Department of Health Statistics, School of Public Health, Shanxi Medical University, No.56 Xinjian South Road, Taiyuan, 030001, China.
Department of Mathematics, School of Basic Medical Science, Shanxi Medical University, Taiyuan, China.
BMC Public Health. 2022 Oct 28;22(1):1981. doi: 10.1186/s12889-022-14357-5.
Diet has long been hypothesized to play an important role in hyperuricemia, and weight gain is a factor that is strongly associated with the rise in serum urate. We aimed to clarify the mediating role of obesity in the relationship between diet and hyperuricemia and to determine whether a weight-loss diet is an effective way to prevent hyperuricemia.
This cross-sectional study analysed representative samples of United States (n = 20,081; NHANES 2007-2016) adults. Nutrient patterns were derived with two methods: principal component analysis (PCA) and reduced rank regression (RRR) with obesity. Logistic regression and multivariable linear regression were applied to analyse the association between nutrient patterns in obesity and hyperuricemia. Mediation analyses were used to determine whether four obesity indicators, including body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI) and lipid accumulation product index (LAP), mediated the relationship between nutrient patterns and hyperuricemia.
PCA revealed three nutrient patterns (including "Low energy diet", "Lower vitamin A, C, K pattern" and "Vitamin B group"), and only Vitamin B group had a total effect on hyperuricemia. RRR revealed one main nutrient pattern associated with obesity, which was characterized by High fat and low vitamin levels and was significantly associated with hyperuricemia. Mediation analysis showed that obesity mostly or even completely mediated the relationship between nutrient patterns and hyperuricemia, especially traditional obesity indicators, which played a key intermediary effect. The proportions of indirect effects for BMI and WC were as high as 53.34 and 59.69, respectively.
Our findings suggest that the direct effect of diet on hyperuricemia is weak, and obesity plays a critical mediating role in the relationship between diet and hyperuricemia, which confirms that a weight-loss diet such as a "Low fat and high vitamin diet" may be useful in preventing hyperuricemia.
饮食早已被假设在高尿酸血症中发挥重要作用，而体重增加是与血清尿酸升高密切相关的因素。我们旨在阐明肥胖在饮食与高尿酸血症之间关系中的中介作用，并确定减肥饮食是否是预防高尿酸血症的有效方法。
本横断面研究分析了具有代表性的美国成年人样本（n=20081；NHANES 2007-2016）。使用两种方法（主成分分析（PCA）和基于肥胖的降秩回归（RRR））得出营养模式。应用逻辑回归和多变量线性回归分析肥胖与高尿酸血症之间的营养模式相关性。采用中介分析来确定四个肥胖指标（包括体重指数（BMI）、腰围（WC）、内脏脂肪指数（VAI）和脂质蓄积产物指数（LAP））是否在营养模式与高尿酸血症之间的关系中起中介作用。
PCA 揭示了三种营养模式（包括“低能量饮食”、“低维生素 A、C、K 模式”和“维生素 B 组”），只有维生素 B 组对高尿酸血症有总效应。RRR 揭示了一个与肥胖相关的主要营养模式，其特点是高脂肪和低维生素水平，与高尿酸血症显著相关。中介分析表明，肥胖主要甚至完全中介了营养模式与高尿酸血症之间的关系，尤其是传统的肥胖指标，它们起着关键的中介作用。BMI 和 WC 的间接效应比例分别高达 53.34%和 59.69%。
我们的研究结果表明，饮食对高尿酸血症的直接影响较弱，肥胖在饮食与高尿酸血症之间的关系中起着关键的中介作用，这证实了减肥饮食（如“低脂肪和高维生素饮食”）可能有助于预防高尿酸血症。
