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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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Yu Y, Zheng J, Li J, Li X, Liu Z, Yang R, Hong H, Zhang J. Serum uric acid level is associated with glomerular ischemic lesions in patients with primary membranous nephropathy: an analytical, cross-sectional study. Sci Rep 2024; 14:7457. [PMID: 38548844 PMCID: PMC10978902 DOI: 10.1038/s41598-024-57813-5] [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: 10/19/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
To investigate the relationship between serum uric acid level and glomerular ischemic lesions (GIL) in patients with primary membranous nephropathy (PMN) and identify relevant risk factors. A total of 201 patients with PMN but normal renal function confirmed by renal biopsy executed in the Liaocheng People's Hospital, China, during January 2020-January 2023 were analyzed retrospectively. The enrolled patients were divided into a hyperuricemia group and a normal serum uric acid group (control group) according to their serum uric acid levels. Then, the participants were further divided into a non-GIL group or a GIL group based on the patient's renal biopsy results. The two groups' clinical and pathological data and meaningful indicators for differences were analyzed by binary logistic regression analysis. Additionally, the serum uric acid level prediction value on GIL was investigated using receiver operating characteristic (ROC) curves. Compared with the control group, the hyperuricemia group exhibited high serum uric acid, the prevalence of GIL, serum albumin, the prevalence of hypertension, and low-density lipoprotein cholesterol (LDL) levels (P < 0.05). Compared with the non-GIL group, the GIL group exhibited were older, had enhanced serum uric acid, serum albumin, and an increased prevalence of tubular atrophy/interstitial fibrosis (TA/IF), arteriolosclerosis, and low eGFR levels (P < 0.05). The binary logistic regression analysis revealed that the serum uric acid and the TA/IF are independent risk factors of GIL (P < 0.05). The AUC of ROC of GIL of PMN patients, predicted based on the serum uric acid concentration, was 0.736 (P < 0.05), wherein the threshold = 426.5 μmol/L and the Youden's index = 0.41. Serum uric acid concentration and the TA/IF are independent risk factors of GIL in patients with PMN, and the former exhibits prediction value on GIL in patients with PMN.
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Affiliation(s)
- Yamin Yu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Juan Zheng
- Department of Joint Laboratory for Translational Medicine Research, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Jie Li
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Xiuzhen Li
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Zewei Liu
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Ruiheng Yang
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Hong Hong
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, People's Republic of China
| | - Junjun Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
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Di Gioia G, Crispino SP, Maestrini V, Monosilio S, Squeo MR, Lemme E, Segreti A, Serdoz A, Fiore R, Zampaglione D, Pelliccia A. Prevalence of Hyperuricemia and Associated Cardiovascular Risk Factors in Elite Athletes Practicing Different Sporting Disciplines: A Cross-Sectional Study. J Clin Med 2024; 13:560. [PMID: 38256692 PMCID: PMC10816906 DOI: 10.3390/jcm13020560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/29/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
Uricemia has been identified as an independent risk factor for cardiovascular disease. In the general population, hyperuricemia is associated with hypertension, endothelial dysfunction, and other cardiovascular risk (CVR) factors. Our aim was to explore the prevalence of hyperuricemia among Olympic athletes, evaluating the influence of sporting discipline and its correlation with CVR factors. We enrolled 1173 Olympic athletes classified into four disciplines: power, skill, endurance, and mixed. Clinical, anthropometric data, and complete blood test results were collected. Hyperuricemia was present in 4.4% of athletes, 0.3% were hypertensive, 11.7% had high-normal blood pressure values, 0.2% were diabetic, 1.2%. glucose intolerance, 8.2% active smokers, and 3% were obese. Males had a higher prevalence of hyperuricemia (5.3%) than females (3.4%) with no significant differences between different sporting disciplines (male, p = 0.412; female p = 0.561). Males with fat mass >22% presented higher uricemia (5.8 ± 1 vs. 5.3 ± 1 mg/dL, p = 0.010) like hypertensive athletes (6.5 ± 0.3 vs. 5.3 ± 1 mg/dL, p = 0.031), those with high-normal blood pressure (5.13 ± 1 vs. 4.76 ± 1.1 mg/dL, p = 0.0004) and those with glucose intolerance (6 ± 0.8 vs. 5.3 ± 1 mg/dL, p = 0.066). The study provides a comprehensive evaluation of hyperuricemia among Olympic athletes, revealing a modest prevalence, lower than in the general population. However, aggregation of multiple CVR factors could synergistically elevate the risk profile, even in a population assumed to be at low risk. Therefore, uric acid levels should be monitored as part of the CVR assessment in athletes.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
| | - Viviana Maestrini
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Sara Monosilio
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Erika Lemme
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Andrea Serdoz
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Roberto Fiore
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Domenico Zampaglione
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
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Acevedo-Fernández M, Porchia LM, Elguezabal-Rodelo RG, López-Bayghen E, Gonzalez-Mejia ME. Concurrence of hyperinsulinemia and hyperuricemia significantly augmented all-cause mortality. Nutr Metab Cardiovasc Dis 2023; 33:1725-1732. [PMID: 37407310 DOI: 10.1016/j.numecd.2023.05.023] [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: 02/24/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND AND AIMS Hyperinsulinemia and hyperuricemia are known to increase the risk of mortality due to certain complications, such as Type 2 Diabetes and cardiovascular disease. However, despite their common comorbidities, their combined effect has not been evaluated. The study's aim was to evaluate the combine effect of hyperinsulinemia and hyperuricemia on all-cause mortality. METHODS AND RESULTS NHANES datasets (cycles 2003-2018) were examined. Differences between groups were evaluated using Rao-Scott Chi-square and General Linear Model for categorical and continuous data, respectively. Hazard Ratios (HR) were calculated using Cox regression with 95% confidence intervals (95%CI). There was significant difference (p < 0.05) in the mortality rate between the control group (2.3 ± 0.2%), the hyperinsulinemia only group (3.1 ± 0.3%), the hyperuricemia only group (4.0 ± 0.8%), and both conditions (5.1 ± 0.8%). Individually, when compared to the control group, there was a significant increase in mortality risk for hyperinsulinemia (HR: 1.50, 95%CI: 1.12-2.01, p = 0.007) and hyperuricemia (HR: 1.80, 95%CI:1.18-2.75, p = 0.006). However, when both conditions were present, there appeared an additive effect in the mortality risk (HR: 2.32, 95%CI: 1.66-3.25, p < 0.001). When stratified by BMI class, only normal weight participants presented with a significant risk (HR: 7.00, 95%CI: 2.50-20.30, p < 0.001). Also, when stratified by age, only participants older than 40 years presented a risk (HR: 2.22, 95%CI: 1.56-3.16, p < 0.001). CONCLUSION Alone, hyperuricemia and hyperinsulinemia significantly increased the mortality rate; however, the combined presence of both pathologies was associated with a significantly augmented mortality rate. Normal weight participant or that were >40 years old had a greater risk for mortality.
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Affiliation(s)
- Maximino Acevedo-Fernández
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901, Colonia Volcanes, C.P, 72420, Puebla, Mexico
| | - Leonardo M Porchia
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados Del Instituto Politécnico Nacional, México City, 07360, Mexico
| | - Rebeca Garazi Elguezabal-Rodelo
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901, Colonia Volcanes, C.P, 72420, Puebla, Mexico
| | - Esther López-Bayghen
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados Del Instituto Politécnico Nacional, México City, 07360, Mexico
| | - M Elba Gonzalez-Mejia
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901, Colonia Volcanes, C.P, 72420, Puebla, Mexico.
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