Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling

Springer Science and Business Media LLC - Tập 27 Số 6 - Trang 653-658 - 2014
Liu, Hong1, Zhang, Xiao-Min1, Wang, Yan-Li1, Liu, Bi-Cheng1
1Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China.

Tóm tắt

Hyperuricemia is a non-communicable disease that threatens human health, and its prevalence has been increasing in recent decades. However, there have been no national surveys about hyperuricemia performed in China. We aimed to investigate the prevalence of hyperuricemia and its risk factors in Chinese adults. Using data from 36,348 participants aged 18 years and older from the China National Survey of Chronic Kidney Disease (a nationwide cross-sectional survey with a randomized, multistage, stratified sampling strategy), we investigated the prevalence of hyperuricemia. Male subjects with serum uric acid ≥416.0 μmol/l (7.0 mg/dl) and female subjects with ≥357.0 μmol/l (6.0 mg/dl) were diagnosed with hyperuricemia. The prevalence of hyperuricemia was calculated, and the factors associated with hyperuricemia were analyzed using logistic regression. The adjusted prevalence of hyperuricemia among Chinese adults in 2009–2010 was 8.4 % [95 % confidence interval (CI) 8.0–8.8 %], and it was 9.9 % (9.2–10.6 %) in men and 7.0 % (6.5–7.5 %) in women. The prevalence was much higher among urban than rural residents (14.9 vs. 6.6 %, p < 0.01). Areas with high per capita gross domestic product (GDP) levels had higher prevalence of hyperuricemia. In the multivariate regression model, the estimated glomerular filtration rate was inversely associated with hyperuricemia. Alcohol consumption, body mass index and serum triglyceride levels were positively correlated with hyperuricemia. Other factors independently correlated with hyperuricemia were age, sex, education level, area of residence, and economic development. In order to demonstrate the discriminatory power for hyperuricemia of the risk factors all together, we calculated the probabilities by logistic regression analysis, which represented the combined effects of these risk factors. Then, receiver operating characteristic analysis was used to demonstrate the value of the probabilities for hyperuricemia diagnosis. Finally, ROC curve analysis revealed the area under the curve was 0.746 (95 % CI 0.739–0.754), statistically significant for the association with hyperuricemia of these risk factors considered all together (p < 0.001). Hyperuricemia is prevalent in the economically developed areas of China. Our report indicates the feasibility of studying the influence that economic changes have on the prevalence of hyperuricemia.

Tài liệu tham khảo

citation_journal_title=Circ J; citation_title=Uric acid and blood pressure; citation_author=Y Kawano; citation_volume=75; citation_publication_date=2011; citation_pages=2755-2756; citation_doi=10.1253/circj.CJ-11-1222; citation_id=CR1 citation_journal_title=J Cardiol; citation_title=The relationships among hyperuricemia, endothelial dysfunction, and cardiovascular diseases: molecular mechanisms and clinical implications; citation_author=P Puddu, GM Puddu, E Cravero, L Vizioli, A Muscari; citation_volume=59; citation_publication_date=2012; citation_pages=235-242; citation_doi=10.1016/j.jjcc.2012.01.013; citation_id=CR2 citation_journal_title=Diabetol Metab Syndr.; citation_title=High plasma uric acid concentration: causes and consequences; citation_author=EP Oliveira, RC Burini; citation_volume=4; citation_publication_date=2012; citation_pages=12; citation_doi=10.1186/1758-5996-4-12; citation_id=CR3 Sluijs I, Beulens JW, van der A DL, Spijkerman AM, Schulze MB, van der Schouw YT (2013) Plasma uric acid is associated with increased risk of type 2 diabetes independent of diet and metabolic risk factors. J Nutr 143:80–85 citation_journal_title=Ren Fail; citation_title=New insights into uric Acid effects on the progression and prognosis of chronic kidney disease; citation_author=V Filiopoulos, D Hadjiyannakos, D Vlassopoulos; citation_volume=34; citation_publication_date=2012; citation_pages=510-520; citation_doi=10.3109/0886022X.2011.653753; citation_id=CR5 citation_journal_title=Arthritis Rheum; citation_title=Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008; citation_author=Y Zhu, BJ Pandya, HK Choi; citation_volume=63; citation_publication_date=2011; citation_pages=3136-3141; citation_doi=10.1002/art.30520; citation_id=CR6 citation_journal_title=Ann Rheum Dis; citation_title=Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study; citation_author=G Trifirò, P Morabito, L Cavagna; citation_volume=75; citation_publication_date=2013; citation_pages=694-700; citation_doi=10.1136/annrheumdis-2011-201254; citation_id=CR7 citation_journal_title=Hypertens Res.; citation_title=Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan; citation_author=K Naqahama, K Iseki, T Inoue, T Touma, Y Ikemiya, S Takishita; citation_volume=27; citation_publication_date=2004; citation_pages=227-233; citation_doi=10.1291/hypres.27.227; citation_id=CR8 citation_journal_title=Clin Rheumatol; citation_title=Prevalence of hyperuricemia in Bangkok population; citation_author=S Uaratanawong, S Suraamornkul, S Angkeaw, R Uaratanawong; citation_volume=30; citation_publication_date=2011; citation_pages=887-893; citation_doi=10.1007/s10067-011-1699-0; citation_id=CR9 citation_journal_title=Lancet; citation_title=Prevalence of chronic kidney disease in China: a cross-sectional survey; citation_author=L Zhang, F Wang, L Wang; citation_volume=379; citation_publication_date=2012; citation_pages=815-822; citation_doi=10.1016/S0140-6736(12)60033-6; citation_id=CR10 citation_journal_title=JAMA; citation_title=Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey; citation_author=J Fang, MH Alderman; citation_volume=283; citation_publication_date=2000; citation_pages=2404-2410; citation_doi=10.1001/jama.283.18.2404; citation_id=CR11 citation_journal_title=Asia Pac J Clin Nutr.; citation_title=Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults; citation_author=BF Zhou; citation_volume=11; citation_publication_date=2002; citation_pages=S685-S693; citation_doi=10.1046/j.1440-6047.11.s8.9.x; citation_id=CR12 citation_journal_title=Arch Med Res; citation_title=Prevalence of hyperuricemia and its relationship with metabolic syndrome in Thai adults receiving annual health exams; citation_author=V Lohsoonthorn, B Dhanamun, MA Williams; citation_volume=37; citation_publication_date=2006; citation_pages=883-889; citation_doi=10.1016/j.arcmed.2006.03.008; citation_id=CR13 citation_journal_title=Rheumatol Int; citation_title=Hyperuricemia in Saudi Arabia; citation_author=AS Al-Arfaj; citation_volume=20; citation_publication_date=2001; citation_pages=61-64; citation_doi=10.1007/s002960000076; citation_id=CR14 citation_journal_title=J Rheumatol; citation_title=Hyperuricemia and gout in Taiwan: results from the Nutritional and Health Survey in Taiwan (1993–96); citation_author=HY Chang, WH Pan, WT Yeh, KS Tsai; citation_volume=28; citation_publication_date=2001; citation_pages=1640-1646; citation_id=CR15 citation_journal_title=Lancet; citation_title=Ageing populations: the challenges ahead; citation_author=K Christensen, G Doblhammer, R Rau, JW Vaupel; citation_volume=374; citation_publication_date=2009; citation_pages=1196-1208; citation_doi=10.1016/S0140-6736(09)61460-4; citation_id=CR16 citation_journal_title=J Rheumatol; citation_title=Dietary and lifestyle changes associated with high prevalence of hyperuricemia and gout in the Shandong coastal cities of Eastern China; citation_author=Z Miao, C Li, Y Chen; citation_volume=35; citation_publication_date=2008; citation_pages=1859-1864; citation_id=CR17 citation_journal_title=Metab Syndr Relat Disord.; citation_title=Prevalence and determinants of hyperuricemia in middle-aged, urban Chinese men; citation_author=R Villegas, YB Xiang, Q Cai; citation_volume=8; citation_publication_date=2010; citation_pages=263-270; citation_doi=10.1089/met.2009.0084; citation_id=CR18 citation_journal_title=BMC Public Health.; citation_title=Prevalence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces; citation_author=L Qiu, XQ Cheng, J Wu; citation_volume=13; citation_publication_date=2013; citation_pages=664; citation_doi=10.1186/1471-2458-13-664; citation_id=CR19 No authors listed (2003) Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 916: i–viii, 1–149 citation_journal_title=Arch Intern Med; citation_title=Risk factors for end-stage renal disease: 25-year follow-up; citation_author=CY Hsu, C Iribarren, CE McCulloch, J Darbinian, AS Go; citation_volume=169; citation_publication_date=2009; citation_pages=342-350; citation_doi=10.1001/archinternmed.2008.605; citation_id=CR21 citation_journal_title=J Clin Hypertens (Greenwich).; citation_title=Uric acid, hypertension, and chronic kidney disease among Alaska Eskimos: the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study; citation_author=SE Jolly, M Mete, H Wang; citation_volume=14; citation_publication_date=2012; citation_pages=71-77; citation_doi=10.1111/j.1751-7176.2011.00574.x; citation_id=CR22 citation_journal_title=Int J Endocrinol; citation_title=Association between serum uric acid levels and diabetes mellitus; citation_author=P Bandaru, A Shankar; citation_volume=2011; citation_publication_date=2011; citation_pages=604715; citation_doi=10.1155/2011/604715; citation_id=CR23