Gender-Specific Differences in Prevalence and Association of Cardio-Metabolic Parameters and Hyperuricemia: A Population-Based Cross-Sectional Study, Nakhon Nayok, Thailand
-
Chawin Suwanchatchai
,
Kitsarawut Khuancharee
,
Chantra Tanunyutthawongse
,
Sivaporn Wannaiampikul
,
Photsathorn Haetanurak
Abstract
Background: Although the prevalence of HUA is increasing, epidemiologic studies on HUA in the middle-aged and elderly population are limited. The present study aimed to calculate the prevalence and evaluate the sex-related associations between metabolic parameters and hyperuricemia (HUA) among middle-aged and elderly adults.
Methods: This was a population-based cross-sectional study from 2018 to 2019 in rural areas of Nakhon Nayok Province, Thailand. We enrolled 780 subjects aged 40 yr and over for health check-ups and examination surveys. The age-standardized prevalence of HUA was estimated by the direct method. A multiple logistic regression was performed to identify the potential risk factors associated with HUA.
Results: The prevalence of HUA were 30.9% (42% in males vs. 20% in females). Elderly adults were associated with a 35% increase in the risk of HUA. Obesity was found to be strongly associated with an increased prevalence of HUA in both sexes. Hypertriglyceridemia (51% increase in males vs. 23% increase in females), and high fasting glucose (90% increase in males vs. 49% increase in females) were also associated risk factors for HUA in both sexes. However, low high-density lipoprotein was only associated with a 67% increase in the risk of HUA in females.
Conclusion: The age-standardized prevalence of HUA among females is relatively lower than in males. This study also revealed that obesity is strongly associated with HUA in both sexes.
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7. Hakoda M (2012). Recent trends in hyperu-ricemia and gout in Japan. Japan Med As-soc J, 55:319-23.
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9. Higa S, Yoshida M, Shima D, et al (2019). A Retrospective, Cross-Sectional Study on the Prevalence of Hyperuricemia Using a Japanese Healthcare Database. Arch Rheumatol, 35:41-51.
10. Conen D, Wietlisbach V, Bovet P, et al (2004). Prevalence of hyperuricemia and relation of serum uric acid with cardio-vascular risk factors in a developing country. BMC Public Health, 4:9.
11. Billa G, Dargad R, Mehta A (2018). Preva-lence of Hyperuricemia in Indian Sub-jects attending Hyperuricemia Screening Programs-A Retrospective Study. J Assoc Physicians India, 66:43-6.
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14. Lohsoonthorn V, Dhanamun B, Williams MA (2006). Prevalence of hyperuricemia and its relationship with metabolic syn-drome in Thai adults receiving annual health exams. Arch Med Res, 37:883-9.
15. Song P, Wang H, Xia W, et al (2018). Preva-lence and correlates of hyperuricemia in the middle-aged and older adults in China. Sci Rep, 8:4314.
16. Zhang Q, Gong H, Lin C, et al (2020). The prevalence of gout and hyperuricemia in middle-aged and elderly people in Tibet Autonomous Region, China: A preliminary study. Medicine (Baltimore), 99:e18542.
17. Lin C-S, Lee W-L, Hung Y-J, et al (2012). Prevalence of hyperuricemia and its as-sociation with antihypertensive treat-ment in hypertensive patients in Taiwan. Int J Cardiol, 156:41-6.
18. Qiu L, Cheng X-q, Wu J, et al (2013). Preva-lence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public Health, 13:664.
19. Song P, Wang H, Xia W, et al (2019). Gen-der- and Age-Specific Differences in the Association of Hyperuricemia and Hy-pertension: A Cross-Sectional Study. Int J Endocrinol, 2019:7545137.
20. Premgamone A, Ditsatapornjaroen T, Jindawong B, et al (2011). The Preva-lence of Hyperuricemia and Associated Factors in the Rural Community, Khon Kaen Province. Srinagarin Medical Journal, 26:41-7.
21. Sari I, Akar S, Pakoz B, et al (2009). Hyperu-ricemia and its related factors in an ur-ban population, Izmir, Turkey. Rheumatol Int, 29:869-74.
22. Wannaiampikul S, Sangsawangchot P, Ta-nunyutthawongse C (2020). High preva-lence of hyperuricemia and lack of as-sociation with rs2280205 and rs6820230 alleles of the SLC2A9 gene in urban Bangkok, Thailand. Genet Mol Res, 19:GMR18511.
23. Zhang X, Meng Q, Feng J, et al (2018). The prevalence of hyperuricemia and its correlates in Ganzi Tibetan Autono-mous Prefecture, Sichuan Province, Chi-na. Lipids Health Dis, 17:235.
24. Liu R, Han C, Wu D, et al (2015). Preva-lence of Hyperuricemia and Gout in Mainland China from 2000 to 2014: A Systematic Review and Meta-Analysis. Biomed Res Int, 2015:762820.
25. Ni Q, Lu X, Chen C, et al (2019). Risk fac-tors for the development of hyperu-ricemia: A STROBE-compliant cross-sectional and longitudinal study. Medicine (Baltimore), 98:e17597.
26. Techatraisak K, Kongkaew T (2017). The association of hyperuricemia and meta-bolic syndrome in Thai postmenopausal women. Climacteric, 20:552-7.
27. Bujang MA, Sa’at N, Tg Abu Bakar Sidik TMI, et al. (2018). Sample size guidelines for logistic regression from observa-tional studies with large population: em-phasis on the accuracy between statistics and parameters based on real life clini-cal data. Malays J Med Sci, 25:122-130.
28. WHO (2004). Appropriate body-mass index for Asian populations and its implica-tions for policy and intervention strate-gies. Lancet, 363:157-163.
29. Yu Q, Shen H-C, Hu Y-C, et al (2017). Preva-lence and Metabolic Factors of Hyperu-ricemia in an Elderly Agricultural and Fishing Population in Taiwan. Arch Rheumatol, 32:149-57.
30. Yu S, Yang H, Guo X, et al (2016). Preva-lence of hyperuricemia and its corre-lates in rural Northeast Chinese popula-tion: from lifestyle risk factors to meta-bolic comorbidities. Clin Rheumatol, 35:1207-15.
31. Ahmad OB, Boschi Pinto C, Lopez A, et al (2001). Age Standardization of rates: a new WHO standard. (GPE Discussion Paper Series no. 31). Geneva: World Health Organization.
32. Lee MS, Lin SC, Chang HY, et al (2005). High prevalence of hyperuricemia in elderly Taiwanese. Asia Pac J Clin Nutr, 14:285-92.
33. Lyu X, Du Y, Liu G, et al (2023). Prevalence and influencing factors of hyperurice-mia in middle-aged and older adults in the Yao minority area of China: a cross-sectional study. Sci Rep, 13:10185.
34. Zhong L, Liu S, Qiu X, et al (2022). High Prevalence of Hyperuricemia and Asso-ciated Factors among Zhuang Adults: A Cross-Sectional Study Based on the Eth-nic Minority Population Cohort in the Southwestern China. Int J Environ Res Public Health, 19:16040.
35. Bai R, Ying X, Shen J, et al (2022). The vis-ceral and liver fat are significantly asso-ciated with the prevalence of hyperu-ricemia among middle age and elderly people: A cross-sectional study in Chongqing, China. Front Nutr, 9:961792.
36. Xu Y, Dong H, Zhang B, et al (2022). Asso-ciation between dyslipidaemia and the risk of hyperuricaemia: a six-year longi-tudinal cohort study of elderly individu-als in China. Ann Med, 54:2402-2410.
37. Timsans J, Kauppi JE, Kerola AM, et al (2023). Hyperuricaemia: prevalence and association with mortality in an elderly Finnish population. BMJ Open, 13:e072110.
38. Trifirò G, Morabito P, Cavagna L, et al (2013). Epidemiology of gout and hype-ruricemia in Italy during the years 2005-2009: a nationwide population-based study. Ann Rheum Dis, 72:694-700.
39. Han B, Wang N, Chen Y, et al (2020). Prev-alence of hyperuricemia in an Eastern Chinese population: a cross-sectional study. BMJ Open, 10:e035614.
40. Piao W, Zhao L, Yang Y, et al (2022). The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Re-sults from CNHS 2015-2017. Nutrients, 14:4095.
41. Chen-Xu M, Yokose C, Rai SK, et al (2019). Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol, 71:991-999.
42. Wang Q, Wang C, Xue J, et al (2021). Char-acteristics of serum uric acid distribu-tion in occupation, age, gender groups, and its influencing factors in physical examination subjects in Nanjing from 2012 to 2016. Zhonghua Nei Ke Za Zhi, 60:29-34.
43. Yang J, Liu Z, Zhang C, et al (2013). The prevalence of hyperuricemia and its correlates in an inland Chinese adult population, urban and rural Jinan. Rheu-matol Int, 33:1511-7.
44. Corry DB, Eslami P, Yamamoto K, et al (2008). Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens, 26:269-75.
45. Chen L-y, Zhu W-h, Chen Z-w, et al (2007). Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B, 8:593-8.
46. Bedir A, Topbas M, Tanyeri F, et al (2003). Leptin might be a regulator of serum uric acid concentrations in humans. Jpn Heart J, 44:527-36.
47. Matsuura F, Yamashita S, Nakamura T, et al (1998). Effect of visceral fat accumula-tion on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesi-ty. Metabolism, 47:929-33.
48. Battelli MG, Bortolotti M, Polito L, et al (2018). The role of xanthine oxidoreduc-tase and uric acid in metabolic syn-drome. Biochim Biophys Acta Mol Basis Dis, 1864:2557-65.
49. Wei CY, Sun CC, Wei JC, et al (2015). Asso-ciation between Hyperuricemia and Metabolic Syndrome: An Epidemiologi-cal Study of a Labor Force Population in Taiwan. Biomed Res Int, 2015:369179.
2. Stewart DJ, Langlois V, Noone D (2019). Hyperuricemia and Hypertension: Links and Risks. Integr Blood Press Control, 12:43-62.
3. Wang J, Qin T, Chen J, et al (2014). Hype-ruricemia and risk of incident hyperten-sion: a systematic review and meta-analysis of observational studies. PLoS One, 9:e114259.
4. Abeles AM (2015). Hyperuricemia, gout, and cardiovascular disease: an update. Curr Rheumatol Rep, 17:13.
5. Mallat SG, Al Kattar S, Tanios BY, et al (2016). Hyperuricemia, Hypertension, and Chronic Kidney Disease: an Emerg-ing Association. Curr Hypertens Rep, 18:74.
6. Zhu Y, Pandya BJ, Choi HK (2011). Preva-lence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Sur-vey 2007-2008. Arthritis Rheum, 63:3136-41.
7. Hakoda M (2012). Recent trends in hyperu-ricemia and gout in Japan. Japan Med As-soc J, 55:319-23.
8. Kim Y, Kang J, Kim GT (2018). Prevalence of hyperuricemia and its associated fac-tors in the general Korean population: an analysis of a population-based na-tionally representative sample. Clin Rheumatol, 37:2529-38.
9. Higa S, Yoshida M, Shima D, et al (2019). A Retrospective, Cross-Sectional Study on the Prevalence of Hyperuricemia Using a Japanese Healthcare Database. Arch Rheumatol, 35:41-51.
10. Conen D, Wietlisbach V, Bovet P, et al (2004). Prevalence of hyperuricemia and relation of serum uric acid with cardio-vascular risk factors in a developing country. BMC Public Health, 4:9.
11. Billa G, Dargad R, Mehta A (2018). Preva-lence of Hyperuricemia in Indian Sub-jects attending Hyperuricemia Screening Programs-A Retrospective Study. J Assoc Physicians India, 66:43-6.
12. Ali N, Perveen R, Rahman S, et al (2018). Prevalence of hyperuricemia and the re-lationship between serum uric acid and obesity: A study on Bangladeshi adults. PLoS One, 13:e0206850.
13. Uaratanawong S, Suraamornkul S, Angkeaw S, et al (2011). Prevalence of hyperu-ricemia in Bangkok population. Clin Rheumatol, 30:887-93.
14. Lohsoonthorn V, Dhanamun B, Williams MA (2006). Prevalence of hyperuricemia and its relationship with metabolic syn-drome in Thai adults receiving annual health exams. Arch Med Res, 37:883-9.
15. Song P, Wang H, Xia W, et al (2018). Preva-lence and correlates of hyperuricemia in the middle-aged and older adults in China. Sci Rep, 8:4314.
16. Zhang Q, Gong H, Lin C, et al (2020). The prevalence of gout and hyperuricemia in middle-aged and elderly people in Tibet Autonomous Region, China: A preliminary study. Medicine (Baltimore), 99:e18542.
17. Lin C-S, Lee W-L, Hung Y-J, et al (2012). Prevalence of hyperuricemia and its as-sociation with antihypertensive treat-ment in hypertensive patients in Taiwan. Int J Cardiol, 156:41-6.
18. Qiu L, Cheng X-q, Wu J, et al (2013). Preva-lence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public Health, 13:664.
19. Song P, Wang H, Xia W, et al (2019). Gen-der- and Age-Specific Differences in the Association of Hyperuricemia and Hy-pertension: A Cross-Sectional Study. Int J Endocrinol, 2019:7545137.
20. Premgamone A, Ditsatapornjaroen T, Jindawong B, et al (2011). The Preva-lence of Hyperuricemia and Associated Factors in the Rural Community, Khon Kaen Province. Srinagarin Medical Journal, 26:41-7.
21. Sari I, Akar S, Pakoz B, et al (2009). Hyperu-ricemia and its related factors in an ur-ban population, Izmir, Turkey. Rheumatol Int, 29:869-74.
22. Wannaiampikul S, Sangsawangchot P, Ta-nunyutthawongse C (2020). High preva-lence of hyperuricemia and lack of as-sociation with rs2280205 and rs6820230 alleles of the SLC2A9 gene in urban Bangkok, Thailand. Genet Mol Res, 19:GMR18511.
23. Zhang X, Meng Q, Feng J, et al (2018). The prevalence of hyperuricemia and its correlates in Ganzi Tibetan Autono-mous Prefecture, Sichuan Province, Chi-na. Lipids Health Dis, 17:235.
24. Liu R, Han C, Wu D, et al (2015). Preva-lence of Hyperuricemia and Gout in Mainland China from 2000 to 2014: A Systematic Review and Meta-Analysis. Biomed Res Int, 2015:762820.
25. Ni Q, Lu X, Chen C, et al (2019). Risk fac-tors for the development of hyperu-ricemia: A STROBE-compliant cross-sectional and longitudinal study. Medicine (Baltimore), 98:e17597.
26. Techatraisak K, Kongkaew T (2017). The association of hyperuricemia and meta-bolic syndrome in Thai postmenopausal women. Climacteric, 20:552-7.
27. Bujang MA, Sa’at N, Tg Abu Bakar Sidik TMI, et al. (2018). Sample size guidelines for logistic regression from observa-tional studies with large population: em-phasis on the accuracy between statistics and parameters based on real life clini-cal data. Malays J Med Sci, 25:122-130.
28. WHO (2004). Appropriate body-mass index for Asian populations and its implica-tions for policy and intervention strate-gies. Lancet, 363:157-163.
29. Yu Q, Shen H-C, Hu Y-C, et al (2017). Preva-lence and Metabolic Factors of Hyperu-ricemia in an Elderly Agricultural and Fishing Population in Taiwan. Arch Rheumatol, 32:149-57.
30. Yu S, Yang H, Guo X, et al (2016). Preva-lence of hyperuricemia and its corre-lates in rural Northeast Chinese popula-tion: from lifestyle risk factors to meta-bolic comorbidities. Clin Rheumatol, 35:1207-15.
31. Ahmad OB, Boschi Pinto C, Lopez A, et al (2001). Age Standardization of rates: a new WHO standard. (GPE Discussion Paper Series no. 31). Geneva: World Health Organization.
32. Lee MS, Lin SC, Chang HY, et al (2005). High prevalence of hyperuricemia in elderly Taiwanese. Asia Pac J Clin Nutr, 14:285-92.
33. Lyu X, Du Y, Liu G, et al (2023). Prevalence and influencing factors of hyperurice-mia in middle-aged and older adults in the Yao minority area of China: a cross-sectional study. Sci Rep, 13:10185.
34. Zhong L, Liu S, Qiu X, et al (2022). High Prevalence of Hyperuricemia and Asso-ciated Factors among Zhuang Adults: A Cross-Sectional Study Based on the Eth-nic Minority Population Cohort in the Southwestern China. Int J Environ Res Public Health, 19:16040.
35. Bai R, Ying X, Shen J, et al (2022). The vis-ceral and liver fat are significantly asso-ciated with the prevalence of hyperu-ricemia among middle age and elderly people: A cross-sectional study in Chongqing, China. Front Nutr, 9:961792.
36. Xu Y, Dong H, Zhang B, et al (2022). Asso-ciation between dyslipidaemia and the risk of hyperuricaemia: a six-year longi-tudinal cohort study of elderly individu-als in China. Ann Med, 54:2402-2410.
37. Timsans J, Kauppi JE, Kerola AM, et al (2023). Hyperuricaemia: prevalence and association with mortality in an elderly Finnish population. BMJ Open, 13:e072110.
38. Trifirò G, Morabito P, Cavagna L, et al (2013). Epidemiology of gout and hype-ruricemia in Italy during the years 2005-2009: a nationwide population-based study. Ann Rheum Dis, 72:694-700.
39. Han B, Wang N, Chen Y, et al (2020). Prev-alence of hyperuricemia in an Eastern Chinese population: a cross-sectional study. BMJ Open, 10:e035614.
40. Piao W, Zhao L, Yang Y, et al (2022). The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Re-sults from CNHS 2015-2017. Nutrients, 14:4095.
41. Chen-Xu M, Yokose C, Rai SK, et al (2019). Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol, 71:991-999.
42. Wang Q, Wang C, Xue J, et al (2021). Char-acteristics of serum uric acid distribu-tion in occupation, age, gender groups, and its influencing factors in physical examination subjects in Nanjing from 2012 to 2016. Zhonghua Nei Ke Za Zhi, 60:29-34.
43. Yang J, Liu Z, Zhang C, et al (2013). The prevalence of hyperuricemia and its correlates in an inland Chinese adult population, urban and rural Jinan. Rheu-matol Int, 33:1511-7.
44. Corry DB, Eslami P, Yamamoto K, et al (2008). Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens, 26:269-75.
45. Chen L-y, Zhu W-h, Chen Z-w, et al (2007). Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B, 8:593-8.
46. Bedir A, Topbas M, Tanyeri F, et al (2003). Leptin might be a regulator of serum uric acid concentrations in humans. Jpn Heart J, 44:527-36.
47. Matsuura F, Yamashita S, Nakamura T, et al (1998). Effect of visceral fat accumula-tion on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesi-ty. Metabolism, 47:929-33.
48. Battelli MG, Bortolotti M, Polito L, et al (2018). The role of xanthine oxidoreduc-tase and uric acid in metabolic syn-drome. Biochim Biophys Acta Mol Basis Dis, 1864:2557-65.
49. Wei CY, Sun CC, Wei JC, et al (2015). Asso-ciation between Hyperuricemia and Metabolic Syndrome: An Epidemiologi-cal Study of a Labor Force Population in Taiwan. Biomed Res Int, 2015:369179.
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| Issue | Vol 53 No 6 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i6.15910 | |
| Keywords | ||
| Hyperuricemia Metabolic parameters Elderly adults Population-based study Sex difference | ||
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How to Cite
1.
Suwanchatchai C, Khuancharee K, Tanunyutthawongse C, Wannaiampikul S, Haetanurak P. Gender-Specific Differences in Prevalence and Association of Cardio-Metabolic Parameters and Hyperuricemia: A Population-Based Cross-Sectional Study, Nakhon Nayok, Thailand. Iran J Public Health. 2024;53(6):1361-1371.
