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Association between smoking and gout: a meta-analysis. Clin Rheumatol 2018; 37:1895-1902. [PMID: 29696438 DOI: 10.1007/s10067-018-4118-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/01/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
Previous studies showed that smoking is linked with the decreased risk of gout, but the results remain controversial. The aim of this meta-analysis was to determine the associations between smoking and the risk of gout. A systematic literature search of PubMed and EMBASE was conducted. Data were extracted by two independent reviewers. The pooled odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of associations, using random effects and fixed effects models. Five studies with a total of 17,915,507 participants with 16,880 gouts were enrolled. Heterogeneity among the effect sizes of five studies was reported as I2 = 87.9%. Our meta-analysis indicated that smoking (ever- vs non-, OR = 0.87, 95% CI = 0.67-1.12) was not associated with the risk of gout in random effects model, whereas there was an association between smoking (ever- vs non-, OR = 0.70, 95% CI = 0.65-0.74) and gout risk in fixed effects model. Our finding indicates that smoking may not be involved in the risk of gout. However, further studies are still needed to confirm our results.
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Fanning N, Merriman TR, Dalbeth N, Stamp LK. An association of smoking with serum urate and gout: A health paradox. Semin Arthritis Rheum 2017; 47:825-842. [PMID: 29398126 DOI: 10.1016/j.semarthrit.2017.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/01/2017] [Accepted: 11/16/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The potential effect of cigarette smoking on levels of serum urate and risk of gout has been considered by a large number of studies, either as the primary variable of interest or as a covariate. METHODS Here we systematically review the published evidence relating to the relationship of smoking with serum urate, hyperuricaemia, and gout. RESULTS Many studies have reported that smoking reduces serum urate, however, the evidence has not been conclusive with other studies pointing to the opposite or no effect. It has also been suggested that smoking reduces the risk of gout, although there is some evidence to contradict this finding. CONCLUSION A consensus has yet to be reached as to the effect of smoking on serum urate levels and the risk of gout.
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Affiliation(s)
- Niamh Fanning
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand.
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
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Teng GG, Pan A, Yuan JM, Koh WP. Cigarette Smoking and the Risk of Incident Gout in a Prospective Cohort Study. Arthritis Care Res (Hoboken) 2016; 68:1135-42. [PMID: 26714165 PMCID: PMC5515666 DOI: 10.1002/acr.22821] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 12/03/2015] [Accepted: 12/15/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Cigarette smoking is shown to reduce serum urate. However, its impact on risk of gout is unknown. We prospectively examined the relationship between cigarette smoking and gout risk in this Asian cohort. METHODS We analyzed the data from the Singapore Chinese Health Study, a cohort of 63,257 Chinese ages 45-74 years at recruitment in 1993-1998. Information on cigarette smoking and other lifestyle factors was collected through in-person interviews at recruitment. This analysis included 53,213 participants who took part in either the first followup (1999-2004) and/or the second followup interviews (2006-2010). Cox proportional hazards models were used to assess the relationship between cigarette smoking and gout risk. RESULTS A total of 2,244 incident cases of physician-diagnosed gout were identified after a mean followup of 11.1 years. Among men, compared to never smokers, the risk of gout in current smokers was decreased by 27% (hazard ratio [HR] 0.73 [95% confidence interval (95% CI) 0.63-0.84]). This risk reduction was greater in lean male smokers (HR 0.69 [95% CI 0.57-0.83]) than overweight smokers (HR 0.87 [95% CI 0.67-1.13]) (P = 0.09 for interaction). This inverse association with smoking was rapidly attenuated to become null even in former smokers who had recently quit smoking. Conversely, there was no association between smoking and gout risk in women. In a companion cross-sectional study, current smokers had significantly lower levels of serum urate than former and never smokers, and this observation was present in men and not women. CONCLUSION Current smoking is associated with lower risk of gout in men in this Asian cohort.
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Affiliation(s)
- Gim Gee Teng
- University Medicine Cluster, Division of Rheumatology, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - An Pan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Min Yuan
- University of Pittsburgh Cancer Institute, Division of Cancer Control and Population Sciences, Pittsburgh, Pennsylvania
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, Pennsylvania
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Duke-NUS Graduate Medical School Singapore, Singapore
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Villegas R, Xiang YB, Cai Q, Fazio S, Linton M, Li H, Elasy T, Zheng W, Shu XO. Prevalence and determinants of hyperuricemia in middle-aged, urban Chinese men. Metab Syndr Relat Disord 2010; 8:263-70. [PMID: 20158446 DOI: 10.1089/met.2009.0084] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Hyperuricemia is associated with metabolic syndrome and has emerged as a marker for both type 2 diabetes and cardiovascular disease. We estimated the prevalence and lifestyle risk factors of hyperuricemia in middle-aged, urban Chinese men. METHODS The study included 3,978 urban Chinese men 40-74 years of age from a population-based cohort study, the Shanghai Men's Health Study, who were free of type 2 diabetes at baseline and had provided fasting blood samples. Uric acid concentrations were measured by the uricase method. Hyperuricemia was defined as >7.0 mg/dL. Anthropometric measurements and information on lifestyle factors and disease history were collected by in-person interviews. RESULTS One quarter of the study subjects had hyperuricemia. Participants with metabolic syndrome had a higher prevalence of hyperuricemia. Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference, and weight gain (since age 20) were positively associated with the prevalence of hyperuricemia. Physical activity was inversely related to the prevalence of hyperuricemia. The odds ratios for hyperuricemia for quintiles of nonoccupational physical activity were 1.00, 0.80, 0.73, 0.75, and 0.57 (P trend <0.001). Participants with hyperuricemia were less likely to be current smokers, but were more likely to drink alcohol regularly. Beer consumption was associated with higher risk of hyperuricemia compared with consumption of wine or liquor. CONCLUSIONS In this representative sample of middle-aged, urban Chinese men, hyperuricemia is highly prevalent. Obesity, weight gain in adulthood, and alcohol intake were associated with a higher prevalence of hyperuricemia, whereas daily physical activity and smoking were inversely related to the prevalence of hyperuricemia.
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Affiliation(s)
- Raquel Villegas
- Vanderbilt Epidemiology Center, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37203-1738, USA.
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Uetani M, Suwazono Y, Kobayashi E, Inaba T, Oishi M, Nogawa K. A longitudinal study of the influence of shift work on serum uric acid levels in workers at a telecommunications company. Occup Med (Lond) 2005; 56:83-8. [PMID: 16267101 DOI: 10.1093/occmed/kqi178] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hyperuricemia is a lifestyle-related disease. Although there have been many previous reports about the association of serum uric acid (UA) levels with lifestyle, including eating habits and alcohol intake, there has been no report of a longitudinal study of the relationship between serum UA levels and shift work. AIMS To clarify the influence of shift work on serum UA levels in Japanese workers. METHODS This was a 4-year cohort study of 15 871 workers at a telecommunications company. Pooled logistic regression analyses by sex were performed, with job schedule type, age, body mass index (BMI), lifestyle and the results of blood chemistries as covariates. RESULTS In males, shift work, part-time work, BMI, consumption of alcohol (less than twice per week, two to five times per week or more than five times per week) and little preference for vegetables were positively associated with the development of increased serum UA (>or=8 mg/dl in males, >or=6 mg/dl in females). In females, age, BMI and a history of smoking were positively associated with the development of increased serum UA. CONCLUSION This study revealed that shift work is independently related to increased serum UA in males.
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Affiliation(s)
- Mirei Uetani
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuohku, Chiba 260-8670, Japan.
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Rathmann W, Funkhouser E, Dyer AR, Roseman JM. Relations of hyperuricemia with the various components of the insulin resistance syndrome in young black and white adults: the CARDIA study. Coronary Artery Risk Development in Young Adults. Ann Epidemiol 1998; 8:250-61. [PMID: 9590604 DOI: 10.1016/s1047-2797(97)00204-4] [Citation(s) in RCA: 201] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the association of hyperuricemia with the various components of the Insulin Resistance Syndrome (IRS) in a biracial cohort of young adults. METHODS Cross-sectional study in 4053 young black and white adults aged 18-30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. RESULTS Body mass index (BMI), fasting insulin, and triglycerides were significantly higher, and high density lipoprotein (HDL)-cholesterol lower in subjects with hyperuricemia (uric acid > or = 7.0 mg/dl in males; > or = 6.0 mg/dl in females) (all p < 0.001). BMI showed the strongest positive correlation with uric acid among the IRS components. Significant associations of hyperuricemia with these risk factors were observed in all sex-race groups, which persisted after controlling for possible confounders including age, education, physical activity, smoking, alcohol intake, oral contraceptive use, and creatinine. Further adjustment for BMI and/or waist-to-hip ratio caused a large decrease in the strength of the associations. Adjustment for insulin also lead to decreases; however, the influence of fasting insulin appeared weaker than obesity. Even after controlling for obesity, insulin, and the other components of the IRS, male subjects in both races in the upper tertile of triglycerides were still more likely to have hyperuricemia. CONCLUSIONS The association of hyperuricemia with most aspects of the IRS may result predominantly from their covariation with adiposity and secondarily with insulin level. Elevated triglyceride level seems to have an independent relationship with hyperuricemia in males. The relationship between hyperuricemia and cardiovascular disease observed in previous studies may be secondary to its association with the IRS.
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Affiliation(s)
- W Rathmann
- Department of Biometrics and Epidemiology, Diabetes Research Institute at the Heinrich Heine University, Düsseldorf, Germany
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Newaz MA, Adeeb NN, Muslim N, Razak TA, Htut NN. Uric acid, xanthine oxidase and other risk factors of hypertension in normotensive subjects. Clin Exp Hypertens 1996; 18:1035-50. [PMID: 8922344 DOI: 10.3109/10641969609081033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Uric acid produced by xanthine oxidase (also a source of superoxide radicals) has been known to increase in hypertensive patients. In this study we evaluated the possible involvement of uric acid and xanthine oxidase in the pathogenesis of hypertension by examining their association with mean arterial pressure (MAP) and factors related to blood pressure. These factors include age, quetelet index (weight/height2), cholesterol, creatinine, calcium (Ca), magnesium (Mg), sodium (Na), potassium (K) and urea. Fifty Two (male-19, female-33) normal healthy individuals were studied. Correlation studies of demographic variables showed that age was positively correlated with MAP [r = 0.309, p = 0.026] and cholesterol [r = 0.503, p = 0.000] while quetelet index was positively correlated with age [r = 422, p = 0.000] MAP [r = 0.331, p = 0.016] and xanthine oxidase [r = 0.331, p = 0.016]. MAP was positively correlated with uric acid [r = 0.511, p = 0.000], cholesterol [r = 0.492, p = 0.000] and xanthine oxidase enzyme activity [r = 0.388, p = 0.004] and negatively correlated with plasma calcium [r = 0.603, p = 0.000]. Correlation studies of measured parameters with uric acid and xanthine oxidase showed that uric acid was positively correlated with creatinine [r = 0.627, p = 0.000], plasma magnesium [r 0.442, p = 0.001] and negatively correlated with plasma calcium [r = 0.546, p = 0.000] while xanthine oxidase was negatively correlated with plasma calcium [r = -0.404, p = 0.003] and plasma sodium [r = -0.288, p = 0.038]. Stepwise multiple regression with MAP as dependent variable showed that 65% of total variability of blood pressure can be accounted for by plasma calcium, cholesterol, creatinine, plasma K, plasma Na, uric acid and xanthine oxidase in order of increasing R2 [xanthine oxidase: T-value = 3.26, R2 = 0.653]. It can be concluded that in normotensive subjects, uric acid and xanthine oxidase have significant association with blood pressure and thus are one of the many factors which are involved in the cause or effect of hypertension.
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Affiliation(s)
- M A Newaz
- Department of Biochemistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Goldbourt U, Medalie JH, Herman JB, Neufeld HN. Serum uric acid: correlation with biochemical, anthropometric, clinical and behavioral parameters in 10,000 Israeli men. JOURNAL OF CHRONIC DISEASES 1980; 33:435-43. [PMID: 7380977 DOI: 10.1016/0021-9681(80)90040-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Jusko WJ. Role of tobacco smoking in pharmacokinetics. JOURNAL OF PHARMACOKINETICS AND BIOPHARMACEUTICS 1978; 6:7-39. [PMID: 349132 DOI: 10.1007/bf01066061] [Citation(s) in RCA: 127] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Newland H. Hyperuricemia in coronary, cerebral and peripheral arterial disease: an explanation. Med Hypotheses 1975; 1:152-5. [PMID: 1196166 DOI: 10.1016/0306-9877(75)90011-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Zalokar J, Lellouch J, Claude JR, Kuntz D. Epidemiology of serum uric acid and gout in Frenchmen. JOURNAL OF CHRONIC DISEASES 1974; 27:59-75. [PMID: 4815072 DOI: 10.1016/0021-9681(74)90008-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Zalokar J, Lellouch J, Claude JR, Kuntz D. Serum uric acid in 23,923 men and gout in a subsample of 4257 men in France. JOURNAL OF CHRONIC DISEASES 1972; 25:305-12. [PMID: 4639928 DOI: 10.1016/0021-9681(72)90166-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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