Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Medical Center of Kidney Disease, Shanghai, China.
BMJ Open. 2021 Mar 10;11(3):e044905. doi: 10.1136/bmjopen-2020-044905.
To explore the association between urbanicity and hyperuricaemia (HUA) and whether urbanicity is an independent risk factor for HUA in Chinese adults.
Data analysis from a cross-sectional survey.
8579 subjects aged 18 years or older were enrolled in the study from the 2009 wave of the China Health and Nutrition Survey to analyse the association between urbanicity and HUA. We divided them into three categories according to urbanisation index (low, medium and highly urbanised groups).
HUA was defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women.
The prevalence of HUA in low, medium and highly urbanised groups was 12.2%, 14.6% and 19.8%, respectively. The independent factors influencing serum uric acid included age, gender, hypertension, diabetes, chronic kidney disease, drinking, obesity and community-level urbanisation index (β=0.016, p<0.001). The risk of HUA in the highly urbanised group was significantly higher than that of the low urbanised group (OR 1.771, 95% CI 1.545 to 2.029, p<0.001), even after adjusting for other covariates (OR 1.661, 95% CI 1.246 to 2.212, p=0.001). In a subgroup analysis, we found that age, gender, comorbidity (such as hypertension, diabetes, obesity and chronic kidney disease) and physical activity affected the association between urbanisation and the risk of HUA.
Our findings suggest that living in highly urbanised areas is linked with higher risk of HUA independent of cardiometabolic and health-related behavioural risk factors, which have been shown to increase along with urbanisation.
探讨城市化与高尿酸血症（HUA）的关系，以及城市化是否是中国成年人 HUA 的独立危险因素。
横断面调查数据分析。
2009 年中国健康与营养调查的一个横断面研究纳入了 8579 名年龄在 18 岁及以上的成年人，以分析城市化与 HUA 之间的关系。根据城市化指数（低、中、高度城市化组）将他们分为三组。
HUA 定义为血清尿酸男性≥7mg/dL，女性≥6mg/dL。
低、中、高度城市化组的 HUA 患病率分别为 12.2%、14.6%和 19.8%。影响血清尿酸的独立因素包括年龄、性别、高血压、糖尿病、慢性肾脏病、饮酒、肥胖和社区层面的城市化指数（β=0.016，p<0.001）。高度城市化组发生 HUA 的风险明显高于低度城市化组（OR 1.771，95%CI 1.545 至 2.029，p<0.001），即使在调整了其他协变量后（OR 1.661，95%CI 1.246 至 2.212，p=0.001）。在亚组分析中，我们发现年龄、性别、合并症（如高血压、糖尿病、肥胖和慢性肾脏病）和体力活动影响了城市化与 HUA 风险之间的关系。
我们的研究结果表明，居住在高度城市化地区与 HUA 的风险增加独立相关，这种风险增加与代谢和健康相关的行为危险因素有关，这些危险因素随着城市化而增加。
