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Objective@#To understand the prevalence of hyperuricemia in university students and examine associated factors,and to provide evidence for the prevention and treatment of hyperuricemia.@*Methods@#Health examination data of 11 858 students for admission in October 2021 were used to compare the detection rates between groups with different characteristics. Multivariable Logistic regression was performed to identify potential factors associated with hyperuricemia.@*Results@#A total of 3 372 cases of hyperuricemia were found, with a detection rate of 28.4%. The detection rate of male students was significantly higher than that of female students (42.4%,14.6%). The rate increased with higher BMI. Moreover, the detection rate was higher among undergraduates and those with hypertension( χ 2=1 126.2, 180.7, 138.2 ,107.9, P <0.01). Multivariable Logistic regression analysis showed that male sex, younger age, higher BMI, hypertension and higher hemoglobin level were positively associated with hyperuricemia, whereas higher glomerular filtration rate was negatively associated among the students( P <0.01).@*Conclusion@#Greater attention should be given to hyperuricemia in university students, and targeted health education should be strengthened for them, especially undergraduates, boys, overweight and obese students, and those with hypertension or high hemoglobin levels.
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Objective@#To investigate the prevalence and association of hyperuricemia (HUA) and hypertriglyceridemic Waist (HTW) phenotype in children and adolescents aged 6-17 years in Inner Mongolia, providing a basis for the prevention and treatment of hyperuricemia in adolescents in Inner Mongolia.@*Methods@#A total of 2 175 students of primary, junior high, and senior high school students from eight counties (districts) in Inner Mongolia were chosen and received a questionnaire survey, physical examination, and laboratory test by used a multi stage stratified random sampling approach. The association between the HTW phenotype and HUA was analyzed using binary Logistic regression.@*Results@#The prevalence of the HTW phenotype was 2.1%, with boys(2.5%) higher than that of girls(1.6%) ( χ 2=14.50, P<0.05). The average SUA level of the participants was 308.00 (259.00, 371.00) mmol/L, with a statistically significant sex difference(Z=-9.87, P<0.05). The prevalence of HUA was 21.1%. The frequency of HUA in the HTW phenotype(44.4%) was higher than in other phenotypes, followed by enlarged waist (EW) phenotype. After controlling for associated variables, the EW phenotypes (OR=1.76，95%CI=1.26-2.47) and HTW phenotypes (OR=2.25, 95%CI=1.12-4.52) were associated with higher risk for HUA(P<0.05).@*Conclusion@#In Inner Mongolia, the prevalence of HUA in children and adolescents aged 6-17 years is high, and there shows a positive association between the HTW phenotype and hyperuricemia. For the prevention of hyperuricemia, more attention should be paid to children and adolescents with HTW phenotype.
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Objective@#To investigate the prevalence and association of hyperuricemia (HUA) and hypertriglyceridemic Waist (HTW) phenotype in children and adolescents aged 6-17 years in Inner Mongolia, providing a basis for the prevention and treatment of hyperuricemia in adolescents in Inner Mongolia.@*Methods@#A total of 2 175 students of primary, junior high, and senior high school students from eight counties (districts) in Inner Mongolia were chosen and received a questionnaire survey, physical examination, and laboratory test by used a multi stage stratified random sampling approach. The association between the HTW phenotype and HUA was analyzed using binary Logistic regression.@*Results@#The prevalence of the HTW phenotype was 2.1%, with boys(2.5%) higher than that of girls(1.6%) ( χ 2=14.50, P<0.05). The average SUA level of the participants was 308.00 (259.00, 371.00) mmol/L, with a statistically significant sex difference(Z=-9.87, P<0.05). The prevalence of HUA was 21.1%. The frequency of HUA in the HTW phenotype(44.4%) was higher than in other phenotypes, followed by enlarged waist (EW) phenotype. After controlling for associated variables, the EW phenotypes (OR=1.76，95%CI=1.26-2.47) and HTW phenotypes (OR=2.25, 95%CI=1.12-4.52) were associated with higher risk for HUA(P<0.05).@*Conclusion@#In Inner Mongolia, the prevalence of HUA in children and adolescents aged 6-17 years is high, and there shows a positive association between the HTW phenotype and hyperuricemia. For the prevention of hyperuricemia, more attention should be paid to children and adolescents with HTW phenotype.
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Objective To analyze the prevalence and risk factors of hyperuricemia (HUA) in Shenyang City, and to provide evidence for the prevention and treatment of HUA in this region. Methods From January 2013 to December 2020, 98,327 subjects who underwent physical examination in Shengjing Hospital of China Medical University in Shenyang were selected. The detection rate of HUA was calculated, and the risk factors of HUA were analyzed by multivariate logistic regression analysis. Results From 2013 to 2020, the overall prevalence of HUA was 22.48%, 30.75% in males and 9.13% in females. The prevalence rate in the male was significantly higher than that in the female (P<0.05). Except for a slight decrease in 2015 and 2020, the total prevalence rate showed an increasing trend year by year. With the increase of age, the prevalence of HUA in males decreased, while in females, it decreased slightly from 40 to 59 years old and increased significantly after 60 years old. With the increase of BMI (Body Mass Index), the prevalence of HUA also increased, and the difference was statistically significant (P<0.05). Logistic regression analysis showed that male, body mass index, physical examination year, hypertension, hyperlipidemia, hyperglycemia, triglyceride, LDL-C, abnormal liver and renal function were positively correlated with HUA, while age and HDL-C were negatively correlated with HUA. Conclusion HUA occurs mainly in male people among physical examination population in Shenyang. With the increase of BMI, HUA increases.
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Objective To investigate the anti-hyperuricemia effects of Bixie deacidification fang on hyperuricemia mice and its mechanism of renal protein transport. Methods The effects of Bixie deacidification fang were investigated on hyperuricemia mice induced by potassium oxonate. Bixie deacidification fang was administered to hyperuricemia mice daily at doses of 220, 440 and 880 mg/kg for 10 days, and allopurinol (5mg/kg) was given as positive control. Serum and urine levels of uric acid and creatinine were determined by colorimetric method. Simultaneously, protein levels of urate transporter 1 (URAT1) and organic anion transporter 1 (OAT1) in the kidney were analyzed by Western blot. Results Compared with the model group, high-dose of Bixie deacidification fang inhibited xanthine oxidase (XOD) activities in serum (18.12±1.33 u/L) and that in liver (70.15±5.20 u/g protein) (P<0.05), decrease levels of serum uric acid (2.04 ± 0.64mg/L) (P<0.05) and serum creatinine (0.35±0.18µmol/L) and blood urea nitrogen (BUN)(8.83±0.71mmol/L) (P<0.05), ncreased levels of urine uric acid (38.34±8.23mg/L), urine creatinine (34.38±1.98mmol/L), down-regulated of URAT1 and up-regulated of OAT1 protein expressions (P<0.05) in the renal tissue of hyperuricemia mice. Conclusion Bixie deacidification fang recipe may promote the excretion of uric acid in the kidney by up-regulating the expression of OAT1 protein to promote the excretion of uric acid, and down-regulating the expression of URAT1 protein to inhibit the reabsorption of uric acid.
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Although current synthetic anti-gout drugs have significant therapeutic effects in reducing serum uric acid levels, they have serious side effects such as allergic reactions and liver and kidney damage. Natural products with a wide range of uric acid-lowering and high safety have played a critical role in anti-gout drug discovery and development. This paper reviews the natural products with uric acid-lowering or anti-gout pharmacological effects and the investigation on their mechanisms of action, to provide information for drug discovery and development.
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ObjectiveTo explore the pharmacodynamic effects of total flavonoids of Paeonia suffruticosa flower （TFPFs） on rats with hyperuricemia and provide scientific data support for the research and development of therapeutic drugs for hyperuricemia. MethodThe hyperuricemia model was induced by adenine combined with ethambutol in rats. The rats were randomly divided into a blank control group， a model group， two positive control groups （allopurinol at 42 mg·kg-1 and Tongfengshu tablets at 600 mg·kg-1）， and high-， medium-， and low-dose TFPFs groups （260， 130， and 65 mg·kg-1）. The general conditions of rats were observed and recorded， and the body weight was recorded once every 5 days. The 24-hour urine volume， water intake， uric acid （UA）， and urinary protein of rats were determined after the last administration. The kidney index was calculated. The pathological changes in thymus and spleen tissues of rats were observed by hematoxylin-eosin （HE） staining. The serum activities of UA， creatinine （Cr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， and total antioxidant capacity （T-AOC） of rats were determined. The xanthine oxidase （XOD） and adenosine deaminase （ADA） activities in the liver were detected. The content of uric acid transporter 1 （URAT1）， organic anion transporter 1 （OAT1）， and glucose transporter 9 （GLUT9） in the kidney was detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the results in the model group， TFPFs could improve the mental state of rats， increase the body weight（P<0.01）， promote UA excretion（P<0.01）， reduce the content of urinary protein（P<0.05）， relieve renal glomerular atrophy， renal tubular epithelial cell status， and urate crystal deposition in renal tubules， dwindle 24-hour urine volume， water intake， kidney index（P<0.05）， serum levels of UA， Cr， BUN， and MDA（P<0.05，P<0.01）， inhibit the activities of XOD（P<0.05） and ADA（P<0.05，P<0.01）in the liver， diminish the expression of GLUT9 in the renal homogenate（P<0.05）， and increase serum SOD and T-AOC activities as well as OAT1 expression（P<0.01） in the kidney. The pathological changes of thymus and spleen were improved. ConclusionTFPFs possess a protective effect on the kidney of rats with hyperuricemia， which is achieved by promoting uric acid excretion， inhibiting oxidation and the activity of key enzymes in uric acid synthesis， and regulating the expression of uric acid transporters.
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ObjectiveTo explore the pharmacodynamic effects of total flavonoids of Paeonia suffruticosa flower （TFPFs） on rats with hyperuricemia and provide scientific data support for the research and development of therapeutic drugs for hyperuricemia. MethodThe hyperuricemia model was induced by adenine combined with ethambutol in rats. The rats were randomly divided into a blank control group， a model group， two positive control groups （allopurinol at 42 mg·kg-1 and Tongfengshu tablets at 600 mg·kg-1）， and high-， medium-， and low-dose TFPFs groups （260， 130， and 65 mg·kg-1）. The general conditions of rats were observed and recorded， and the body weight was recorded once every 5 days. The 24-hour urine volume， water intake， uric acid （UA）， and urinary protein of rats were determined after the last administration. The kidney index was calculated. The pathological changes in thymus and spleen tissues of rats were observed by hematoxylin-eosin （HE） staining. The serum activities of UA， creatinine （Cr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， and total antioxidant capacity （T-AOC） of rats were determined. The xanthine oxidase （XOD） and adenosine deaminase （ADA） activities in the liver were detected. The content of uric acid transporter 1 （URAT1）， organic anion transporter 1 （OAT1）， and glucose transporter 9 （GLUT9） in the kidney was detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the results in the model group， TFPFs could improve the mental state of rats， increase the body weight（P<0.01）， promote UA excretion（P<0.01）， reduce the content of urinary protein（P<0.05）， relieve renal glomerular atrophy， renal tubular epithelial cell status， and urate crystal deposition in renal tubules， dwindle 24-hour urine volume， water intake， kidney index（P<0.05）， serum levels of UA， Cr， BUN， and MDA（P<0.05，P<0.01）， inhibit the activities of XOD（P<0.05） and ADA（P<0.05，P<0.01）in the liver， diminish the expression of GLUT9 in the renal homogenate（P<0.05）， and increase serum SOD and T-AOC activities as well as OAT1 expression（P<0.01） in the kidney. The pathological changes of thymus and spleen were improved. ConclusionTFPFs possess a protective effect on the kidney of rats with hyperuricemia， which is achieved by promoting uric acid excretion， inhibiting oxidation and the activity of key enzymes in uric acid synthesis， and regulating the expression of uric acid transporters.
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Objective: To observe the changes of serum uric acid levels and clinical characteristic in patients with chronic hepatitis C combined with hyperuricemia after direct antiviral agents (DAA) therapy. Methods: A prospective cohort study was used to investigate the risk of hyperuricemia in patients with chronic hepatitis C who received DAA treatment to obtain sustained virological response. The changes and factors influencing serum uric acid levels after 12 weeks of DAA treatment were observed. Comparisons between groups were performed using χ (2) test or Fisher's exact test, analysis of variance, Student's t test, or the non-parametric Mann-Whitney U test. Serum uric acid (SUA) changes, liver and kidney function indexes before and after treatment were compared by repeated measurement and paired t-test. Uric acid reduction was defined as a decrease in SUA from baseline at 12 weeks after treatment. Rates of change in eGFR, aspartate aminotransferase/platelet ratio, alanine aminotransferase and controlled attenuation parameter were defined from baseline (baseline to 12 weeks after treatment). Binary logistic regression analysis was used to compare the risk factors and factors influencing high and low uric acid level. Results: 161 cases with chronic hepatitis C who received DAA treatment were included, of which 19.3% patients were hyperuricemic. eGFR < 60 ml/(min·1.73 m(2)) and body mass index were independent risk factors for hyperuricemia in patients with chronic hepatitis C (eGFR: OR = 0.123, P = 0.002; body mass index: OR = 1.220, P = 0.002). SUA levels was changed significantly before treatment, at the end of treatment and at 12 weeks after treatment (327.96 vs. 320.76 vs. 314.92, F = 3.272, P = 0.042). At 12 weeks after treatment, SUA, liver stiffness, alanine aminotransferase and control attenuation parameters were all significantly lower than baseline (P < 0.05). The rate of increase in eGFR from baseline and the rate of decrease in controlled attenuation parameter during treatment were the factors influencing SUA reduction (eGFR: OR = 5124, P = 0.000; controlled attenuation index: OR = 0.010, P = 0.039). Conclusion: In chronic hepatitis C, reduced eGFR and body mass index are the risk factors for the development of hyperuricemia and a significant reduction in serum uric acid levels after DAA treatment can eradicate the virus.
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Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Humans , Hyperuricemia/drug therapy , Prospective Studies , Uric AcidABSTRACT
OBJECTIVE To investigat e the effects of water extract （WCS）and ethanol extract （ECS）from the root of Caragana sinica on hyperuricemia （HUA）in mice. METHODS Kunming mice were randomly divided into normal control group ， model group ，allopurinol group （positive control ，5 mg/kg），benzbromarone group （positive control ，7.8 mg/kg），WCS low-dose ， medium-dose and high-dose groups （38，75，150 mg/kg），ECS low-dose ，medium-dose and high-dose groups （50，100，200 mg/kg）， with 10 mice in each group. Except for the normal control group ，the other mice were given potassium oxazinate intraperitoneally and hypoxanthine intragastrically for consecutive 7 d to establish HUA model. On the third day of modeling ，mice in each administration group were given corresponding drugs intragastrically ，and normal control group and model group were given equal volume of normal saline once a day for 5 consecutive days.The body weight of mice were weighted during administration ；one hour after the last administration ，the organ indexes of liver ，kidney and spleen were calculated ；the contents of serum uric acid （SUA）， blood urea nitrogen （BUN）and serum creatinine （SCR）；the activity of xanthine oxidase （XOD）in serum and liver tissue were determined. Relative mRNA and protein expressions of XOD in liver tissue ，relative expre ssions of GLUT9，URAT1 and OAT 1 in renal tissue were all detected ；and the pathological changes of renal tissue were observed. RESULTS There were no significant differences in liver index and spleen index in each group （P＞0.05）. Compared with normal control group ， except for allopurinol group ， there were no significant differences in the body weight and the contents of BUN and SCR in mice of other administration groups （P＞0.05）；the renal index and SUA content of mice in the m odel group and allopurinol group were significantly increased （P＜0.05）；in the model group ，the XOD activity in serum and liver tissue ，the relative mRNA and protein expression of XOD in liver tissue ，the relative expressions of GLUT 9 and URAT 1 protein in renal tissue were significantly increased （P＜0.05），and the relative expression of OAT 1 protein in renal tissue was significantly decreased （P＜ 0.05）. Compared with model group ，renal indexes of mice were decreased significantly in WCS and ECS groups （P＜0.05），and the pathological damage of renal tissue was significantly improved ；SUA content ，XOD activity in serum and liver tissue ，the relative mRNA and protein expression of XOD in liver tissue ，and the relative expression of URAT 1 protein in renal tissue were decreased significantly in administration groups （P＜0.05）. The relative expression of GLUT 9 protein in renal tissue of mice in benzbromarone group and ECS high-dose group decreased significantly （P＜0.05）；relative expression of OAT 1 protein in renal tissue of mice in benzbromarone group ，WCS low-dose and high-dose groups ，ECS low-dose group were increased significantly （P＜0.05）. CONCLUSIONS WCS and ECS can significantly decrease the contents of SUA in HUA model mice ，and improve pathological state of renal tissue ，the mechanism of which may be associated with inhibiting XOD activity and uric acid reabsorption，and down-regulating protein and mRNA expression of XOD.
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Objective:To analyze the differences in gut microbiota between patients with hyperuricemia (HUA) and healthy population for better understanding the correlation between gut microflora and high uric acid.Methods:This study recruited 63 adult volunteers, including 25 HUA patients (HUA group) and 38 healthy people (control group), who underwent physical examination in the PLA Strategic Support Force Characteristic Medical Center in 2021. Their fecal samples were collected and analyzed by 16S rRNA high-throughput full-length gene sequencing to analyze the composition of gut microbiota.Results:The overall composition of gut microbiota was different between HUA group and control group. The α diversity index decreased significantly in HUA group and β diversity analysis showed that there were significant differences between the two groups. HUA group showed increased Bacteroidetes and decreased Firmicutes. LEfSe analysis indicated a unique microbiota structure in HUA group, characterized by significantly decreased short-chain fatty acid (SCFA)-producing bacteria represented by Faecalibacterium prausnitzii and significantly increased Streptococcus salivarius, Bacteroides fragilis, Fusobacterium hwasookii, Flavonifractor plautii, Mycobacterium mucogenicum B and Blautia sp003287895. In addition, functional prediction through PICRUSt2 showed that the metabolism related to gut microbiota SCFA pathway in HUA group was decreased, which was consistent to the unique microbiota structure. Conclusions:Compared with healthy population, patients with hyperuricemia had different composition of gut microbiota and metabolic feature.
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Objective:To investigate the prevalence of hyperuricemia (HUA), patients′ awareness of HUA, and related factors among elderly in community.Methods:The health check-up data of 6 897 residents aged over 65 years in Gumei Community of Shanghai were collected from January 2019 to January 2020. There were 1 156 subject with increased serum uric acid levels (HUA group) and 5 741 with normal uric acid levels (non-HUA group). The differences of clinical indicators between HUA group and non-HUA group were analyzed and the risk factors of HUA was determined by multivariate logistic stepwise regression. A questionnaire survey on the knowledge of HUA and the adoption of relevant health behaviors was conducted among HUA patients.Results:The overall prevalence was 16.8% (1 156/6 897) in this population. The prevalence in males was significantly higher than that in females[26.4%(842/3 195) vs. 8.5%(314/3 702), P<0.001); and the prevalence in females increased with age (χ 2=7.56, P=0.023). Body mass index(BMI), waist circumference(WC), total cholesterol(TC), triglyceride(TG), serum creatinine, alanine aminotransferase(ALT) and albumin/urine creatinine ratio(UACR) in the HUA group were significantly higher than those in the non-HUA group, while estimated glomerular filtration rate(eGFR) and high-density lipoprotein(HDL) were lower than those in the non-HUA group (all P<0.01). The prevalence of hypertension, decreased renal function, overweight or obesity, abdominal obesity, fatty liver and renal cyst in HUA group was significantly higher than that in non-HUA group (all P<0.01). High values of TG, low-density lipoprotein(LDL), WC, hypertension and fatty liver were risk factors for HUA( OR=1.14, 1.20, 1.03, 1.43, 2.19; P<0.01); while female gender, eGFR, HDL and glycosylated hemoglobin A1c(HbA1c) were protective factors for HUA( OR=0.32, 0.94, 0.65, 0.78; P<0.01). The questionnaire survey was conducted among 1 090 HUA patients, and the results showed that 73.2% (798 cases) were aware of the disease after the health check-up results released; only 30.9% (337 cases) knew the diagnostic criteria of HUA, 21.1% (230 cases) knew that HUA needed life-long follow-up care, 56.3% (614 cases), 49.2% (536 cases) and 47.9% (522 cases) thought that HUA should eat less seafood, broth and soya bean products, 17.0%(185 cases) were atcohol drinker and the awareness rates of above questions in patients with gout were higher than those in patients without gout ( P<0.05). Conclusion:The study shows that the prevalence of HUA among the elderly in Gumei community of Shanghai is high, and the HUA related knowledge levels and health behavior performance are not ideal, especially for HUA patients without gout, therefore health education should be strengthened for elderly residents in the community.
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Saliva, like blood, urine, and other body fluids, contains extremely rich substances, among which salivary uric acid has a good correlation with serum uric acid, and could replace serum uric acid to a certain extent. In recent years, it has been found that salivary uric acid has a unique clinical value that serum uric acid does not have, and it is related to the occurrence and development of adolescent hypertension, adolescent body fat accumulation and preeclampsia, etc., so it is speculated that salivary uric acid has a certain application prospect. The aim of this review is to provide an update on the research of salivary uric acid and its future prospect.
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Objective:To investigate the correlation between hyperuricemia and hypertension in hospital employees.Methods:A cohort was constructed from staff participating health checkups at the Xiangya Hospital of Central South University, baseline health examinations and questionnaires were conducted from February 1, 2011, to January 29, 2012; 502 participants were excluded according to the nadir criteria, and 3 525 participants were followed-up from February 1, 2012, to December 31, 2018, according to the results of annual employee checkups. The participants were divided into the normal uric acid (3 232 cases) and hyperuricemia groups (293 cases) according to the baseline examination results. The presence of hyperuricemia was used as an observation index and occurrence of hypertension within 7 years was used as an outcome indicator. Age, sex, body mass index, creatinine, LDL cholesterol, triacylglycerol, HDL cholesterol, fasting glucose, marriage, education, job position, smoking, alcohol consumption, and exercise status were used as confounding factors to construct five Cox regression models and calculate their HR values, adjusted HR values, and 95% CI to analyze the relationship between hyperuricemia and the occurrence of hypertension in the overall population and female and male populations. Results:The follow-up of the study participants was conducted for a period of (6.19±1.25) years, with a total of 21 831 person-years of follow-up. The 7-year cumulative prevalence of hypertension was 16.5% in the total population, 12.5% in the female population, 30.1% in the male population, 14.1% in the normal uric acid group, and 42.0% in the hyperuricemia group. The prevalence density of hypertension was 26.6, 19.6, 53.8, and 22.4 per 1 000 person-years in the total, female, male, and normouricemic groups, respectively. Without adjusting for any confounding variables, the risk of hypertension was higher in the total population, female population, and male population in the hyperuricemia group than in the normal uric acid group [ HR=3.86, 5.69, 1.60, (95% CI: 3.17-4.72, 4.36-7.43, 1.18-2.16)] (all P<0.05); after gradually adjusting for confounders, this correlation was only manifested in the female population [adjusted HR=1.91 (95% CI: 1.08-3.36)] (all P<0.05), and the difference was not statistically significant in the male population ( P>0.05). Conclusion:Among female hospital employees, hyperuricemia is an independent risk factor for the development of hypertension.
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Objective:To investigate the incidence and influential factors of hyperuricemia in older adult patients who live in the sanatorium and to improve the prevention and treatment of hyperuricemia people.Methods:A total of 800 older adult patients living in Wuyunshan Sanatorium between June 2017 and December 2019 were recruited for this study. The prevalence of hyperuricemia was determined as per the diagnostic criteria of hyperuricemia. These patients were divided into control and hyperuricemia groups according to whether they had hyperuricemia. General data, health status, physical examination, and laboratory indices were compared between the two groups. The influential factors of hyperuricemia were analyzed using the logistic regression analysis method.Results:The incidence of hyperuricemia in older adult patients living in the sanatorium was 18% (144/800). There was significant difference in the prevalence of hyperuricemia between male and female older adults [22.17% (104/469) vs. (12.08%) (40/331), χ2 = 13.38, P < 0.001]. The incidence of hyperuricemia was significantly higher in male older adults aged 60-90 years than in female older adults at the same age brackets [18.50% (59/319) vs. 5.48% (12/219), χ2 = 19.20, P < 0.001]. The overall prevalence of hyperuricemia and the prevalences of hyperuricemia in male and female older adults significantly increased with aging ( Z = 30.47, 11.92, 24.81, P < 0.001). There were significant differences in age, sex, alcohol consumption, urinary protein-positive, exercise, the prevalences of hypertriglyceridemia, hypercholesterolemia, and renal insufficiency between the control and hyperuricemia groups ( χ2/ t = 2.36, 19.41, 41.18, 10.11, 50.42, 8.24, 6.43, 8.59, all P < 0.05). Age, alcohol consumption, hypercholesterolemia and renal insufficiency were independent risk factors of hyperuricemia in older adults living in sanatorium ( OR = 2.07, 2.54, 2.31, 2.76, 95% CI = 1.218-3.541, 1.740-3.729, 1.538-3.468, 1.920-3.974). Exercise was a protective factor of hyperuricemia ( OR = 0.49, 95% CI = 0.356-0.694). Conclusion:Older adults living in sanatorium have a high incidence of hyperuricemia. Prevention and treatment of hyperuricemia should be strengthened in older adults who have a high risk for hyperuricemia to reduce the incidence of hyperuricemia.
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Objective@#To investigate the serum uric acid levels among residents living in Balikun County, Xinjiang Uygur Autonomous Region from 2018 to 2021, so as to provide insights into local hyperuricemia control.@*Methods@#The residents at ages of 20 to 69 years undergoing physical examinations in Balikun County Hospital during the period from 2018 to 2021 were enrolled. Their age, gender, and history of medication and disease were collected, and serum uric acid levels were measured. The gender- and age-specific prevalence of hyperuricemia and hypouricemia was descriptively analyzed.@*Results@#A total of 3 097 subjects were enrolled, which included 1 210 males ( 39.07% ) and 1 887 females ( 60.93% ) and had a mean age of ( 46.12±12.84 ) years. The overall mean serum uric acid was ( 260.41±71.99 ) μmol/L, and the mean serum uric acid was ( 298.22±69.57 ) μmol/L in men and ( 236.17±62.44 ) μmol/L in women. The serum uric acid level appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hyperuricemia was 4.26%, with 4.63% prevalence in men and 4.03% in women. The prevalence of hyperuricemia appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hypouricemia was 0.71%, with 0.25% prevalence in men and 1.01% in women; the prevalence of moderate hypouricemia was 11.11%, with 2.56% prevalence in men and 16.59% in women.@*Conclusions@#Low level of serum uric acid and prevalence of hyperuricemia is detected among residents living in Balikun County. Monitoring of serum uric acid is recommended to be intensified among men.
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Objective@#To obtain the prevalence of hyperuricemia among primary and secondary school students in Shandong Province, and to provide data support for the prevention and treatment of hyperuricemia in children and adolescents.@*Methods@#The stratified cluster random sampling method was used to collect the data of 3 609 primary and secondary school students in urban and rural areas in Shandong Province, including the blood uric acid, waist circumference, height, and weight.@*Results@#The average blood uric acid value of primary and secondary school students was (316.17±82.57)μmol/L, and the total detection rate of hyperuricemia was 17.4%. The detection rate of blood uric acid was 18.9% and hyperuricemia[(338.26±90.30)μmol/L] of boys were higher than those of girls[(294.25±67.29)μmol/L,15.9%], and the difference were statistically significant( t/χ 2=16.60, 5.48, P < 0.05). The detection rate of blood uric acid (21.6%) and hyperuricemia [(353.24±78.98)μmol/L] in urban areas was higher than that in rural areas, and higher in coastal areas[(376.80±85.46)μmol/L, 26.6%] than inland; the differences were statistically significant ( t =14.54, 15.27, χ 2=48.15, 132.53, P <0.01). The differences in the blood uric acid value and the detection rate of hyperuricemia between different ages were statistically significant ( t/χ 2=11.79, 18.11, P <0.01). The detection rate of blood uric acid increased with the increase of obesity, waist circumference,blood pressure,blood lipids and blood sugar,and the difference were statistically significant ( χ 2=999.95, 561.08 , 447.57, 196.37, 115.08, P <0.01).@*Conclusion@#The detection rate of hyperuricemia among primary and secondary school students in Shandong Province is relatively high. The hyperuricemia is related to gender, age, BMI, waist circumference, blood pressure,blood lipids and blood sugar. Highrisk groups should have regular physical examinations to actively improve their unhealthy lifestyles and reduce the incidence of hyperuricemia.
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This study aims to evaluate the methodological and reporting quality of diagnosis and treatment guidelines for hyperuricemia as well as the expert consensuses and promote the understanding and application of the diagnosis and treatment guidelines for hyperuricemia. With "hyperuricemia" "guidelines" "consensus" "recommendations" as the key words in titles, the authors searched for the published clinical guidelines on hyperuricemia in Chinese against CNKI, Wanfang, VIP, Medlive and the official website of the industry association. The retrieval time limit was until May 31, 2021. The appraisal of guidelines for research and evaluation Ⅱ(AGREEⅡ) and the reporting items for practice guidelines in health care(RIGHT) were employed to evaluate the methodological quality and reporting quality of 14 guidelines/consensuses included. The average scores of the guidelines/consensuses were 80.85%(48.61%-98.61%) for the domain of scope and purpose, 34.52%(0-69.44%) for the domain of stakeholder involvement, 35.53%(6.25%-92.19%) for the domain of rigor of development, 55.85%(23.61%-86.11%) for the domain of clarity of presentation, 26.19%(0-76.04%) for the domain of applicability, and 21.42%(0-50.00%) for the domain of editorial independence. Nine guidelines/consensuses were of medium overall quality with grade B recommendation, and five guidelines/consensuses were of poor quality with grade C recommendation. The RIGHT classified the fourteen guidelines/consensuses into one of high reporting quality, three of medium reporting quality, and ten of low reporting quality. The results of this study indicate that the standardization and rigor of the methodological quality and the reporting quality of the clinical guidelines/consensuses for hyperuricemia in China remain to be strengthened.
Subject(s)
China , Consensus , Humans , Hyperuricemia/drug therapy , Publications , Reference StandardsABSTRACT
Abstract Background: Most of the few studies that have established reference ranges for serum uric acid (SUA) have not taken into account factors which may interfere with its levels and followed rigorous laboratory quality standards. The aim of this study was to establish reference ranges for SUA and determine the prevalence of hyperuricemia. Method: Cross-sectional study including 15,100 participants (all sample) aged 35 to 74 years from baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicentric cohort of volunteer civil servants from five universities and one research institute located in different regions of Brazil. It was established a reference sample excluding participants with factors that directly influence SUA levels: glomerular filtration rate lower than 60 ml/min, excessive alcohol intake, use of diuretics, aspirin, estrogen or urate-lowering therapy. SUA was measured using the uricase method and following rigorous international quality standards. Reference ranges were defined as values between percentiles 2.5 (P2.5) and 97.5 (P97.5) of SUA distribution in the reference sample, stratified by sex. Hyperuricemia was defined as SUA ≥ 7 mg/100 ml in the all sample. Results: The reference sample was composed of 10,340 individuals (55.3% women, median age 50 years). Reference ranges (P2.5 to P97.5) for SUA were: 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Sex was a major determinant for SUA levels (median [IQR], mg/100 ml: 6.1 [5.3-7.0] for men versus 4.5 [3.9-5.3] for women, p < 0.001). Higher levels of SUA were found in patients with higher BMI. Higher age had (a modest) influence only for women. The prevalence of hyperuricemia for all sample (N = 15,100) was 31.9% (95% confidence interval [CI] 30.8- 33.0%) in men and 4.8% (95% CI 4.3-5.3%) in women. Conclusion: SUA reference ranges were 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Prevalence of hyperuricemia was 31.9% in men and 4.8% in women. Updated SUA reference ranges and prevalence of hyperuricemia are higher nowadays and might be used to guide laboratories and the screening for diseases related to SUA.
ABSTRACT
Abstract Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD.
Resumo A hiperuricemia é comum na doença renal crônica (DRC) e pode estar presente em até 50% dos pacientes que se apresentam para diálise. A hiperuricemia pode ser secundária ao comprometimento da taxa de filtração glomerular (TFG) que ocorre na DRC. No entanto, ela também pode preceder o desenvolvimento da doença renal e mesmo prever uma DRC incidente. Estudos experimentais de modelos hiperuricêmicos descobriram que tanto o ácido úrico solúvel quanto o cristalino podem causar danos renais significativos, caracterizados por isquemia, fibrose tubulointersticial e inflamação. Entretanto, a maioria dos estudos de randomização Mendeliana falhou em demonstrar uma relação causal entre o ácido úrico e a DRC, e os ensaios clínicos têm apresentado resultados variáveis. Aqui sugerimos explicações potenciais para os achados clínicos e genéticos negativos, incluindo o papel do ácido úrico cristalino, do ácido úrico intracelular e da atividade da xantina oxidase na lesão renal mediada por ácido úrico. Propomos ensaios clínicos futuros, bem como um algoritmo para o tratamento de hiperuricemia em pacientes com DRC.