SAT0604 FAST FOOD HABITS AND SERUM URATE CHANGE IN YOUNG ADULTS: 15-YEAR PROSPECTIVE ANALYSIS

Abstract

Background:Fast food consumption has strong positive associations with weight gain and insulin resistance.1Obesity and insulin resistance are in turn strongly associated with elevated serum urate (SU) levels, largely mediated by insulin’s anti-uricosuric ability.2Objectives:To investigate the relation between fast food consumption and changes in SU over a 15-year period among young black and white adults in the United States.Methods:Participants for the CARDIA study included 3,122 young (age 18-30 years in 1985-86) black and white adults in the United States who were followed up with repeated dietary and clinical assessments and had both baseline and year 15 SU measurement available. Frequency of fast food consumption (fast food frequency, FFF) was quantified on a semicontinuous scale and classified as <1, 1-2, or >2 times per week. We used multivariable linear regression models to investigate the association of FFF at baseline as well as change in FFF with 15-year changes in SU.Results:Our analysis included data from 3,122 subjects who had SU data available both at baseline and year 15 (Table 1). After adjustment for age, sex, education, baseline height and weight, and baseline SU, baseline FFF (defined as 3 times per week year 0 differences between participants) was independently associated with increases in SU among both black (beta=0.11, p=0.04) and white (beta=0.11, p=0.01) individuals (Table 2). Change in FFF (defined as 3 times a week 15-year change within participants) was also independently associated with increases in SU among white (beta=0.09, p=0.01) individuals but not blacks (beta=0.03, p=0.93) (Table 2). There was a significant correlation between weight change and SU change (correlation coefficient 0.34, p<0.001).Figure 1depicts the joint associations of year 0 FFF and 15-year changes in FFF with change in weight. Compared to the average 15-year SU change among participants with baseline FFF <1 time per week and 15-year FFF change <0 time per week, those with high FFF at both baseline and follow-up had an extra 0.21 mg/dL increase (i.e., 75% of overall population SU increase over 15 years [0.28 mg/dL]) in SU during that time. After adjusting for covariates in model 2, change in weight (beta=0.03, p<0.001) and homeostasis model for insulin resistance (HOMA) (beta=0.05, p<0.001) remained significantly associated with SU change.Table 1.Participant CharacteristicsCharacteristicBlacks (n=1468)Whites (n=1654)Age, years (year 0)24.4 (3.8)25.6 (3.3)Male (%)4448Weight, kg (year 0)72.8 (16.7)70.0 (14.0)Weight, kg (year 15)87.9 (20.9)80.7 (18.6)Serum urate, mg/dL (year 0)5.1 (1.4)5.4 (1.4)Serum urate, mg/dL (year 15)5.6 (1.4)5.5 (1.4)All values reported as mean (SD) unless otherwise noted.Table 2.Mean Adjusted Change in Serum Urate by Baseline and Change in Fast Food FrequencyFast Food VariableBlacksWhitesBeta (SE)pBeta (SE)pModel 1Baseline0.11 (0.04)0.010.11 (0.04)0.01Change0.003 (0.033)0.930.09 (0.04)0.01Model 2Baseline0.12 (0.04)0.010.09 (0.04)0.02Change0.004 (0.03)0.880.08 (0.04)0.03Model 1: age, sex, education, baseline height and weight, baseline SUModel 2: model 1 + alcohol, physical activity, and smoking (both baseline and year 15 change)Conclusion:Fast-food consumption has strong positive associations with SU, suggesting that fast food increases the risk of hyperuricemia and gout. The observed association is likely mediated by weight gain and resultant changes in insulin resistance.