Abstract
Adiposity and alcohol consumption are reported to be associated with a higher level of serum uric acid (SUA), but whether their effect differs on SUA percentile distribution is still unclear. In this study, we aimed to investigate how alcohol intake and body fat percentage (%BF) integrated with body mass index (BMI) influence the distribution of SUA in Chinese adults. Data from the China National Health Survey (CNHS) which included adults from 10 provinces of China were used (n = 31,746, aged 20–80 years, 40% male). %BF and BMI were integrated into eight expanded body composition groups to understand how excess body adiposity affects the distribution of SUA in the populational level. Self-report alcohol intake information was collected by face-to-face questionnaire interview. Quantile regression (QR) was used to analyze the data. We found that adiposity and alcohol consumption were associated with SUA, especially at the upper percentile in both sexes. In obese men, the QR coefficients at the 75th and 95th percentiles were 74.0 (63.1–84.9) and 80.9 (52.5–109.3) μmol/L, respectively. The highest quartile of %BF in men had a 92.6 (79.3–105.9) μmol/L higher SUA levels at its 95th percentile than the 5th quartile (p < 0.001). Compared with normal or underweight with the lowest %BF group (NWBF1), the obesity-highest %BF group (OBBF4) had the strongest positive effect on SUA, especially at the higher percentile of SUA. In BMI-defined normal or underweight participants, a higher quartile of %BF had greater effect size in all SUA percentiles. In men, current alcohol drinking had the strongest effect at the 95th percentile of SUA (QR coefficient: 31.8, with 95% CI: 22.6–41.0) comparing with 14.5, 95% CI of 8.4 to 20.6 in the 5th SUA percentile. High risk of alcohol consumption had a greater effect on SUA, especially in the higher SUA percentile. The observation of stronger association at the higher percentile of SUA suggests that decreasing body adiposity and alcohol intake at the populational level may shift the upper tails of the SUA distributions to lower values, thereby reducing the incidence of hyperuricemia.
Highlights
The serum uric acid (SUA), the end product of purine metabolism, has been found to be associated with cardiovascular, metabolism diseases, and mortality [1–3]
In the general linear regression model (GLM) estimations, overweight and obesity were strongly associated with higher SUA, but we found that these associations were stronger at the upper percentiles of SUA by QR estimations (Table 3)
For the first time, we investigated the association among body adiposity, alcohol consumption, and SUA using QR analysis in a large general Chinese population
Summary
The serum uric acid (SUA), the end product of purine metabolism, has been found to be associated with cardiovascular, metabolism diseases, and mortality [1–3]. The prevalence of hyperuricemia has been increasing in recent decades, of which the upper percentiles of SUA are of interest in the context of hyperuricemia and other risk diseases [4–7]. Adiposity and alcohol consumption are reported to be associated with a higher level of SUA [8, 9], but whether their effect differs on SUA percentile distribution is still unclear
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