Prevalence and related factors of hyperuricaemia in Chinese children and adolescents: a pooled analysis of 11 population-based studies

Abstract

Background and aims Hyperuricaemia can lead to gout and is associated with an increased risk of cardiometabolic disease. We aimed to investigate the prevalence of hyperuricaemia and its related factors in Chinese children and adolescents. Methods We pooled data from 11 population-based studies comprising 54,580 participants aged 3–19 years. The sex- and age-standardized prevalence of hyperuricaemia was estimated overall and by sex, age, weight status, geographic region and survey year. Results Serum uric acid (SUA) increased gradually from 3 to 11 years with no significant sex difference, and then increased dramatically during 11–15 years. The estimated overall prevalence of hyperuricaemia was 23.3% (26.6% in boys and 19.8% in girls, p < .001). The prevalence increased with growing age (3.7, 9.8, 15.8, 35.5 and 31.7% among children aged 3–5, 6–8, 9–11, 12–15 and 16–19 years, respectively, p for trend < .001) and with increasing weight status (18.2, 37.6, 50.6 and 64.5% among children with non-overweight, overweight, obesity and extreme obesity, respectively, p for trend < .001). The prevalence was higher in North than in South (24.2 vs . 19.7%, p < .001), and increased markedly from 16.7% during 2009–2015 to 24.8% during 2016–2019. In multivariable regression analyses, sex, age, obesity, region and survey year were independently associated with odds of hyperuricaemia. Conclusions The prevalence of hyperuricaemia in Chinese children and adolescents is unexpectedly high. The findings suggest an urgent need to implement effective interventions to reduce risk of hyperuricaemia in Chinese youths. KEY MESSAGES Question: What is the prevalence of hyperuricaemia in Chinese children and adolescents? Findings: In this large pooled cross-sectional study comprising >50,000 children and adolescents aged 3–19 years, we found that the prevalence of hyperuricaemia was high in overall population and subgroups of sex, age, obesity, region and survey year. Meaning: Our findings indicate that hyperuricaemia is an important health problem in Chinese children and adolescents, and effective intervention strategies are needed to reduce its burden.

Distribution of serum uric acid concentration and its association with lipid profiles: a single-center retrospective study in children aged 3 to 12 years with adenoid and tonsillar hypertrophy

“…SUA was found to increase markedly around puberty, and within the following adolescent years, it likely reached adult concentrations [ 6 ]. Hyperuricemia in adults is defined using an SUA concentration > 7 mg/dL (420 μmol/L) in men and 6 mg/dL (360 μmol/L) in women, irrespective of the presence or absence of symptoms or signs of the deposition of urate crystals [ 1 , 20 ].…”

“…In one cross-sectional survey performed in 2017–2018 in China, hyperuricemia was defined using an SUA concentration > 5.5 mg/dL in Chinese adolescents aged 13–19 years [ 8 ]. In addition, a large pooled cross-sectional study generated an estimated overall prevalence of hyperuricemia of 23.3% (26.6% in boys and 19.8% in girls) in Chinese children and adolescents aged 3–19 years during 2009–2019, using the adult reference range [ 6 ]. Ito et al reported that the prevalence of gout and asymptomatic hyperuricemia was 0.04% among children aged 0–18 years in Japan on the basis of a survey of the 2016–2017 health insurance claims database and a definition of hyperuricemia using an SUA > 7 mg/dL [ 7 ].…”

“…Both the SUA and TC concentrations were found to increase with age. SUA increased gradually between 3 and 11 years of age and then increased markedly at approximately 11–15 years of age until it reached an adult concentration [ 6 ]. The TC concentrations increase from birth, stabilize at approximately 2 years old, and reach a peak prior to puberty [ 26 ].…”

“…Many studies have demonstrated asymptomatic hyperuricemia or a high level of serum UA (SUA) as a risk factor for lifestyle-related diseases and all-cause mortality, demonstrating their close relationships with metabolic syndrome (MetS) and cardiovascular disease [ 4 , 5 ]. The SUAs of some adolescents have been shown to be unexpectedly high, and the related chronic noncommunicable diseases are now developing at a younger age than previously [ 6 – 9 ]. Therefore, the prevention of high SUA concentrations and the minimization of metabolic risk in childhood may be beneficial.…”

Impact of Early Life Factors on Metabolic Phenotypes of Obesity in Preschool Children

“…Serum triglycerides (TG), total cholesterol, LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C), uric acid (UA), and fasting plasma glucose (FPG) were analyzed using the Hitachi 7060C Automatic Biochemistry Analysis System (Hitachi, Tokyo, Japan) according to the protocol ( 15 ). Metabolic risk factors were defined as high TG levels: TG concentration of ≥1.24 mmol/L, low HDL-C levels: HDL-C concentration of ≤1.03 mmol/L, impaired fasting glucose: FPG level of ≥5.6 mmol/L; and high UA levels: UA concentration of >420 μmol/L in boys and >360 μmol/L in girls ( 15 , 20 ). According to children’s BMI (normal weight, overweight/obesity) and metabolic status (healthy without metabolic risk factors, unhealthy with one or more metabolic risk factors), they were classified into four metabolic phenotypes of obesity: MHNW (as the reference), MHO, MUNW and MUO ( 21 ).…”