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Hu W, Ye Z, Li T, Shi Z. Associations Between Composite Dietary Antioxidant Index and Gout: National Health and Nutrition Examination Survey 2007-2018. Biol Res Nurs 2024; 26:150-159. [PMID: 37616306 DOI: 10.1177/10998004231198166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Introduction: To explore the relationship between the composite dietary antioxidant index (CDAI) and gout to provide support for preventing gout through dietary intervention. Methods: Eligible participants from the 2007 to 2018 National Health and Nutrition Examination Survey aged 20 years and older were included in this cross-sectional study. The weighted chi-square test was used to compare the categorical variables difference between CDAI quartiles groups. The weighted univariate and binary logistic regression analysis were used to test the association between variables and gout. The weighted multivariable logistic regression was used to test the association of CDAI and gout in 4 different models. Subgroup analysis on the associations of CDAI with gout was conducted with stratified factors. Results: The final participants were 26,117, 13,103 (50.17%) were female, 8718 (33.38%) were 40-59 years, 11,200 (42.88%) were white and 1232 (4.72%) had gout. After adjusting for all covariates, the CDAI was associated with gout (odds ratio (OR), .97; 95% CI: .95-1.00). Participants in the highest CDAI quantile group were at low risk of gout (odds ratio (OR), .65; 95% CI: .50-.84) versus those in the lowest quantile group. Subgroup analysis and interaction test showed no significant dependence on diabetes mellitus (DM), marital status, alcohol status, hypertension, poverty income ratio (PIR), education level, body mass index (BMI), smoke status, age, sex, race, and chronic kidney disease (CKD) on this association (all p for interaction >.05). Conclusions: Composite dietary antioxidant index was inversely associated with gout in US adults, and dietary antioxidant intervention might be a promising method in the therapy of gout and greater emphasis should be placed on zinc, selenium, carotenoids, vitamins A, C, and E.
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Affiliation(s)
- Wanqin Hu
- Department of Nursing, Medical College, Jiaying University, Meizhou, China
- Department of Nursing, Hunan Provincial People's Hospital, Changsha, China
| | - Ziwei Ye
- Department of Nursing, Medical College, Jiaying University, Meizhou, China
| | - Tao Li
- Department of pathophysiology, Medical College, Jiaying University, Meizhou, China
| | - Zeya Shi
- Department of Nursing, Hunan Provincial People's Hospital, Changsha, China
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Wang H, Qin S, Li F, Zhang H, Zeng L. A cross-sectional study on the association between dietary inflammatory index and hyperuricemia based on NHANES 2005-2018. Front Nutr 2023; 10:1218166. [PMID: 37810924 PMCID: PMC10552180 DOI: 10.3389/fnut.2023.1218166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Background Hyperuricemia is a common condition that can lead to gout and other related diseases. It has been suggested that Inflammatory factors play important role in the development and progression of hyperuricemia. The dietary inflammatory index (DII) enables the assessment of the inflammatory potential of an individual's diet. This study aimed to investigate the association between DII and hyperuricemia. Methods This study was performed based on a cross-sectional dataset from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Participants aged 18 years and above with dietary intake and serum uric acid level information were included. DII scores were calculated using dietary intake data, based on which participants were categorized into tertiles. Multivariable logistic regression analysis was adopted to investigate the association between DII and hyperuricemia. Results Among a total of 31,781 participants in the analysis, 5,491 had hyperuricemia. After adjusting confounding factors, the odds of hyperuricemia are significantly higher in the second (OR 1.17, 95% CI 1.07-1.29) and third tertiles (OR 1.31, 95% CI 1.19-1.44) relative to the first one. Conclusion This study suggested that diet with higher inflammatory potential, as measured by DII, is associated with increased hyperuricemia risk. These findings indicated that dietary modification may be a potential approach for hyperuricemia's prevention and control.
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Affiliation(s)
- Hao Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Shengmei Qin
- Department of Nursing, Stomatological Hospital Southern Medical University, Guangzhou, China
| | - Feng Li
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Huanhuan Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Ling Zeng
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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Wang MY, Prabahar K, Găman MA, Zhang JL. Vitamin E supplementation in the treatment on nonalcoholic fatty liver disease (NAFLD): Evidence from an umbrella review of meta-analysis on randomized controlled trials. J Dig Dis 2023; 24:380-389. [PMID: 37503812 DOI: 10.1111/1751-2980.13210] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/11/2023] [Accepted: 07/25/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE We conducted this umbrella review of meta-analysis on randomized controlled trials to clarify the effects of vitamin E administration on alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), degrees of steatosis and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). METHODS PubMed, MEDLINE, SCOPUS, EMBASE, and Web of Science were searched to identify pertinent articles published up to June 2023. To calculate the overall effect size (ES) and confidence intervals (CI), random-effects model was used. RESULTS Six meta-analyses were included in the umbrella review. By pooling ES based on the random-effects model, we found that vitamin E supplementation significantly decreased ALT (ES -6.47, 95% CI -11.73 to -1.22, P = 0.01), AST (ES -5.35, 95% CI -9.78 to -0.93, P = 0.01), degrees of fibrosis (ES -0.24, 95% CI -0.36 to -0.12, P < 0.001) and steatosis (ES -0.67, 95% CI -0.88 to -0.45, P < 0.001) in NAFLD patients, but had no effect on GGT. In the subgroup analyses, we detected that fibrosis scores notably decreased when vitamin E dosage was >600 IU/day (ES -0.25, 95% CI -0.41 to -0.10, P = 0.002) and when the treatment duration was ≥12 months (ES -0.24, 95% CI -0.37 to -0.12, P < 0.001). CONCLUSION Vitamin E administration improves ALT, AST, fibrosis, and steatosis in NAFLD subjects. Fibrosis scores were significantly reduced when vitamin E dosage exceeded 600 IU/day or with a treatment duration of at least 12 months.
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Affiliation(s)
- Ming Yue Wang
- School of Pharmacy, Nantong University, Nantong, Jiangsu Province, China
- Department of Pharmacy, Yancheng Third People's Hospital, Yancheng, Jiangsu Province, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Jin Lin Zhang
- School of Pharmacy, Nantong University, Nantong, Jiangsu Province, China
- Department of Pharmacy, Tumor Hospital Affiliated to Nantong University, Nantong, Jiangsu Province, China
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Juraschek SP, Gaziano JM, Glynn RJ, Gomelskaya N, Bubes VY, Buring JE, Shmerling RH, Sesso HD. Effects of vitamin C supplementation on gout risk: results from the Physicians' Health Study II trial. Am J Clin Nutr 2022; 116:812-819. [PMID: 35575611 PMCID: PMC9437983 DOI: 10.1093/ajcn/nqac140] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Short-term randomized trials suggest that a 500 mg/d vitamin C supplement reduces serum urate, whereas observational studies show vitamin E is inversely associated with gout risk. OBJECTIVES We evaluated the effect of supplemental vitamin C (prespecified primary exposure) and vitamin E (prespecified secondary exposure) on new diagnoses of gout. METHODS We performed a post hoc analysis of data from the Physicians' Health Study II, a randomized, double-blind, placebo-controlled factorial trial of randomized vitamin C (500 mg/d) and vitamin E (400 IU every other day). The primary outcome was new gout diagnoses, self-reported at baseline and throughout the follow-up period of ≤10 y. RESULTS Of 14,641 randomly assigned male physicians in our analysis, the mean age was 64 ± 9 y; 1% were Black, and 6.5% had gout prior to randomization. The incidence rate of new gout diagnoses during follow-up was 8.0 per 1000 person-years among those assigned vitamin C compared with 9.1 per 1000 person-years among those assigned placebo. The vitamin C assignment reduced new gout diagnoses by 12% (HR: 0.88; 95% CI: 0.77, 0.99; P = 0.04). These effects were greatest among those with a BMI <25 kg/m 2 (P-interaction = 0.01). Vitamin E was not associated with new gout diagnoses (HR: 1.05; 95% CI: 0.92, 1.19; P = 0.48). CONCLUSIONS Vitamin C modestly reduced the risk of new gout diagnoses in middle-aged male physicians. Additional research is needed to determine the effects of higher doses of vitamin C supplementation on serum urate and gout flares in adults with established gout.The Physicians' Health Study II is registered at clinicaltrials.gov (identifier: NCT00270647).
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Affiliation(s)
- Stephen P Juraschek
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - J Michael Gaziano
- Division of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Robert J Glynn
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Natalya Gomelskaya
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Vadim Y Bubes
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Julie E Buring
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert H Shmerling
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Howard D Sesso
- Division of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Zhang L, Shi X, Yu J, Zhang P, Ma P, Sun Y. Dietary Vitamin E Intake Was Inversely Associated with Hyperuricemia in US Adults: NHANES 2009-2014. ANNALS OF NUTRITION AND METABOLISM 2020; 76:354-360. [PMID: 32957105 DOI: 10.1159/000509628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 06/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Current evidence on the association between dietary vitamin E intake and hyperuricemia risk is limited and conflicting. OBJECTIVE The aim of the study was to assess the association of dietary vitamin E intake with hyperuricemia in US adults. METHODS We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey, 2009-2014. Dietary vitamin E intake was evaluated through two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were used to examine the association between dietary vitamin E intake and hyperuricemia. RESULTS Overall, 12,869 participants were included. The prevalence of hyperuricemia was 19.35%. After adjustment for age, gender, BMI, race, educational level, smoking status, alcohol consumption, physical activity, total daily energy intake, total cholesterol, protein intake, glomerular filtration rate, serum Cr, use of uric acid drugs, and drug abuse, the odds ratio (95% confidence interval) of hyperuricemia for the highest tertile of dietary vitamin E intake was 0.77 (0.63-0.96) compared with that of the lowest tertile. In men, dietary vitamin E intake and hyperuricemia were negatively correlated. In stratified analyses by age (20-39, 40-59, and ≥60 years), dietary vitamin E intake was inversely associated with hyperuricemia only among participants aged ≥60 years. Dose-response analyses showed that dietary vitamin E intake was inversely associated with hyperuricemia in a nonlinear manner. CONCLUSION Dietary vitamin E intake was negatively correlated with hyperuricemia in US adults, especially among males and participants aged ≥60 years.
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Affiliation(s)
- Lixia Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
| | - Xiaoyan Shi
- Department of Microorganism Test, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Jinran Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
| | - Peipei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China
| | - Ping Ma
- Department of Anesthesiology, The Third People's Hospital of Qingdao, Qingdao, China
| | - Yongye Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, China,
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Associations of Serum Retinol and α-Tocopherol Levels with Uric Acid Concentrations: Analysis of a Population-Based, Nationally Representative Sample. Nutrients 2020; 12:nu12061797. [PMID: 32560339 PMCID: PMC7353330 DOI: 10.3390/nu12061797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 12/22/2022] Open
Abstract
The effects of serum retinol and α-tocopherol on serum uric acid levels have not been established, especially in Asian people. This study evaluated the independent associations of retinol and α-tocopherol with serum uric acid levels in the Korean population. We included 6023 participants aged ≥ 19 years from the Korean National Health and Nutrition Examination Survey (KNHANES). Serum retinol and α-tocopherol levels were divided into quintiles, and a multivariate linear regression model was used to evaluate the association of serum retinol and α-tocopherol levels with uric acid concentration. Additionally, we used multivariate logistic regression to examine the relationships between the levels of these micronutrients and hyperuricemia. Serum retinol levels were positively associated with uric acid concentrations in a dose-dependent fashion in both sexes (ptrend < 0.001); the difference in serum uric acid levels between the highest and lowest quintiles of retinol levels was 0.57 mg/dL in men and 0.54 mg/dL in women. In the multivariable logistic model, the hyperuricemia risk increased linearly with the increase in serum retinol level, regardless of sex (ptrend < 0.001). Although the serum α-tocopherol level appeared to be significantly associated with increased uric acid levels, this association was nullified after adjusting for serum retinol levels. Serum retinol levels were positively associated with serum uric acid levels and hyperuricemia in a dose-response fashion. Maintaining serum retinol concentrations under sub-toxic levels might be necessary to prevent hyperuricemia-related adverse health outcomes.
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Roumeliotis S, Roumeliotis A, Dounousi E, Eleftheriadis T, Liakopoulos V. Dietary Antioxidant Supplements and Uric Acid in Chronic Kidney Disease: A Review. Nutrients 2019; 11:nu11081911. [PMID: 31443225 PMCID: PMC6723425 DOI: 10.3390/nu11081911] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 02/07/2023] Open
Abstract
Increased serum levels of uric acid have been associated with the onset and development of chronic kidney disease (CKD), cardiovascular disease, and mortality, through several molecular pathogenetic mechanisms, such as inflammation and oxidative stress. Oxidative stress is present even in the early stages of CKD, progresses parallelly with the deterioration of kidney function, and is even more exacerbated in end-stage renal disease patients undergoing maintenance hemodialysis. Although acting in the plasma as an antioxidant, once uric acid enters the intracellular environment; it behaves as a powerful pro-oxidant. Exogenous intake of antioxidants has been repeatedly shown to prevent inflammation, atherosclerosis and oxidative stress in CKD patients. Moreover, certain antioxidants have been proposed to exert uric acid-lowering properties. This review aims to present the available data regarding the effects of antioxidant supplements on both oxidative stress and uric acid serum levels, in a population particularly susceptible to oxidative damage such as CKD patients.
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Affiliation(s)
- Stefanos Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Athanasios Roumeliotis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Evangelia Dounousi
- Department of Nephrology, School of Medicine, University of Ioannina, Ioannina 45110, Greece
| | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
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Peng H, Feng D, Wang Y, Dong Z, Chen Q, Zhang L, Luo R, Chen J, Wang A, Ma S. Effect of Oral Vitamin C Supplementation on High-Altitude Hyperuricemia in Young Men Initially Migrating to High Altitude: A Pilot Study. High Alt Med Biol 2018; 19:373-381. [PMID: 30358417 DOI: 10.1089/ham.2018.0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Clinical studies have shown that oral vitamin C supplementation can reduce serum uric acid levels in multiple populations and may also improve acute mountain sickness. However, it is unclear whether this protocol can improve high-altitude hyperuricemia. Therefore, we aimed to evaluate the role of vitamin C supplementation on high-altitude hyperuricemia. METHODS A preliminary prospective control study was performed in 2015. Young male army recruits (n = 66), who had recently arrived on the Tibetan Plateau for the first time, were recruited for study I. Subjects were assigned to either the vitamin C group, who took an oral daily dose of 500 mg vitamin C for 1 month, or the blank control group, who had no intervention. The levels of serum uric acid, serum creatinine, and blood urea nitrogen were monitored at baseline and at the end of 1 month. In a second study II in 2016 (n = 120), the effect of 500 mg/d vitamin C on high-altitude hyperuricemia was compared with 75 IU/d of vitamin E. RESULTS In study I, the level of serum uric acid at 1 month was significantly higher than at baseline (436.1 ± 79.3 μmol/L vs. 358.0 ± 79.8 μmol/L, p < 0.001) and the prevalence of hyperuricemia was also significantly higher (63.6% [95% confidence interval, CI: 52.0%-75.2%] vs. 19.7% [95% CI: 10.1%-29.3%], p < 0.001). Both the level of serum uric acid (411.5 ± 74.2 μmol/L vs. 460.8 ± 54.8 μmol/L, p = 0.003) and the prevalence of hyperuricemia (48.5% [95% CI: 31.4%-65.6%] vs. 78.8% [95% CI: 64.9%-92.7%], p = 0.020) were significantly lower in the vitamin C group than in the blank control group. In study II, the levels of serum uric acid and the frequency of hyperuricemia also increased over 1 month and were similar in the vitamin C and the vitamin E groups at both baseline and 1 month (p > 0.05). The change in serum uric acid was positively correlated with both the changes in serum creatinine (r = 0.599, p < 0.001) and blood urea nitrogen (r = 0.207, p = 0.005). CONCLUSIONS These findings indicate that healthy young men develop an increase in serum uric acid within a month of moving from low to high altitude. Oral vitamin C supplementation can safely reduce this increase at a low cost.
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Affiliation(s)
- Hui Peng
- 1 Department of Infectious Disease, Kunming General Hospital of Chengdu Military Command, Kunming, China.,2 Department of Postgraduate, Kunming Medical University, Kunming, China
| | - Dongfang Feng
- 3 Laboratory Department, Tibet Military Region General Hospital, Tibet, China
| | - Yingkai Wang
- 4 Medical Administration Division, Tibet Military Region General Hospital, Tibet, China
| | - Zixi Dong
- 5 Medical Administration Division, Kunming General Hospital of Chengdu Military Region, Kunming, China
| | - Qing Chen
- 1 Department of Infectious Disease, Kunming General Hospital of Chengdu Military Command, Kunming, China.,2 Department of Postgraduate, Kunming Medical University, Kunming, China
| | - Lihong Zhang
- 1 Department of Infectious Disease, Kunming General Hospital of Chengdu Military Command, Kunming, China
| | - Ruigang Luo
- 6 Medical Team, Tibet Military Region 77649 Unit, Tibet, China
| | - Jinsong Chen
- 6 Medical Team, Tibet Military Region 77649 Unit, Tibet, China
| | - Anjun Wang
- 6 Medical Team, Tibet Military Region 77649 Unit, Tibet, China
| | - Shiwu Ma
- 1 Department of Infectious Disease, Kunming General Hospital of Chengdu Military Command, Kunming, China.,7 State Key Laboratory of Organ Failure Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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