Analysis of the prevalence rate and influencing factors of hyperuricemia among middle-aged and elderly residents in one district / 解放军医学杂志

ABSTRACT

Objective: To investigate the prevalence, harm and risk factors of hyperuricemia (HUA) among middle-aged and elderly residents in Tianning District of Changzhou City, Jiangsu Province. Methods: From January to May 2018, a total of 6110 residents aged over fifty years were randomly selected from two communities in Tianning District of Changzhou City, Jiangsu Province, and then arranged to take part in a questionnaire and physical examination. Their fasting venous blood were extracted for detection of serum uric acid, creatinine, urea nitrogen, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG). The prevalence of HUA in all the subjects and the clinical features of HUA patients were investigated, the factors affecting HUA were analyzed with monofactorial independent-samples t test and multivariate logistic regression analysis, and the relationship of bad habits and comorbidities to HUA was analyzed with monofactorial independent-samples t test. Results: Rejecting the subjects with incomplete data, 5848 subjects were involved in present investigation, among them 993 were HUA patients (17.0%). Compared with those with normal uric acid, the proportion of males [50.5%(501/993) vs. 45.4%(2206/4855), P=0.004] was higher, the average age [(67.9 ±9.4) vs. (66.6 ± 8.7), P<0.0001] was elder, smoking [26.1%(259/993) vs. 22.7%(1104/4855), P=0.023), alcohol drinking [24.4%(242/993) vs. 18.4%(891/4855), P<0.0001], and with hypertension [65.3%(648/993) vs. 53.3%(2587/4855), P<0.0001] and proteinuria [11.1%(110/993) vs. 7.4%(358/4855), P<0.0001] were higher in HUA residents. The LDL-C [(2.89 ± 0.80) vs. (2.95 ± 0.76) mmol/L, P=0.041), HDL-C [(1.09 ± 0.26) mmol/L vs. (1.18 ± 0.28) mmol/L, P<0.0001], and GFR [(68.4 ± 18.7) ml/(min·1.73 m2) vs. (76.3 ± 17.4) ml/(min·1.73 m2), P<0.0001] were significantly lower, while the BMI [(26.3 ± 3.3) kg/m2 vs. (25.2 ± 3.4) kg/m2, P<0.0001] and TG [(2.06 ± 1.65) mmol/L vs. (1.57 ± 1.11) mmol/L, P<0.0001] were significantly higher in residents with HUA than those with normal uric acid. The serum uric acid levels increased gradually with age increasing in 50-60 years, 60-70 years, 70-80 years and ≧80 years elder groups [(296.4 ± 97.0), (300.4 ±91.1), (304.8 ±93.5) and (334.3 ± 110.2) μmol/L, respectively], and the same was in the prevalence of HUA (15.0%, 15.8%, 17.7% and 26.2%, respectively) with statistically significance (P<0.0001). The results of univariate analysis showed that age, male, smoking, alcohol drinking, hypertension, BMI, TG, proteinuria and renal dysfunction were positively correlated with the increase of serum uric acid, while HDL-C were negatively correlated with serum uric acid. The relationship of some comorbidities (overweight, hypertension, diabetes, dyslipidemia and renal dysfunction) and of some bad habits (smoking and alcohol drinking) to HUA was further analyzed, the total number of comorbidities and bad habits was seven. Of the 5848 residents, 415(7.1%), 1215(20.8%), 1775(30.4%), 1507(25.8%), 717(12.3%), 192(3.3%) and 27(0.5%) with zero, one, two, three, four, five and six number comorbidities and bad habits, respectively. With the increase of the number of co-morbidity and bad habits, the levels of serum uric acid increased [(256.6 ± 69.5), (278.8 ± 81.2), (295.9 ± 87.0), (319.3 ± 103.0), (337.8 ± 99.9), (361.0 ± 100.4) and (390.0 ± 106.2) μmol/L, respectively], and the prevalence of HUA (4.6%, 10.3%, 15.7%, 22.2%, 24.6%, 26.0% and 37.0%, respectively) increased too, both with statistically significance (P<0.0001). The effects of renal dysfunction on HUA were further analyzed, the results showed that the incidence of HUA was higher in patients with renal dysfunction than those with normal renal function, no matter whatever combination of risk factors, except for seven residents with renal dysfunction and alcohol drinking, and combined with dyslipidemia and hypertension. The results of multivariate logistic regression analysis showed that age, alcohol drinking, hypertension, overweight, increased TG, and renal dysfunction were the independent risk factors of HUA, while high HDL-C was the protective factor of HUA. Conclusions The prevalence of HUA is 17.0% in the urban residents aged over fifty years in Tanning District of Changzhou City, Jiangsu Province in 2018. Advanced age, alcohol drinking, hypertension, overweight, high serum TG, proteinuria and renal dysfunction are the risk factors for HUA, while high HDL-C is the protective factor of HUA. The serum uric acid and the prevalence of HUA increased significantly as the number of co-morbidity and bad habits increased. Renal dysfunction is important risk factor of HUA.