI: 10.1186/s13075-021-02701-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/09/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Previous studies have shown that the incidence and risk factors of gout differs according to sex. However, little research has been done on the association between reproductive factors and gout. We conducted an analysis of a large nationwide population-based cohort of postmenopausal women to determine whether there is an association between reproductive factors and the incidence of gout. METHODS A total of 1,076,378 postmenopausal women aged 40-69 years who participated in national health screenings in 2009 were included in the study. The outcome was the occurrence of incident gout, which was defined using the ICD-10 code of gout (M10) in the claim database. Cox proportional hazard models were used for the analyses and stratified analyses according to body mass index (BMI) and the presence/absence of chronic kidney disease (CKD) were performed. RESULTS The mean follow-up duration was 8.1 years, and incident cases of gout were 64,052 (incidence rate 7.31 per 1000 person-years). Later menarche, earlier menopause, and a shorter reproductive span were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC) and hormone replacement therapy (HRT) were associated with an increased risk of gout. The association between reproductive factors and gout was not statistical significant in the high BMI group. The effects of OC and HRT usage on gout were not significant in the CKD group. CONCLUSION Shorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increased risk of gout.
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Kim MH, Song MR. Association between hyperuricemia and metabolic risk components in Korean women. Health Care Women Int 2021; 43:282-292. [PMID: 34125656 DOI: 10.1080/07399332.2021.1883025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
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.
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Affiliation(s)
- Min-Hee Kim
- Department of Family Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Hu J, Xu W, Yang H, Mu L. Uric acid participating in female reproductive disorders: a review. Reprod Biol Endocrinol 2021; 19:65. [PMID: 33906696 PMCID: PMC8077923 DOI: 10.1186/s12958-021-00748-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/18/2021] [Indexed: 12/21/2022] Open
Abstract
Uric acid (UA) is the end metabolic product of purine metabolism. Early on, UA was considered to be a metabolite with a certain antioxidant capacity. As research has progressed, other properties of UA have been explored, and its association with many diseases has been found. The association between UA and kidney disease and cardiovascular disease is well established; however, there is still a paucity of reviews on the association between UA and the female reproductive system. An increasing number of epidemiological studies have shown elevated serum UA levels in patients with polycystic ovary syndrome (PCOS), endometriosis, etc. Additionally, serum UA can be used as a predictor of pregnancy complications and adverse foetal outcomes. An increasing number of animal experiments and clinical studies have revealed possible mechanisms related to the involvement of UA in certain female reproductive disorders: oxidative stress, chronic inflammation, mitochondrial dysfunction, etc. This article reviews the current mainstream mechanisms regarding the pathogenesis of UA and the role of UA in certain specific female reproductive disorders (direct involvement in the development of certain diseases or enhancement of other risk factors) in the hope of contributing to clinical prevention, diagnosis, treatment and improvement in prognosis.
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Affiliation(s)
- Junhao Hu
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, No.96 Fuxue Road, 325000, Wenzhou, People's Republic of China
| | - Wenyi Xu
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, No.96 Fuxue Road, 325000, Wenzhou, People's Republic of China
| | - Haiyan Yang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, No.96 Fuxue Road, 325000, Wenzhou, People's Republic of China.
| | - Liangshan Mu
- School of Medicine, Zhejiang University, No.866 Yuhantang Road, 310058, Hangzhou, People's Republic of China.
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Age difference in the combined effect of soda drinks consumption and body adiposity on hyperuricaemia in US adults. Public Health Nutr 2021; 24:5756-5768. [PMID: 33541468 DOI: 10.1017/s1368980021000513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate age-related differences in the independent/combined association of added sugar intake from soda and body adiposity with hyperuricaemia in gender-stratified US adults. DESIGN Consumption of added sugar from soda was calculated from 24-h dietary interviews and categorised into none, regular and excessive consumption. Hyperuricaemia was defined as serum uric acid levels >417 mmol/l in men and >357 mmol/l in women. Multiple regression models with interaction terms and logistic models adjusted for covariates were conducted under survey-data modules. SETTING National Health and Nutrition Examination Survey during 2007-2016. PARTICIPANTS 15 338 adults without gout, failing kidneys, an estimated glomerular filtration rate < 30 or diabetes were selected. RESULTS The age-stratified prevalence rate of hyperuricaemia was 18·8-20·4 % in males and 6·8-17·3 % in females. Hyperuricaemia prevalence of approximately 50 % was observed in young and middle age males who consumed excessive added sugar from soda. Excessive added sugar intake was observed to be associated with 1·5- to 2·0-fold and 2·0- to 2·3-fold increased risk of the probability of hyperuricaemia in young and middle age males and middle age females, respectively. Study participants, regardless of age or gender, who were obese and consumed excessive added sugar from soda had the highest risk of having hyperuricaemia. CONCLUSIONS Our study revealed that the association between hyperuricaemia and consumption of excessive added sugar from soda may vary by age and gender. Obese adults who consumed excessive added sugar from soda had the highest risk of hyperuricaemia, a finding that was found across all age-specific groups for both genders.
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Zitt E, Fischer A, Lhotta K, Concin H, Nagel G. Sex- and age-specific variations, temporal trends and metabolic determinants of serum uric acid concentrations in a large population-based Austrian cohort. Sci Rep 2020; 10:7578. [PMID: 32371883 PMCID: PMC7200724 DOI: 10.1038/s41598-020-64587-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
Little is known about sex- and age-specific variations and temporal trends in serum uric acid (SUA) concentrations, the prevalence of hyperuricemia and its association with metabolic risk factors in the general population. Between January 1, 1985 and June 30, 2005 146,873 participants (42% women) were recruited. Prevalence of hyperuricemia was estimated applying a common (SUA > 360 µmol/L) and sex-specific cut-off points (women > 340 µmol/L, men > 420 µmol/L). At baseline, mean age was 41.2 years in men and 51.5 years in women, mean SUA concentration was 314.8 µmol/L and 243.6 µmol/L, respectively. Applying a common cut-off point, the prevalence of hyperuricemia was 18.5% in men and 4.4% in women and by sex-specific cut-off points it was 15.1% and 13.8%, respectively. SUA levels increased by 6.7 µmol/L per decade in men, but remained constant in women until the age of 50 years with a sharp increase by approximately 22 µmol/L per decade thereafter. In men and women, hyperuricemia was associated with obesity, hypertriglyceridemia and elevated gamma-glutamyl transferase. With increasing age SUA levels and the prevalence of hyperuricemia rise in a sex-specific manner. Above the age of 65 years, the sex-specific prevalence of hyperuricemia in women outreaches that in men.
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Affiliation(s)
- Emanuel Zitt
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.,Department of Internal Medicine III (Nephrology and Dialysis), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.,Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Anton Fischer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.,Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Karl Lhotta
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria.,Department of Internal Medicine III (Nephrology and Dialysis), Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria. .,Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
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Hyperuricemia and its association with adiposity and dyslipidemia in Northwest China: results from cardiovascular risk survey in Xinjiang (CRS 2008-2012). Lipids Health Dis 2020; 19:58. [PMID: 32238146 PMCID: PMC7115071 DOI: 10.1186/s12944-020-01211-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 02/24/2020] [Indexed: 01/14/2023] Open
Abstract
Background Hyperuricemia predisposes to gout, which may result in tophi, kidney stones, or urate nephropathy even kidney failure. Many metabolic risk factors and disorders has been recognized as a key risk factor contributing to development of hyperuricemia. Aim To determine the prevalence of hyperuricemia and its association with adiposity and dyslipidemia. Methods We recruited non-hospitalized participants (aged ≥35 years) in Xinjiang, a northwest part of China based on the Cardiovascular Risk Survey (CRS 2008–2012). Information of general health status, seafood or internal organs intake and history of disease were obtained by using an interview-based questionnaire. The levels of serum uric acid (sUA) and creatinine and lipid profiles were measured. A multivariate logistic regression model was performed to assess the association between prevalence of hyperuricemia and adiposity and dyslipidemia. Results This study recruited 16,611 participants, and 14,618 was included (mean age of 50.5 ± 12.6 years, 46.6% was males). The study population comprised three ethnic groups with 39.4% of Han, 32.6% of Uygur and 28% of Kazakh Chinese. The overall prevalence of hyperuricemia was 9.1% (95% CI: 8.6 to 9.6) and it was11.8% in men was 6.7% in women. The three ethnic groups also had different hyperuricemia prevalence with 15.4% in Han, 4.6% in Uygur and 5.5% in Kazakh Chinese, which corresponding to a respective mean sUA levels of 306.2 ± 86.9, 249.4 ± 76.1 and 259.8 ± 78.7 μmol/L. Participants with diabetes, hypertension or hypertriglyceridemia and higher blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC) had higher levels of sUA (P < 0.001 respectively). Multivariate logistic regression analysis revealed that age, gender, ethnicity, drinking, obesity, waist circumference, TG (≥2.26 mmol/L), TC (≥6.22 mmol/L) are major risk factors for hyperuricemia. Compared to the 35–44-year age group [adjusted odds ratio (AOR) = 1], the risk of hyperuricemia increased 1.61-fold in the 65–74-year age group (AOR = 1.61, 95% CI: 1.34–1.91; P < 0.001), and 1.71-fold in the 75- and older age group (AOR = 1.71, 95% CI: 1.27–2.29; P < 0.001). There was a 1.45-fold higher risk of hyperuricemia in men (AOR = 1.45, 95% CI: 1.24–1.68; P < 0.001) compared to women. Further, the risk of hyperuricemia increased significantly with drinking (AOR = 1.36; 95% CI: 1.16–1.61; P < 0.001), overweight (AOR = 1.25; 95% CI: 1.06–1.48; P = 0.01), obesity (AOR = 1.28; 95% CI: 1.10–1.49; P < 0.001), waist circumference (AOR = 1.48; 95% CI: 1.24–1.78; P < 0.001), TC (≥6.22 mmol/L, AOR = 1.45; 95% CI: 1.19–1.75; P < 0.001), TG (≥2.26 mmol/L, AOR = 2.74; 95% CI: 2.39–3.14; P < 0.001). Conclusions These findings documented that the hyperuricemia is prevalent in the economically developing regions of northwest China. Hyperuricemia is associated with advanced age, male ender and general metabolic and cardiovascular risk factors. Obesity and dyslipidemia increase the risk of hyperuricemia.
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Wan H, Zhang K, Wang Y, Chen Y, Zhang W, Xia F, Zhang Y, Wang N, Lu Y. The Associations Between Gonadal Hormones and Serum Uric Acid Levels in Men and Postmenopausal Women With Diabetes. Front Endocrinol (Lausanne) 2020; 11:55. [PMID: 32153501 PMCID: PMC7044188 DOI: 10.3389/fendo.2020.00055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/28/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: In assessing the development of hyperuricemia in diabetic adults, the role of the sex steroid axis is underappreciated. Furthermore, dehydroepiandrosterone (DHEA) has been recommended as a nutritional supplement. However, is DHEA suitable for diabetic adults with hyperuricemia? This issue has received little attention. Aim: The objective of this study was to investigate the associations between gonadal hormones and uric acid (UA) levels in diabetic adults, paying particular attention to the association between DHEA and UA levels. Methods: We analyzed 4,426 participants out of 4,813 diabetic adults enrolled from seven communities in a cross-sectional survey conducted in 2018. Participants underwent several examinations, including assessments of anthropometric parameters, blood pressure, glucose, lipid profiles, UA, total testosterone (TT), estradiol (E2), the follicle-stimulating hormone (FSH), the luteinizing hormone (LH), and dehydroepiandrosterone (DHEA). Results: Among men and compared with individuals in the first quartile, participants in the fourth quartile of TT and FSH had odds of hyperuricemia that were significantly decreased by so much as 48 and 34%, respectively (both P < 0.05). However, participants in the fourth quartile of DHEA had 79% increased odds of hyperuricemia (P < 0.05). Among postmenopausal women, participants in the fourth quartile of DHEA, TT, and LH had odds of hyperuricemia that were significantly increased by 155, 99, and 76%, respectively (all P < 0.05). These associations were adjusted for potential confounding factors. Conclusions: Sex differences were found in the associations between gonadal hormones and UA levels in diabetic men and postmenopausal women, which should be monitored to prevent hyperuricemia when sex hormone treatment, especially DHEA, is administered. Further studies are needed.
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Affiliation(s)
- Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunping Zhang
- Department of Endocrinology and Metabolism, The People's Hospital of Xiangyun, Shanghai, China
- *Correspondence: Yunping Zhang p3134582163.com
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ningjian Wang
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yingli Lu
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The Prevalence of Hyperuricemia Sharply Increases from the Late Menopausal Transition Stage in Middle-Aged Women. J Clin Med 2019; 8:jcm8030296. [PMID: 30832319 PMCID: PMC6463386 DOI: 10.3390/jcm8030296] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 12/22/2022] Open
Abstract
The impact of menopausal transition on change of serum uric acid level remains unknown. The present study evaluated the relationship of menopausal stages with prevalent hyperuricemia in middle-aged women. This cross-sectional study included 58,870 middle-aged Korean women, aged ≥40, who participated in a health examination from 2014 to 2016. Menopausal stages were obtained with a standardized, self-administered questionnaire and were categorized according to the criteria of the Stages of Reproductive Aging Workshop (STRAW+10). Hyperuricemia was defined as a serum uric acid level of ≥6 mg/dL. The prevalence of hyperuricemia increased as menopausal stage increased. The multivariable-adjusted odds ratios (95% confidence intervals) for prevalent hyperuricemia comparing early transition, late transition, and post-menopause to pre-menopause were 1.19 (0.80–1.77), 2.13 (1.35–3.36), and 1.65 (1.33–2.04), respectively. This association was stronger among non-obese compared to obese participants and in those with low high-sensitivity C-reactive protein (hsCRP) levels (<1.0 mg/L) compared to those with elevated hsCRP levels of ≥1.0 mg/L (p for interaction = 0.01). In this large sample of middle-aged women, the prevalence of hyperuricemia significantly increased from the menopausal stage of late transition, independent of potential confounders. Appropriate preventive strategies for reducing hyperuricemia and its related consequences should be initiated prior to menopause.
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Jung JH, Song GG, Lee YH, Kim JH, Hyun MH, Choi SJ. Serum uric acid levels and hormone therapy type: a retrospective cohort study of postmenopausal women. Menopause 2018; 25:77-81. [PMID: 28796699 DOI: 10.1097/gme.0000000000000953] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Serum uric acid levels increase in postmenopausal women, but decrease when hormone therapy (HT) is administered. No study has, however, evaluated the effects of different types of HT on serum uric acid levels. We therefore examined whether estrogen therapy (ET), estrogen plus progestogen therapy (EPT), and tibolone use affected serum uric acid levels in this population. METHODS We performed a retrospective cohort study of postmenopausal women. From 2005 to 2015, postmenopausal women who had undergone blood uric acid-level testing at least twice were enrolled. Participants were grouped according to HT regimen: ET, EPT, or tibolone. The nonhormone therapy group did not receive HT. Differences in serum uric acid levels were examined in each group. Our analysis was adjusted to accommodate different follow-up intervals for individual participants. Multiple variables were adjusted using the Tukey-Kramer method. Age, body mass index, hypertension, diabetes mellitus, dyslipidemia, estimated glomerular filtration rate, alcohol consumption, smoking status, and comedications were also adjusted. RESULTS After adjusting for multiple variables, the serum uric acid level increased to 0.87 ± 0.27 mg/dL (least squares mean ± standard error) in the nonhormone therapy group, and serum uric levels in the EPT group were found to be significantly lower (-0.38 ± 0.29 mg/dL, P < 0.001). The serum uric acid levels in the ET and tibolone groups did not, however, differ significantly from the nonhormone therapy group level. CONCLUSIONS We attribute our findings to the effects of progestogen, rather than estrogen.
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Affiliation(s)
- Jae H Jung
- Korea University College of Medicine, Seoul, Korea.,Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Gwan G Song
- Korea University College of Medicine, Seoul, Korea.,Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Young H Lee
- Korea University College of Medicine, Seoul, Korea.,Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Jae-Hoon Kim
- Korea University College of Medicine, Seoul, Korea.,Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Myung H Hyun
- Korea University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Sung J Choi
- Korea University College of Medicine, Seoul, Korea.,Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea
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Techatraisak K, Kongkaew T. The association of hyperuricemia and metabolic syndrome in Thai postmenopausal women. Climacteric 2017; 20:552-557. [DOI: 10.1080/13697137.2017.1369513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- K. Techatraisak
- Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - T. Kongkaew
- Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Xu X, Li C, Zhou P, Jiang T. Uric acid transporters hiding in the intestine. PHARMACEUTICAL BIOLOGY 2016; 54:3151-3155. [PMID: 27563755 DOI: 10.1080/13880209.2016.1195847] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/19/2016] [Accepted: 05/24/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT Hyperuricaemia is known as an abnormally increased uric acid level in the blood. Although it was observed many years ago, since uric acid excretion via the intestine pathway accounted for approximately one-third of total elimination of uric acid, the molecular mechanism of 'extra-renal excretion' was poorly understood until the finding of uric acid transporters. OBJECTIVE The objective of this study was to gather all information related to uric acid transporters in the intestine and present this information as a comprehensive and systematic review article. METHODS A literature search was performed from various databases (e.g., Medline, Science Direct, Springer Link, etc.). The key terms included uric acid, transporter and intestine. The period for the search is from the 1950s to the present. The bibliographies of papers relating to the review subject were also searched for further relevant references. RESULTS The uric acid transporters identified in the intestine are discussed in this review. The solute carrier (SLC) transporters include GLUT9, MCT9, NPT4, NPT homolog (NPT5) and OAT10. The ATP binding cassette (ABC) transporters include ABCG2 (BCRP), MRP2 and MRP4. Bacterial transporter YgfU is a low-affinity and high-capacity transporter for uric acid. CONCLUSION The present review may be helpful for further our understanding of hyperuricaemia and be of value in designing future studies on novel therapeutic pathways.
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Affiliation(s)
- Xianxiang Xu
- a School of Biomedical Sciences, Huaqiao University , Quanzhou , China
- b Institute of Chinese Meteria Medica, China Academy of Chinese Medical Sciences , Beijing , China
| | - Canghai Li
- b Institute of Chinese Meteria Medica, China Academy of Chinese Medical Sciences , Beijing , China
| | - Pan Zhou
- a School of Biomedical Sciences, Huaqiao University , Quanzhou , China
| | - Tingliang Jiang
- b Institute of Chinese Meteria Medica, China Academy of Chinese Medical Sciences , Beijing , China
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Towiwat P, Li ZG. The association of vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and gout. Int J Rheum Dis 2016; 18:495-501. [PMID: 26082349 DOI: 10.1111/1756-185x.12622] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
About 2500 years ago, gout was observed by Hippocrates and many people suffered severe pain and deformity. Lifestyle and diet play a significant role in gout and serum uric acid levels. Epidemiological and research studies have supported this evidence. Many recommendations and guidelines from different parts of the world mention the impact of diet on gout. Recently, new research has shown associations between vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and the risk of gout. Our review summarizes recently published research regarding dietary impact on the risk of gout and serum uric acid levels.
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Affiliation(s)
- Patapong Towiwat
- Autoimmune Immunology and Rheumatology Division, Internal Medicine Department, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok, Thailand
| | - Zhan-Guo Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China
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Abstract
PURPOSE OF REVIEW This article presents recent epidemiologic contributions focusing on gout-related conditions, especially if controversial, to find plausible, despite hypothetical, mechanistic explanations from the clinician perspective. RECENT FINDINGS The prevalence of gout is increasing, but it is only partially clear that the incidence may be increasing as well. Direct associations of gout with increased risk of diabetes, black races, neurodegenerative disorders, and sugar-enriched foods have been recently questioned. A negative association with smoking has been reported, and new evidence shows that the impact of diet may be independent of obesity. Kidney disease and diuretics have been confirmed to be associated with gout, whereas new data on aging and menopause have come to challenge apparently established disease mechanisms. Regarding treatments, increase in bladder cancer associated with chronic allopurinol use has been reported, and the positive effect of urate-lowering treatment on cardiovascular events has been contested. SUMMARY Epidemiological data in gout-related conditions are still evolving and claim for future cohort or intervention studies to prove causality. Controversies in epidemiological results fertilize the ground for studies to prove mechanisms and causality and provides a unique opportunity for clinical intervention to improve outcomes, especially with regard to treatments.
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Guo M, Niu JY, Li SR, Ye XW, Fang H, Zhao YP, Gu Y. Gender differences in the association between hyperuricemia and diabetic kidney disease in community elderly patients. J Diabetes Complications 2015; 29:1042-9. [PMID: 26387809 DOI: 10.1016/j.jdiacomp.2015.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 01/23/2023]
Abstract
AIMS To investigate gender differences of the associations between hyperuricemia and diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM) based on electronic health records (EHR). METHODS A total of 20,207 older diabetic patients (mean age 71±7years) were investigated based on the EHR from 2012 to 2013 in the Minhang District of Shanghai-China. The status of hyperuricemia, albuminuric DKD and the odds ratios of DKD relative to hyperuricemia were analyzed among 8541 men and 11,666 women. RESULTS The overall rate of hyperuricemia was 20.5% (males: 17.2%, females: 23.0%) and that of albuminuric DKD was 36.2% (males: 32.2%, female: 39.1%) in these diabetic patients. Hyperuricemia was independently associated with increased risk of reduced renal function and albuminuria (p<0.001) in both genders. After adjustment of traditional DKD risk factors, hyperuricemia had a stronger association with albuminuric DKD in males (OR 1.67, 95% CI: 1.48-1.88) than in females (OR 1.23, 95% CI: 1.12-1.35). CONCLUSIONS This study showed an independent association of hyperuricemia with albuminuric DKD that was stronger in elderly males for the first time in China based on EHR. The level of uric acid should be monitored and managed in older diabetic patients.
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Affiliation(s)
- Mei Guo
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Jian-Ying Niu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - She-Ran Li
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Xian-Wu Ye
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Hong Fang
- Center for Disease Prevention and Control of Minhang District, No. 965 Zhongyi Road, Shanghai 201101, China
| | - Yan-Ping Zhao
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Yong Gu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China; Department of Nephrology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai 200040, China.
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