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Huang Y, Jing H, Wang Z, Li Z, Chacha S, Teng Y, Mi B, Zhang B, Liu Y, Li Q, Shen Y, Yang J, Qu Y, Wang D, Yan H, Dang S. Does Serum Uric Acid Mediate Relation between Healthy Lifestyle and Components of Metabolic Syndrome? Nutrients 2024; 16:2137. [PMID: 38999885 PMCID: PMC11243389 DOI: 10.3390/nu16132137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
A healthy lifestyle is related to metabolic syndrome (MetS), but the mechanism is not fully understood. This study aimed to examine the association of components of MetS with lifestyle in a Chinese population and potential mediation role of serum uric acid (SUA) in the association between lifestyle behaviors and risk of components of MetS. Data were derived from a baseline survey of the Shaanxi urban cohort in the Regional Ethnic Cohort Study in northwest China. The relationship between components of MetS, healthy lifestyle score (HLS), and SUA was investigated by logistic or linear regression. A counterfactual-based mediation analysis was performed to ascertain whether and to what extent SUA mediated the total effect of HLS on components of MetS. Compared to those with 1 or less low-risk lifestyle factors, participants with 4-5 factors had 43.6% lower risk of impaired glucose tolerance (OR = 0.564; 95%CI: 0.408~0.778), 60.8% reduction in risk of high blood pressure (OR = 0.392; 95%CI: 0.321~0.478), 69.4% reduction in risk of hypertriglyceridemia (OR = 0.306; 95%CI: 0.252~0.372), and 47.3% lower risk of low levels of HDL cholesterol (OR = 0.527; 95%CI: 0.434~0.641). SUA mediated 2.95% (95%CI: 1.81~6.16%) of the total effect of HLS on impaired glucose tolerance, 14.68% (95%CI: 12.04~18.85%) on high blood pressure, 17.29% (95%CI: 15.01~20.5%) on hypertriglyceridemia, and 12.83% (95%CI: 10.22~17.48%) on low levels of HDL cholesterol. Increased HLS tends to reduce risk of components of MetS partly by decreasing the SUA level, which could be an important mechanism by which lifestyle influences MetS.
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Affiliation(s)
- Yan Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Hui Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Ziping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Zongkai Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Samuel Chacha
- Department of Molecular Diagnostics, Sumbwanga Regional Referral Hospital, Rukwa 413, Tanzania;
| | - Yuxin Teng
- Department of Human Resources, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China;
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Binyan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Yezhou Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Qiang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Yuan Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Yang Qu
- HKU Business School, 3/F K.K. Leung Building, The University of Hong Kong, Pokfulam Road, Hong Kong;
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L7 8XZ, UK;
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.H.); (H.J.); (Z.W.); (Z.L.); (B.M.); (B.Z.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (H.Y.)
- Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an 710061, China
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Wu Q, Guan Y, Xu C, Wang N, Liu X, Jiang F, Zhao Q, Sun Z, Zhao G, Jiang Y. Association of Serum Uric Acid with Diabetes in Premenopausal and Postmenopausal Women-A Prospective Cohort Study in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16137. [PMID: 36498206 PMCID: PMC9737491 DOI: 10.3390/ijerph192316137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
There have been few prospective studies on the association between serum uric acid (SUA) and the risk of diabetes in women, and there have been few large-scale Chinese studies based on menopause to investigate the association. Therefore, the present study aimed to investigate the above relationship in Chinese female adults without diabetes. Methods: Data from 5743 premenopausal women and 11,287 postmenopausal women aged 20−74 years were obtained from the Shanghai Suburban Adult Cohort and Biobank (SSACB) study conducted in China. Cox regression models were applied to evaluate the association between SUA levels and the risk of diabetes. Restricted cubic spline analysis and stratified analysis on the basis of menopausal status were performed to explore the dose−response association between SUA levels and diabetes. Results: Among 17,030 participants, incidence rates of diabetes were 3.44/1000 person-years in premenopausal and 8.90/1000 person-years in postmenopausal women. The SUA levels in postmenopausal women were higher than that in premenopausal women (p < 0.0001). In Cox regression analysis, after adjusting for confounding factors, for each 10 µmol/L increase in SUA levels, the adjusted HR of diabetes was 1.01 (95% CI: 0.97−1.04) in postmenopausal women, and 1.03 (95% CI: 1.01−1.04) in premenopausal women. Compared with the lowest quartile of SUA levels, the HR (95% CI) of diabetes in the highest quartile was 0.99 (0.55−1.79) in premenopausal women and 1.39 (1.07−1.81) in postmenopausal women. Compared with those without hyperuricemia, the HR (95% CI) for diabetes was 1.89 (0.67−5.31) in premenopausal women with hyperuricemia, and 1.55 (1.19−2.02) in postmenopausal women. Moreover, restricted cubic splines models showed that there was a linear relationship between SUA levels and diabetes risk in premenopausal (p for nonlinear = 0.99) and postmenopausal women (p for nonlinear = 0.95). Furthermore, the restricted cubic spline graph showed that the risk of diabetes in postmenopausal women increased with an increase in SUA levels (p = 0.002). Conclusions: In a cohort of Chinese adult women, SUA levels are associated with diabetes risk in postmenopausal women, but this association was not observed in premenopausal women.
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Affiliation(s)
- Qian Wu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Ying Guan
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Chunze Xu
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xing Liu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Feng Jiang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Qi Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Zhongxing Sun
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Genming Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
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