The Prevalence of Hyperuricemia Sharply Increases from the Late Menopausal Transition Stage in Middle-Aged Women.

Sung Cho,Soo-Jin Lee,Yoosoo Chang,Seungho Ryu,Cheryl Winkler

doi:10.3390/jcm8030296

Abstract

The impact of menopausal transition on change of serum uric acid level remains unknown. The present study evaluated the relationship of menopausal stages with prevalent hyperuricemia in middle-aged women. This cross-sectional study included 58,870 middle-aged Korean women, aged ≥40, who participated in a health examination from 2014 to 2016. Menopausal stages were obtained with a standardized, self-administered questionnaire and were categorized according to the criteria of the Stages of Reproductive Aging Workshop (STRAW+10). Hyperuricemia was defined as a serum uric acid level of ≥6 mg/dL. The prevalence of hyperuricemia increased as menopausal stage increased. The multivariable-adjusted odds ratios (95% confidence intervals) for prevalent hyperuricemia comparing early transition, late transition, and post-menopause to pre-menopause were 1.19 (0.80–1.77), 2.13 (1.35–3.36), and 1.65 (1.33–2.04), respectively. This association was stronger among non-obese compared to obese participants and in those with low high-sensitivity C-reactive protein (hsCRP) levels (<1.0 mg/L) compared to those with elevated hsCRP levels of ≥1.0 mg/L (p for interaction = 0.01). In this large sample of middle-aged women, the prevalence of hyperuricemia significantly increased from the menopausal stage of late transition, independent of potential confounders. Appropriate preventive strategies for reducing hyperuricemia and its related consequences should be initiated prior to menopause.

Highlights

Until the early 1800s, uric acid was thought to be a biologically inert waste product, but hyperuricemia is increasingly considered a potential risk factor for various chronic conditions such as chronic kidney disease, cardiovascular disease, and metabolic syndrome, and has a well-established causal role in gout [1,2,3]
blood pressure (BP), glucose, total cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, alanine transaminase (ALT), GGT, Homeostatic model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and total energy intake were positively associated with menopausal stage, while estimated glomerular filtration rate (eGFR) and high-density lipoprotein (HDL)-cholesterol were inversely associated with menopausal stage (p for trend
To explore whether the association was mediated by metabolic parameters, insulin resistance, or inflammation, we performed additional analyses while adjusting for medications for hypertension, glucose, systolic BP, triglycerides, HDL-cholesterol, LDL-cholesterol, HOMA-IR, eGFR, and hsCRP

Summary

Introduction

Until the early 1800s, uric acid was thought to be a biologically inert waste product, but hyperuricemia is increasingly considered a potential risk factor for various chronic conditions such as chronic kidney disease, cardiovascular disease, and metabolic syndrome, and has a well-established causal role in gout [1,2,3]. A study using the Third National Health and Nutrition Examination Survey showed a positive and independent association of menopause with hyperuricemia and gout [11,12]. Menopause was independently associated with a high level of uric acid after adjustment for age and body mass index (BMI) [13]. The change in uric acid level according to menopausal transition stage has not been evaluated considering whether the association between menopausal transition stage and hyperuricemia differs by obesity. A better understanding the relationship between menopausal stage and hyperuricemia helps for identifying optimal timing for preventive measures for hyperuricemia

Methods

Results

Discussion

Conclusion