Demographic, regional and temporal trends of hyperuricemia epidemics in mainland China from 2000 to 2019: a systematic review and meta-analysis

Abstract

Background Hyperuricemia (HUA) is becoming a global public health problem and associated with multiple diseases. Objective We conducted a systematic review to synthesize the pooled prevalence of HUA in mainland China and delineate its demographic, regional, and temporal trends over the past two decades. Methods Systematic literature searches of PubMed, SCOPUS, Web of Science, the China National Knowledge Infrastructure (CNKI), and the Wanfang digital database were conducted to screen studies published from 1 January 2000 to 31 August 2019, reporting the prevalence of HUA in mainland China. The search strings were (‘hyperuricemia’ OR ‘hyperuricaemia’ OR ‘uric acid’) AND (‘prevalence’ OR ‘epidemiology’) AND ‘China’. Article quality was appraised quantitatively from 11 items. Before formal meta-analysis, age-standardized prevalence was transformed. The random-effects model was applied to synthesize the pooled prevalence due to its high heterogeneity. Then we stratified the prevalence estimates by age, gender, area, nationality, and publication year for subgroup analysis. Results Totally 177 eligible studies with a whole population of 2,277,712 were included in the present meta-analysis. The pooled prevalence in mainland China was estimated at 16.4% (95% CI: 15.3%~17.6%). In studies with the onset age at 20 ~ 29 years old, males had a twice times higher HUA prevalence than females (21.5% vs. 8.9%). The prevalence of HUA was 13.7% (11.8%~15.7%) in people aged 15~ years old, 16.5% in 30~ (14.8%~18.4%), 17.9% in 40~ (16.4%~19.5%), 19.4% in 50~ (17.8%~21.0%), 20.5% in 60~ (18.8%~22.3%), and 24.9% in over 70 (22.9%~27.1%). Stratified by regions, southern (25.5%) and southwestern (21.2%) China shared the highest prevalence, and the lowest prevalence was observed in the northwest (12.6%). From 2001 to 2017, the prevalence estimates of HUA steadily climbed from 8.5% to 18.4% with minor fluctuations. Multiple regression revealed that HUA prevalence was positively correlated to the larger sample size, area, advanced onset age, and published year. Conclusions The last two decades witnessed the rapid growth prevalence of HUA in China. Early screening and personalized health education for HUA need to be given enough attention.

Long-Term Drinking Behavior Change Patterns and Its Association With Hyperuricemia in Chinese Adults: Evidence From China Health and Nutrition Survey

“…However, there was no association between the drinking patterns and HUA in the females. The rate of HUA was in sync with the estimations in our previously published meta-analysis that evaluated a whole population of 2,277,712 in China (15.5% vs 16.4%, respectively) [4].…”

“…Hyperuricemia (HUA) is a potentially modi able risk factor for kidney dysfunction, cardiovascular disease (CVD) or death, and affects 21% of the world population [1][2][3]. The burden of HUA has dramatically increased over recent decades: from approximately 8.5% in 2001 to approximately 18.4% in 2017 in China [4]. Asymptomatic HUA is associated with daily routine lifestyle activities, such as regular exercise, smoking status, daily diet structure, or alcohol drinking behaviors [5].…”

Distinct Prognostic Role of Serum Uric Acid Levels for Predicting All-Cause Mortality Among Chinese Adults Aged 45~75 Years With and Without Diabetes

“…Prevalence of hyperuricemia (HUA) is more than 20% of the general population and presents a rapid increase globally ( 1 ). In China, the disease burden of HUA has risen significantly over the recent decades, from approximately 8.5% in 2001 to approximately 18.4% in 2017 ( 2 ). Clinical trials report that elevated serum uric acid (SUA) is a strong predictor of poor outcomes in cardiovascular death, acute ischemic stroke, and all-cause death ( 3 – 6 ).…”

Prevalence and Risk Factors of Hyperuricemia in Guangming District, Shenzhen: An Observational Study from a District Hospital in 2020

“…Regional difference on the prevalence rate of hyperuricemia has been reported. A meta-analysis on the prevalence of hyperuricemia in mainland China from 2000 to 2019 [5] showed the prevalence of hyperuricemia in the southern, southwestern, and northeastern regions were 25.5%, 21.2% and 15.9, respectively. In particular, the prevalence rate in Guangdong has been reported to be as high as 42.2%, which is comparable to the rate determined in this study.…”