Abstract
BackgroundElevated serum uric acid (sUA) concentrations are common in the general population and are associated with chronic metabolic conditions and adverse clinical outcomes. We evaluated secular trends in the burden of hyperuricaemia from 2006–2014 within the Irish health system.MethodsData from the National Kidney Disease Surveillance Programme was used to determine the prevalence of elevated sUA in adults, age > 18 years, within the Irish health system. Hyperuricaemia was defined as sUA > 416.4 μmol/L in men and > 339.06 μmol/L in women, and prevalence was calculated as the proportion of patients per year with mean sUA levels above sex-specific thresholds. Temporal trends in prevalence were compared from 2006 to 2014 while general estimating equations (GEE) explored variation across calendar years expressed as odds ratios (OR) and 95% Confidence intervals (CI).ResultsFrom 2006 to 2014, prevalence of hyperuricaemia increased from 19.7% to 25.0% in men and from 20.5% to 24.1% in women, P<0.001. The corresponding sUA concentrations increased significantly from 314.6 (93.9) in 2006 to 325.6 (96.2) in 2014, P<0.001. Age-specific prevalence increased in all groups from 2006 to 2014, and the magnitude of increase was similar for each age category. Adjusting for baseline demographic characteristics and illness indicators, the likelihood of hyperuricemia was greatest for patients in 2014; OR 1.45 (1.26–1.65) for men and OR 1.47 (1.29–1.67) in women vs 2006 (referent). Factors associated with hyperuricaemia included: worsening kidney function, elevated white cell count, raised serum phosphate and calcium levels, elevated total protein and higher haemoglobin concentrations, all P<0.001.ConclusionsThe burden of hyperuricaemia is substantial in the Irish health system and has increased in frequency over the past decade. Advancing age, poorer kidney function, measures of nutrition and inflammation, and regional variation all contribute to increasing prevalence, but these do not fully explain emerging trends.
Highlights
Serum uric acid has emerged as an important biomarker of cardiovascular health and a large body of evidence incriminates elevated concentrations in the development of several chronic metabolic conditions, cardiovascular disease, and associated mortality [1,2,3,4,5,6]
Age-specific prevalence increased in all groups from 2006 to 2014, and the magnitude of increase was similar for each age category
The burden of hyperuricaemia is substantial in the Irish health system and has increased in frequency over the past decade
Summary
Serum uric acid (sUA) has emerged as an important biomarker of cardiovascular health and a large body of evidence incriminates elevated concentrations in the development of several chronic metabolic conditions, cardiovascular disease, and associated mortality [1,2,3,4,5,6]. Evidence has accumulated that elevated sUA concentrations above conventional thresholds predict future myocardial infarction, stroke and cardiovascular death and all-cause mortality [7,8,9] These studies suggest at the very least that sUA is an important metabolic and cardiovascular biomarker that merits measurement and surveillance. Given the potential contribution of sUA to chronic disease and mortality, periodic surveillance of sUA concentrations at a population level and within health systems is desirable to evaluate burden and temporal trends [10,11,12]. We evaluated secular trends in the burden of hyperuricaemia from 2006–2014 within the Irish health system
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