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Chen J, Liu X, Lu S, Man S, Zhang L, Xu X, Deng W, Jiang X. Linear associations of Chinese visceral adiposity index and its change with hyperuricemia: A prospective cohort study. Nutr Metab Cardiovasc Dis 2024; 34:2472-2479. [PMID: 39079837 DOI: 10.1016/j.numecd.2024.06.021] [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: 04/10/2024] [Revised: 06/15/2024] [Accepted: 06/24/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND AND AIMS This study aims to investigate the association of Chinese visceral adiposity index (CVAI) with incident hyperuricemia (HUA). METHODS AND RESULTS We included 5186 adults aged ≥45 years from China Health and Retirement Longitudinal Study. Modified Poisson regression model was used to estimate the relative risks (RRs) of incident HUA associated with baseline CVAI, and logistic model was used to estimate the odds ratios (ORs) of HUA for CVAI change. Restricted cubic splines analysis was adopted to model the dose-response associations. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the predictive value of CVAI. During 4-year follow-up, a total of 510 (9.8%) HUA cases were identified. The RRs (95%CIs) of incident HUA were 3.75 (2.85-4.93) for quartile 4 versus quartile 1 and 1.56 (1.45-1.69) for per-standard deviation increase in baseline CVAI. For the analyses of CVAI change, compared with stable group, participants in decreased group had 34% lower risk (OR 0.66, 95%CI 0.49-0.87) and those in increased group had 35% (1.35, 1.03-1.78) higher risk of HUA. Linear associations of baseline CVAI and its change with HUA were observed (Pnonlinear >0.05). Besides, the AUC value for HUA was 0.654 (0.629-0.679), which was higher than other five obesity indices. CONCLUSIONS Our study found linear associations between baseline CVAI and its change and risk of HUA. CVAI had the best predictive performance in predicting incident HUA. These findings suggest CVAI as a reliable obesity index to identify individuals with higher HUA risk.
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Affiliation(s)
- Jia Chen
- Department of Endocrinology, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Xuejiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Shuai Lu
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Siliang Man
- Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Liang Zhang
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Xiaojie Xu
- Department of Endocrinology, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China
| | - Wei Deng
- Department of Endocrinology, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China.
| | - Xieyuan Jiang
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, 100035 Beijing, China.
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Dai Y, Zhang Y, Wang B, Cao L, Wang Z. The association between triglyceride glucose index and gout: a cross-sectional analysis based on NHANES 2007-2018. BMC Endocr Disord 2024; 24:218. [PMID: 39415137 PMCID: PMC11481382 DOI: 10.1186/s12902-024-01747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 10/01/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index, defined as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2], provides insights into overall metabolic status. However, the association between the TyG index and gout has not been investigated. Therefore, this study explored the correlation between the TyG index and gout. METHODS Using data from the National Health and Nutrition Examination Survey, which was conducted from 2007 to 2018, this study investigated the relationship between the TyG index and gout. Demographic data and potential risk factors were analyzed and compared using t tests for continuous data and chi-square tests for categorical data. Logistic regression and subgroup analysis were performed to examine the association between the TyG index and gout. RESULTS A total of 14,924 participants were enrolled, among whom 726 (4.86%) were diagnosed with gout. Without controlling for any covariates, a significant positive correlation was observed between an elevated TyG index and increased risk of gout, with an odds ratio (OR) of 2.07 and a 95% confidence interval (CI) ranging from 1.76 to 2.43. After full adjustment, this association remained statistically significant, with an adjusted OR of 1.43 and a 95% CI from 1.14 to 1.80. Subgroup analyses revealed significant interactions, particularly for females (OR = 2.55; 95% CI: 2.00-3.26), individuals with no military service history (OR = 2.15; 95% CI: 1.66-2.43), and those without diabetes (OR = 2.00; 95% CI: 1.64-2.43). CONCLUSION A positive correlation was observed between the TyG index and gout. Consequently, further large-scale prospective studies are warranted for a comprehensive analysis of the role of the TyG index in gout.
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Affiliation(s)
- Yahui Dai
- Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 748 Middle Zhongshan Road, Songjiang District, Shanghai, China
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Yushan Zhang
- Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Putuo District, Shanghai, China
| | - Bo Wang
- Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 748 Middle Zhongshan Road, Songjiang District, Shanghai, China
| | - Lei Cao
- Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 748 Middle Zhongshan Road, Songjiang District, Shanghai, China.
| | - Zhiyuan Wang
- Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Putuo District, Shanghai, China.
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Zhang Z, Wang P, Xiong Q, Xu S, Kang D, He Z, Yao C, Jian G. Advancements in the study of IL-6 and its receptors in the pathogenesis of gout. Cytokine 2024; 182:156705. [PMID: 39053079 DOI: 10.1016/j.cyto.2024.156705] [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] [Received: 05/02/2024] [Revised: 06/11/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
Gout is an autoinflammatory disease characterized by the deposition of monosodium urate crystals in or around the joints, primarily manifesting as inflammatory arthritis that recurs and resolves spontaneously. Interleukin-6 (IL-6) is a versatile cytokine with both anti-inflammatory and pro-inflammatory capabilities, linked to a variety of inflammatory diseases such as gouty arthritis, rheumatoid arthritis, inflammatory bowel disease, vasculitis, and several types of cancer. The rapid production of IL-6 during infections and tissue damage aids in host defense. However, excessive synthesis of IL-6 and dysregulation of its receptor signaling (IL-6R) might contribute to the pathology of diseases. Recent advancements in clinical and basic research, along with developments in animal models, have established the significant role of IL-6 and its receptors in the pathogenesis of gout, although the precise mechanisms remain to be fully elucidated. This review discusses the role of IL-6 and its receptors in gout progression and examines contemporary research on modulating IL-6 and its signaling pathways for treatment. It aims to provide insights into the pathogenesis of gout and to advance the development of targeted therapies for gout-related inflammation.
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Affiliation(s)
- Zeng Zhang
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China
| | - Peng Wang
- Xichong County People's Hospital, Nanchong 637200, Sichuan, China
| | - Qin Xiong
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China
| | - Shanshan Xu
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China
| | - Dong Kang
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China
| | - Zhengguang He
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China
| | - Chengjiao Yao
- Affiliated Hospital of Sichuan Bei Medical College, Nanchong 637000, Sichuan, China
| | - Guilin Jian
- The Third People's Hospital of Suining City, Suining 629000, Sichuan, China.
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4
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Wang M, Meng H. Association between cardiovascular health assessed by life's essential 8 and hyperuricemia in U.S. adults: the NHANES 2009-2020. Front Endocrinol (Lausanne) 2024; 15:1445787. [PMID: 39296712 PMCID: PMC11408204 DOI: 10.3389/fendo.2024.1445787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/20/2024] [Indexed: 09/21/2024] Open
Abstract
Background This study presented the new Life's Essential 8 (LE8) framework for examining cardiovascular health (CVH) to analyze the potential relationship between the latter and hyperuricemia (HUA) in the U.S. population. Methods Data on individuals aged at least 20 years were collected from the National Health and Nutrition Examination Survey (NHANES) 2009-2020. Smoothed curve fitting and multivariate logistic regression analyses were then performed on a sample of 25,681 adults to explore the association between LE8 and HUA. A sensitivity analysis was conducted to examine the robustness of the research findings. Results The study found a strong negative association between LE8 and HUA, with an odds ratio (OR) of 0.71 and a 95% confidence interval (CI) from 0.69 to 0.73 after adjusting for multiple confounding factors. The sensitivity analysis further validated the robustness of this association. This analysis consistently showed negative associations across different genders, ages, races, and education levels (p < 0.05), but there were no significant relationships with marital status. The association between uric acid levels and LE8 displayed an inverted L-shaped curve, with an inflection point around 41.43. Conclusions The findings indicate a strong negative relationship between LE8 and HUA among the U.S. population, suggesting that higher scores on the LE8, which assesses CVH, were associated with reduced uric acid levels. The consistent negative association underscores the LE8 framework's potential as a valuable tool for understanding and managing HUA in CVH.
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Affiliation(s)
- Meng Wang
- Department of Computer and Simulation Technology, Faculty of Health Service, Naval Medical University, Shanghai, China
| | - Heyu Meng
- China-Japan Union Hospital of Jilin University, Changchun, China
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Pascart T, Ducoulombier V, Jauffret C. Early-onset gout. Joint Bone Spine 2024; 91:105704. [PMID: 38336273 DOI: 10.1016/j.jbspin.2024.105704] [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] [Received: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Early-onset gout (EOG) is characterized by the occurrence of the first symptoms of gout at an unusually young age, usually <40 years. The aim of this review is to provide an overview of the epidemiology, clinical presentation and prognosis, association with comorbidities and specific management of EOG. A particularly high proportion of patients with EOG come from ethnic groups with stronger genetic factors, such as populations in the Pacific and Taiwan, who therefore have the highest prevalence of gout overall. The clinical presentation and severity of gout are broadly similar between EOG and common gout, although a longer disease duration exacerbates the disease, which more often tends to become polyarticular. Patients suffering from EOG develop metabolic comorbidities commonly associated with gout earlier in life, although those tend to be less frequent at the time of diagnosis. Some international guidelines recommend early treatment of EOG patients with urate-lowering therapies.
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Affiliation(s)
- Tristan Pascart
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France; ETHICS Laboratory, EA7446, Lille Catholic University, Lille, France.
| | - Vincent Ducoulombier
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France
| | - Charlotte Jauffret
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lomme, France; University of Lille, ULR 2694 - METRICS, CERIM, Lille, France
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Zhang F, Lim WLF, Huang Y, Lam SM, Wang Y. Lipidomics and metabolomics investigation into the effect of DAG dietary intervention on hyperuricemia in athletes. J Lipid Res 2024; 65:100605. [PMID: 39067518 PMCID: PMC11416290 DOI: 10.1016/j.jlr.2024.100605] [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] [Received: 04/17/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024] Open
Abstract
The occurrence of hyperuricemia (HUA; elevated serum uric acid) in athletes is relatively high despite that exercise can potentially reduce the risk of developing this condition. Although recent studies have shown the beneficial properties of DAG in improving overall metabolic profiles, a comprehensive understanding of the effect of DAG in modulating HUA in athletes is still lacking. In this study, we leveraged combinatorial lipidomics and metabolomics to investigate the effect of replacing TAG with DAG in the diet of athletes with HUA. A total of 1,074 lipids and metabolites from 94 classes were quantitated in serum from 33 athletes, who were categorized into responders and non-responders based on whether serum uric acid levels returned to healthy levels after the DAG diet intervention. Lipidomics and metabolomics analyses revealed lower levels of xanthine and uric acid in responders, accompanied by elevated plasmalogen phosphatidylcholines and diminished acylcarnitine levels. Our results highlighted the mechanisms behind how the DAG diet circumvented the risk and effects associated with high uric acid via lowered triglycerides at baseline influencing the absorption of DAG resulting in a decline in ROS and uric acid production, increased phospholipid levels associated with reduced p-Cresol metabolism potentially impacting on intestinal excretion of uric acid as well as improved ammonia recycling contributing to decreased serum uric acid levels in responders. These observed alterations might be suggestive that successful implementation of the DAG diet can potentially minimize the likelihood of a potentially vicious cycle occurring in high uric acid, elevated ROS, and impaired mitochondrial metabolism environment.
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Affiliation(s)
- Fangyingnan Zhang
- School of Food Science and Engineering, South China University of Technology, Guangzhou, Guangdong, China
| | - Wei Ling Florence Lim
- LipidALL Technologies Company Limited, Changzhou, Jiangsu Province, People's Republic of China
| | - Yuan Huang
- Ersha Sports Training Center of Guangdong Province, Guangzhou, Guangdong, China
| | - Sin Man Lam
- LipidALL Technologies Company Limited, Changzhou, Jiangsu Province, People's Republic of China; State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Yonghua Wang
- School of Food Science and Engineering, South China University of Technology, Guangzhou, Guangdong, China.
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Cai N, Chen M, Wu L, Feng P, Ye X, Liu Q, Zhu X, Lu C, Zheng Q, Wang Y. Association between physical activity and the prevalence of gout among patients with type 2 diabetes mellitus and hyperuricemia: a two-center population-based cross-sectional study. Clin Rheumatol 2024; 43:2955-2961. [PMID: 39060811 PMCID: PMC11330382 DOI: 10.1007/s10067-024-07081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 07/16/2024] [Accepted: 07/20/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Diabetes mellitus (DM) and gout cohabitation severely reduces patient life quality while raising financial burden on individual and society. The aim of this study was to elucidate the association between physical activity (PA) and the prevalence of gout among type 2 DM (T2DM) and hyperuricemia (HUA) patients. METHODS In all, we recruited 2291 T2DM patients with HUA. Among them, 448 had gout and 1843 did not. We collected patient data, such as anthropometry, laboratory reports, and medical history, for our analyses. The PA assessment was based on the Chinese version of International PA Questionnaire-short (IPAQ). Moreover, the relationship between PA and gout risk was examined using multivariate logistic regression models. RESULTS Total PA was markedly low among gout patients, relative to controls (p < 0.05). Based on the IPAQ categorical score, 38.2% exhibited "low," 26.8% "moderate," and 35.0% "high" PA among gout patients. In comparison, 12.4% performed "low," 53.8% "moderate," and 33.8% "high" PA among controls. Multivariate analysis revealed that, after adjustment of confounding factors, both low (OR 6.382) and high PA (OR 2.048) had a higher prevalence of gout, as compared to moderate PA. Moreover, we revealed that the male sex, age, HUA duration, serum uric acid, glycated hemoglobin, dyslipidemia history, and drinking status were also independent indicators of the prevalence of gout. Furthermore, stratification analyses revealed results consistent with our prior results. CONCLUSIONS PA intensity was associated with the prevalence of gout among T2DM and HUA patients, and the lowest prevalence was achieved from moderate intensity PA. Key Points • PA intensity was associated with the prevalence of gout among T2DM and HUA patients. • The lowest prevalence of gout was achieved from moderate intensity PA.
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Affiliation(s)
- Ningyu Cai
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Mengdie Chen
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Lijing Wu
- Department of Internal Medicine, Yuhuan Second People's Hospital, No.77, Environmental Protection Middle Road, Chu Men Town, Yuhuan, 317600, Zhejiang, China
| | - Ping Feng
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Xun Ye
- Department of Endocrinology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China
| | - Qiao Liu
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Xianping Zhu
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Chaoyin Lu
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, Zhejiang, China
| | - Qidong Zheng
- Department of Internal Medicine, Yuhuan Second People's Hospital, No.77, Environmental Protection Middle Road, Chu Men Town, Yuhuan, 317600, Zhejiang, China
| | - Yiyun Wang
- Department of Internal Medicine, Yuhuan Second People's Hospital, No.77, Environmental Protection Middle Road, Chu Men Town, Yuhuan, 317600, Zhejiang, China.
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Du L, Zong Y, Li H, Wang Q, Xie L, Yang B, Pang Y, Zhang C, Zhong Z, Gao J. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduct Target Ther 2024; 9:212. [PMID: 39191722 DOI: 10.1038/s41392-024-01916-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/08/2024] [Accepted: 06/27/2024] [Indexed: 08/29/2024] Open
Abstract
Hyperuricemia, characterized by elevated levels of serum uric acid (SUA), is linked to a spectrum of commodities such as gout, cardiovascular diseases, renal disorders, metabolic syndrome, and diabetes, etc. Significantly impairing the quality of life for those affected, the prevalence of hyperuricemia is an upward trend globally, especially in most developed countries. UA possesses a multifaceted role, such as antioxidant, pro-oxidative, pro-inflammatory, nitric oxide modulating, anti-aging, and immune effects, which are significant in both physiological and pathological contexts. The equilibrium of circulating urate levels hinges on the interplay between production and excretion, a delicate balance orchestrated by urate transporter functions across various epithelial tissues and cell types. While existing research has identified hyperuricemia involvement in numerous biological processes and signaling pathways, the precise mechanisms connecting elevated UA levels to disease etiology remain to be fully elucidated. In addition, the influence of genetic susceptibilities and environmental determinants on hyperuricemia calls for a detailed and nuanced examination. This review compiles data from global epidemiological studies and clinical practices, exploring the physiological processes and the genetic foundations of urate transporters in depth. Furthermore, we uncover the complex mechanisms by which the UA induced inflammation influences metabolic processes in individuals with hyperuricemia and the association with its relative disease, offering a foundation for innovative therapeutic approaches and advanced pharmacological strategies.
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Grants
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
- 82002339, 81820108020 National Natural Science Foundation of China (National Science Foundation of China)
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Affiliation(s)
- Lin Du
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yao Zong
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, 6009, Australia
| | - Haorui Li
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qiyue Wang
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Lei Xie
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Bo Yang
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yidan Pang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Changqing Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
| | - Zhigang Zhong
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China.
| | - Junjie Gao
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Institute of Sports Medicine, Shantou University Medical College, Shantou, 515041, China.
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
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Hu X, Lin H, Huang Y, Xu P, Xu B, Yu H, Wang M, Feng S, Li Y, Shen K. Effect of Hepatic Impairment on the Pharmacokinetics and Pharmacodynamics of SHR4640, a Selective Human Urate Transporter 1 Inhibitor. J Clin Pharmacol 2024. [PMID: 39141421 DOI: 10.1002/jcph.6113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024]
Abstract
This parallel-group, open-label Phase I study evaluated the effect of mild to moderate hepatic impairment on pharmacokinetics (PK), pharmacodynamics (PD), and safety of a single oral dose of SHR4640. Participants with mild or moderate hepatic impairment were enrolled, with each cohort consisting of eight individuals, alongside eight well-matched controls with normal hepatic function. The participants were administered 10 mg SHR4640, and blood samples were collected for PK evaluation over 72 h. Additionally, serum uric acid (sUA) levels were measured to assess PD changes. Safety was evaluated through adverse events, laboratory tests, vital signs, and electrocardiograms. The Cmax of SHR4640 decreased by 15.0% in the mild hepatic impairment group (geometric least squares means of the ratios [GMR] = 0.850, 90% CI: 0.701-1.03) and by 17.5% in the moderate hepatic impairment group (GMR = 0.825, 90% CI: 0.681-1.00). These reductions were not statistically significant compared to the normal hepatic function group. AUC0-t and AUC0-inf were similar across all groups, indicating that overall exposure to the drug was not clinical significantly affected by hepatic impairment. Apparent clearance and volume of distribution of SHR4640 showed no association with the severity of hepatic impairment as measured by the Child-Pugh score. There were no significant differences in the changes in sUA levels from baseline across different levels of hepatic function. SHR4640 is well tolerated in participants with mild or moderate hepatic impairment. Mild and moderate hepatic impairment did not have a clinically relevant impact on PK, PD, and safety of SHR4640. SHR4640 can be used in patients with mild to moderate hepatic impairment without the need for dose adjustment.
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Affiliation(s)
- Xiaotong Hu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Hongda Lin
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yan Huang
- Xiangya Hospital of Central South University, Changsha, China
| | - Pingsheng Xu
- Xiangya Hospital of Central South University, Changsha, China
| | - Bin Xu
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Haibin Yu
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Meixia Wang
- Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Sheng Feng
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yijing Li
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Kai Shen
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
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Xiao N, Zhang X, Xi Y, Li Z, Wei Y, Shen J, Wang L, Qin D, Xie Z, Li Z. Study on the effects of intestinal flora on gouty arthritis. Front Cell Infect Microbiol 2024; 14:1341953. [PMID: 39176260 PMCID: PMC11339034 DOI: 10.3389/fcimb.2024.1341953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
Gouty arthritis (GA), a metabolic and immunologic disease, primarily affects joints. Dysbiosis of intestinal flora is an important cause of GA. The metabolic disorders of intestinal flora leading to GA and immune disorders might play an important role in patients with hyperuricemia and established GA. However, the exact mechanisms, through which the dysbiosis of intestinal flora causes the development of GA, are not fully understood yet. Moreover, several therapies commonly used to treat GA might alter the intestinal flora, suggesting that modulation of the intestinal flora might help prevent or treat GA. Therefore, a better understanding of the changes in the intestinal flora of GA patients might facilitate the discovery of new diagnostic and therapeutic approaches. The current review article discusses the effects of intestinal flora dysbiosis on the pathogenesis of GA and the cross-regulatory effects between gut flora and drugs for treating GA. This article also highlights the modulatory effects of gut flora by traditional Chinese medicine (TCM) to lower uric acid levels and relieve joint pain as well as provides a summary and outlook, which might help guide future research efforts.
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Affiliation(s)
| | | | | | | | | | | | | | - Dongdong Qin
- Yunnan University of Chinese Medicine, Kunming, China
| | - Zhaohu Xie
- Yunnan University of Chinese Medicine, Kunming, China
| | - Zhaofu Li
- Yunnan University of Chinese Medicine, Kunming, China
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Cai N, Chen M, Feng P, Zheng Q, Zhu X, Yang S, Zhang Z, Wang Y. Relationships between obesity and prevalence of gout in patients with type 2 diabetes mellitus: a cross-sectional population-based study. BMC Endocr Disord 2024; 24:137. [PMID: 39090627 PMCID: PMC11295670 DOI: 10.1186/s12902-024-01672-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the relationships between generalized, abdominal, and visceral fat obesity and the prevalence of gout in patients with type 2 diabetes mellitus (T2DM). METHODS Data were obtained from the electronic medical databases of the National Metabolic Management Center (MMC) of Yuhuan Second People's Hospital and Taizhou Central Hospital (Taizhou University Hospital) between September 2017 and June 2023. Four obesity indicators were analyzed: waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and visceral fat area (VFA). The relationships between these parameters and gout prevalence were analyzed using multivariate logistic regression and restricted cubic spline (RCS) analyses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of the four parameters for gout. RESULTS This cross-sectional study enrolled 10,535 participants (600 cases and 9,935 controls). Obesity was more common in patients with gout, and the obesity indicators were markedly higher in this group. After adjustment for confounders, obesity, as defined by BMI, WC, WHR, and VFA, was found to be associated with greater gout prevalence, with odds ratios (OR) of 1.775, 1.691, 1.858, and 1.578, respectively (P < 0.001). The gout odds ratios increased markedly in relation to the obesity indicator quartiles (P-value for trend < 0.001), and the obesity indicators were positively correlated with gout prevalence, as shown using RCS. The area under the ROC curve values for BMI, WC, WHR, and VFA were 0.629, 0.651, 0.634, and 0.633, respectively. CONCLUSION Obesity-whether general, abdominal, or visceral fat obesity-was positively linked with elevated gout risk. But uncovering the causality behind the relationship requires further prospective study. Obesity indicators (BMI, WC, WHR, and VFA) may have potential value for diagnosing gout in clinical practice.
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Affiliation(s)
- Ningyu Cai
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Mengdie Chen
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Ping Feng
- Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Qidong Zheng
- Department of Internal Medicine, Yuhuan Second People's Hospital, Yuhuan, China
| | - Xianping Zhu
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Suqing Yang
- Customer Service Center, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Zhaobo Zhang
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Yiyun Wang
- Department of Internal Medicine, Yuhuan Second People's Hospital, Yuhuan, China.
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Guo X, Yu Y, Zhang Y, Sun L, Li Y, Song B, Hang L, Baba M, Wasaki Y, Kikumori K, Murayama E. A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled 14-Week Study of Mirogabalin in Chinese Patients with Diabetic Peripheral Neuropathic Pain. Pain Ther 2024; 13:937-952. [PMID: 38896199 PMCID: PMC11255142 DOI: 10.1007/s40122-024-00617-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION There is no approved effective drug for diabetic peripheral neuropathic pain (DPNP) in China. Gabapentinoids including mirogabalin have shown promise, although data in Chinese patients are scarce. METHODS This phase 3, multicenter, randomized, double-blind, placebo-controlled trial investigated the efficacy and safety of mirogabalin for treating DPNP in China. Mirogabalin was administered at 5 mg twice daily for the first week and uptitrated to 15 mg twice daily for a total duration of 14 weeks. The primary efficacy endpoint was the change from baseline in weekly average daily pain score (ADPS) at week 14; secondary endpoints included the ADPS responder rate, Short-Form McGill Pain Questionnaire visual analogue scale score, patient global impression of change (PGIC), average daily sleep interference score (ADSIS), EuroQol 5-dimensions 5-levels (EQ-5D-5L), and incidence of treatment-emergent adverse events (TEAEs). RESULTS Of 393 patients (mirogabalin, n = 196; placebo n = 197), the mean age was 58.2 years (mirogabalin, 58.7 years; placebo, 57.7 years) and 54.2% were male (mirogabalin, 56.1%; placebo, 52.3%). Mirogabalin elicited a greater change from baseline in the weekly ADPS vs. placebo at week 14: least-squares mean difference (95% confidence interval) vs. placebo - 0.39 (- 0.74, - 0.04), p = 0.0301. PGIC, ADSIS, and EQ-5D-5L data reflected significantly better improvements for patients receiving mirogabalin vs. placebo. The incidence of TEAEs was 75.0% and 75.1% in the mirogabalin and placebo groups, respectively. Most TEAEs were mild or moderate, and the incidence of TEAEs leading to treatment discontinuation was 2.6% in the mirogabalin group and 1.5% in the placebo group. CONCLUSIONS Although the effect size of mirogabalin was reduced due to the placebo effect, mirogabalin is a safe and effective treatment option for Chinese patients with DPNP. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT04094662.
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Affiliation(s)
- Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Yang Yu
- Department of Endocrinology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yongbo Zhang
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China
| | - Li Sun
- Siping Central People's Hospital, No. 89 South Yingbin Street, Tiexie District, Siping, 136000, Jilin Province, China
| | - Yufeng Li
- Beijing Pinggu Hospital, No. 59 Xingping North Road, Pinggu District, Beijing, 101200, China
| | - Bing Song
- The First Affiliated Hospital of Jinzhou Medical University, Guta District, No. 2, 5H Part, Renmin Street, Liaoning Province 121001, Jinzhou City, China
| | - Li Hang
- Daiichi Sankyo (China) Holdings Co., Ltd, Floor 51, Wheelock Square, 1717 Nanjing West Road, Shanghai, 200040, China
| | - Masayuki Baba
- Neurology Center, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori, 030-8553, Japan
| | - Yosuke Wasaki
- Asset Portfolio Management Department, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo, 140-8710, Japan
| | - Kunika Kikumori
- Data Intelligence Department, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo, 140-8710, Japan
| | - Emiko Murayama
- Specialty Medicine Clinical Development Department, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo, 140-8710, Japan
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Li C, Huang Y, Wu C, Qiu Y, Zhang L, Xu J, Zheng J, Zhang X, Li F, Xia D. Astilbin inhibited neutrophil extracellular traps in gouty arthritis through suppression of purinergic P2Y6 receptor. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155754. [PMID: 38820662 DOI: 10.1016/j.phymed.2024.155754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 05/04/2024] [Accepted: 05/15/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Gouty arthritis (GA), a common inflammatory condition triggered by monosodium urate crystal accumulation, often necessitates safer treatment alternatives due to the limitations of current therapies. Astilbin, a flavonoid from Smilax glabra Roxb, has demonstrated potential in traditional Chinese medicine for its anti-inflammatory properties. However, the anti-GA effect and its underlying mechanism have not been fully elucidated. PURPOSE This study aimed to investigate the therapeutic potential of astilbin in GA, focusing on its effects on neutrophil extracellular traps (NETs), as well as the potential molecular target of GA both in vitro and in vivo. STUDY DESIGN Firstly, astilbin inhibited the citrullinated histone H3 (Cit h3) protein levels and reduced the NETs formation in neutrophils stimulated by monosodium urate (MSU). Secondly, we wondered the effect of astilbin on migration of neutrophils and dimethyl-sulfoxide (DMSO)-differentiated HL-60 (dHL-60) cells under the stimulation of MSU. Then, the effect of astilbin on suppressing NETs through purinergic P2Y6 receptor (P2Y6R) and Interlukin-8 (IL-8)/ CXC chemokine receptor 2 (CXCR2) pathway was investigated. Also, the relationship between P2Y6R and IL-8/CXCR2 was explored in dHL-60 cells under stimulation of MSU. Finally, we testified the effect of astilbin on reducing NETs in GA through suppressing P2Y6R and then down-regulating IL-8/CXCR2 pathway. METHODS MSU was used to induce NETs in neutrophils and dHL-60 cells. Real-time formation of NETs and migration of neutrophils were monitored by cell living imaging with or without MSU. Then, the effect of astilbin on NETs formation, P2Y6R and IL-8/CXCR2 pathway were detected by immunofluorescence (IF) and western blotting. P2Y6R knockdown dHL-60 cells were established by small interfering RNA to investigate the association between P2Y6R and IL-8/CXCR2 pathway. Also, plasmid of P2Y6R was used to overexpress P2Y6R in dHL-60 cells, which was employed to explore the role of P2Y6R in astilbin inhibiting NETs. Within the conditions of knockdown and overexpression of P2Y6R, migration and NETs formation were assessed by transmigration assay and IF staining, respectively. In vivo, MSU-induced GA mice model was established to assess the effect of astilbin on inflammation by haematoxylin-eosin and ELISA. Additionally, the effects of astilbin on neutrophils infiltration, NETs, P2Y6R and IL-8/CXCR2 pathway were analyzed by IF, ELISA, immunohistochemistry (IHC) and western blotting. RESULTS Under MSU stimulation, astilbin significantly suppressed the level of Cit h3 and NETs formation including the fluorescent expressions of Cit h3, neutrophils elastase, myeloperoxidase, and intra/extracellular DNA. Also, results showed that MSU caused NETs release in neutrophils as well as a trend towards recruitment of dHL-60 cells to MSU. Astilbin could markedly decrease expressions of P2Y6R and IL-8/CXCR2 pathway which were upregulated by MSU. By silencing P2Y6R, the expression of IL-8/CXCR2 pathway and migration of dHL-60 cells were inhibited, leading to the suppression of NETs. These findings indicated the upstream role of P2Y6R in the IL-8/CXCR2 pathway. Moreover, overexpression of P2Y6R was evidently inhibited by astilbin, causing a downregulation in IL-8/CXCR2 pathway, migration of dHL-60 cells and NETs formation. These results emphasized that astilbin inhibited the IL-8/CXCR2 pathway primarily through P2Y6R. In vivo, astilbin administration led to marked reductions in ankle swelling, inflammatory infiltration as well as neutrophils infiltration. Expressions of P2Y6R and IL-8/CXCR2 pathway were evidently decreased by astilbin and P2Y6R inhibitor MRS2578 either alone or in combination. Also, astilbin and MRS2578 showed notable effect on reducing MSU-induced NETs formation and IL-8/CXCR2 pathway whether used alone or in combination, parallelly demonstrating that astilbin decreased NETs formation mainly through P2Y6R. CONCLUSION This study revealed that astilbin suppressed NETs formation via downregulating P2Y6R and subsequently the IL-8/CXCR2 pathway, which evidently mitigated GA induced by MSU. It also highlighted the potential of astilbin as a promising natural therapeutic for GA.
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Affiliation(s)
- Cantao Li
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Yan Huang
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Chenxi Wu
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Yu Qiu
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Lu Zhang
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Jiaman Xu
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Junna Zheng
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Xiaoxi Zhang
- Academy of Chinese Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, PR China
| | - Fenfen Li
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China
| | - Daozong Xia
- School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310000, PR China.
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14
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Dong R, Li F, Li B, Chen Q, Huang X, Zhang J, Huang Q, Zhang Z, Cao Y, Yang M, Li J, Li Z, Li C, Liu G, Zhong S, Feng G, Zhang M, Xiao Y, Lin K, Shen Y, Shao H, Shi Y, Yu X, Li X, Yao L, Du X, Xu Y, Kang P, Gao G, Ouyang B, Chen W, Zeng Z, Chen P, Chen C, Yang H. Effects of an Early Intensive Blood Pressure-lowering Strategy Using Remifentanil and Dexmedetomidine in Patients with Spontaneous Intracerebral Hemorrhage: A Multicenter, Prospective, Superiority, Randomized Controlled Trial. Anesthesiology 2024; 141:100-115. [PMID: 38537025 DOI: 10.1097/aln.0000000000004986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
BACKGROUND Although it has been established that elevated blood pressure and its variability worsen outcomes in spontaneous intracerebral hemorrhage, antihypertensives use during the acute phase still lacks robust evidence. A blood pressure-lowering regimen using remifentanil and dexmedetomidine might be a reasonable therapeutic option given their analgesic and antisympathetic effects. The objective of this superiority trial was to validate the efficacy and safety of this blood pressure-lowering strategy that uses remifentanil and dexmedetomidine in patients with acute intracerebral hemorrhage. METHODS In this multicenter, prospective, single-blinded, superiority randomized controlled trial, patients with intracerebral hemorrhage and systolic blood pressure (SBP) 150 mmHg or greater were randomly allocated to the intervention group (a preset protocol with a standard guideline management using remifentanil and dexmedetomidine) or the control group (standard guideline-based management) to receive blood pressure-lowering treatment. The primary outcome was the SBP control rate (less than 140 mmHg) at 1 h posttreatment initiation. Secondary outcomes included blood pressure variability, neurologic function, and clinical outcomes. RESULTS A total of 338 patients were allocated to the intervention (n = 167) or control group (n = 171). The SBP control rate at 1 h posttreatment initiation in the intervention group was higher than that in controls (101 of 161, 62.7% vs. 66 of 166, 39.8%; difference, 23.2%; 95% CI, 12.4 to 34.1%; P < 0.001). Analysis of secondary outcomes indicated that patients in the intervention group could effectively reduce agitation while achieving lighter sedation, but no improvement in clinical outcomes was observed. Regarding safety, the incidence of bradycardia and respiratory depression was higher in the intervention group. CONCLUSIONS Among intracerebral hemorrhage patients with a SBP 150 mmHg or greater, a preset protocol using a remifentanil and dexmedetomidine-based standard guideline management significantly increased the SBP control rate at 1 h posttreatment compared with the standard guideline-based management. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Rui Dong
- Department of Critical Care Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Fen Li
- Department of Critical Care Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Bin Li
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
| | - Qiming Chen
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xianjian Huang
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Jiehua Zhang
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Qibing Huang
- Department of Emergency Neurosurgical Intensive Care Unit, Qilu Hospital of Shandong University and Brain Science Research Institute of Shandong University, Jinan, China
| | - Zeli Zhang
- Department of Emergency Neurosurgical Intensive Care Unit, Qilu Hospital of Shandong University and Brain Science Research Institute of Shandong University, Jinan, China
| | - Yunxing Cao
- Department of Intensive Care Unit, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingbiao Yang
- Neurosurgery Department, The First Affiliated Hospital of Hunan University of Medicine, Huaihua, China
| | - Jianwei Li
- Department of Critical Care Medicine, Zhongshan People's Hospital, Zhongshan, China
| | - Zhanfu Li
- Department of Intensive Care Unit, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Cuiyu Li
- Department of Intensive Care Unit, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Guohua Liu
- Department of Neurosurgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Shu Zhong
- Department of Neurosurgery, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, China
| | - Guang Feng
- Department of Neurosurgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Ming Zhang
- Department of Neurosurgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Yumei Xiao
- Neurological Intensive Medicine Department, Maoming People's Hospital, Maoming, China
| | - Kangyue Lin
- Neurological Intensive Medicine Department, Maoming People's Hospital, Maoming, China
| | - Yunlong Shen
- Department of Neurosurgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Huanzhang Shao
- Department of Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Shi
- Department of Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangyou Yu
- Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaopeng Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Lan Yao
- Department of Emergency Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xinyu Du
- Department of Emergency Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ying Xu
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Pei Kang
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Guoyi Gao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bin Ouyang
- Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenjin Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhenhua Zeng
- Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pingyan Chen
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Hong Yang
- Department of Critical Care Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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Jing Y, Ma L, Zhang Y, Li X, Jiang J, Long J, Ma L. Impact of health literacy, social support, and socioeconomic position on the serum uric acid level in asymptomatic hyperuricaemia patients in China: a structural equation model. BMC Public Health 2024; 24:1606. [PMID: 38886726 PMCID: PMC11181562 DOI: 10.1186/s12889-024-19085-6] [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] [Received: 07/04/2023] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hyperuricaemia (HUA) poses a significant public health challenge on a global scale. It is mostly asymptomatic hyperuricemia (AHU) with unsatisfactory recognition and control rates. The role of health literacy in influencing health outcomes is of utmost importance, and enhancing health literacy is helpful for patients in managing risk factors. Additionally, social support and socioeconomic position (SEP) have been identified as potential factors influencing health. However, the exact relationships between these factors and AHU remain unclear. This study aimed to investigate the status of health literacy among patients with AHU and explore the relationships between health literacy, social support, SEP, and serum uric acid (SUA) levels. METHODS A cross-sectional study was conducted among 349 participants with AHU in Luzhou, China. The research instruments included a sociodemographic characteristics questionnaire, the Health Literacy Scale for Chronic Patients (HLSCP), and the Social Support Scale (SSRS). The construction of the SEP index was achieved through the application of principal component analysis. Univariate and hierarchical regression analyses were used to evaluate the associations between SEP, social support, health literacy, and SUA levels. Furthermore, structural equation modelling (SEM) was utilized to examine these associations. RESULTS (1) Most patients exhibited low health literacy (90.18 ± 15.11), and only 44.4% possessed basic health literacy. (2) SEP was positively correlated with SUA levels (β = 4.086, P < 0.001), and health literacy was negatively related to SUA levels (β = -0.399, P < 0.001). There was no significant relationship between social support and SUA levels (β = 0.051, t = 1.085). (3) Health literacy mediated the association between SEP and SUA levels (β = -0.490, 95% CI: -0.620 to -0.382). SEP had a direct positive effect on SUA levels (β = 0.723) and health literacy (β = 0.696), and the total effect of SEP on SUA levels was 0.233. CONCLUSIONS The findings indicate a low level of health literacy among patients with AHU and suggest that health literacy might play a mediating role in the relationship between SEP and SUA levels. Consequently, future initiatives are recommended to prioritize health literacy and devise appropriate intervention strategies to enhance the self-management capabilities of patients with AHU.
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Affiliation(s)
- Yunfang Jing
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Lilai Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China
| | - Yuanfan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China
| | - Xiaohong Li
- Health Management Center, The Affiliated Hospital, Southwest Medical UniversitySichuan Province, Luzhou, 646000, China
| | - Jun Jiang
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Jie Long
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Ling Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China.
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16
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Chen L, Zhu Y, Huang Y, Shen K, Chen L. The association between Helicobacter pylori infection and the risk for gout in hyperuricemia patients in China - A cross-sectional study. Gut Pathog 2024; 16:24. [PMID: 38678252 PMCID: PMC11056053 DOI: 10.1186/s13099-024-00615-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE Helicobacter pylori (H. pylori) infection has been reported to be associated with multiple metabolic diseases. However, the connection between H. pylori infection and gout has not been explored previously. Our study aimed to investigate the association of gout and H. pylori infection in hyperuricemia population in China. PATIENTS AND METHODS This cross-sectional study was performed among the subjects who underwent health checkup in our health promotion center from January 1, 2020 to December 31, 2021. A total of 53,629 subjects with a mean age of 44.2 years were included in this study. H. pylori infection was defined as a positive [13]C-urea breath test. The effect of H. pylori infection on gout was assessed by multiple logistic regression analysis. RESULTS 720 subjects with gout and 15,077 subjects with asymptomatic hyperuricemia (> 420 µmol/L in male and > 360 µmol/L in female) were enrolled. The prevalence rates of H. pylori infection, hyperuricemia and gout were 26.3%, 29.5%, 1.3%, respectively. The prevalence rate of H. pylori infection was significantly higher in subjects with gout than in those with asymptomatic hyperuricemia (35.0% vs. 27.2%; P<0.001). Multiple logistic regression analysis showed that H. pylori infection was associated with an increased risk of gout independent of serum uric acid level in hyperuricemia population (odds ratio [OR]: 1.320, 95% confidence interval [CI]: 1.124-1.550, P = 0.001). CONCLUSION H. pylori infection is positively associated with higher risk of gout in hyperuricemia population. The causal relationship and potential mechanism between H. pylori infection and gout warrants further investigation.
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Affiliation(s)
- Lin Chen
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou Zhejiang, China
| | - Yue Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou Zhejiang, China
| | - Yilin Huang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou Zhejiang, China
| | - Keqing Shen
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou Zhejiang, China
| | - Liying Chen
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou Zhejiang, China.
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Xiao N, Xie Z, He Z, Xu Y, Zhen S, Wei Y, Zhang X, Shen J, Wang J, Tian Y, Zuo J, Peng J, Li Z. Pathogenesis of gout: Exploring more therapeutic target. Int J Rheum Dis 2024; 27:e15147. [PMID: 38644732 DOI: 10.1111/1756-185x.15147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/23/2024]
Abstract
Gout is a chronic metabolic and immune disease, and its specific pathogenesis is still unclear. When the serum uric acid exceeds its saturation in the blood or tissue fluid, it is converted to monosodium urate crystals, which lead to acute arthritis of varying degrees, urinary stones, or irreversible peripheral joint damage, and in severe cases, impairment of vital organ function. Gout flare is a clinically significant state of acute inflammation in gout. The current treatment is mostly anti-inflammatory analgesics, which have numerous side effects with limited treatment methods. Gout pathogenesis involves many aspects. Therefore, exploring gout pathogenesis from multiple perspectives is conducive to identifying more therapeutic targets and providing safer and more effective alternative treatment options for patients with gout flare. Thus, this article is of great significance for further exploring the pathogenesis of gout. The author summarizes the pathogenesis of gout from four aspects: signaling pathways, inflammatory factors, intestinal flora, and programmed cell death, focusing on exploring more new therapeutic targets.
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Affiliation(s)
- Niqin Xiao
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhaohu Xie
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhiyan He
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Yundong Xu
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Shuyu Zhen
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Xiaoyu Zhang
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Jiayan Shen
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Jian Wang
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Yadan Tian
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Jinlian Zuo
- First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, China
| | - Jiangyun Peng
- The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Zhaofu Li
- Yunnan University of Chinese Medicine, Kunming, China
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Gao Y, Bi L, Li A, Du M, Song M, Jiang G. Associations of Bisphenols Exposure and Hyperuricemia Based on Human Investigation and Animal Experiments. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:5290-5298. [PMID: 38468128 DOI: 10.1021/acs.est.4c00792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Hyperuricemia is characterized by elevated blood uric acid (UA) levels, which can lead to certain diseases. Epidemiological studies have explored the association between environmental contaminant exposure and hyperuricemia. However, few studies have investigated the role of chemical exposure in the development of hyperuricemia. Here, we sought to investigate the effects of bisphenol exposure on the occurrence of hyperuricemia. Fifteen bisphenol chemicals (BPs) were detected in human serum and urine samples collected from an area with a high incidence of hyperuricemia in China. Serum UA levels positively correlated with urinary bisphenol S (BPS), urinary bisphenol P (BPP), and serum bisphenol F (BPF). The effects of these three chemicals on UA levels in mice were explored at various exposure concentrations. An increase in serum UA levels was observed in BPS- and BPP-exposed mice. The results showed that BPS exposure increased serum UA levels by damaging the structure of the kidneys, whereas BPP exposure increased serum UA levels by disturbing purine metabolism in the liver. Moreover, BPF did not induce an increase in serum UA levels owing to the inhibition of guanine conversion to UA. In summary, we provide evidence of the mechanisms whereby exposure to three BPs disturbs UA homeostasis. These findings provide new insights into the risks of exposure to bisphenol chemicals.
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Affiliation(s)
- Yue Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lei Bi
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
| | - Mei Du
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
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Deng J, Lai P, Xie L, Qiu S, Qiu D, Zhang J. Cardiovascular safety of febuxostat versus allopurinol among the Asian patients with or without gout: A systematic review and meta-analysis. Clin Transl Sci 2024; 17:e13757. [PMID: 38488426 PMCID: PMC10941583 DOI: 10.1111/cts.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/18/2024] Open
Abstract
The cardiovascular (CV) safety of febuxostat compared to allopurinol for the treatment of hyperuricemia among Asian patients is uncertain. In this study, we conducted a systematic review and meta-analysis to compare the CV safety profiles of febuxostat with allopurinol in Asian patients with hyperuricemia. A total of 13 studies were included. On the basis of the pooled results of cohort studies, febuxostat users were at a significantly higher risk for acute coronary syndrome (ACS; hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 1.03-1.09, p < 0.01), atrial fibrillation (HR: 1.19, 95% CI: 1.05-1.35, p < 0.01) than allopurinol users, whereas no significant difference between febuxostat and allopurinol existed for urgent coronary revascularization (HR: 1.07, 95% CI: 0.98-1.16, p = 0.13), and stroke (HR: 0.96, 95% CI: 0.91-1.01, p = 0.13). Nevertheless, that difference in results of acute decompensated heart failure (ADHF; HR: 0.73, 95% CI: 0.35-1.53, p = 0.40) and all-cause death (HR = 0.86, 95% CI: 0.49-1.51, p = 0.60) was not significant based on randomized controlled trials. In the Chinese subgroup, febuxostat could increase the risk of ADHF (HR: 1.22, 95% CI: 1.01-1.48, p < 0.05), CV death (HR: 1.25, 95% CI: 1.03-1.50, p < 0.05), and all-cause mortality (HR: 1.07, 95% CI: 1.01-1.14, p < 0.05) compared to allopurinol. In conclusion, the use of febuxostat, compared with allopurinol among Asian patients, was associated with a significantly increased risk of adverse CV events.
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Affiliation(s)
- Jian‐hao Deng
- Pharmacy DepartmentLongyan Second HospitalLongyanChina
| | - Peng‐hui Lai
- Pharmacy DepartmentLongyan Second HospitalLongyanChina
| | - Li‐shan Xie
- Pharmacy DepartmentLongyan Second HospitalLongyanChina
| | - Shu‐sheng Qiu
- Pharmacy DepartmentLongyan Second HospitalLongyanChina
| | - De‐sheng Qiu
- Neurology DepartmentLongyan Second HospitalLongyanChina
| | - Jia‐xing Zhang
- Pharmacy DepartmentGuizhou Provincial People's HospitalGuiyangChina
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Chen Y, Liu J, Cong C, Li Y, Hu Y. Traditional Chinese Medicine is Associated with the Reduction in Endpoint Events in Patients with Gouty Arthritis: Cohort Study and Association Rule Analysis. Int J Gen Med 2024; 17:525-539. [PMID: 38371521 PMCID: PMC10874188 DOI: 10.2147/ijgm.s451097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/06/2024] [Indexed: 02/20/2024] Open
Abstract
Objective This study aimed to evaluate the effect of traditional Chinese medicine (TCM) on endpoint events in patients with gouty arthritis (GA). Methods and Materials A total of 2091 hospitalized GA patients were followed up by telephone, and propensity score matching (PSM) was used to reduce potential bias in the study design. Cox proportional risk model and Kaplan-Meier survival curve were utilized to analyze the impact and time effect of factors on the readmission of GA patients. The differences of laboratory indexes before and after treatment between the low and high exposure groups were compared, and the types and frequencies of medicines in all patients were counted. Association rule analysis was performed to investigate the association between TCM and test indexes or endpoint events. Results After 1:1 PSM, 187 patients were enrolled in the TCM group and 187 patients in the non-TCM group. The incidence of readmission, new tophus, and all-cause death was lower in the TCM group than that in the non-TCM group (P < 0.05). Cox proportional risk regression analysis showed that TCM, NSAIDs and uric acid lowering drug were independent protective factors for GA readmission. The protective effect was enhanced by the prolongation of TCM treatment and the drug combinations. Kaplan-Meier survival curves indicated a significantly lower readmission rate in the high exposure group than in the low exposure group (P < 0.01). Compared with before treatment, NLR, hs-CRP, UA, TC and other laboratory indexes of the low and high exposure groups were improved after treatment (P < 0.01); The improvement of TG and TC in the high exposure group was more significant than the low exposure group (P < 0.01). The analysis of medicines used by all patients identified the top 20 Chinese herbal medicines and the top 2 Chinese patent medicines. The core drugs identified through association rule analysis that can improve test index and reduce the incidence of endpoint events include Yiyiren, Danshen, and HQC, among others. The network diagram of association rule analysis intuitively shows the relationship between core drugs and "improvement of indicators" and "the absence of endpoint events". Conclusion TCM is associated with a reduced incidence of endpoint events in patients with GA.
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Affiliation(s)
- Yiming Chen
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
- Anhui Key Laboratory of Application and Development of Internal medicine of Modern Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
| | - Jian Liu
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
- Anhui Key Laboratory of Application and Development of Internal medicine of Modern Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
| | - Chengzhi Cong
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
| | - Yang Li
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
| | - Yuedi Hu
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230038, People’s Republic of China
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Si X, Huang L, Ding Q, Zhang W, Zhao R, Ai C, An Z, Liu G, Zhang C, Zhong X, Feng Y. Comparison of clinical and economic evaluation between selected generic and original febuxostat tablets in Chinese gout patients with hyperuricemia: A real-world multicenter retrospective study. Medicine (Baltimore) 2024; 103:e37081. [PMID: 38277524 PMCID: PMC10817005 DOI: 10.1097/md.0000000000037081] [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: 11/25/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024] Open
Abstract
Generic febuxostat tablets were listed in China's third-round centralized drug procurement program. However, there are no sufficient data available on the use of febuxostat in a real-world setting. This study aimed to compare the efficacy, safety, and cost of selected generic febuxostat with original febuxostat in primary gout and hyperuricemia. Medical records at 3 tertiary hospitals from January 2014 to February 2022 were retrospectively analyzed. Propensity score matching was used to balance the distribution of baseline characteristics. The proportion of patients achieving target serum uric acid (SUA) levels at 12 weeks, the percent changes from baseline in SUA, adverse drug reactions, and the cost of febuxostat therapy were assessed. A total of 221 patients were recruited and 57 pairs of patients were 1:1 matched in the 2 groups. There was no statistically significant difference in the proportion of patients achieving a target SUA levels below 300 μmol/L, the percent changes of SUA decreased from baseline, and the incidence of adverse drug reactions between the 2 groups (all P > .05). The daily febuxostat cost in the generic group were significantly lower than that in original group (P < .05). Based on the results of this study, the clinical efficacy of selected generic febuxostat is comparable to that of original febuxostat for gout with hyperuricemia. No serious adverse reactions were reported in the 2 groups, and generic febuxostat is more economical than the original febuxostat.
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Affiliation(s)
- Xia Si
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Lin Huang
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Qingming Ding
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Wei Zhang
- Department of Pharmacy, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Rui Zhao
- Department of Pharmacy, Beijing Chao-Yang Hospital, Beijing, China
| | - Chao Ai
- Department of Pharmacy, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Zhuoling An
- Department of Pharmacy, Beijing Chao-Yang Hospital, Beijing, China
| | - Gang Liu
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Chunyan Zhang
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Xue Zhong
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Yufei Feng
- Department of Pharmacy, Peking University People’s Hospital, Beijing, China
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22
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Fang Y, Mei W, Wang C, Ren X, Hu J, Su F, Cao L, Tavengana G, Jiang M, Wu H, Wen Y. Dyslipidemia and hyperuricemia: a cross-sectional study of residents in Wuhu, China. BMC Endocr Disord 2024; 24:2. [PMID: 38166872 PMCID: PMC10759755 DOI: 10.1186/s12902-023-01528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND While dyslipidemia has been recognized as a potential risk factor for hyperuricemia, there is currently a dearth of large-scale data specifically focused on studying the relationship between these two conditions. To address this gap, the present study analyzed a dataset of 298,891 physical examination records to investigate in greater detail the clinical classification and compositional relationship between hyperuricemia and dyslipidemia. METHODS For this investigation, a cross-sectional research design was utilized to analyze physical examination data that was gathered from Yijishan Hospital in Wuhu, China between 2011 and 2016. Logistic regression was employed to examine the association between hyperuricemia and dyslipidemia. Furthermore, the association between hyperuricemia and dyslipidemia was evaluated based on the clinical classifications of dyslipidemia and its components. RESULTS A total of 298,891 participants from China (124,886 [41.8%] females) were included in the study, with an age range of 18 to 90 years (mean [SD]: 47.76 [13.54] years). In multivariate analysis, the odds of hyperuricemia was 1.878 times higher in patients with dyslipidemia compared to those without dyslipidemia (95% confidence interval [CI]: 1.835-1.922). In the clinical classification of dyslipidemia, individuals with hypertriglyceridemia and mixed hyperlipidemia had 1.753 times (95% CI: 1.706-1.802) and 1.925 times (95% CI: 1.870-1.982) higher odds of hyperuricemia, respectively, compared to those without dyslipidemia. Among the components of dyslipidemia, the odds ratios for hyperuricemia in individuals in the fourth quartile compared to those in the first quartile were 3.744 (95% CI: 3.636-3.918) for triglycerides, 1.518 (95% CI: 1.471-1.565) for total cholesterol, and 1.775 (95% CI: 1.718 - 1.833) for non-high-density lipoprotein cholesterol. CONCLUSIONS Dyslipidemia has been independently linked with hyperuricemia. Moreover, the elevation of triglycerides or total cholesterol levels, including conditions such as hypertriglyceridemia and mixed hyperlipidemia, have been observed to have a positive association with the development of hyperuricemia.
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Affiliation(s)
- Yicheng Fang
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Wendan Mei
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Chenxu Wang
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Xia Ren
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Jian Hu
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Fan Su
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Lei Cao
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Grace Tavengana
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Mingfei Jiang
- School of Clinical Medicine, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Huan Wu
- School of Laboratory Medicine, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China
| | - Yufeng Wen
- School of Public Health, Wannan Medical College, 22 West Wenchang Road, 241002, Wuhu, Anhui Province, China.
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Li G, Li J, Tian F, Ren J, Guo Z, Pan S, Liu D, Duan J, Liu Z. A 10-year retrospective cohort of diabetic patients in a large medical institution: Utilizing multiple machine learning models for diabetic kidney disease prediction. Digit Health 2024; 10:20552076241265220. [PMID: 39229465 PMCID: PMC11369867 DOI: 10.1177/20552076241265220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/13/2024] [Indexed: 09/05/2024] Open
Abstract
Objective As the prevalence of diabetes steadily increases, the burden of diabetic kidney disease (DKD) is also intensifying. In response, we have utilized a 10-year diabetes cohort from our medical center to train machine learning-based models for predicting DKD and interpreting relevant factors. Methods Employing a large dataset from 73,101 hospitalized type 2 diabetes patients at The First Affiliated Hospital of Zhengzhou University, we analyzed demographic and medication data. Machine learning models, including XGBoost, CatBoost, LightGBM, Random Forest, AdaBoost, GBDT (gradient boosting decision tree), and SGD (stochastic gradient descent), were trained on these data, focusing on interpretability by SHAP. SHAP explains the output of the models by assigning an importance value to each feature for a particular prediction, enabling a clear understanding of how individual features influence the prediction outcomes. Results The XGBoost model achieved an area under the curve (AUC) of 0.95 and an area under the precision-recall curve (AUPR) of 0.76, while CatBoost recorded an AUC of 0.97 and an AUPR of 0.84. These results underscore the effectiveness of these models in predicting DKD in patients with type 2 diabetes. Conclusions This study provides a comprehensive approach for predicting DKD in patients with type 2 diabetes, employing machine learning techniques. The findings are crucial for the early detection and intervention of DKD, offering a roadmap for future research and healthcare strategies in diabetes management. Additionally, the presence of non-diabetic kidney diseases and diabetes with complications was identified as significant factors in the development of DKD.
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Affiliation(s)
- Guangpu Li
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Jia Li
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Fei Tian
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingjing Ren
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Zuishuang Guo
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaokang Pan
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongwei Liu
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiayu Duan
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Zhangsuo Liu
- Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
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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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Ding Y, Xu Z, Zhou X, Luo Y, Xie R, Li Y. Association between weight-adjusted-waist index and the risk of hyperuricemia in adults: a population-based investigation. Front Endocrinol (Lausanne) 2023; 14:1236401. [PMID: 37900143 PMCID: PMC10600370 DOI: 10.3389/fendo.2023.1236401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Objective This investigation sought to elucidate the potential correlation between a recently characterized adiposity metric, termed the Weight-Adjusted-Waist Index (WWI) and hyperuricemia. Methods A cross-sectional design was employed in this study, featuring both hyperuricemic and non-hyperuricemic subjects with complete WWI data, sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 2017 to March 2020. WWI was calculated utilizing the formula which involves the division of waist circumference (WC) by the square root of the body weight. In order to determine the relationship between WWI and hyperuricemia, both univariate and multivariate logistic regression models, appropriately weighted, were employed in the analysis. The linearity of relationships was validated using smooth curve fitting. Additionally, subgroup evaluations and interaction assessments were conducted. Results The study sample comprised 7437 subjects, yielding a hyperuricemia prevalence of 18.22%. Stratifying WWI into tertiles, a progressive rise in hyperuricemia prevalence was evident with increasing WWI (Tertile 1: 11.62%, Tertile 2: 17.91%, Tertile 3: 25.13%). The odds ratio (OR) demonstrated that individuals within the highest WWI tertile were significantly more prone to hyperuricemia than those in the lowest tertile (OR = 2.41, 95% CI: 1.88-3.08). Conclusion This study provides evidence that an elevated WWI is correlated with an increased risk of hyperuricemia in the adult population of the United States. These results suggest that WWI may serve as a viable anthropometric indicator for predicting hyperuricemia.
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Affiliation(s)
- Yunyi Ding
- Department of Nephrology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhuohan Xu
- Department of Nephrology, The First Clinical Medical College of Zhejiang Traditional Chinese Medical University, Hangzhou, China
| | - Xue Zhou
- School of Mechanical Engineering, Zhejiang University, Hangzhou, China
| | - Yichen Luo
- School of Mechanical Engineering, Zhejiang University, Hangzhou, China
| | - Ruijie Xie
- Division of Clinical Epidemiology and Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Yayu Li
- Department of Nephrology, Hangzhou TCM Hospital, Hangzhou, China
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Pang L, Xue X, He Y, Wang C, Han L, Li M, Qi H, Li C, Lu J. The Effect of Decrease in Serum Urate for the Risk of Gout Flares During Urate-Lowering Therapy Initiation Among Chinese Male Gout Patients: A Prospective Cohort Study. J Inflamm Res 2023; 16:3937-3947. [PMID: 37706063 PMCID: PMC10497051 DOI: 10.2147/jir.s424820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/01/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose Higher baseline serum urate or higher initial urate-lowering medication dose increased risk of gout flares during urate-lowering therapy (ULT) initiation. The decrease in serum urate may play a crucial role in this process. Therefore, we aim to explore the relationship between decrease in serum urate and the risk of gout flares during ULT initiation. Patients and Methods A 12-week prospective cohort study of Chinese male gout patients was conducted at Shandong Provincial Clinical Research Center for Immune Diseases and Gout in China. Patients were grouped by baseline serum urate (7-7.9 mg/dL, 8-8.9 mg/dL and ≥9 mg/dL). All patients received febuxostat 20 mg daily during weeks 0-4, then escalated to 40mg during weeks 4-12 if serum urate >6mg/dL. The main outcomes were the number of gout flares and the decrease in serum urate. Poisson regression was performed. Results A total of 282 participants were enrolled, of whom 260 completed (84, 87 and 89 in each group) from March 2021 to December 2021. A 44.2% of all participants experienced at least one gout flare. In the multivariate Poisson regression 1, Δ serum urate 0-12 weeks (IRR 1.184, 95% CI, 1.062-1.320; P=0.002), the number of gout flares before treatment 1 year (1.017, 1.010-1.024; P<0.001) and tophus (1.580, 1.023-2.440; P=0.039) were independently associated with the number of gout flares. While in the multivariate Poisson regression 2, baseline serum urate (1.256, 1.050-1.503; P=0.013) and the number of gout flares before treatment 1 year (1.014, 1.007-1.022; P<0.001) were independently associated with the number of gout flares, Δ serum urate 0-12 weeks (1.055, 0.923-1.207; P=0.433) was no longer a risk factor. Conclusion ULT-induced gout flares depend on the degree of decrease in serum urate, which is affected by baseline serum urate. Higher baseline serum urate and greater decrease in serum urate lead to higher risk of gout flares.
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Affiliation(s)
- Lei Pang
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Xiaomei Xue
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Yuwei He
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Can Wang
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Lin Han
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Maichao Li
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Han Qi
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Changgui Li
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
| | - Jie Lu
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People’s Republic of China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, 266003, People’s Republic of China
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Lyu X, Du Y, Liu G, Mai T, Li Y, Zhang Z, Bei C. Prevalence and influencing factors of hyperuricemia in middle-aged and older adults in the Yao minority area of China: a cross-sectional study. Sci Rep 2023; 13:10185. [PMID: 37349536 PMCID: PMC10287663 DOI: 10.1038/s41598-023-37274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023] Open
Abstract
Hyperuricemia (HUA) endangers human health, and its prevalence has increased rapidly in recent decades. The current study investigated HUA's prevalence and influencing factors in Gongcheng, southern China. A cross-sectional investigation was conducted; 2128 participants aged 30-93 years were included from 2018 to 2019. Univariate and multivariate logistic regression models were used to screen HUA variables. A Bayesian network model was constructed using the PC algorithm to evaluate the association between influencing factors and HUA. The prevalence of HUA was 15.6% (23.2% in men, 10.7% in women). After screening the variables using a logistic regression analysis model, fatty liver disease (FLD), dyslipidemia, abdominal obesity, creatinine (CREA), somatotype, bone mass, drinking, and physical activity level at work were included in the Bayesian network model. The model results showed that dyslipidemia, somatotype, CREA, and drinking were directly related to HUA. Bone mass and FLD were indirectly associated with HUA by affecting the somatotype. The prevalence of HUA in Gongcheng was high in China. The prevalence of HUA was related to somatotype, drinking, bone mass, physical activity level at work, and other metabolic diseases. A good diet and moderate exercise are recommended to maintain a healthy somatotype and reduce the prevalence rate of HUA.
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Affiliation(s)
- Xiao Lyu
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China
| | - Yuanxiao Du
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China
| | - Guoyu Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China
| | - Tingyu Mai
- Department of Environmental and Occupational Health, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China
| | - You Li
- Department of Environmental and Occupational Health, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China
| | - Zhiyong Zhang
- Department of Environmental and Occupational Health, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China.
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, School of Public Health, Guilin Medical University, Guilin, China.
| | - Chunhua Bei
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China.
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, School of Public Health, Guilin Medical University, Guilin, China.
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