The Prevalence Of Hyperuricemia And Its Risk Factors In The Population Of The Outback Of Shandong Province

BACKGROUND:Uric acid is the body of the purine metabolites finally. Long-term high purine diet could cause elevated blood uric acid. In the past the incidence of hyperuricemia in coastal areas is significantly higher than that in inland areas. With the rapid economic development and improved living standards, people’s lifestyle and eating habits had changed, high-fat and high-protein diet, smoking, alcohol abuse and high load working pressure make significantly the higher incidence of hyperuricemia in inland areas. Long-term elevated blood uric acid levels could cause gout arthritis, gout stones and kidney stones. Many epidemiological studies had confirmed that hyperuricemia was associated with cardiovascular disease, hypertension, chronic kidney disease, metabolicsyndrome and even nervous system diseases. Though there were so many studies about the influencing factors on serum uric acid levels and HUA, the degree of influence of each factor was not unclear. At present, the epidemic study of hyperuricemia about inland areas is less and not comprehensive. So we aim to analyze the serum uric acid level, determine the prevalence and the risk factors of hyperuricemia among residents aged≥20years in outback of Shandong province.METHODS:The cross-sectional survey was conducted among11234subjects (8399male and2835female) selected in a randomized and stratified study from the outback of Shandong province during the period between January and December of2012. We collected their serum samples to determine biochemical indicators including uric acid, glucose, blood lipids, liver function, and renal function. For all the subjects who participated in the survey questionnaire, asking medical history, general health, nutrition and diet, smoking and drinking and the labor intensity of physical activity. At the same time, body height, weight, and blood pressure were examined, and the body mass index (BMI) was calculated. By age, all respondents will be divided into four age groups,20-34,35-49,50-64, over65years (male and female respectively). We compared the level of serum uric acid and the prevalence of hyperuricemia in different age groups (male and female respectively) and compared general metabolic indicators between the normal group and hyperuricemia group (male and female respectively). Multiple linear regression was used to clarify the contributions of different variables on uric acid. The risk factors of hyperuricemia were analyzed by univariate and multivariate logistic regression analysis.RESULTS:The total prevalence of HUA in outback of Shandong province was15.71%(95%CI:15.04%-16.38%),18.89%(95%CI:18.05%-19.72%) in man and6.31%(95%CI:5.42%-7.20%) in women. The prevalence rate of HUA and the blood uric acid level in males whose age over50years old were lower than that less than50years old. After age35, the older was the age, the lower was the blood uric acid level in men; However the tendency in women was contrary. Within each age group, the serum uric acid level in males was high than that in females (P<0.001). The prevalence rate of HUA with obesity or hyper-triglycerides or hypertension was28.9%,30.6%,21.8%respectively. For females, systolic blood pressure, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, blood urea nitrogen, creatinine, gamma-glutamyltransferase and alanine aminotransferase were positively correlated with serum uric acid(P<0.001), however the blood sugar and high-density lipoprotein cholesterol was negatively correlated with serum uric acid(P<0.001), and serum creatinine, blood urea nitrogen and triglycerides had a greater impact on uric acid (Standard β=0.200vs.0.127vs.0.123). For male, diastolic blood pressure, body mass index, total cholesterol, triglycerides, low-density lipoprotein cholesterol, blood urea nitrogen, creatinine, gamma-glutamyltransferase and alanine aminotransferase were positively correlated with serum uric acid(P<0.001), however the blood sugar and high-density lipoprotein cholesterol was negatively correlated with serum uric acid(P<0.001), and serum creatinine, triglycerides, body mass index were more important to serum uric acid (Standard β=0.229vs.0.165vs.0.146). Our results also indicated that drinking, obesity, hyper-triglyceridemia, hypertension, serum creatinine, blood urea nitrogen, alanine aminotransferase and serum gamma-glutamyltransferase were associated with HUA in man. However, hypertension, low-density lipoprotein, serum creatinine, alanine aminotransferase, hyper-triglyceridemia and blood urea nitrogen were related to HUA in women. For the elderly, hypertension, high triglycerides, high serum creatinine were risk factors for the HUA, however, smoking is protective factor, blood sugar, obesity and high density lipoprotein haven’t been found associated with HUA.CONCLUSIONS:The prevalence of hyperuricemia is higher in outback of Shandong province. Hypertension, coronary heart disease, chronic kidney disease, non-alcoholicfattyliver disease and certain neurological diseases are more or less linked with Uric acid. Drinking, obesity, hypertension, abnormal liver and renal functions might increase the risk of HUA. Changing lifestyle, such as decreasing alcohol consumption, adopting proper structure of diet, controlling hypertension and obesity and lowing blood lipids might decrease the risk of HUA.