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. 2022;15(2):216-227.
doi: 10.1159/000521163. Epub 2021 Nov 26.

The Effect of Body Weight and Alcohol Consumption on Hyperuricemia and Their Population Attributable Fractions: A National Health Survey in China

Huijing He  1 , Li Pan  1 , Xiaolan Ren  2 , Dingming Wang  3 , Jianwei Du  4 , Ze Cui  5 , Jingbo Zhao  6 , Hailing Wang  7 , Xianghua Wang  8 , Feng Liu  9 , Lize Pa  10 , Xia Peng  11 , Ye Wang  1 , Chengdong Yu  1 , Guangliang Shan  1
Affiliations

The Effect of Body Weight and Alcohol Consumption on Hyperuricemia and Their Population Attributable Fractions: A National Health Survey in China

Huijing He et al. Obes Facts. 2022.

Abstract

Introduction: The prevalence of hyperuricemia (HUA) is increasing worldwide; understanding of population attributable fraction of modifiable risk factors (MRFs) is important for disease prevention. Given the sparse evidence on how MRFs influence HUA in mainland China, we aimed to explore the effect of excess body weight and alcohol consumption and their population attributable fractions of HUA based on a national survey in mainland China.

Methods: Using data from the China National Health Survey which included 31,746 Han Chinese of 20-80 years of age from 10 provinces, we estimated the prevalence and MRFs (overweight/obesity and alcohol consumption) of HUA. HUA was defined as serum uric acid >417 μmol/L in men and >340 μmol/L in women. Restricted cubic-spline models were used to demonstrate the linear and nonlinear associations between exposures and HUA. The adjusted population attributable risk (PAR) was calculated to understand the relative importance of each MRF.

Results: The prevalence of HUA was 25.1% in men and 15.9% in women. The population fraction of HUA cases that could be avoided by weight loss was 20.6% (19.3%-22.0%) in men and 18.1% (17.1%-19.0%) in women. The PAR of alcohol consumption was 12.8% (8.5%-17.1%) in men. Participants from Southwest China (Yunnan) had the highest HUA prevalence (47.9% in men and 29.9% in women) but with lower PAR of MRFs, especially in men (16.7%). Subjects in North China had lower HUA prevalence but higher PAR of MRFs. Around 44.8% male HUA cases in Inner Mongolia (26.9% of HUA prevalence) and 37.7% cases in Heilongjiang (34.4% of HUA prevalence) were attributable to overweight/obesity and alcohol consumption.

Conclusion: There are significant sex and geographic difference on PAR of HUA due to MRFs. More tailored prevention strategies are needed to prevent HUA through weight loss and reduction of alcohol consumption.

Keywords: Alcohol consumption; Body mass index; Hyperuricemia; Obesity; Risk factors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
The forest plot yielded by the logistic regression models to reflect the associated factors of hyperuricemia in different sexes. BMI, body mass index; OR, odds ratio.
Fig. 2
Fig. 2
RCS models reflecting the association between age, MRFs, and the OR of HUA stratified by sex. MRFs in male were BMI and alcohol consumption, and in female was BMI. The solid lines represent the predicted value, and the shadows were their 95% CI. The adjusted factors were residential areas, education attainment, and study sites. RCS, restricted cubic-spline; MRF, modifiable risk factor; OR, odds ratio; HUA, hyperuricemia; BMI, body mass index; CI: confidence interval.
Fig. 3
Fig. 3
The geographic disparity on HUA prevalence and PAR (%) of MRFs among adults from the CNHS, 2012–2017. a Male: the MRFs were overweight/obesity and alcohol consumption. b Female: the MRF was overweight/obesity. PAR was adjusted for age, residential areas, and education attainment. The overall PAR was additionally adjusted for study sites. HUA, hyperuricemia; MRF, modifiable risk factor; PAR, population attributable risk; CNHS, China National Health Survey.
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