Skip to main content
SpringerLink
Log in

Prevalence of hyperuricemia and its associated factors in the general Korean population: an analysis of a population-based nationally representative sample

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Hyperuricemia is not only a risk factor for gout but also an independent determinant of hypertension, diabetes, and chronic kidney diseases. Although the incidence of gout in Korean adults is increasing, epidemiologic studies on hyperuricemia in the general Korean population are limited. Thus, this study aimed at evaluating the prevalence of hyperuricemia and its associated factors among non-institutionalized Korean adults. The present study included 5548 participants (2403 men and 3145 women) aged ≥ 19 years from The Korea National Health and Nutrition Examination Survey. Based on the new 2016 census data, the age-standardized prevalence and mean uric acid level were calculated using the chi-square test and t test, respectively. A multivariate logistic regression analysis was performed to evaluate the risk factors associated with hyperuricemia. The age-standardized prevalence of hyperuricemia and mean uric acid level in the general Korean population was 11.4% (17.0% in men and 5.9% in women) and 5.1 mg/dL (5.83 mg/dL in men and 4.36 mg/dL in women), respectively. The prevalence of hyperuricemia was high in young Korean adults, and a U-shaped association was observed between hyperuricemia and age. While obesity, metabolic syndrome, renal impairment, and low-grade inflammation were positively associated with hyperuricemia in both sexes, alcohol consumption, education, and current smoking status had a positive association with hyperuricemia only in women. Hyperuricemia is prevalent in the young population in Korea, and special efforts are necessary to reduce the potential harmful effects of hyperuricemia on the health of adults, particularly the younger-generation adults, in Korea.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kuo CF, Grainge MJ, Zhang W, Doherty M (2015) Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol 11:649–662

    Article  PubMed  Google Scholar 

  2. Kuwabara M, Niwa K, Nishi Y, Mizuno A, Asano T, Masuda K, Komatsu I, Yamazoe M, Takahashi O, Hisatome I (2014) Relationship between serum uric acid levels and hypertension among Japanese individuals not treated for hyperuricemia and hypertension. Hypertens Res 37:785–789

    Article  PubMed  CAS  Google Scholar 

  3. Dehghan A, Van Hoek M, Sijbrands EJ, Hofman A, Witteman JC (2008) High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 31:361–362

    Article  PubMed  CAS  Google Scholar 

  4. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P (2014) Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: a systematic review and meta-analysis based on observational cohort studies. BMC Nephrol 15:122

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Chen JH, Chuang SY, Chen HJ, Yeh WT, Pan WH (2009) Serum uric acid level as an independent risk factor for all-cause, cardiovascular, and ischemic stroke mortality: a Chinese cohort study. Arthritis Rheum 61:225–232

    Article  PubMed  CAS  Google Scholar 

  6. Zhu Y, Pandya BJ, Choi HK (2011) Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheumatol 63:3136–3141

    Article  Google Scholar 

  7. Trifirò G, Morabito P, Cavagna L, Ferrajolo C, Pecchioli S, Simonetti M, Bianchini E, Medea G, Cricelli C, Caputi AP (2012) Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study. Ann Rheum Dis-2011-201254

  8. Hollis-Moffatt JE, Xu X, Dalbeth N, Merriman ME, Topless R, Waddell C, Gow PJ, Harrison AA, Highton J, Jones PB (2009) Role of the urate transporter SLC2A9 gene in susceptibility to gout in New Zealand Māori, Pacific Island, and Caucasian case–control sample sets. Arthritis Rheum 60:3485–3492

    Article  PubMed  Google Scholar 

  9. Cheng LS-C, Chiang S-L, Tu H-P, Chang S-J, Wang T-N, Ko AM-J, Chakraborty R, Ko Y-C (2004) Genomewide scan for gout in Taiwanese aborigines reveals linkage to chromosome 4q25. Am J Hum Genet 75:498–503

    Article  PubMed  CAS  Google Scholar 

  10. Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M (2014) Comorbidities in patients with gout prior to and following diagnosis: case-control study. Ann Rheum Dis-2014-206410

  11. Yu S, Yang H, Guo X, Zhang X, Zhou Y, Ou Q, Zheng L, Sun Y (2016) Prevalence of hyperuricemia and its correlates in rural Northeast Chinese population: from lifestyle risk factors to metabolic comorbidities. Clin Rheumatol 35:1207–1215

    Article  PubMed  Google Scholar 

  12. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G (2004) Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 350:1093–1103

    Article  PubMed  CAS  Google Scholar 

  13. Choi HK, Curhan G (2008) Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ 336:309–312

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA (2010) Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 62:170–180

    Google Scholar 

  15. Chuang S-Y, Lee S-C, Hsieh Y-T, Pan W-H (2011) Trends in hyperuricemia and gout prevalence: nutrition and health survey in Taiwan from 1993-1996 to 2005-2008. Asia Pac J Clin Nutr 20:301–308

    PubMed  CAS  Google Scholar 

  16. Kim J-W, Kwak SG, Lee H, Kim S-K, Choe J-Y, Park S-H (2017) Prevalence and incidence of gout in Korea: data from the national health claims database 2007–2015. Rheumatol Int 37:1499–1506

    Article  PubMed  Google Scholar 

  17. Lee CH, Sung NY (2011) The prevalence and features of Korean gout patients using the National Health Insurance Corporation database. J Rheum Dis 18:94–100

    Article  Google Scholar 

  18. Ryu S, Chang Y, Zhang Y, Kim S-G, Cho J, Son HJ, Shin H, Guallar E (2012) A cohort study of hyperuricemia in middle-aged South Korean men. Am J Epidemiol 175:133–143

    Article  PubMed  Google Scholar 

  19. Kweon S, Kim Y, M-j J, Kim Y, Kim K, Choi S, Chun C, Khang Y-H, Oh K (2014) Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 43:69–77

    Article  PubMed  PubMed Central  Google Scholar 

  20. Armstrong T, Bull F (2006) Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). J Public Health 14:66–70

    Article  Google Scholar 

  21. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB (2007) Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 75:72–80

    Article  PubMed  Google Scholar 

  22. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612

    Article  PubMed  PubMed Central  Google Scholar 

  23. Alberti K, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart J-C, James WPT, Loria CM, Smith SC (2009) Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation 120:1640–1645

    Article  PubMed  CAS  Google Scholar 

  24. Uaratanawong S, Suraamornkul S, Angkeaw S, Uaratanawong R (2011) Prevalence of hyperuricemia in Bangkok population. Clin Rheumatol 30:887–893

    Article  PubMed  Google Scholar 

  25. Nagahama K, Iseki K, Inoue T, Touma T, Ikemiya Y, Takishita S (2004) Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan. Hypertens Res 27:227–233

    Article  PubMed  Google Scholar 

  26. Yoo TW, Sung KC, Shin HS, Kim BJ, Kim BS, Kang JH, Lee MH, Park JR, Kim H, Rhee EJ (2005) Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J 69:928–933

    Article  PubMed  CAS  Google Scholar 

  27. Yang J, Liu Z, Zhang C, Zhao Y, Sun S, Wang S, Zhao Y, Zhang Y, Li J, Lu F (2013) The prevalence of hyperuricemia and its correlates in an inland Chinese adult population, urban and rural of Jinan. Rheumatol Int 33:1511–1517

    Article  PubMed  Google Scholar 

  28. Chen S-Y, Chen C-L, Shen M-L, Kamatani N (2003) Trends in the manifestations of gout in Taiwan. Rheumatology 42:1529–1533

    Article  PubMed  Google Scholar 

  29. Yamanaka H (2011) Gout and hyperuricemia in young people. Curr Opin Rheumatol 23:156–160

    Article  PubMed  Google Scholar 

  30. Oyama C, Takahashi T, Oyamada M, Oyamada T, Ohno T, Miyashita M, Saito S, Komatsu K, Takashina K, Takada G (2006) Serum uric acid as an obesity-related indicator in early adolescence. Tohoku J Exp Med 209:257–262

    Article  PubMed  CAS  Google Scholar 

  31. Khang Y-H, Yun S-C (2010) Trends in general and abdominal obesity among Korean adults: findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys. J Korean Med Sci 25:1582–1588

    Article  PubMed  PubMed Central  Google Scholar 

  32. Park HS, Oh SW, Cho S-I, Choi WH, Kim YS (2004) The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol 33:328–336

    Article  PubMed  Google Scholar 

  33. Han E, Kim TH, Powell LM (2013) Beverage consumption and individual-level associations in South Korea. BMC Public Health 13:195

    Article  PubMed  PubMed Central  Google Scholar 

  34. Liu H, Zhang X-M, Wang Y-L, Liu B-C (2014) Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol 27:653–658

    Article  PubMed  CAS  Google Scholar 

  35. Lim S, Jang H, Lee H, Kimm K, Park C, Cho N (2006) A rural-urban comparison of the characteristics of the metabolic syndrome by gender in Korea: the Korean Health and Genome tudy (KHGS). J Endocrinol Investig 29:313–319

    Article  CAS  Google Scholar 

  36. Kim S, Lee J, Lee J, Na J, Han J, Yoon D, Baik S, Choi D, Choi K (2006) Prevalence of diabetes and impaired fasting glucose in Korea: Korean National Health and Nutrition Survey 2001. Diabetes Care 29:226–231

    Article  PubMed  CAS  Google Scholar 

  37. Liu L, Lou S, Xu K, Meng Z, Zhang Q, Song K (2013) Relationship between lifestyle choices and hyperuricemia in Chinese men and women. Clin Rheumatol 32:233–239

    Article  PubMed  Google Scholar 

  38. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G (2004) Alcohol intake and risk of incident gout in men: a prospective study. Lancet 363:1277–1281

    Article  PubMed  Google Scholar 

  39. Faller J, Fox IH (1982) Ethanol-induced hyperuricemia: evidence for increased urate production by activation of adenine nucleotide turnover. N Engl J Med 307:1598–1602

    Article  PubMed  CAS  Google Scholar 

  40. Brand F, McGee D, Kannel W, STOKES III J, Castelli W (1985) Hyperuricemia as a risk factor of coronary heart disease: the Framingham study. Am J Epidemiol 121:11–18

    Article  PubMed  CAS  Google Scholar 

  41. Villegas R, Xiang Y-B, Cai Q, Fazio S, Linton M, Li H, Elasy T, Zheng W, Shu XO (2010) Prevalence and determinants of hyperuricemia in middle-aged, urban Chinese men. Metab Syndr Relat Disord 8:263–270

    Article  PubMed  PubMed Central  Google Scholar 

  42. Yu M-A, Sanchez-Lozada LG, Johnson RJ, Kang D-H (2010) Oxidative stress with an activation of the renin–angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. J Hypertens 28:1234–1242

    PubMed  Google Scholar 

  43. Kang D-H, Park S-K, Lee I-K, Johnson RJ (2005) Uric acid–induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 16:3553–3562

    Article  PubMed  CAS  Google Scholar 

  44. Marangella M (2005) Uric acid elimination in the urine. In: Hyperuricemic syndromes: pathophysiology and therapy, Vol. 147. Karger publishers, pp 132–148

  45. Palmer TM, Nordestgaard BG, Benn M, Tybjærg-Hansen A, Smith GD, Lawlor DA, Timpson NJ (2013) Association of plasma uric acid with ischaemic heart disease and blood pressure: mendelian randomisation analysis of two large cohorts. BMJ 347:f4262

    Article  PubMed  PubMed Central  Google Scholar 

  46. Bedir A, Topbas M, Tanyeri F, Alvur M, Arik N (2003) Leptin might be a regulator of serum uric acid concentrations in humans. Jpn Heart J 44:527–536

    Article  PubMed  CAS  Google Scholar 

  47. Nan H, Qiao Q, Dong Y, Gao W, Tang B, Qian R, Tuomilehto J (2006) The prevalence of hyperuricemia in a population of the coastal city of Qingdao, China. J Rheumatol 33:1346–1350

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea

    Yunkyung Kim & Geun-Tae Kim

  2. Department of Family Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea

    Jihun Kang

  3. Central Institute for Medical Research, Kosin University Gospel Hospital, Busan, Republic of Korea

    Jihun Kang

Authors
  1. Yunkyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jihun Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geun-Tae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Geun-Tae Kim.

Ethics declarations

The protocol of this study was approved by the institutional review board of the Kosin University Gospel Hospital (KUGH 2018-02-012), and this study was in accordance with the Declaration of Helsinki. Furthermore, a written informed consent was obtained from all participants, and all study processes were in accordance with the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology.

Disclosures

None

Electronic supplementary material

ESM 1

(DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, Y., Kang, J. & Kim, GT. Prevalence of hyperuricemia and its associated factors in the general Korean population: an analysis of a population-based nationally representative sample. Clin Rheumatol 37, 2529–2538 (2018). https://doi.org/10.1007/s10067-018-4130-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-018-4130-2

Keywords

Search

Navigation