Original article
Epidemiological
Prevalence of Hyperuricemia and its Relationship with Metabolic Syndrome in Thai Adults Receiving Annual Health Exams

https://doi.org/10.1016/j.arcmed.2006.03.008Get rights and content

Background

Associations between hyperuricemia, metabolic syndrome, cardiovascular disease and diabetes have been reported. Limited information, however, is available concerning the prevalence and correlates of hyperuricemia among Thai men and women. We sought to estimate the prevalence of hyperuricemia among a population of patients receiving annual health exams and to evaluate its relationship with metabolic syndrome (MetS).

Methods

We conducted a cross-sectional study of 1,381 patients (376 men and 1,005 women) who first participated in annual health examinations at the Preventive Medicine Clinic of the King Chulalongkorn Memorial Hospital in Bangkok, Thailand during the period July 1999 through February 2000. Hyperuricemia was defined as >7.0 mg/dL in men and >6.0 mg/dL in women. MetS was defined using the modified ATP III criteria.

Results

The overall prevalence of the hyperuricemia was 10.6%. The condition was more common in men than in women (18.4 vs. 7.8%). Among women, serum uric acid was statistically significantly correlated with body mass index (BMI), systolic and diastolic blood pressure, high-density lipoprotein-cholesterol, triglyceride and fasting plasma glucose (all p <0.05). Men with serum uric acid concentrations >6.7 mg/dL (upper quartile) had a 3.91-fold increased in risk of MetS (95% CI:1.36–11.23), as compared with those who had concentrations <5.1 mg/dL (lowest quartile). Among women, the risk of MetS increased at least 2-fold for concentration of serum uric acid concentrations >4.0 mg/dL (p for trend <0.001).

Conclusions

Hyperuricemia is prevalent among Thai men and women receiving routine health exams. Additionally, serum uric acid is positively associated with MetS.

Introduction

Hyperuricemia is commonly detected in subjects with abnormal purine metabolism, including overproduction of uric acid and insufficient uric acid excretion from the kidney (1). Prolonged hyperuricemia, often associated with gout, is an important risk factor for damaged joint (2). Hyperuricemia has been shown to be associated with several components of metabolic syndrome (MetS) and investigators have postulated that increased concentrations of uric acid may be another important component of the syndrome (3). In some epidemiologic studies, a close relationship between hyperuricemia and hypertension, insulin resistance and cardiovascular disease risk factors (such as obesity and smoking) has been reported 4, 5, 6, 7. Hyperuricemia is diagnosed in 5–30% of the general population, although the prevalence is higher among some ethnic groups (e.g., Japanese) and appears to be increasing worldwide (8). Serum uric acid concentrations are known to increase with age and are further increased after menopause in women (9). Considering current increases in the incidence and prevalence of obesity and MetS worldwide, as well as emerging evidence documenting associations between hyperuricemia and cardiovascular complications, Conen and colleagues have called for increased emphasis to be placed on understanding the epidemiological characteristic of hyperuricemia in developing countries (4).

Little information, however, exists concerning the prevalence and epidemiological characteristics of hyperuricemia in Thailand. We, therefore, conducted the present study to estimate the prevalence of hyperuricemia among Thai men and women receiving routine health examinations. We also sought to evaluate the extent to which, if at all, serum uric acid concentrations were associated with the risk of MetS.

Section snippets

Study Population and Data Collection

We conducted a cross-sectional study of 1,381 patients (376 men and 1,005 women) who first participated in annual health examinations at the Preventive Medicine Clinic of the King Chulalongkorn Memorial Hospital in Bangkok, Thailand during the period of July 1999 through February 2000. Participants were those with no previously diagnosed diabetes mellitus, hypertension, or gout and were not taking uric acid-, lipid- or blood pressure-lowering medication. During routine clinic visits

Results

Overall, the prevalence of hyperuricemia was 10.6% in this study population. Hyperuricemia was more common in men than in women (18.4 vs. 7.8%) (Table 1). Men with hyperuricemia, as compared to those without the condition, were older (p = 0.001), were more likely to have reported smoking (p = 0.019), and were former consumers of alcohol (p = 0.184). Women with hyperuricemia as compared with their counterparts without the condition were older (p <0.001), less well educated (p = 0.004) and were

Discussion

The 10.6% prevalence of hyperuricemia noted among Thai men and women in our study is higher than estimates reported for several other populations. For instance, Al-Arfaj and colleagues reported that the prevalence of hyperuricemia was 8.4% among Saudi men and women (15). Notably, hyperuricemia was defined using the same criteria for both studies. The prevalence of hyperuricemia in our study population is lower, however, than estimates reported for Japanese men and women who participated in a

Acknowledgments

This research was supported by Rachadapiseksompoj Faculty of Medicine Research Fund, Chulalongkorn University, Thailand, and National Institutes of Health. The research was completed while Dr. Vitool Lohsoonthorn was a Teaching Assistant-Consultant in Thailand for the 2005 Multidisciplinary International Research Training (MIRT) fellows. The MIRT Program of the University of Washington, School of Public Health and Community Medicine is supported by awards from the National Institutes of Health

References (28)

  • J. Vazquez-Mellado et al.

    Primary prevention in rheumatology: the importance of hyperuricemia

    Best Pract Res Clin Rheumatol

    (2004)
  • A. Costa et al.

    Uric acid concentration in subjects at risk of type 2 diabetes mellitus: relationship to components of the metabolic syndrome

    Metabolism

    (2002)
  • R.L. Wortmann

    Gout and hyperuricemia

    Curr Opin Rheumatol

    (2002)
  • H.K. Choi et al.

    Pathogenesis of gout

    Ann Intern Med

    (2005)
  • E. Bonora et al.

    Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study

    Int J Obes Relat Metab Disord

    (1996)
  • D. Conen et al.

    Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country

    BMC Public Health

    (2004)
  • F. Jossa et al.

    Serum uric acid and hypertension: the Olivetti heart study

    J Hum Hypertens

    (1994)
  • Y. Taniguchi et al.

    Serum uric acid and the risk for hypertension and Type 2 diabetes in Japanese men: The Osaka Health Survey

    J Hypertens

    (2001)
  • J.V. Selby et al.

    Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries

    Am J Epidemiol

    (1990)
  • S.W. Lai et al.

    Epidemiology of hyperuricemia in the elderly

    Yale J Biol Med

    (2001)
  • Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)

    JAMA

    (2001)
  • K. Shiwaku et al.

    Prevalence of the metabolic syndrome using the modified ATP III definitions for workers in Japan, Korea and Mongolia

    J Occup Health

    (2005)
  • M.C. Hochberg et al.

    Rheumatology, 3rd ed

    (2003)
  • K. Nagahama et al.

    Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan

    Hypertens Res

    (2004)
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