The Effect of Body Weight and Alcohol Consumption on Hyperuricemia and Their Population Attributable Fractions: A National Health Survey in China

Abstract

Introduction: The prevalence of hyperuricemia is increasing world widely; the understanding of population attributable faction of modifiable risk factors is important for disease prevention. Given the sparse evidence on how modifiable risk factors influence hyperuricemia in mainland China, we aim to explore the effect of excess weight and alcohol consumption and the population attributable fractions of hyperuricemia based on a national survey in mainland China. Methods: Using data from China National Health Survey which included 31746 Han Chinese aged 20-80 from ten provinces, we estimated the prevalence and modifiable risk factors (overweight/obesity and alcohol consumption)of hyperuricemia. Hyperuricemia was defined as serum uric acid > 417 μmol/L in men and > 340 μmol/L in women. Restricted cubic spline models were used to demonstrate the linear and non-linear association between exposures and hyperuricemia. The adjusted population attributable risk (PAR) was calculated to understand the relative importance of each modifiable risk factor. Results: The prevalence of hyperuricemia was 25.1% in men and 15.9% in women. The population fraction of hyperuricemia cases that could be avoided by weight loss was 20.6% (19.2% to 22.0%) in men and 18.1% (17.1% to 19.0%) in women. The PAR of alcohol consumption was 12.8% (8.5% to 17.1%) in men. Participants from southwest China had the highest hyperuricemia prevalence (47.9% in men and 29.9% in women), but with lower PAR of modifiable risk factors, especially in men (16.7%). Subjects in North China had lower hyperuricemia prevalence but higher PAR of modifiable risk factors. 44.8% male hyperuricemia cases in Inner Mongolia (26.9% of hyperuricemia prevalence) and 37.7% cases in men from Heilongjiang (34.4% of hyperuricemia prevalence) were attributable to overweight/obesity and alcohol consumption. Conclusion: There are significant sex and geographic difference on population attributable risk of hyperuricemia due to modifiable risk factors. More tailored prevention strategies are needed to prevent hyperuricemia through weight loss and the reduction of alcohol consumption.

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

“…The final sample was 31,746, restricted to subjects without missing values of SUA, BMI or %BF, and eGFR ≥ 60 ml/min per 1.73 m 2 [to exclude potential kidney disorders ( 17 )], no self-reported as gout or using diuretic medication. The flowchart of the inclusion and exclusion criteria for the analytical sample was illustrated in our previous work ( 18 ). As SUA varies substantially by sex, we analyzed the data by sex separately.…”

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

“…About 70% of daily SUA excretion occurs via the kidney, and in 5%-25% of humans, impaired renal excretion leads to hyperuricemia (5). Our previous work revealed an around 20% hyperuricemia prevalence among adults in mainland China (6). Hyperuricemia is a necessary precursor to develop gout and is also associated with an increased risk of cardiometabolic morbidities and premature mortality (7,8).…”

Joint Effect of Beer, Spirits Intake, and Excess Adiposity on Hyperuricemia Among Chinese Male Adults: Evidence From the China National Health Survey

“…Our previous work revealed that, in men, the prevalence of overweight/obesity and current alcohol drinking was high, that is, over 40 and 65%, respectively. The proportions of HUA cases that could be attributed to overweight/obesity and alcohol consumption were 20.6 and 12.8%, respectively ( 4 ). It is well known that excess adiposity and alcohol consumption are the most essential modifiable risk factors for cardiometabolic diseases, and previous studies have explored their interaction role toward metabolic health ( 9 , 10 ).…”

“…Our previous work indicated that over 65% of men were obese, whereas 32% were women due to their much less alcohol drinking behaviors as well as lower alcohol intake dose than men ( 4 ). The combined effect of excess adiposity and alcohol consumption, thereby, may be more essential for the male population from the public health prospective.…”

“…The prevalence of HUA in the US population was over 21% based on the data from the US National Health and Nutrition Examination Survey (NHANES) 2007-2008 (3). The data from the China National Health Survey (CNHS) showed that the prevalence of HUA was as high as 25.1% in men and 15.9% in women in mainland China (4).…”