Wen Xianghui, Zhang Yanli, Gu Jieruo, Wang Yina
Shenzhen Longhua District Central Hospital, Shenzhen, China.
Shenzhen Longhua Institute of Immunology Transformation, Shenzhen, China.
Int J Rheum Dis. 2025 May;28(5):e70254. doi: 10.1111/1756-185X.70254.
This longitudinal study investigated age- and gender-specific disparities in hyperuricemia and their metabolic associations in a community-based cohort, addressing gaps in long-term uric acid trajectory data.
A prospective cohort of 465 adults (123 males, 342 females) was stratified by serum uric acid (SUA > 420 μmol/L) and followed annually for 3 years. Standardized assessments included anthropometric, biochemical, and clinical evaluations.
Males had a 3.8-fold higher hyperuricemia prevalence than females (39.84% vs. 10.53%, p < 0.001), with age-specific peaks in males (20-29 and > 60 years) and females (> 60 years). Hyperuricemic individuals exhibited elevated BMI (24.75 ± 3.38 vs. 22.43 ± 3.01 kg/m, p < 0.001), systolic blood pressure (SBP: 124.62 ± 16.42 vs. 118.25 ± 14.99 mmHg, p = 0.001), fasting glucose (FBG: 5.48 ± 0.79 vs. 5.25 ± 0.80 mmol/L, p = 0.013), and renal dysfunction markers (serum creatinine: 74.10 ± 16.57 vs. 59.24 ± 14.68 μmol/L, p < 0.001). Age-stratified comorbidity patterns showed dyslipidemia predominance in younger groups (58.82%) versus cardiorenal complications hypertension (31.03%), elevated FBG (41.38%) and renal impairment (75.86%) in older adults. Multivariate analysis identified age, sex, BMI, and lipid profiles as SUA determinants (β = -0.248 to 0.472, p < 0.05), with eGFR inversely associated (β = -0.273, p < 0.05). Longitudinal data revealed alanine aminotransferase (ALT) as a novel predictor (β = 0.125, p = 0.038), while baseline hyperuricemia did not predict long-term SUA.
Hyperuricemia demonstrates significant age- and gender-related disparities, with persistent metabolic abnormalities contributing to cardiorenal and hepatic risks. Younger populations face dyslipidemia and liver dysfunction, whereas older adults exhibit hypertension and renal impairment. Regular monitoring and age-specific interventions are critical for mitigating metabolic syndrome progression.
这项纵向研究调查了社区队列中高尿酸血症的年龄和性别特异性差异及其代谢关联，填补长期尿酸轨迹数据的空白。
对465名成年人（123名男性，342名女性）的前瞻性队列按血清尿酸（SUA>420μmol/L）分层，并进行为期3年的年度随访。标准化评估包括人体测量、生化和临床评估。
男性高尿酸血症患病率比女性高3.8倍（39.84%对10.53%，p<0.001），男性在特定年龄组（20-29岁和>60岁）出现高峰，女性在>60岁出现高峰。高尿酸血症个体的BMI升高（24.75±3.38对22.43±3.01kg/m，p<0.001）、收缩压（SBP：124.62±16.42对118.25±14.99mmHg，p=0.001）、空腹血糖（FBG：5.48±0.79对5.25±0.80mmol/L，p=0.013）和肾功能不全标志物（血清肌酐：74.10±16.57对59.24±14.68μmol/L，p<0.001）升高。年龄分层的合并症模式显示，年轻组以血脂异常为主（58.82%），而老年人心肾并发症、高血压（31.03%）、空腹血糖升高（41.38%）和肾功能损害（75.86%）更为常见。多变量分析确定年龄、性别、BMI和血脂谱为SUA的决定因素（β=-0.248至0.472，p<0.05），而估算肾小球滤过率（eGFR）呈负相关（β=-0.273，p<0.05）。纵向数据显示丙氨酸转氨酶（ALT）是一个新的预测指标（β=0.125，p=0.038），而基线高尿酸血症不能预测长期SUA。
高尿酸血症表现出明显的年龄和性别相关差异，持续的代谢异常会增加心肾和肝脏风险。年轻人群面临血脂异常和肝功能障碍，而老年人群则表现为高血压和肾功能损害。定期监测和针对特定年龄的干预措施对于减轻代谢综合征进展至关重要。
