Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 2024 E, Monument St, Suite B-319, Baltimore, MD, USA.
BMC Musculoskelet Disord. 2013 Dec 11;14:347. doi: 10.1186/1471-2474-14-347.
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.
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.
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), <HS education (RR = 1.27, 95% CI: 0.99-1.63), hypertension (RR = 1.65, 95% CI: 1.30-2.09), CHD (RR = 1.57, 95% CI: 0.99-2.50), obesity (class I RR = 2.37, 95% CI: 1.65-3.41 and ≥ class II RR = 3.47, 95% CI: 2.33-5.18), eGFR < 60 (RR = 2.85, 95% CI: 1.62-5.01) and triglycerides (Quartile 4 vs. Quartile 1: RR = 2.00, 95% CI: 1.38-2.89). In separate models, urate levels at baseline (RR 1 mg/dL increase = 2.33, 95% CI: 1.94-2.80) and 3 years after baseline (RR for a 1 mg/dL increase = 1.92, 95% CI: 1.78-2.07) were associated with incident hyperuricemia after accounting for demographic and clinical risk factors.
Demographic and clinical risk factors that are routinely collected as part of regular medical care are jointly associated with the development of hyperuricemia.
血清尿酸水平升高与不良结局相关，包括但不限于痛风。目前尚不清楚血清尿酸水平是否是高尿酸血症发生的唯一预测因素，还是人口统计学和临床危险因素也可预测高尿酸血症的发生。本研究的目的是在一项基于人群的 ARIC 研究中确定 9 年内高尿酸血症发生的危险因素。
ARIC 从美国 4 个社区招募了参与者；将尿酸水平<7.0mg/dL 的 8342 名参与者纳入本分析。使用基于 AIC 的选择方法，在改良泊松回归模型中，确定 9 年高尿酸血症（尿酸水平>7.0g/dL）的风险因素（包括基线、3 年和 3 年内尿酸水平变化）。
高尿酸血症的 9 年累积发生率为 4%；男性为 5%；女性为 3%；非裔美国人占 6%，白人为 3%。调整后的模型包括 9 个 9 年内高尿酸血症发生的预测因素：男性（RR=1.73，95%CI：1.36-2.21）、非裔美国人（RR=1.79，95%CI：1.37-2.33）、吸烟（RR=1.27，95%CI：0.97-1.67）、<高中教育（RR=1.27，95%CI：0.99-1.63）、高血压（RR=1.65，95%CI：1.30-2.09）、冠心病（RR=1.57，95%CI：0.99-2.50）、肥胖（I 级 RR=2.37，95%CI：1.65-3.41，≥ II 级 RR=3.47，95%CI：2.33-5.18）、eGFR<60（RR=2.85，95%CI：1.62-5.01）和甘油三酯（四分位距 4 比四分位距 1：RR=2.00，95%CI：1.38-2.89）。在单独的模型中，基线时尿酸水平（RR 每增加 1mg/dL=2.33，95%CI：1.94-2.80）和基线后 3 年尿酸水平（RR 每增加 1mg/dL=1.92，95%CI：1.78-2.07）与在考虑人口统计学和临床危险因素后高尿酸血症的发生相关。
作为常规医疗护理的一部分常规收集的人口统计学和临床危险因素与高尿酸血症的发生有关。
