Yang Yuxiang, Cai Shuya, Tamas Szili-Torok, Zhang Shuai, Piao Wei, Nan Jing, Li Fusheng, Zhao Liyun, Yu Dongmei
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China NHC Key Laboratory of Public Nutrition and Health, Beijing 100050, China.
Wei Sheng Yan Jiu. 2025 Jul;54(4):540-548. doi: 10.19813/j.cnki.weishengyanjiu.2025.04.003.
To investigate the association between adherence to the dietary approaches to stop hypertension(DASH)diet and serum uric acid levels, the risk of hyperuricemia, and the mediation role of systematic inflammation, among Chinese adults from 5 provinces.
China Nutrition and Health Follow-up Study(2021) was conducted based on a part of the participants in China Nutrition and Health Surveillance(2010-2012) and subsequently newly sampled participants. A total of 6963 Chinese adults were selected from and information on socioeconomic status, diet, body measurements, and laboratory examination were investigated. Using the DASH score to evaluate the adherence to the DASH diet, the participants were categorized into quintiles. Using multiple adjustment generalized linear regression and logistic regression analysis the association between DASH diet and serum uric acid level and the risk of hyperuricemia were explored. The mediation role of systematic inflammation on the above associations was evaluated among 2112 participants who were tested for serum high-sensitivity C-reactive protein(hs-CRP).
In 6963 participants, the average serum uric acid level was 317.4 μmol/L, and the prevalence of hyperuricemia was 21.18%. The result showed that participants who were 18-44 years, female, overweight or obese, urban residents, higher education level, married, higher household income, non-smokers, higher physical activity level, non-hyperuricemia had higher adherence to the DASH diet(P<0.05). After adjusting for potential confounders, including age, gender, body mass index, living area, education level, marital status, household income, current smoking, excessive drinking, physical activity level, and condition of hypertension, diabetes mellitus, and dyslipidemia, the adherence to DASH diet had a negative association with serum uric acid levels(Q5 vs. Q1, relative concentration =0.93, 95%CI 0.91-0.94, P_(trend)<0.01) and with the risk of hyperuricemia(Q5 vs. Q1, OR =0.59, 95%CI 0.48-0.73, P_(trend)<0.01). Mediation analysis revealed that hs-CRP significantly mediated 17.69%(95%CI 10.22%-25.15%, P_(mediation)<0.01)of the association between DASH diet and serum uric acid level and 26.00%(95%CI 7.50%-44.49%, P_(mediation)<0.01)of the association between DASH score and the risk of hyperuricemia, respectively.
Adhering to the DASH diet had negative associations with serum uric acid levels and the risk of hyperuricemia among Chinese adults from 5 provinces. Systematic inflammation may be an important biological mechanism partially mediating the association between the DASH diet on serum uric acid levels and hyperuricemia.
探讨中国5省成年人中坚持终止高血压膳食疗法（DASH）饮食与血清尿酸水平、高尿酸血症风险之间的关联，以及系统性炎症的中介作用。
中国营养与健康随访研究（2021年）基于中国营养与健康监测（2010 - 2012年）的部分参与者及随后新抽样的参与者开展。共选取6963名中国成年人，调查了社会经济状况、饮食、身体测量和实验室检查等信息。使用DASH评分评估对DASH饮食的依从性，将参与者分为五等份。采用多重调整广义线性回归和逻辑回归分析，探讨DASH饮食与血清尿酸水平及高尿酸血症风险之间的关联。在2112名检测血清高敏C反应蛋白（hs-CRP）的参与者中，评估系统性炎症对上述关联的中介作用。
在6963名参与者中，血清尿酸平均水平为317.4μmol/L，高尿酸血症患病率为21.18%。结果显示，年龄在18 - 44岁、女性、超重或肥胖、城市居民、教育水平较高、已婚、家庭收入较高、不吸烟、身体活动水平较高、非高尿酸血症的参与者对DASH饮食的依从性较高（P<0.05）。在调整潜在混杂因素，包括年龄、性别、体重指数、居住地区、教育水平、婚姻状况、家庭收入、当前吸烟、过量饮酒、身体活动水平以及高血压、糖尿病和血脂异常状况后，对DASH饮食的依从性与血清尿酸水平呈负相关（Q5 vs. Q1，相对浓度 =0 .93，95%CI 0.91 - 0.94，P趋势<0.01），与高尿酸血症风险也呈负相关（Q5 vs. Q1，OR =0.59，95%CI 0.48 - 0.73，P趋势<0.01）。中介分析显示，hs-CRP分别显著介导了DASH饮食与血清尿酸水平关联的17.69%（95%CI 10.22% - 25.15%，P中介<0.01）以及DASH评分与高尿酸血症风险关联的26.00%（95%CI 7.50% - 44.49%，P中介<0.01）。
在中国5省成年人中，坚持DASH饮食与血清尿酸水平及高尿酸血症风险呈负相关。系统性炎症可能是部分介导DASH饮食与血清尿酸水平及高尿酸血症之间关联的重要生物学机制。
