Risk factors for incident hyperuricemia during mid-adulthood in African American and White men and women enrolled in the ARIC cohort study

BMC Musculoskeletal Disorders

Alan N Baer⁴  Josef Coresh²  Janet W Maynard³  Andrew Law¹  Mara A McAdams-DeMarco¹ 

[1] Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 2024 E. Monument St, Suite B-319, Baltimore, MD, USA;Current affiliation: United States Food and Drug Administration, Baltimore, MD, USA;Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

关键词: Epidemiology;    Urate;    Hyperuricemia;   

Others  :  1129080
DOI  :  10.1186/1471-2474-14-347

 received in 2013-08-08, accepted in 2013-11-25,  发布年份 2013

【 摘 要 】

Background

Increased serum urate levels are associated with poor outcomes including but not limited to gout. It is unclear whether serum urate levels are the sole predictor of incident hyperuricemia or whether demographic and clinical risk factors also predict the development of hyperuricemia. The goal of this study was to identify risk factors for incident hyperuricemia over 9 years in a population-based study, ARIC.

Methods

ARIC recruited individuals from 4 US communities; 8,342 participants who had urate levels <7.0 mg/dL were included in this analysis. Risk factors (including baseline, 3-year, and change in urate level over 3 years) for 9-year incident hyperuricemia (urate level of >7.0 g/dL) were identified using an AIC-based selection approach in a modified Poisson regression model.

Results

The 9-year cumulative incidence of hyperuricemia was 4%; men = 5%; women = 3%; African Americans = 6% and whites = 3%. The adjusted model included 9 predictors for incident hyperuricemia over 9 years: male sex (RR = 1.73 95% CI: 1.36-2.21), African-American race (RR = 1.79 95% CI: 1.37-2.33), smoking (RR = 1.27, 95% CI: 0.97-1.67),

Conclusion

Demographic and clinical risk factors that are routinely collected as part of regular medical care are jointly associated with the development of hyperuricemia.

【 授权许可】

   
2013 McAdams-DeMarco et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Campion EW, Glynn RJ, DeLabry LO: Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am J Med 1987, 82(3):421-426.
• [2]Krishnan E, Pandya BJ, Chung L, Hariri A, Dabbous O: Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study. Am J Epidemiol 2012, 176(2):108-116.
• [3]Liu WC, Hung CC, Chen SC, Yeh SM, Lin MY, Chiu YW, Kuo MC, Chang JM, Hwang SJ, Chen HC: Association of hyperuricemia with renal outcomes, cardiovascular disease, and mortality. Clin J Am Soc Nephrol 2012, 7(4):541-548.
• [4]Tomita M, Mizuno S, Yamanaka H, Hosoda Y, Sakuma K, Matuoka Y, Odaka M, Yamaguchi M, Yosida H, Morisawa H, et al.: Does hyperuricemia affect mortality? A prospective cohort study of Japanese male workers. J Epidemiol 2000, 10(6):403-409.
• [5]Krishnan E, Hariri A, Dabbous O, Pandya BJ: Hyperuricemia and the echocardiographic measures of myocardial dysfunction. Congest Heart Fail 2012, 18(3):138-143.
• [6]Chiou WK, Huang DH, Wang MH, Lee YJ, Lin JD: Significance and association of serum uric acid (UA) levels with components of metabolic syndrome (MS) in the elderly. Arch Gerontol Geriatr 2012, 55(3):724-728.
• [7]Goncalves JP, Oliveira A, Severo M, Santos AC, Lopes C: Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine 2012, 41(3):450-457.
• [8]Lapsia V, Johnson RJ, Dass B, Shimada M, Kambhampati G, Ejaz NI, Arif AA, Ejaz AA: Elevated uric acid increases the risk for acute kidney injury. Am J Med 2012, 125(3):302 e309-317.
• [9]Chuang SY, Chen JH, Yeh WT, Wu CC, Pan WH: Hyperuricemia and increased risk of ischemic heart disease in a large Chinese cohort. Int J Cardiol 2012, 154(3):316-321.
• [10]Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA: Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthrit Care Res 2010, 62(2):170-180.
• [11]Gaffo AL, Jacobs DR Jr, Sijtsma F, Lewis CE, Mikuls TR, Saag KG: Serum urate association with hypertension in young adults: analysis from the Coronary Artery Risk Development in Young Adults cohort. Ann Rheum Dis 2012, 72(28):1321-1327.
• [12]Gaffo AL, Jacobs DR Jr, Lewis CE, Mikuls TR, Saag KG: Association between being African-American, serum urate levels and the risk of developing hyperuricemia: findings from the Coronary Artery Risk Development in Young Adults cohort. Arthrit Res Therapy 2012, 14(1):R4. BioMed Central Full Text
• [13]Hak AE, Choi HK: Menopause, postmenopausal hormone use and serum uric acid levels in US women–the Third National Health and Nutrition Examination Survey. Arthrit Res Therapy 2008, 10(5):R116. BioMed Central Full Text
• [14]Stockl D, Doring A, Thorand B, Heier M, Belcredi P, Meisinger C: Reproductive factors and serum uric acid levels in females from the general population: the KORA F4 study. PLoS One 2012, 7(3):e32668.
• [15]Choi HK, Curhan G: Beer, liquor, and wine consumption and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2004, 51(6):1023-1029.
• [16]Choi HK, Liu S, Curhan G: Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2005, 52(1):283-289.
• [17]Gaffo AL, Roseman JM, Jacobs DR Jr, Lewis CE, Shikany JM, Mikuls TR, Jolly PE, Saag KG: Serum urate and its relationship with alcoholic beverage intake in men and women: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Ann Rheum Dis 2010, 69(11):1965-1970.
• [18]Thompson FE, McNeel TS, Dowling EC, Midthune D, Morrissette M, Zeruto CA: Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005. J Am Diet Assoc 2009, 109(8):1376-1383.
• [19]Misra D, Zhu Y, Zhang Y, Choi HK: The independent impact of congestive heart failure status and diuretic use on serum uric acid among men with a high cardiovascular risk profile: a prospective longitudinal study. Semin Arthritis Rheu 2011, 41(3):471-476.
• [20]Cohen E, Krause I, Fraser A, Goldberg E, Garty M: Hyperuricemia and metabolic syndrome: lessons from a large cohort from Israel. Isr Med Assoc J 2012, 14(11):676-680.
• [21]Lee JM, Kim HC, Cho HM, Oh SM, Choi DP, Suh I: Association between serum uric acid level and metabolic syndrome. J Prev Med Public Health 2012, 45(3):181-187.
• [22]Zhu Y, Pandya BJ, Choi HK: Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med 2012, 125(7):679-687. e671
• [23]Yelken B, Caliskan Y, Gorgulu N, Altun I, Yilmaz A, Yazici H, Oflaz H, Yildiz A: Reduction of uric acid levels with allopurinol treatment improves endothelial function in patients with chronic kidney disease. Clin Nephrol 2012, 77(4):275-282.
• [24]Melendez-Ramirez G, Perez-Mendez O, Lopez-Osorio C, Kuri-Alfaro J, Espinola-Zavaleta N: Effect of the treatment with allopurinol on the endothelial function in patients with hyperuricemia. Endocr Res 2012, 37(1):1-6.
• [25]Kanbay M, Huddam B, Azak A, Solak Y, Kadioglu GK, Kirbas I, Duranay M, Covic A, Johnson RJ: A randomized study of allopurinol on endothelial function and estimated glomular filtration rate in asymptomatic hyperuricemic subjects with normal renal function. Clin J Am Soc Nephrol 2011, 6(8):1887-1894.
• [26]Goicoechea M, de Vinuesa SG, Verdalles U, Ruiz-Caro C, Ampuero J, Rincon A, Arroyo D, Luno J: Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol 2010, 5(8):1388-1393.
• [27]Wei L, Mackenzie IS, Chen Y, Struthers AD, MacDonald TM: Impact of allopurinol use on urate concentration and cardiovascular outcome. Br J Clin Pharmacol 2011, 71(4):600-607.
• [28]Gaffo AL, Saag KG: Drug treatment of hyperuricemia to prevent cardiovascular outcomes: are we there yet? Am J Cardiovasc Drugs 2012, 12(1):1-6.
• [29]Nakaya I, Namikoshi T, Tsuruta Y, Nakata T, Shibagaki Y, Onishi Y, Fukuhara S: Management of asymptomatic hyperuricaemia in patients with chronic kidney disease by Japanese nephrologists: a questionnaire survey. Nephrology (Carlton) 2011, 16(5):518-521.
• [30]The ARIC investigators: The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. Am J Epidemiol 1989, 129(4):687-702.
• [31]Iribarren C, Folsom AR, Eckfeldt JH, McGovern PG, Nieto FJ: Correlates of uric acid and its association with asymptomatic carotid atherosclerosis: the ARIC Study. Atherosclerosis Risk in Communities. Ann Epidemiol 1996, 6(4):331-340.
• [32]Eckfeldt JH, Chambless LE, Shen YL: Short-term, within-person variability in clinical chemistry test results. Experience from the Atherosclerosis Risk in Communities Study. Arch Pathol Lab Med 1994, 118(5):496-500.
• [33]Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al.: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009, 150(9):604-612.
• [34]Zou G: A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004, 159(7):702-706.
• [35]Gaffo AL, Jacobs DR Jr, Lewis CE, Mikuls TR, Saag KG: Association between being African-American, serum urate levels, and the risk of developing hyperuricemia: findings from the coronary artery risk development in young adults (CARDIA) cohort. Arthritis Res Ther 2012, 14(1):R4. BioMed Central Full Text
• [36]Shiraishi H, Une H: The effect of the interaction between obesity and drinking on hyperuricemia in Japanese male office workers. J Epidemiol 2009, 19(1):12-16.
• [37]Liang MH, Fries JF: Asymptomatic hyperuricemia: the case for conservative management. Ann Intern Med 1978, 88(5):666-670.
• [38]Reunanen A, Takkunen H, Knekt P, Aromaa A: Hyperuricemia as a risk factor for cardiovascular mortality. Acta Med Scand Suppl 1982, 668:49-59.
• [39]Zafrir B, Goren Y, Paz H, Wolff R, Salman N, Merhavi D, Lavi I, Lewis BS, Amir O: Risk score model for predicting mortality in advanced heart failure patients followed in a heart failure clinic. Congest Heart Fail 2012, 18(5):254-261.
• [40]Wiener RC, Shankar A: Association between Serum Uric Acid Levels and Sleep Variables: Results from the National Health and Nutrition Survey 2005–2008. Int J Inflam 2012, 2012:363054.
• [41]Kohagura K, Kochi M, Miyagi T, Kinjyo T, Maehara Y, Nagahama K, Sakima A, Iseki K, Ohya Y: An association between uric acid levels and renal arteriolopathy in chronic kidney disease: a biopsy-based study. Hypertens Res 2012, 36(1):43-49.
• [42]Ito S, Naritomi H, Ogihara T, Shimada K, Shimamoto K, Tanaka H, Yoshiike N: Impact of serum uric acid on renal function and cardiovascular events in hypertensive patients treated with losartan. Hypertens Res 2012, 35(8):867-873.
• [43]Takayama S, Kawamoto R, Kusunoki T, Abe M, Onji M: Uric acid is an independent risk factor for carotid atherosclerosis in a Japanese elderly population without metabolic syndrome. Cardiovasc Diabetol 2012, 11:2. BioMed Central Full Text
• [44]Neri L, Rocca Rey LA, Lentine KL, Hinyard LJ, Pinsky B, Xiao H, Dukes J, Schnitzler MA: Joint association of hyperuricemia and reduced GFR on cardiovascular morbidity: a historical cohort study based on laboratory and claims data from a national insurance provider. Am J Kidney Dis 2011, 58(3):398-408.
• [45]Seki S, Tsutsui K, Fujii T, Yamazaki K, Anzawa R, Yoshimura M: Association of uric acid with risk factors for chronic kidney disease and metabolic syndrome in patients with essential hypertension. Clin Exp Hypertens 2010, 32(5):270-277.
• [46]Wen CP, David Cheng TY, Chan HT, Tsai MK, Chung WS, Tsai SP, Wahlqvist ML, Yang YC, Wu SB, Chiang PH, et al.: Is high serum uric acid a risk marker or a target for treatment? Examination of its independent effect in a large cohort with low cardiovascular risk. Am J Kidney Dis 2010, 56(2):273-288.
• [47]Ho WJ, Tsai WP, Yu KH, Tsay PK, Wang CL, Hsu TS, Kuo CT: Association between endothelial dysfunction and hyperuricaemia. Rheumatology (Oxford) 2010, 49(10):1929-1934.
• [48]Hamaguchi S, Furumoto T, Tsuchihashi-Makaya M, Goto K, Goto D, Yokota T, Kinugawa S, Yokoshiki H, Takeshita A, Tsutsui H: Hyperuricemia predicts adverse outcomes in patients with heart failure. Int J Cardiol 2011, 151(2):143-147.
• [49]Shah A, Keenan RT: Gout, hyperuricemia, and the risk of cardiovascular disease: cause and effect? Curr Rheumatol Rep 2010, 12(2):118-124.
• [50]Kuo CF, Yu KH, Luo SF, Ko YS, Wen MS, Lin YS, Hung KC, Chen CC, Lin CM, Hwang JS, et al.: Role of uric acid in the link between arterial stiffness and cardiac hypertrophy: a cross-sectional study. Rheumatology (Oxford) 2010, 49(6):1189-1196.
• [51]Feig DI, Soletsky B, Johnson RJ: Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA 2008, 300(8):924-932.
• [52]Soletsky B, Feig DI: Uric Acid Reduction Rectifies Prehypertension in Obese Adolescents. Hypertension 2012, 60(5):1148-1156.
• [53]Nishida Y, Akaoka I, Nishizawa T: Effect of sex hormones on uric acid metabolism in rats. Experientia 1975, 31(10):1134-1135.
• [54]Numakura K, Satoh S, Tsuchiya N, Saito M, Maita S, Obara T, Tsuruta H, Inoue T, Narita S, Horikawa Y, et al.: Hyperuricemia at 1 year after renal transplantation, its prevalence, associated factors, and graft survival. Transplantation 2012, 94(2):145-151.