Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Nutrients. 2022 Nov 4;14(21):4672. doi: 10.3390/nu14214672.
Hyperuricemia is the chief cause of gout and has been linked with hypertension, cardiovascular and renal disease, diabetes and metabolic syndrome. Liver with the highest protein expression of xanthine oxidase, the main enzyme responsible for uric acid formation, is the primary site of uric acid biosynthesis. However, there are few studies that examine the association between liver function and new-onset hyperuricemia. Hence, using the Taiwan Biobank dataset, we aimed to explore the capability of liver function parameters, including gamma-glutamyl transferase, total bilirubin, albumin, alanine aminotransferase and aspartate aminotransferase in association with the subsequent development of hyperuricemia. We analyzed 21,030 participants without hyperuricemia at baseline. Hyperuricemia was defined as a uric acid concentration > 6.0 mg/dL in women or >7.0 mg/dL in men. New-onset hyperuricemia was defined as participants without baseline hyperuricemia having developed hyperuricemia upon subsequent exam. Overall, 1804 (8.6%) of the study subjects developed new-onset hyperuricemia. After multivariable analysis, significant associations were found between the male sex (odds ratio [OR], 4.412; p < 0.001), high values of systolic blood pressure (SBP) (OR, 1.006; p = 0.012), body mass index (BMI) (OR, 1.064; p < 0.001), fasting glucose (OR, 1.005; p < 0.001), triglycerides (OR, 1.001; p = 0.003), uric acid (OR, 5.120; p < 0.001), low values of estimated glomerular filtration rates (eGFR) (OR, 0.995; p < 0.001), total bilirubin (OR, 0.616; p < 0.001) and new-onset hyperuricemia. The cutoff level of total bilirubin, according to the Youden index, of receiver operating characteristic curve for identifying new-onset hyperuricemia was 0.65 mg/dL. Low total bilirubin was defined as ≤0.65 mg/dL. After multivariable analysis, we found a significant association between low total bilirubin level (≤0.65 mg/dL) (OR = 0.806; p < 0.001) and new-onset hyperuricemia. Our present study demonstrated that in addition to male sex, high SBP, BMI, fasting glucose, triglycerides, and uric acid and low eGFR, the serum’s total bilirubin levels were negatively associated with new-onset hyperuricemia in a large Taiwanese cohort.
高尿酸血症是痛风的主要病因，与高血压、心血管和肾脏疾病、糖尿病和代谢综合征有关。肝脏中黄嘌呤氧化酶的蛋白表达最高，黄嘌呤氧化酶是尿酸形成的主要酶，是尿酸生物合成的主要部位。然而，很少有研究探讨肝功能与新发高尿酸血症之间的关系。因此，我们使用台湾生物银行数据集，旨在探讨γ-谷氨酰转移酶、总胆红素、白蛋白、丙氨酸氨基转移酶和天冬氨酸氨基转移酶等肝功能参数与随后高尿酸血症发展之间的关联。我们分析了 21030 名基线时无高尿酸血症的参与者。高尿酸血症定义为女性尿酸浓度>6.0mg/dL 或男性>7.0mg/dL。新发高尿酸血症定义为基线时无高尿酸血症的参与者在随后的检查中出现高尿酸血症。总体而言，1804 名（8.6%）研究对象发生了新发高尿酸血症。多变量分析后，发现男性（比值比[OR]，4.412；p<0.001）、较高的收缩压（SBP）（OR，1.006；p=0.012）、体重指数（BMI）（OR，1.064；p<0.001）、空腹血糖（OR，1.005；p<0.001）、甘油三酯（OR，1.001；p=0.003）、尿酸（OR，5.120；p<0.001）、估计肾小球滤过率（eGFR）（OR，0.995；p<0.001）低值、总胆红素（OR，0.616；p<0.001）与新发高尿酸血症之间存在显著关联。根据受试者工作特征曲线的约登指数，总胆红素的截断值为 0.65mg/dL，可用于识别新发高尿酸血症。总胆红素低定义为≤0.65mg/dL。多变量分析后，我们发现总胆红素水平低（≤0.65mg/dL）（OR=0.806；p<0.001）与新发高尿酸血症之间存在显著关联。本研究表明，除了男性、高 SBP、BMI、空腹血糖、甘油三酯和尿酸以及低 eGFR 外，总胆红素水平在大型台湾队列中与新发高尿酸血症呈负相关。
