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Prevalence and risk factors associated with hyperuricemia among working population at high altitudes: a cross-sectional study in Western China

  • Yang Shen
  • Yanling Wang
  • Chun ChangEmail author
  • Suning Li
  • Weihao Li
  • Bingying Ni
Original Article
  • 36 Downloads

Abstract

Chronic exposure to high altitude may lead to hyperuricemia. We investigated the prevalence of hyperuricemia and its risk factors among employees in high-altitude areas. A cross-sectional survey with cluster sampling was performed at 23 worksites on the Qinghai-Tibet Plateau. Subjects were evaluated by using questionnaires, anthropometric and laboratory measurements, and abdominal ultrasound. A multilevel logistic regression model and restricted cubic spline were used to explore the associated factors of hyperuricemia. Of the 4198 employees included in the study, the age-standardized prevalence of hyperuricemia was 28.1% (95% confidence interval (CI) 26.7–29.5), with 31.9% (95%CI 30.2–33.6) in men and 17.9% (95%CI 15.7–20.1) in women. Hypertension, hyperlipidemia, and a meat-food pattern were positively associated with hyperuricemia in both sexes, while diabetes, shift work, body mass index, non-alcoholic fatty liver disease, and low intake of fruits and vegetables were significantly associated with hyperuricemia only in men. Furthermore, a nonlinear dose-response association between the number of cardiovascular risk factors (CRFs) and hyperuricemia was observed. Compared with those having 0 CRFs, the full-adjusted odds ratios (ORs) and 95%CIs for 1, 2, and ≥ 3 CRFs were 1.76 (95%CI 1.25–2.47), 2.54 (95%CI 1.81–3.55), and 3.05 (95%CI 2.16–4.31) in men, respectively, and 2.13 (95%CI 1.43–3.17), 2.78 (95%CI 1.71–4.53), and 3.13 (95%CI 1.50–6.55) in women, respectively. Hyperuricemia is common in employees at high-altitude areas. However, working at higher altitudes does not mean necessarily higher risk of hyperuricemia, as dietary factors and clustered CRFs are more significant. Thus, workplace-based lifestyle modifications should be promoted.

Keywords

Epidemiology High altitude Hyperuricemia Prevalence Risk factor Worksite 

Abbreviations

SUA

Serum uric acid

CRFs

Cardiovascular risk factors

BP

Blood pressure

BMI

Body mass index

SBP

Systolic blood pressure

DBP

Diastolic blood pressure

TC

Total cholesterol

TG

Triglycerides

FBG

Fasting blood glucose

NAFLD

Non-alcoholic fatty liver disease

OR

Odds ratio

CI

Confidence interval

Notes

Acknowledgements

We would like to acknowledge all the employees who participated in the study and investigators for their valuable help in data collection.

Author contribution

CC and YW conceived and designed the study, YS analyzed the data and wrote the paper, CC reviewed and edited the paper, SL helped in preparing the database and helped in the data analysis, WL and BN edited the paper, and all authors read and approved the final manuscript.

Compliance with ethical standards

Disclosures

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Bardin T, Richette P (2014) Definition of hyperuricemia and gouty conditions. Curr Opin Rheumatol 26(2):186–191CrossRefGoogle Scholar
  2. 2.
    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(4):227–233CrossRefGoogle Scholar
  3. 3.
    Qiu L, Cheng XQ, Wu J, Liu JT, Xu T, Ding HT, Liu YH, Ge ZM, Wang YJ, Han HJ, Liu J, Zhu GJ (2013) Prevalence of hyperuricemia and its related risk factors in healthy adults from northern and northeastern Chinese provinces. BMC Public Health 13:664CrossRefGoogle Scholar
  4. 4.
    Borghi C, Rosei EA, Bardin T, Dawson J, Dominiczak A, Kielstein JT, Manolis AJ, Perez-Ruiz F, Mancia G (2015) Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens 33(9):1729–1741CrossRefGoogle Scholar
  5. 5.
    Trifiro G, Morabito P, Cavagna L, Ferrajolo C, Pecchioli S, Simonetti M, Bianchini E, Medea G, Cricelli C, Caputi AP et al (2013) Epidemiology of gout and hyperuricaemia in Italy during the years 2005-2009: a nationwide population-based study. Ann Rheum Dis 72(5):694–700CrossRefGoogle Scholar
  6. 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 Rheum 63(10):3136–3141CrossRefGoogle Scholar
  7. 7.
    Kumar AUA, Browne LD, Li X, Adeeb F, Perez-Ruiz F, Fraser AD, Stack AG (2018) Temporal trends in hyperuricaemia in the Irish health system from 2006-2014: a cohort study. PLoS One 13(5):e0198197CrossRefGoogle Scholar
  8. 8.
    Nagahama K, Inoue T, Kohagura K, Ishihara A, Kinjo K, Ohya Y (2014) Hyperuricemia predicts future metabolic syndrome: a 4-year follow-up study of a large screened cohort in Okinawa, Japan. Hypertens Res 37(3):232–238CrossRefGoogle Scholar
  9. 9.
    Kim Y, Kang J, Kim GT (2018) Prevalence of hyperuricemia and its associated factors in the general Korean population: an analysis of a population-based nationally representative sample. Clin Rheumatol 37(9):2529–2538CrossRefGoogle Scholar
  10. 10.
    Wu J, Qiu L, Cheng XQ, Xu T, Wu W, Zeng XJ, Ye YC, Guo XZ, Cheng Q, Liu Q, Liu L, Xu CL, Zhu GJ (2017) Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population. Sci Rep 7(1):5456CrossRefGoogle Scholar
  11. 11.
    Arestegui AH, Fuquay R, Sirota J, Swenson ER, Schoene RB, Jefferson JA, Chen W, Yu XQ, Kelly JP, Johnson RJ, Escudero E (2011) High altitude renal syndrome (HARS). J Am Soc Nephrol 22(11):1963–1968CrossRefGoogle Scholar
  12. 12.
    Jefferson JA, Escudero E, Hurtado ME, Kelly JP, Swenson ER, Wener MH, Burnier M, Maillard M, Schreiner GF, Schoene RB, Hurtado A, Johnson RJ (2002) Hyperuricemia, hypertension, and proteinuria associated with high-altitude polycythemia. Am J Kidney Dis 39(6):1135–1142CrossRefGoogle Scholar
  13. 13.
    Chen W, Liu Q, Wang H, Chen W, Johnson RJ, Dong X, Li H, Ba S, Tan J, Luo N, Liu T, He H, Yu X (2011) Prevalence and risk factors of chronic kidney disease: a population study in the Tibetan population. Nephrol Dial Transplant 26(5):1592–1599CrossRefGoogle Scholar
  14. 14.
    Shen Y, Chang C, Zhang J, Jiang Y, Ni B, Wang Y (2017) Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study. Environ Health Prev Med 22(1):19CrossRefGoogle Scholar
  15. 15.
    Cho K, Tian M, Lan Y, Zhao X, Yan LL (2013) Validation of the Omron HEM-7201 upper arm blood pressure monitor, for self-measurement in a high-altitude environment, according to the European Society of Hypertension International Protocol revision 2010. J Hum Hypertens 27(8):487–491CrossRefGoogle Scholar
  16. 16.
    Fang J, Alderman MH (2000) Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA 283(18):2404–2410CrossRefGoogle Scholar
  17. 17.
    Yang ZJ, Liu J, Ge JP, Chen L, Zhao ZG, Yang WY, China National D (2012) Metabolic Disorders Study G: Prevalence of cardiovascular disease risk factor in the Chinese population: the 2007-2008 China National Diabetes and Metabolic Disorders Study. Eur Heart J 33(2):213–220CrossRefGoogle Scholar
  18. 18.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr et al (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289(19):2560–2572CrossRefGoogle Scholar
  19. 19.
    Hu DY, Ding RJ (2008) Guidelines for management of adult dyslipidemia in China. Zhonghua Nei Ke Za Zhi 47(9):723–724PubMedGoogle Scholar
  20. 20.
    Zhou BF (2002) Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci 15(3):245–252PubMedGoogle Scholar
  21. 21.
    Wang Z, Hao G, Wang X, Wang W, Chen W, Zhu M (2016) Hypertension Control in Community Health Center Project G: Short-term hypertension management in community is associated with long-term risk of stroke and total death in China: a community controlled trial. Medicine (Baltimore) 95(48):e5245CrossRefGoogle Scholar
  22. 22.
    Sanyal AJ, American Gastroenterological A (2002) AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 123(5):1705–1725CrossRefGoogle Scholar
  23. 23.
    Chen X, Li Y, Sheng CS, Huang QF, Zheng Y, Wang JG (2010) Association of serum uric acid with aortic stiffness and pressure in a Chinese workplace setting. Am J Hypertens 23(4):387–392CrossRefGoogle Scholar
  24. 24.
    Cui L, Meng L, Wang G, Yuan X, Li Z, Mu R, Wu S (2017) Prevalence and risk factors of hyperuricemia: results of the Kailuan cohort study. Mod Rheumatol 27(6):1066–1071CrossRefGoogle Scholar
  25. 25.
    Sugie T, Imatou T, Miyazaki M, Une H (2005) The effect of alcoholic beverage type on hyperuricemia in Japanese male office workers. J Epidemiol 15(2):41–47CrossRefGoogle Scholar
  26. 26.
    Ryu S, Chang Y, Zhang Y, Kim SG, Cho J, Son HJ, Shin H, Guallar E (2012) A cohort study of hyperuricemia in middle-aged south Korean men. Am J Epidemiol 175(2):133–143CrossRefGoogle Scholar
  27. 27.
    Liu H, Zhang XM, Wang YL, Liu BC (2014) Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol 27(6):653–658CrossRefGoogle Scholar
  28. 28.
    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(2):233–239CrossRefGoogle Scholar
  29. 29.
    Gong S, Song J, Wang L, Zhang S, Wang Y (2016) Hyperuricemia and risk of nonalcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 28(2):132–138PubMedGoogle Scholar
  30. 30.
    Uetani M, Suwazono Y, Kobayashi E, Inaba T, Oishi M, Nogawa K (2006) A longitudinal study of the influence of shift work on serum uric acid levels in workers at a telecommunications company. Occup Med (Lond) 56(2):83–88CrossRefGoogle Scholar
  31. 31.
    Orth-Gomer K (1983) Intervention on coronary risk factors by adapting a shift work schedule to biologic rhythmicity. Psychosom Med 45(5):407–415CrossRefGoogle Scholar
  32. 32.
    Taino G, Giardini G, Pecchio O, Brevi M, Giorgi M, Verardo MG, Detragiache E, Imbriani M (2012) Work at high altitudes: risk factors and health surveillance. G Ital Med Lav Ergon 34(3 Suppl):235–237PubMedGoogle Scholar
  33. 33.
    He F, Wang LL, Yu XL (2017) Dietary patterns associated hyperuricemia among Chinese aged 45 to 59 years: an observational study. Medicine 96(50):e9248CrossRefGoogle Scholar
  34. 34.
    Oda E, Kawai R, Sukumaran V, Watanabe K (2009) Uric acid is positively associated with metabolic syndrome but negatively associated with diabetes in Japanese men. Intern Med 48(20):1785–1791CrossRefGoogle Scholar
  35. 35.
    Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q (2007) Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes Res Clin Pract 76(1):68–74CrossRefGoogle Scholar
  36. 36.
    Zhang L, Qin LQ, Cui HY, Liu AP, Wang PY (2011) Prevalence of cardiovascular risk factors clustering among suburban residents in Beijing, China. Int J Cardiol 151(1):46–49CrossRefGoogle Scholar
  37. 37.
    Li M, Hu X, Fan Y, Li K, Zhang X, Hou W, Tang Z (2016) Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis. Sci Rep 6:19520CrossRefGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Yang Shen
    • 1
  • Yanling Wang
    • 1
  • Chun Chang
    • 1
    Email author
  • Suning Li
    • 2
  • Weihao Li
    • 1
  • Bingying Ni
    • 1
  1. 1.Department of Social Medicine and Health Education, School of Public HealthPeking UniversityBeijingChina
  2. 2.Division of Prevention and Community Health, National Center for Cardiovascular DiseaseFuwai Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijingChina

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