Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China.
Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
BMJ Open. 2024 Feb 12;14(2):e074391. doi: 10.1136/bmjopen-2023-074391.
Arthritis is thought to be closely related to serum uric acid. The study aims to assess the association between asymptomatic hyperuricemia (AH) and arthritis.
A multistage, stratified cluster was used to conduct a cross-sectional study of adult US civilians aged≥20 years from the 2007-2018 National Health and Nutrition Examination Survey. Participants with hyperuricemia and without hyperuricemia prior to gout were included. A questionnaire was used to determine whether participants had arthritis and the type of arthritis. Logistic regression was used to investigate the association between hyperuricemia and arthritis.
During the past 12 years, the percentage of participants with arthritis changed from 25.95% (22.53%-29.36%) to 25.53% (21.62%-29.44%). The prevalence of osteoarthritis (OA) increased from 8.70% (95% CI: 6.56% to 10.85%) to 12.44% (95% CI: 9.32% to 15.55%), the prevalence of AH changed from 16.35% (95% CI: 14.01% to 18.40%) to 16.39% (95% CI: 13.47% to 19.30%). Participants with AH were associated with onset of arthritis (OR=1.34, 95% CI: 1.07 to 1.69), but the association was muted after adjusting demographic and socioeconomic factors. For participants aged 40-49 years, AH is associated with incident arthritis (OR=1.96, 95% CI: 1.23 to 2.99) and the relationship remained after adjusting for education level, income to poverty ratio, body mass index, diabetes, hypertension and smoking (OR=2.00, 95% CI: 1.94 to 3.36). Compared with male, female participants with AH are more likely to develop arthritis, especially in OA (OR=1.35, 95% CI: 1.14 to 1.60).
Our data identified AH as the risk factor for incident arthritis, especially for OA, which might be exaggerated in aged population and female population.
关节炎被认为与血清尿酸密切相关。本研究旨在评估无症状高尿酸血症(AH)与关节炎之间的关系。
采用多阶段、分层聚类的方法,对 2007-2018 年美国国家健康与营养调查中年龄≥20 岁的成年美国平民进行横断面研究。纳入有高尿酸血症且在痛风前无高尿酸血症的参与者。使用问卷确定参与者是否患有关节炎以及关节炎的类型。采用 logistic 回归分析高尿酸血症与关节炎之间的关系。
在过去的 12 年中,关节炎患者的比例从 25.95%(22.53%-29.36%)变为 25.53%(21.62%-29.44%)。骨关节炎(OA)的患病率从 8.70%(95%CI:6.56%至 10.85%)增加到 12.44%(95%CI:9.32%至 15.55%),AH 的患病率从 16.35%(95%CI:14.01%至 18.40%)变为 16.39%(95%CI:13.47%至 19.30%)。患有 AH 的参与者与关节炎的发病相关(OR=1.34,95%CI:1.07 至 1.69),但在调整人口统计学和社会经济因素后,这种关联减弱了。对于 40-49 岁的参与者,AH 与新发关节炎相关(OR=1.96,95%CI:1.23 至 2.99),在调整教育水平、收入贫困比、体重指数、糖尿病、高血压和吸烟后,这种关系仍然存在(OR=2.00,95%CI:1.94 至 3.36)。与男性相比,女性参与者患有 AH 更易发生关节炎,尤其是 OA(OR=1.35,95%CI:1.14 至 1.60)。
我们的数据确定 AH 是关节炎发病的危险因素,尤其是 OA,在老年人群和女性人群中可能会被夸大。