The Effect of Body Adiposity and Alcohol Consumption on Serum Uric Acid: A Quantile Regression Analysis Based on the China National Health Survey

He, Huijing; Pan, Li; Ren, Xiaolan; Wang, Dingming; Du, Jian; Cui, Ze; Zhao, Jingbo; Wang, Hailin; Wang, Xianghua; Liu, Feng; Pa, Lize; Xia, Peng; Wang, Ye; Yu, Chengdong; Shan, Guangliang

doi:10.3389/fnut.2021.724497

Cited by 5 publications

(7 citation statements)

References 39 publications

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“…In this population-based cohort study with 9.94-year follow-up, the HLS, a composite healthy lifestyle measure of smoking, alcohol consumption, physical activity, diet, and body composition, was inversely associated with the risk of T2DM, and such association was partially Table 3 Adjusted HR for association between baseline SUA and T2DM Model 1: adjusted for age, sex, healthy lifestyle scores (continuous), family history of diabetes, family history of hypertension, prevalence of hypertension, use of antihypertensive medication, and use of lipid-lowing medication Model 2: Model1 + TG (mmol/L), HDL-C (mmol/L), and FPG (mmol/L) # sex-specific quartile of baseline SUA:74-, 312-, 363-, 423-768 µmol/L for male, 74-, 231-, 271-, 317-859 µmol/L for female * Hyperuricemia was defined as SUA ≥ 420 µmol/L for men and SUA ≥ 360 µmol/L for women HR, hazard ratio; SUA, serum uric acid; T2DM, type 2 diabetes mellitus; CI, confidence interval; SD, standard deviation There has been preponderant evidence on the impact of individual lifestyle behaviors. For example, there is evidence that SUA is linked to dietary factors [31,32], and adiposity and alcohol consumption are associated with a higher SUA [33]. Mean change in BMI, but not in WC, was statistically significantly associated with change in SUA over a 1-year follow-up in males [34].…”

Section: Discussionmentioning

confidence: 99%

Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid

He,

Shao,

et al. 2023

Nutr Metab (Lond)

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Background Whether and to what extent serum uric acid (SUA) mediates the association between combined lifestyle behaviors and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to investigate the role of SUA in the relationship between healthy lifestyle scores (HLS) and the incidence of T2DM. Methods This prospective study used data from Zhejiang Metabolic Syndrome cohort. A HLS (5-point scale including healthy waist circumference (WC), never smoking, high physical activity, healthy diet and moderate alcohol intake) was estimated in 13,919 participants, who had SUA at baseline examination in 2009–2014, and were followed-up to 2021–2022 to ascertain incident of T2DM. Cox proportional hazards models and mediation analysis were used to examine the associations between HLS, SUA and T2DM. Results We included 13,919 participants aged 18 years or older without diabetes at baseline (mean age 54.6 [SD 13.9] years, 58.7% female). During a median follow-up of 9.94 years, 645 cases of T2DM occurred. Compared with participants with a poor HLS, those with 4–5 low-risk lifestyle factors showed a 60% reduction in the risk of developing T2DM (adjusted HR, 0.40; 95% CI: 0.28–0.57). Further, the population-attributable risk percent (95% CI) of T2DM for poor adherence to the overall healthy lifestyle (< 4 low-risk factors) was 43.24% (30.02%, 56.46%). The HLS was inversely associated with SUA level. With per score increased in HLS, the beta (95% CI) of SUA (log transformed) was − 0.03 (− 0.03, − 0.02), and the odds ratio (95% CI) of hyperuricemia was 0.82 (0.77, 0.86). The relationship between the HLS and risk of T2DM was mediated by SUA with a 13.06% mediation effect. There was no significant combined effect of HLS and SUA on risk of T2DM (P = 0.097). Conclusions The relationship between overall healthy lifestyle behaviors and T2DM was reconfirmed and the association appeared to be mediated by SUA. The mediation effect of baseline SUA was more pronounced among women who were below 60 years old.

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Section: Discussionmentioning

confidence: 99%

Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid

He,

Shao,

et al. 2023

Nutr Metab (Lond)

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“…A cross-sectional survey from 2013 to 2014 in southwest China among middle-aged adults also showed a higher hyperuricemia prevalence in men than in women (17.3 vs. 10.0%) ( 26 ). The inconsistence among prevalence may be attributed to the population heterogeneity, disparity on covariates distribution, survey time variation of hyperuricemia as its increasing trend, or geographic difference ( 8 , 9 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Life-style risk factors, such as excess adiposity, alcohol consumption, cigarette smoking, and sedentary behavior, were found to be associated with hyperuricemia ( 8 , 9 , 11 , 34 – 38 ). Mendelian randomization studies have demonstrated the causal associations among excess adiposity and alcohol consumption with elevated SUA ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hyperuricemia and the population attributable fraction of modifiable risk factors: Evidence from a general population cohort in China

Guo

et al. 2022

Front. Public Health

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Data on updated hyperuricemia prevalence in Beijing-Tianjin-Hebei (BTH) region in China, which is one of the world-class urban agglomerations, is sparse. Overweight/obesity, alcohol consumption, smoking and sedentary behavior are modifiable risk factors (MRFs) for elevated serum uric acid (SUA), but their population attributable fractions (PAFs) for hyperuricemia is still unclear. Using baseline data from the BTH Physical Examination General Population Cohort, we calculated the crude- and adjusted-prevalence of hyperuricemia based on the 30,158 participants aged 18–80 years. Hyperuricemia was defined as SUA >420 μmol/L in men and >360 μmol/L in women, or currently use of uric acid lowering drugs. Overweight/obesity, alcohol consumption, smoking and sedentary behavior were considered as MRFs and their adjusted PAFs were estimated. The prevalence of hyperuricemia was 19.37%, 27.72% in men and 10.69% in women. The PAFs and 95% confidence intervals for overweight, obesity were 16.25% (14.26–18.25%) and 12.08% (11.40–12.77%) in men, 13.95% (12.31–15.59%) and 6.35% (5.97–6.74%) in women, respectively. Alcohol consumption can explain 4.64% (2.72–6.56%) hyperuricemia cases in men, but with no statistical significance in women. Cigarette smoking contributed to 3.15% (1.09–5.21%) cases in men, but a much lower fraction in women (0.85%, 0.49–1.22%). Compared with sedentary time <2 h per day, the PAFs of 2–4 h, 4–6 h, and more than 6 h per day were 3.14% (1.34–4.93%), 6.72% (4.44–8.99%) and 8.04% (4.95–11.13%) in men, respectively. Sedentary time was not found to be associated with hyperuricemia in women. These findings concluded that hyperuricemia is prevalent in this representative Chinese adult general population with substantial sex difference. Four MRFs (overweight/obesity, alcohol consumption, cigarette smoking and sedentary behavior) accounted for a notable proportion of hyperuricemia cases. The PAF estimations enable the exploration of the expected proportion of hyperuricemia cases that could be prevented if the MRFs were removed, which warrants the public health significance of life-style intervention.

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“…The relationship between adiposity and SUA has been demonstrated by substantial evidence (14)(15)(16). Our previous analysis also indicated that adiposity is related to SUA and hyperuricemia (6,17). Given that body mass index (BMI) is not able to distinguish adiposity between fat-free mass (FFM) and fat mass (FM), the current study uses BMI, fat mass index (FMI), and fatfree mass index (FFMI) as the measurement of body composition.…”

Section: Introductionmentioning

confidence: 92%

The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey

Pan

Liu³

et al. 2022

Front. Endocrinol.

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Reproductive factors have been demonstrated to be associated with hyperuricemia. Body composition is an essential determinant influencing serum uric acid (SUA), but it is largely unknown whether increased SUA was influenced by changed body composition during the menopausal transition. As a secondary analysis of China National Health Survey from 2012-to 2017, this study included 18,997 women aged 20 to 80. Menarche age and menopause information were collected by questionnaire interview. Body mass index (BMI), body fat percentage (BFP), fat mass index (FMI), and fat-free mass index (FFMI) were used as body composition indexes. Hyperuricemia was defined as SUA higher than 360μmol/L (approximately 6 mg/dl). Mediation analysis was performed to explore the direct and indirect effects of menopause on hyperuricemia. A 1:2 age-matched case-control data set (n=6202) was designed to control age-related confounders and was used in multivariable analyses. After adjustment of covariates, postmenopausal women had 14.08 (10.89-17.27) μmol/L higher SUA than their premenopausal counterparts. Overweight/obesity and higher levels of BFP, FMI, and FFMI were all found to be positively associated with hyperuricemia. The mediation analysis showed that the total effect of menopause on hyperuricemia was positive, but was substantially mediated by body composition indexes. Forty-five percent of the total effect can be attributed to the indirect effect mediated by BMI (OR for the natural indirect effect (NIE): 1.09, 95%CI: 1.04-1.13), and over 80% mediated by BFP (OR for NIE: 1.23, 95%CI: 1.16-1.29). However, FFMI did not present the mediated role in the association (OR for NIE: 0.99, 95%CI: 0.96-1.02). The findings revealed that body composition, especially the fat mass indexes, significantly mediated the association between menopause and hyperuricemia. The role of body composition as mediator constitutes clinical and public health significance that should be recognized and considered in healthcare for women experiencing their menopause transition.

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The Effect of Body Adiposity and Alcohol Consumption on Serum Uric Acid: A Quantile Regression Analysis Based on the China National Health Survey

Cited by 5 publications

References 39 publications

Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid

Healthy lifestyle scores associate with incidence of type 2 diabetes mediated by uric acid

Prevalence of hyperuricemia and the population attributable fraction of modifiable risk factors: Evidence from a general population cohort in China

The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey

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