Cadmium Intake, Dietary Patterns and Hyperuricemia Among Adults in China

Zumin Shi

doi:10.1007/s12403-020-00375-4

Abstract

Blood and urine cadmium levels have been found to be positively associated with hyperuricemia (HU) in some studies. Few studies have examined the association between dietary cadmium intake, dietary patterns and HU in the Chinese population. The study analysed data from 8429 adults who participated in the China Health and Nutrition Survey (CHNS). Dietary intake was assessed by 3-day 24 h food record in seven waves of survey (1991, 1993, 1997, 2000, 2004, 2006 and 2009). Serum uric acid was measured in 2009. Dietary pattern was identified using factor analysis. The association between cumulative dietary cadmium intake, dietary patterns and HU was assessed using logistic regression. In total, 1737 (16.3%) participants had HU in the study sample. After adjusting for demographic, lifestyle factors (i.e. smoking, alcohol drinking, physical activity) and chronic conditions, the OR for HU was 2.25 (95%CI 1.84–2.77, p for trend < 0.001) for extreme quartiles of estimated cumulative cadmium intake. A traditional southern dietary pattern characterized by high intake of rice, pork, fish and vegetables, and low intake of wheat was associated with three times increased prevalence of HU; comparing the extreme quartiles, the odds ratio (OR) was 3.24 (95%CI 2.61–4.01). No association between the modern dietary pattern (high intake of fruit, soymilk, egg, milk and deep fried products) and HU was found. In conclusion, traditional southern dietary pattern and cadmium intake are positively associated with hyperuricemia among Chinese adults.

Highlights

Hyperuricemia (HU) is a common metabolic disease that affects a high proportion of the population in both developed and developing counties
Across the quartiles of the cadmium intake, there was a significant increase of HU, chronic kidney disease (CKD), intake of tradition dietary pattern and macronutrients (Table 1)
No interactions were observed between cadmium intake, dietary pattern and sex, hypertension, diabetes, obesity or CKD. In this population-based study of ~ 8500 Chinese adults, the traditional southern dietary pattern with a high intake of rice, pork, fish and vegetables, and low intake of wheat was positively associated with HU after adjusting for lifestyle factors, obesity, hypertension and diabetes

Summary

Introduction

Hyperuricemia (HU) is a common metabolic disease that affects a high proportion of the population in both developed and developing counties. In China, 21.6% of men and 8.6% of women had HU (Liu et al 2011). Diet has been identified as a risk factor for gout (Nuki and Simkin 2006). Diet rich in purine (such as meats, seafood, purine-rich vegetables and animal protein) has been shown to be associated with gout in some studies (Choi et al 2004). Several regional studies suggest that overall dietary patterns are associated with HU in China (Liu et al 2018; Xia et al 2018; Zhang et al 2012). ‘animal products’ dietary pattern was positively associated with HU in the Yi ethnic group (Liu et al 2018). A ‘meat food pattern’ was positively but a ‘traditional Chinese pattern’ was inversely associated with HU in a cross-sectional study conducted in Zhejiang Province, China (Zhang et al 2012)

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