Liu Hong, Zhang Xiao-Min, Wang Yan-Li, Liu Bi-Cheng
Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, 210009, Jiangsu, China.
J Nephrol. 2014 Dec;27(6):653-8. doi: 10.1007/s40620-014-0082-z. Epub 2014 Apr 1.
Hyperuricemia is a non-communicable disease that threatens human health, and its prevalence has been increasing in recent decades. However, there have been no national surveys about hyperuricemia performed in China. We aimed to investigate the prevalence of hyperuricemia and its risk factors in Chinese adults.
Using data from 36,348 participants aged 18 years and older from the China National Survey of Chronic Kidney Disease (a nationwide cross-sectional survey with a randomized, multistage, stratified sampling strategy), we investigated the prevalence of hyperuricemia. Male subjects with serum uric acid ≥416.0 μmol/l (7.0 mg/dl) and female subjects with ≥357.0 μmol/l (6.0 mg/dl) were diagnosed with hyperuricemia. The prevalence of hyperuricemia was calculated, and the factors associated with hyperuricemia were analyzed using logistic regression.
The adjusted prevalence of hyperuricemia among Chinese adults in 2009-2010 was 8.4 % [95 % confidence interval (CI) 8.0-8.8 %], and it was 9.9 % (9.2-10.6 %) in men and 7.0 % (6.5-7.5 %) in women. The prevalence was much higher among urban than rural residents (14.9 vs. 6.6 %, p < 0.01). Areas with high per capita gross domestic product (GDP) levels had higher prevalence of hyperuricemia. In the multivariate regression model, the estimated glomerular filtration rate was inversely associated with hyperuricemia. Alcohol consumption, body mass index and serum triglyceride levels were positively correlated with hyperuricemia. Other factors independently correlated with hyperuricemia were age, sex, education level, area of residence, and economic development. In order to demonstrate the discriminatory power for hyperuricemia of the risk factors all together, we calculated the probabilities by logistic regression analysis, which represented the combined effects of these risk factors. Then, receiver operating characteristic analysis was used to demonstrate the value of the probabilities for hyperuricemia diagnosis. Finally, ROC curve analysis revealed the area under the curve was 0.746 (95 % CI 0.739-0.754), statistically significant for the association with hyperuricemia of these risk factors considered all together (p < 0.001).
Hyperuricemia is prevalent in the economically developed areas of China. Our report indicates the feasibility of studying the influence that economic changes have on the prevalence of hyperuricemia.
高尿酸血症是一种威胁人类健康的非传染性疾病，近几十年来其患病率一直在上升。然而，中国尚未开展过关于高尿酸血症的全国性调查。我们旨在调查中国成年人高尿酸血症的患病率及其危险因素。
利用中国慢性肾脏病全国调查（一项采用随机、多阶段、分层抽样策略的全国性横断面调查）中36348名18岁及以上参与者的数据，我们调查了高尿酸血症的患病率。血清尿酸≥416.0μmol/l（7.0mg/dl）的男性受试者和≥357.0μmol/l（6.0mg/dl）的女性受试者被诊断为高尿酸血症。计算高尿酸血症的患病率，并使用逻辑回归分析与高尿酸血症相关的因素。
2009 - 2010年中国成年人中高尿酸血症的校正患病率为8.4%[95%置信区间（CI）8.0 - 8.8%]，男性为9.9%（9.2 - 10.6%），女性为7.0%（6.5 - 7.5%）。城市居民的患病率远高于农村居民（14.9%对6.6%，p < 0.01）。人均国内生产总值（GDP）水平高的地区高尿酸血症患病率更高。在多变量回归模型中，估计肾小球滤过率与高尿酸血症呈负相关。饮酒、体重指数和血清甘油三酯水平与高尿酸血症呈正相关。与高尿酸血症独立相关的其他因素包括年龄、性别、教育水平、居住地区和经济发展。为了证明所有危险因素对高尿酸血症的鉴别能力，我们通过逻辑回归分析计算概率，这些概率代表了这些危险因素的综合作用。然后，使用受试者工作特征分析来证明这些概率对高尿酸血症诊断的价值。最后，ROC曲线分析显示曲线下面积为0.746（95%CI 0.739 - 0.754），对于所有这些危险因素与高尿酸血症的关联具有统计学意义（p < 0.001）。
高尿酸血症在中国经济发达地区普遍存在。我们的报告表明了研究经济变化对高尿酸血症患病率影响的可行性。
