Prevalence of Hyperuricemia Among Chinese Adults: Findings From Two Nationally Representative Cross-Sectional Surveys in 2015–16 and 2018–19

Traffic-related heavy metals exposure with serum uric acid and hyperuricemia in general Chinese urban adults: Roles of systemic inflammation

The health effects of traffic-derived pollutants have gathered increasing concerns. Our objectives were to evaluate the associations of traffic-related heavy metal exposure with serum uric acid (SUA) and hyperuricemia and to explore the underlying mechanism. Traffic-related heavy metals (including zinc, iron, manganese, copper, lead, cadmium, antimony, and barium) and SUA were determined among 3909 community-based adults from the Wuhan-Zhuhai cohort. Various regression methods were applied to assess the association of heavy metals with SUA and hyperuricemia. Furthermore, mediation analyses were employed to evaluate the potential role of systemic inflammation in these associations. In single metal analyses, positive dose-response relationships between urinary zinc, iron, manganese, and antimony and SUA were observed. Furthermore, each 1-unit increase of ln-transformed urinary zinc levels was related to a 37.9 % (OR=1.379, 95 % CI: 1.148 to 1.657) increase in the hyperuricemia risk. In multiple metal analyses, both Bayesian kernel machine regression (BKMR) and weighted quantile sum regression (WQS) models showed positive associations of heavy metals mixture with SUA and hyperuricemia risk, and WQS analyses further revealed that zinc was the dominant metal (component weight: 0.611 and 0.594, respectively). Additionally, plasma C-reactive protein (CRP) mediated 4.919 % and 8.417 % of the association of urinary zinc with SUA and hyperuricemia, respectively. In conclusion, exposure to several traffic-related heavy metals or traffic-related heavy metal mixtures were positively associated with SUA and hyperuricemia risk in the general Chinese population, in which zinc played a dominating role. Plasma CRP might partly mediate the association of urinary zinc with SUA and hyperuricemia risk.

Clerodendranthus spicatus-Cordyceps cicadae regulates mitophagy and protects renal tubular epithelial cells from hyperuricemic nephropathy

ETHNOPHARMACOLOGICAL RELEVANCE

Clerodendranthus spicatus (CS) and Cordyceps cicadae (CC) are both medicine and food. They have long been used to treat kidney disease, but their mechanisms for treating hyperuricemic nephropathy (HN) are not yet clear.

AIM

We investigated the effect and mechanism of Clerodendranthus spicatus-Cordyceps cicadae (CS-CC) in HN treatment.

METHODS

We detected the chemical profiling of CS-CC freeze-dried powder, drug-containing serum and drug-containing intracellular fluid by UHPLC-Q Exactive Orbitrap-HRMS. We explored the effective components as well as underlying mechanisms of CS-CC in HN treatment via network pharmacological analysis. We constructed HN rat models induced by gavaging potassium oxonate and uric acid (UA) for three weeks, and performed biochemical and pathological tests as well as histological observation. The expressions of fibrosis-associated proteins were quantitatively analyzed using immunohistochemistry staining and western blot analysis. For in vitro studies, we measured the metabolic fluxes in UA-treated HK-2 cells using Seahorse XFe24 analyzer and flow cytometric analysis. Mitophagy-associated proteins were evaluated using immunofluorescence co-localization analysis and western blot analysis.

RESULTS

A total of 14 simultaneous constituents of CS-CC in vivo and in vitro were identified. Network pharmacological analysis highlighted CS-CC regulated mitophagy in HN. CS-CC treatment effectively enhanced renal function and ameliorate renal fibrosis in HN rats. We found PINK1-mediated mitophagy was suppressed in HN, while CS-CC treatment could restore cellular metabolism, activate mitophagy and protect tubular epithelial cells in HN.

CONCLUSIONS

PINK1-mediated mitophagy was significantly inhibited in HN, whereas CS-CC treatment demonstrated remarkable efficacy in attenuating renal fibrosis and promoting mitophagy to protect tubular epithelial cells in HN.

Identification and assessment of Pichia kudriavzevii YS711 isolated from "Jiangshui" with the capacity for uric acid metabolism

Hyperuricemia, a prevalent metabolic disorder, necessitates novel therapeutic strategies. This study reports the isolation and characterization of Pichia kudriavzevii YS711, a novel strain isolated from the traditional Chinese fermented food "Jiangshui", exhibiting exceptional uric acid (UA) degradation capabilities. In vitro studies demonstrated that YS711 degraded 31.2 % of UA within 24 h, converting it to ammonium. This end-product is significantly safer than urea, mitigating potential adverse effects associated with urea accumulation. Whole-genome sequencing revealed a complete UA metabolic pathway in YS711, the first such pathway elucidated in the phylum Ascomycota. This pathway encompasses key enzymes, including urate oxidase, allantoinase, allantoicase, ureidoglycolate lyase, and urea amidolyase. The identification of these genes provides a valuable resource for future metabolic engineering efforts to enhance UA degradation. This research underscores the potential of P. kudriavzevii YS711 as a promising probiotic-based therapeutic agent for hyperuricemia prevention and treatment, offering a safer and potentially more effective alternative to existing approaches.

Age- and Gender-Specific Dynamics of Hyperuricemia: A Longitudinal Community Study on Metabolic Trajectories and Comorbidity Stratification

OBJECTIVE

This longitudinal study investigated age- and gender-specific disparities in hyperuricemia and their metabolic associations in a community-based cohort, addressing gaps in long-term uric acid trajectory data.

METHODS

A prospective cohort of 465 adults (123 males, 342 females) was stratified by serum uric acid (SUA > 420 μmol/L) and followed annually for 3 years. Standardized assessments included anthropometric, biochemical, and clinical evaluations.

RESULTS

Males had a 3.8-fold higher hyperuricemia prevalence than females (39.84% vs. 10.53%, p < 0.001), with age-specific peaks in males (20-29 and > 60 years) and females (> 60 years). Hyperuricemic individuals exhibited elevated BMI (24.75 ± 3.38 vs. 22.43 ± 3.01 kg/m2, p < 0.001), systolic blood pressure (SBP: 124.62 ± 16.42 vs. 118.25 ± 14.99 mmHg, p = 0.001), fasting glucose (FBG: 5.48 ± 0.79 vs. 5.25 ± 0.80 mmol/L, p = 0.013), and renal dysfunction markers (serum creatinine: 74.10 ± 16.57 vs. 59.24 ± 14.68 μmol/L, p < 0.001). Age-stratified comorbidity patterns showed dyslipidemia predominance in younger groups (58.82%) versus cardiorenal complications hypertension (31.03%), elevated FBG (41.38%) and renal impairment (75.86%) in older adults. Multivariate analysis identified age, sex, BMI, and lipid profiles as SUA determinants (β = -0.248 to 0.472, p < 0.05), with eGFR inversely associated (β = -0.273, p < 0.05). Longitudinal data revealed alanine aminotransferase (ALT) as a novel predictor (β = 0.125, p = 0.038), while baseline hyperuricemia did not predict long-term SUA.

CONCLUSION

Hyperuricemia demonstrates significant age- and gender-related disparities, with persistent metabolic abnormalities contributing to cardiorenal and hepatic risks. Younger populations face dyslipidemia and liver dysfunction, whereas older adults exhibit hypertension and renal impairment. Regular monitoring and age-specific interventions are critical for mitigating metabolic syndrome progression.

Phytochemical compounds for treating hyperuricemia associated with gout: a systematic review

Gout is a prevalent metabolic disorder characterized by increased uric acid (UA) synthesis or decreased UA clearance from the bloodstream, leading to the formation of urate crystals in joints and surrounding tissues. Hyperuricemia (HUA), the underlying cause of gout, poses a growing challenge for healthcare systems in developed and developing countries. Currently, the most common therapeutic approaches for gouty HUA primarily involve the use of allopathic or modern medicine. However, these treatments are often accompanied by adverse effects and may not be universally effective for all patients. Therefore, this systematic review aims to provide a comprehensive outline of phytochemical compounds that have emerged as alternative treatments for HUA associated with gout and to examine their specific mechanisms of action. A systematic search was conducted to identify phytochemicals that have previously been evaluated for their effectiveness in reducing HUA. From a review of > 800 published articles, 100 studies reporting on 50 phytochemicals associated with the management of HUA and gout were selected for analysis. Experimental models were used to investigate the effects of these phytochemicals, many of which exhibited multiple mechanisms beneficial for managing HUA. This review offers valuable insights for identifying and developing novel compounds that are safer and more effective for treating HUA associated with gout.

Study on the potential links between clinical features of oral lichenoid mucositis and systemic diseases

OBJECTIVE

This study aimed to analyze the clinical characteristics of oral lichenoid disease and investigate its potential association with systemic diseases.

METHODS

This study was a retrospective cross-sectional analysis. The study comprised 116 patients who had been diagnosed with oral lichenoid disease, including 70 with oral lichen planus and 46 with lichenoid lesions. The study meticulously documented the distribution and types of lesions in oral lichenoid disease patients.

RESULTS

The average age was 46 years, with females representing 69.8% and males 30.2%. The prevalence of major systemic diseases among these patients was notable: thyroid disorders were observed in 64.7%, dyslipidemia in 44.0%, hyperuricemia in 36.2%, hypertension in 28.5%, and diabetes in 21.6%. Significant associations were found between specific lesion sites and systemic diseases. Network-like lesions in the gingival-buccal groove were highly correlated with thyroid disorders (P < 0.000). Lichenoid lesions on the lips were significantly associated with dyslipidemia (P < 0.002). Furthermore, lesions on both the dorsal (P < 0.000) and ventral (P < 0.038) surfaces of the tongue, particularly patchy lesions on the dorsal surface, showed a strong association with hyperuricemia.

CONCLUSION

These findings indicated a significant correlation between the clinical manifestations of oral lichenoid disease and systemic conditions such as thyroid disorders, dyslipidemia, and hyperuricemia.

Wuling capsule alleviates hyperuricaemia and protects UA- injured HK-2 cells by regulating uric acid transporter proteins

Introduction

Wuling capsule is a Chinese patent medicine mainly used for the treatment of chronic liver disease in clinical practice. Our previous work has revealed that Wuling capsule could inhibit liver fibrosis by regulating macrophage polarization, and firstly demonstrated its anti-gout effects on monosodium urate (MSU)- induced acute gouty arthritis (AGA) in rats. High uric acid (UA) levels are known to be the primary cause of gout. Therefore, this study investigated the UA lowering, kidney protection effects and underlying mechanisms of Wuling capsule in vivo and in vitro, and also determined its key bioactive constituents.

Methods

The efficacy of Wuling capsule for HUA symptoms in rats was evaluated. Histopathological analysis of liver and kidney tissues were detected by HE staining. The biochemical indices were measured using specific kits. The main constituents of Wuling capsule and its medicated serum were analyzed by UPLC-QTOF-MS/MS. Protective effects of saikosaponin A, tanshinone IIA, schisandrol B, and ganoderic acid A on UA-injured HK-2 cells were assessed via Hoechst 33342/PI staining and flow cytometry. Molecular docking and dynamics simulation predicted the binding energy and stability of these constituents to UA related transporters. The mRNA and protein expression levels of UA related transporters were examined using RT-qPCR and Western blotting.

Results

In HUA rats, Wuling capsule significantly reduced the serum UA level and xanthine oxidase (XOD) content in both serum and liver. Furthermore, it improved liver function markers (ALT, AST) and renal injury indicators (Cr, BUN), ameliorated renal tubule dilation and inflammatory infiltration in the kidney, and regulated the mRNA and protein expression of UA related transporters (URAT1, GLUT9, ABCG2 and OAT1). In vitro, the main constituents of Wuling capsule (saikosaponin A, tanshinone IIA, schisandrol B and ganoderic acid A) improved cell viability and inhibited cell apoptosis in UA-injured HK-2 cells. Subsequently, its four serum constituents also significantly regulated the mRNA and protein expression of URAT1, GLUT9, and ABCG2 selectively.

Discussion

This work demonstrated the therapeutic effect of Wuling capsule on HUA by protecting liver and kidney function and regulating UA related transporters. These findings provide novel support for the further clinical application of Wuling capsule.

Sodium butyrate promotes synthesis of testosterone and meiosis of hyperuricemic male mice

Hyperuricemia (HUA) impaires spermatogenesis. This study was carried out, aiming to determine whether butyric acid (NaB) avoids the HUA-induced decline of sperm quality HUA mice were developed through intra-peritoneal injection of the potassium oxalate combined with intragastric uric acid (UA) and by tube feeding 300 mg·kg-1·d-1NaB. The effect of NaB on the reproduction of HUA male mice was determined by measuring sperm count, sperm motility and testosterone content. In addition, TM3 and GC-2 cells were treated with a solution containing 30 mg/dl UA and 1mM NaB. The effects of NaB on the sperm quality were evaluated with the expression level of the genes involving in LH/cAMP/PKA signaling pathway and meiosis, and that encoding OPRL1 receptor protein. Results showed that NaB improved sperm count, sperm motility, testosterone synthesis, and impaired spermatocyte meiosis via HUA. In addition, in vitro analysis showed that NaB activated the LH/cAMP/PKA signaling pathway of TM3 cells, promoted the synthesis of testosterone, up-regulated the content of pain-sensitive peptide receptor (OPRL1) on the surface of GC-2 cells, and promoted meiosis. NaB also promoted the utilization of ATP by GC-2 cells. We illustrated a close relationship between HUA and spermatogenesis defects. NaB-promoted the expression of the genes functioning in testis meiosis, and the testosterone content may aid to improving spermatogenesis quality.

The Association Between the Triglyceride Glucose Index and Hyperuricemia: A Dose-Response Meta-Analysis

Background: The triglyceride glucose (TyG) index has been correlated with all kinds of diseases. However, its association with hyperuricemia is still a subject of controversy. Methods: This meta-analysis encompassed relevant studies on the TyG index and hyperuricemia obtained from electronic databases, from the launch date until March 2025. The effect sizes and corresponding 95% confidence intervals (CIs) were obtained using a random effects model. Results: Twenty-six trials with 637,954 subjects were incorporated in this study. It was revealed that the TyG index was linked to hyperuricemia (OR = 2.67; 95% CI: 2.34, 3.04; p < 0.001). A dose-response analysis demonstrated that with each 1 mg/dL rise in the TyG index, the risk of being diagnosed with hyperuricemia increased by 2.07 times (OR = 2.07; 95% CI: 1.89, 2.25; p < 0.001). Conclusions: The TyG index has an association with hyperuricemia. Given the constraints identified in our meta-analysis, further cohort studies will be essential to confirm this correlation.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and hyperuricemia: evidence from the CHARLS study

Background and aims

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is an innovative composite lipid measure. This study aims to examine the correlation between NHHR and hyperuricemia in the middle-aged and elderly demographic in China.

Methods

This investigation comprised 4,639 individuals who were devoid of hyperuricemia at baseline in 2011, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS). We utilized multivariable logistic regression, restricted cubic spline (RCS) analysis, and subgroup analysis to investigate the relationship between NHHR and hyperuricemia.

Results

A total of 499 participants (10.76%) experienced hyperuricemia at the 4-year follow-up. The incidence of hyperuricemia was 176% higher for participants in the highest quartile of NHHR than for those in the lowest quartile (OR 2.76, 95% CI 2.10-3.62, p < 0.001). The risk of hyperuricemia was 64% higher in the highest quartile of NHHR than in the lowest quartile in a fully adjusted model (OR 1.64, 95% CI 1.16-2.31, p = 0.005). The risk of hyperuricemia and NHHR had a linearly positive connection, according to restricted cubic spline (RCS) analysis (P for non-linearity > 0.05). Subgroup analysis showed that among women, non-smokers, and those over 60, the relationship between NHHR and hyperuricemia was more significant.

Conclusion

NHHR and hyperuricemia have a substantial linear positive connection, indicating that NHHR might be used as a tool for assessing hyperuricemia risk and offering valuable information for both prevention and therapy.

The role of lipid profile in the relationship between skipping breakfast and hyperuricemia: a moderated mediation model

BACKGROUND

The prevalence of hyperuricemia is rising among oilfield workers in China. This study aimed to explore the underlying mechanisms between skipping breakfast and serum uric acid.

METHODS

A total of 21,676 participants aged 20--60 from a large oilfield company in China were included. Association analysis, multivariate logistic, subgroup analysis, and moderated mediation analysis were performed to assess the association between skipping breakfast and hyperuricemia.

RESULTS

We found that 24.48% of oilfield employees had hyperuricemia. The odds ratio of hyperuricemia linked to skipping breakfast was 0.78 (95%CI: 0.69--0.88). The association between skipping breakfast and hyperuricemia was mediated by TC (22.32%) and LDL-C (21.57%). Age moderated this mediation, with significant effects for skipping breakfast (ß: 0.553, 95%CI: 0.042--1.063) and TC (ß: -0.339, 95%CI: -0.586- -0.093). Similar results were observed for LDL-C mediation (ß: 0.522, 95%CI: 0.009--1.035; ß: -0.585, 95%CI: -0.894- -0.276).

CONCLUSION

Skipping breakfast positively influenced hyperuricemia through TC and LDL-C. Age moderated the relationship between skipping breakfast and serum uric acid. Greater attention should be given to young employees in Chinese oilfield enterprises, with dietary interventions implemented to reduce abnormal lipids metabolism and hyperuricemia.

Overview of pharmacodynamical research of traditional Chinese medicine on hyperuricemic nephropathy: from the perspective of dual-regulatory effect on the intestines and kidneys

Uncontrolled hyperuricemia contributes to chronic kidney disease, characterized by renal inflammatory cell infiltration and tubulointerstitial fibrosis, eventually leading to renal failure. In addition to liver and kidney, the intestine tract plays a vital role in the development and progression of hyperuricemia and hyperuricemic nephropathy (HN) through various mechanisms. The conventional therapeutic strategy for HN is uric acid-lowering therapy (ULT) and renal protection; however, unsatisfactory results are often obtained in clinical practice. Growing evidence has demonstrated that traditional Chinese medicines (TCMs) achieve an anti-HN effect by modulating multiple targets and approaches with fewer side effects. Therefore, this paper reviews the pathogenesis of HN, including the role of soluble and insoluble urates in kidney and intestine, and the role of intestinal tract in the progression of HN. Meanwhile, the recent advancements in TCMs for the treatment of HN are summarized and analyzed, with a focus on their modulation of intestinal flora and metabolites, urate-related transporters, immuno-inflammation and barrier function in the intestines. Notably, for the first time, we propose the perspective that TCMs treat HN through a dual-regulatory effect on the intestines and kidneys. Additionally, the problems existing in current research and the feasible research strategies combined with emerging technologies such as fermentation and nanotechnology are discussed, thus providing novel ideas for HN management.

Metabolic diseases in the East Asian populations

East Asian populations, which account for approximately 20% of the global population, have become central to the worldwide rise of metabolic diseases over the past few decades. The prevalence of metabolic disorders, including type 2 diabetes mellitus, hypertension and metabolic dysfunction-associated steatotic liver disease, has escalated sharply, contributing to a substantial burden of complications such as cardiovascular disease, chronic kidney disease, cancer and increased mortality. This concerning trend is primarily driven by a combination of genetic predisposition, unique fat distribution patterns and rapidly changing lifestyle factors, including urbanization and the adoption of Westernized dietary habits. Current advances in genomics, proteomics, metabolomics and microbiome research have provided new insights into the biological mechanisms that might contribute to the heightened susceptibility of East Asian populations to metabolic diseases. This Review synthesizes epidemiological data, risk factors and biomarkers to provide an overview of how metabolic diseases are reshaping public health in East Asia and offers insights into biological and societal drivers to guide effective, region-specific strategies.

Association between rheumatoid arthritis and hyperuricemia among adults: a cross-sectional study based on NHANES data

OBJECTIVES

This study aimed to explore the relationship between rheumatoid arthritis (RA) and hyperuricemia among adults.

METHOD

All the data were from the National Health and Nutrition Examination Survey (NHANES 1997-2018) database. Linear regression, logistic regression, and restricted cubic spline (RCS) analyses were used to investigate the association between RA and hyperuricemia. Subgroup analysis and interaction tests were conducted to assess the influence of various subgroups on their association.

RESULTS

This study included 41,460 patients, among whom 2603 had RA. The RA group had higher uric acid levels compared with the non-RA group (P < 0.001). Linear regression showed that RA was significantly related to uric acid levels among several adjusted models (all P < 0.05). Logistic regression analysis also indicated the independent association between RA and hyperuricemia in a positive relationship (P < 0.05). Subgroup analysis revealed significant association in the subgroups of females, age ≥ 60 years, non-Hispanics, individuals with hypertension and antihypertensive drugs use, and those with BMI ≥ 30 kg/m2 (all P < 0.05). The interaction test showed that there was no interaction effect between baseline features and RA (all interaction P > 0.05). RCS analysis further found that the course of RA, rather than the age of diagnosis, was related to hyperuricemia (P < 0.05). Furthermore, we found that the association between RA and hyperuricemia was mainly observed in populations with 15-30-year course of RA (P < 0.05).

CONCLUSIONS

RA was associated with hyperuricemia and their association was still stable even after adjusting for several variables, suggesting that uric acid levels should be routinely tested to detect hyperuricemia at an early stage in patients with RA. Key Points • Revealing association between rheumatoid arthritis (RA) and hyperuricemia risk: This study initially explored the association between RA and hyperuricemia, finding that RA was positively related to the higher uric acid levels and hyperuricemia risk. • Reflecting the role of RA course on their association: Our study found that their association was mainly observed in population with RA course of 15-30 years.

Albumin Corona-Coated Nanoscale Metal-Organic Framework for Enzyme-Mediated Cascade Metabolization of Uric Acid in Hyperuricemia

Hyperuricemia, characterized by elevated uric acid levels, is the primary cause of gout. Recombinant uricase is one of the last-resort therapies but generates unwanted pro-inflammatory H2O2 and anti-uricase antibodies. In this work, we developed an albumin corona-coated enzyme-loaded zeolitic imidazolate framework (UCZIF) to sustainably maintain low blood uric acid level without producing H2O2. The corona coating not only preserves loaded enzymes but also reduces macrophage phagocytosis by 73.4% compared to free uricase. In addition, the uptake level of UCZIF by dendritic cells is reduced by 74.1%, and the maturation of dendritic cells is inhibited by 35.4% compared to free uricase. Animal experiments demonstrate that albumin corona-coated UCZIF effectively lowers blood uric acid level in both acute and diet-induced chronic hyperuricemia models with significantly increasing the half-life of uricase. Furthermore, compared to the generation of anti-uricase antibodies during standalone uricase treatment, the levels of anti-uricase immunoglobulins are significantly reduced by 65.5% (immunoglobulin M) and 76.3% (immunoglobulin G) with repeated administration of albumin corona-coated UCZIF. Overall, this albumin corona-coated nanoscale metal-organic framework offers a promising approach to minimize the immunogenicity induced by exogenous enzymes and further safely reduce uric acid levels in the treatment of hyperuricemia.

Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study

Objectives

Febuxostat, an oral medication for treating hyperuricemia (HUA), is a non-purine xanthine oxidase inhibitor that regulates serum uric acid (SUA) metabolism in patients with chronic kidney disease (CKD). However, the drug's effectiveness in improving renal function in patients with non-dialysis stage 3/4 CKD remains unclear. Our aim is to investigate the efficacy of febuxostat on kidney function. In addition, the cardiac function will be assessed.

Method

We conducted a single-center, interventional, randomized, controlled, open-label study. A total of 316 patients with non-dialysis stage 3/4 CKD, with SUA ≥6mg/dL in women and ≥7mg/dL in men, were assigned to either the febuxostat group (n=156) or the control group (n=160). The primary endpoint was the evaluation of changes in kidney biomarkers from baseline to 12 months of treatment, and any changes in cardiac biomarkers and echocardiographs were the secondary endpoint.

Results

The primary endpoint was a comparison between the two groups from baseline to 12 months of treatment. SUA was significantly decreased in patients treated with febuxostat 40 mg (6.85 ± 0.41mg/dL at baseline and 5.27 ± 0.70mg/dL at 12 months of treatment, P<0.001) and this was associated with increased eGFR (34.48 ± 8.42ml/min at baseline and 38.46 ± 8.87ml/min at 12 months of treatment, P<0.001). There were significant decreases in high-sensitivity troponin T (19.50 ± 7.24ng/L at baseline and 16.98 ± 7.32ng/L at 12 months of treatment, P<0.001) and N-terminal-pro brain natriuretic peptide (941.35 ± 374.30pg/ml at baseline and 762.22 ± 303.32 pg/ml at 12 months of treatment, P<0.001) in the febuxostat group. These changes were also associated with increased left ventricular ejection fraction in the febuxostat group (50.47 ± 3.95% at baseline and 51.12 ± 3.96% at the end of the study, P<0.001).

Conclusion

In the interventional group, febuxostat was well-tolerated and demonstrated a reduction in SUA associated with an increase in eGFR. This slowed down the progression of renal disease in patients with non-dialysis stage 3/4 CKD and improved cardiac function.

Safety, Pharmacokinetics, and Efficiency of JS005, a Novel Anti-interleukin-17A Monoclonal Antibody, in Healthy Chinese Adults and Patients with Moderate to Severe Psoriasis

JS005 is a novel anti-IL-17A monoclonal antibody. A Phase Ia study (Study 1) in healthy adults, followed by a Phase Ib/II study (Study 2) in patients with moderate to severe plaque psoriasis (PsO), were designed to evaluate the safety, efficacy, and pharmacokinetic characteristics of JS005. Study 1 was a double-blind, randomized, placebo-controlled, single dose-escalation (15, 60, 150, 300, and 600 mg) study. Forty healthy participants were enrolled. Study 2 consisted of a dose-escalation (60, 150, 300, or 600 mg) phase Ib, and a multicentre, double-blind, placebo-controlled phase II administering JS005 150, 300 mg, or placebo once weekly from week 0 to 4 and once every 4 weeks from week 5 to 12. Forty and 143 patients were enrolled in phases Ib and II, respectively. The exposure of JS005 increased linearly with dosage, while the treatment-emergent adverse events did not show this trend. JS005 was well tolerated in both populations. In phase II of Study 2, the proportion of patients with at least a 75% improvement in the Psoriasis Area and Severity Index at week 12 was significantly higher in each JS005 group than in the placebo group (p < 0.001 for all comparisons). JS005 was highly effective in PsO patients.

Effect of Probiotic Product Containing Heyndrickxia coagulans TBC169 on Hyperuricemia in Rats

Hyperuricemia (HUA) is a metabolic disease characterized by elevated serum uric acid, which is closely related to the gut microbiota. Probiotics have great potential in improving HUA. The purpose of this study was to evaluate the effect and mechanism of probiotic product (SQK) containing Heyndrickxia coagulans TBC169 on HUA rats. Forty SD rats (6 weeks old, 200 ± 20 g) were randomly divided into four groups (Ctrl group, HUA group, SQK1 group, and SQK2 group) of 10 rats each. Rats were given potassium oxonate (100 mg potassium oxonate/100 g BW/day) for 12 weeks to establish HUA model and simultaneously administered with sterile saline (HUA group) or different dose of SQK (SQK1 group, 20.48 mg SQK/100 g BW/day; SQK2 group, 40.95 mg SQK/100 g BW/day) throughout the 12 weeks. The results showed that SQK could degrade uric acid precursors and inhibit the xanthine oxidase (XOD) activity in vitro. Oral supplementation of SQK can reverse the increase of serum uric acid, the increase of the liver and serum XOD activity, and the decrease of ABCG2 expression in the ileum induced by HUA. In addition, SQK could restore the changes in α and β diversity of the ileal microbiota and prevent the increase in pathogenic Helicobacter and Staphylococcus caused by HUA. 16S rRNA sequencing and correlation analysis showed that the chondroitin sulfate (CS) degradation pathway of the gut microbiota played a key role in the prevention of HUA in the SQK group. These findings suggest that SQK may improve HUA by reducing uric acid synthesis and increasing uric acid excretion and provide a basis for its development into a probiotic product to improve HUA.

Protective Effects of a Polyherbal Mixture on Intestinal Injury via the NF-κB Signaling Pathway and Gut Microbiota Modulation in Hyperuricemic Mice

This study investigated the protective effects of a polyherbal tea (PHT) on intestinal injury in hyperuricemia (HUA) mice and the underlying mechanisms. PHT was orally administered to mice for 49 days, while potassium oxonate and hypoxanthine were administered 7 days after PHT administration and continued for 42 days to cause HUA. Treatment with PHT significantly reduced serum uric acid and blood urea nitrogen levels in HUA mice. It also inhibited liver xanthine oxidase activity and promoted intestinal uric acid excretion through the upregulation of transporters GLUT9 and ABCG2. Intestinal barrier integrity was reinforced, as evidenced by the restoration of the villous structure, reduction in edema, and upregulation of tight junction proteins (occludin, ZO-1) and mucin (MUC2). Moreover, PHT suppressed serum LPS levels and inhibited the NF-κB pathway, leading to a reduction in TNF-α and IL-6 levels in the gut. Gut microbiota analysis revealed PHT reversed dysbiosis, enriching beneficial bacteria like Duncaniella sp. and Heminiphilus faecis. By UPLC-MS analysis, 154 compounds of PHT persisted in the gut, suggesting that these compounds are likely to modulate both intestinal barrier function and gut microbiota. These findings suggest that this PHT may have potential as a functional food for the prevention of hyperuricemia.

Eucommia folium can be Prepared as a Tea with the Ability to Prevent and Treat Hyperuricaemia

The aim of this study was to investigate the antihyperuricaemic (HUA) effect of Eucommia folium after preparing a tea made from its leaves (abbreviated as DZ) which has the ability to prevent and treat HUA. In this study, a mouse HUA model was established via gavage of potassium oxonate and hypoxanthine, and this HUA model was treated with DZ to investigate the therapeutic effect of DZ on HUA. This study recruited 30 HUA volunteers, who drank 10 g of DZ daily for four consecutive weeks. The serum HUA levels of UA volunteers were measured once per week to observe the anti-HUA efficacy of DZ at the clinical level. Animal experiments have shown that DZ has therapeutic effects on HUA. DZ effectively reduces the levels of uric acid (UA), creatinine (Cr), and urea nitrogen (BUN) in the serum of HUA mice; decreases xanthine oxidase (XOD) activity in the serum; and alleviates damage to kidney tissues and glomeruli. Metabolomic analysis revealed that DZ affects multiple metabolites, such as orotidine, orotic acid, ureidosuccinic acid, 1-methylhistidine, and other metabolites, and these metabolites are involved mainly in pyrimidine metabolism, histidine metabolism, and riboflavin metabolism. Clinical research revealed that, after DZ was consumed, the UA levels in the HUA volunteers significantly decreased. Our research findings suggest that DZ may have a protective effect against HUA. and is in the same class of traditional Chinese medicines used in medicine and food, with extremely low toxicity and high safety. Therefore, DZ may be suitable for preparation as a functional food with anti HUA effects. CLINICAL TRIAL NUMBER: Not applicable.

Machine learning-based prediction models for renal impairment in Chinese adults with hyperuricaemia: risk factor analysis

In hyperuricaemic populations, multiple factors may contribute to impaired renal function. This study aimed to establish a machine learning-based model to identify characteristic factors related to renal impairment in hyperuricaemic patients, determine dose‒response relationships, and facilitate early intervention strategies. Data were collected through the big data platform of Nanjing Hospital of Traditional Chinese Medicine, encompassing 2,705 patients with hyperuricaemia (1,577 with renal impairment, 828 without) from June 2019 to June 2022. After multiple imputations for missing values, the dataset was randomly split into training (70%) and validation (30%) sets. We employed three machine learning algorithms for feature selection: random forest (with 100 decision trees and an OOB error rate of 23.34%), LASSO regression (optimal lambda of -3.58), and XGBoost (learning rate of 0.3, maximum tree depth of 1, and 50 rounds of boosting). The intersection of features identified by these algorithms through Venn diagram analysis yielded four key predictors. A logistic regression model was subsequently constructed and evaluated for discrimination (AUC), calibration (Brier score), and clinical utility (DCA). Restricted cubic spline (RCS) curves were utilized to analyse the dose‒response relationships. The model, which incorporates age, cystatin C (Cys-C), uric acid (UA), and sex, demonstrated robust performance, with an AUC of 0.818 [95% CI (0.796-0.817)] in the training set and an AUC of 0.82 [95% CI (0.787-0.853)] in the validation set. Calibration tests yielded Brier scores of 0.160 and 0.158, respectively. Clinical decision curves revealed optimal prediction probability intervals of 6-99.02% and 7-93.14%. In the hyperuricaemic population, each 0.5 mg/L increase in Cys-C, 10-year increase in age, and 100 µmol/L increase in UA corresponded to increased risks of 13%, 81%, and 73%, respectively. RCS analysis revealed nonlinear relationships for Age and Cys-C and a linear relationship for UA, with sex-specific distribution patterns. The machine learning-based model incorporating these four indicators demonstrated excellent predictive performance for renal impairment in hyperuricaemic patients. These findings suggest that monitoring Cys-C and UA levels while considering age and sex differences is crucial for risk assessment and prevention strategies.

Association of Metabolic Score for Visceral Fat (METS-VF) with Gout Risk in Patients with Hypertension and Hyperuricemia: A Multicenter Study Based on the Chinese Population

Background

Gout, a rheumatic disease precipitated by hyperuricemia, has become a global health concern due to its increasing prevalence, especially in China. Hyperuricemia and hypertension are significant risk factors for gout, and their coexistence amplifies this risk. Visceral adipose tissue (VAT) plays a crucial role in cardiometabolic diseases, and the metabolic score for visceral fat (METS-VF) is a non-invasive tool for estimating VAT and predicting cardiometabolic risk.

Methods

We conducted a multicenter cross-sectional study involving 8877 patients with hypertension and hyperuricemia from three Chinese medical centers between March 2021 and September 2024. We calculated the METS-VF and other obesity indices and analyzed their associations with gout risk using logistic regression models. The predictive performance of these indices was evaluated using receiver operating characteristic (ROC) curve analysis and clinical decision curve analysis (DCA).

Results

The METS-VF demonstrated a significant positive association with gout risk, independent of traditional risk factors. Each 1-standard deviation increase in the METS-VF was associated with an 82% higher odds of gout (OR=1.82, 95% CI: 1.62 to 2.03). The METS-VF outperformed other obesity indices in predicting gout risk, with a higher area under the ROC curve (AUC) value. DCA indicated that the METS-VF provided a significant net benefit across a wide range of threshold probabilities for predicting gout risk in both genders.

Conclusion

The METS-VF's robust association with gout risk in our multicenter study, independent of conventional risk factors, positions it as a potent predictor for gout. Further investigation is warranted to clarify the underlying mechanisms and the long-term predictive validity of the METS-VF across diverse populations.

Dendrobium huoshanense C. Z. Tang and S. J. Cheng can be prepared as a food with the ability to prevent and treat hyperuricaemia

Background

Hyperuricemia (HUA) is the presence of excessive uric acid (UA) in blood, which leads to an increased risk of chronic kidney disease and gout. There are about 120 million hyperuricemia patients in China, which has surpassed diabetes as the second largest chronic disease.

Objective

The aim of the present study was to investigate the hypouricemic effects of Dendrobium huoshanense C. Z. Tang and S. J. Cheng (DH), and provide a basis for its development into anti HUA products.

Methods

This study established a mouse HUA model by gavage of potassium oxonate (PIO) and hypoxanthine (HX), and treated with DH to investigate the therapeutic effect of DH on hyperuricemia. Use a biochemical assay kit to detect changes in the levels of UA, creatinine (Cr), and urea nitrogen (BUN) in mouse serum; Use ELISA kit to detect the activity of xanthine oxidase (XOD) in serum; Untargeted Metabolomics analysis was performed on the serum of each group of mice using liquid chromatography-mass spectrometry. This study recruited 23 HUA volunteers, volunteers drank 0.5 g DH daily for four consecutive weeks, with serum UA levels measured once a week.

Results

Animal experiments have shown that DH has therapeutic effects on HUA, mainly manifested as: DH effectively reduces the levels of UA, Cr, and BUN in the serum of HUA mice, lowers XOD activity in the serum, and alleviates kidney tissue and glomerular damage. Metabolomics analysis showed that there were 306 significant differences in metabolites between the Sham group, HUA model group, and DH group. Pathway analysis of these differential metabolites revealed that they were mainly involved in pyrimidine metabolism, histidine metabolism, and riboflavin metabolism. Clinical research results show that after drinking DH, UA levels in HUA volunteers significantly decreased, and most HUA volunteers' UA levels decreased to normal levels.

Conclusion

DH has the effect of preventing and treating hyperuricemia, and it belongs to the same class of traditional Chinese medicine as medicine and food, with extremely low toxicity and high safety. Therefore, DH is suitable for preparation as a product for preventing and treating HUA in functional food and other products.

Non-traditional risk factors for atrial fibrillation: epidemiology, mechanisms, and strategies

Atrial fibrillation (AF) has become the pre-dominant arrhythmia worldwide and is associated with high morbidity and mortality. Its pathogenesis is intricately linked to the deleterious impact of cardiovascular risk factors, emphasizing the pivotal imperative for early detection and mitigation strategies targeting these factors for the prevention of primary AF. While traditional risk factors are well recognized, an increasing number of novel risk factors have been identified in recent decades. This review explores the emerging non-traditional risk factors for the primary prevention of AF, including unhealthy lifestyle factors in current society (sleep, night shift work, and diet), biomarkers (gut microbiota, hyperuricaemia, and homocysteine), adverse conditions or diseases (depression, epilepsy, clonal haematopoiesis of indeterminate potential, infections, and asthma), and environmental factors (acoustic pollution and other environmental factors). Unlike traditional risk factors, individuals have limited control over many of these non-traditional risk factors, posing challenges to conventional prevention strategies. The purpose of this review is to outline the current evidence on the associations of non-traditional risk factors with new-onset AF and the potential mechanisms related to these risk factors. Furthermore, this review aims to explore potential interventions targeting these risk factors at both the individual and societal levels to mitigate the growing burden of AF, suggesting guideline updates for primary AF prevention.

Excess Weight Loss at 6 Months Following Laparoscopic Sleeve Gastrectomy Correlates with the Remission of Hyperuricemia

BACKGROUND

Hyperuricemia is a metabolic disorder associated with obesity. Many studies have reported the effect of bariatric surgery on the decrease of serum uric acid level in patients with hyperuricemia. However, since the update of diagnostic criteria of hyperuricemia, the correlation between preoperative body mass index, postoperative weight changes, and the remission of hyperuricemia in patients with obesity after sleeve gastrectomy requires consensus.

METHODS

One hundred and ninety-three patients with obesity and hyperuricemia who underwent laparoscopic sleeve gastrectomy were enrolled. All patients were followed up for 6 months postoperatively. Subgroup analysis was performed using the tertiles of preoperative body mass index, total weight loss, and excess weight loss to investigate the correlation with the remission of hyperuricemia after sleeve gastrectomy.

RESULTS

A total of 193 patients were included in this study. Among them, 123 patients were female and 70 were male. And the mean age was 30.2 ± 7.8 years, preoperative body weight was 116.1 ± 23.3 kg, and the preoperative BMI was 40.5 ± 6.7 kg/m2. 59.1% (114/193) patients achieved remission of hyperuricemia 6 months after sleeve gastrectomy. The TWL% and EWL% were 25.6% ± 5.4% and 75.9% ± 28.2%, respectively. Female patients had a significantly higher remission rate than that of male patients (p < 0.05). Correlations were found between EWL%/preoperative BMI with the remission of hyperuricemia (p < 0.05).

CONCLUSION

Sleeve gastrectomy had a positive effect on the remission of hyperuricemia in patients with obesity. EWL% may play a significant role in the remission of hyperuricemia.

Association between dietary coenzyme Q10 intake and hyperuricemia in Chinese adults: a nationwide cross-sectional study

BACKGROUND

The association of food-sourced Coenzyme Q10(CoQ10) intake with hyperuricemia (HUA) remains unclear. We aimed to investigate the association between dietary CoQ10 intake and HUA among Chinese adults.

METHODS

A total of 7953 Chinese adults from the 2009 China Health and Nutrition Survey (CHNS) were included in the present cross-sectional. Dietary CoQ10 was assessed by 3 consecutive 24-h dietary recall interviews combined with a household food inventory. Multivariable logistic regression models and restricted cubic spline models were used to explore the associations between dietary CoQ10 and HUA.

RESULTS

In an adjusted logistic regression model, the multivariable odds ratio (OR) and 95% confidence interval (CI) for HUA in the highest versus the lowest quartile of total, animal-based, and plant-based CoQ10 intake were 1.40 (95% CI: 1.15 to 1.70), 1.46 (95% CI: 1.20 to 1.78), and 0.80 (95% CI: 0.65 to 0.97), respectively. Dose-response analyses revealed similar linear patterns, with the exception of plant-derived CoQ10, which did not reach statistical significance (p for nonlinearity = 0.09). In stratified analysis, there were no significant interactions between sex, age, BMI, smoking status, drinking status and total dietary CoQ10 intake in relation to the HUA (All p for interaction > 0.05).

CONCLUSIONS

Our study documented a novel positive association between total dietary CoQ10 intake and HUA, with similar trends for animal-derived CoQ10 and an inverse trend for plant-derived CoQ10.

Analysis risk factors of long-term adverse outcomes and a prediction nomogram for coronary artery disease patients underwent fractional flow reserve

Background: The role of fractional flow reserve (FFR) in intermediate lesions has been widely used and recommended by guidelines. However, the long-term outcomes in patient with an intermediate stenosis received FFR have not yet been investigated comprehensively. Methods: We retrospectively included 558 patients underwent both coronary artery angiography (CAG) and FFR. Multivariate logistic regression analysis was employed to identify the independent predictors of major adverse cardiovascular and cerebrovascular events (MACCEs). Additionally, we constructed a prediction nomogram and tested its performance by multiple methods. Results: During a median follow-up of 6.2 years, 87 (15.59%) adverse events were documented. Multivariate logistic regression results revealed that age (OR 1.13, p<0.01), diabetes mellitus (OR, 5.87, p<0.01), hyperuricemia (OR, 2.91, p<0.01) were independently associated with MACCEs. The nomogram consists of age, smoking, hypertension, diabetes mellitus (DM), hyperuricemia, and FFR≤0.8 six factors. The AUC of 3-year, 5-year, 7-year receiver operating characteristic (ROC) curves of training set were 0.697, 0.823, 0.854, and of validation set were 0.845, 0.924, 0.856. The calibration curves and decision curve analysis (DCA) illustrated the ability of the nomogram to predict long-term adverse outcomes and its net benefits in clinical practice. Conclusions: Age, DM, and hyperuricemia were independently associated with long-term adverse outcomes, and the constructed nomogram may be used as a visible tool to predict long-term adverse outcomes for patients underwent FFR.

Nonlinear Association Between the Liver Fat Content and the Risk of Hyperuricemia in Prediabetic Individuals: Evidence from Cross-Sectional Health Screening Data in China

Purpose

The impact of hepatic lipid accumulation on hyperuricemia presents an intriguing research avenue, particularly in light of existing studies linking obesity with hyperuricemia. Nevertheless, there remains a scarcity of quantitative investigations into the correlation between liver fat content (LFC) and hyperuricemia among prediabetic cohorts, notably within the Chinese demographic.

Patients and Methods

This cross-sectional study was conducted at the Health Management Center of Henan Provincial People's Hospital between January 2019 and December 2023, involving 2,950 pre-diabetic participants. Participants were categorized into groups based on diagnostic criteria for hyperuricemia. LFC was assessed using computed tomography. Statistical analyses included multivariate logistic regression, limited cubic spline regression models, and subgroup analyses to explore the association between LFC and hyperuricemia among individuals with pre-diabetes.

Results

The prevalence of hyperuricemia among the 2,950 prediabetic individuals was observed to be 22.20%. Prediabetic individuals with hyperuricemia exhibited higher levels of LFC compared to those without hyperuricemia. This association persisted even after adjusting for other variables, indicating a heightened risk of hyperuricemia among prediabetic individuals with elevated LFC [Q4 vs Q1: odds ratio (OR 2.70), 95% confidence interval (CI) 1.93-3.79, P < 0.001; P for trend < 0.001]. Importantly, a nonlinear relationship between LFC and hyperuricemia risk was identified in the prediabetic individuals, showing a significant increase in hyperuricemia risk when LFC exceeded 8.4% (OR per standard deviation = 1.05, 95% CI: 1.02-1.08, P < 0.001).

Conclusion

In individuals with prediabetes, a higher LFC is associated with an elevated risk of hyperuricemia, especially when LFC exceeds 8.4%.

Development and validation of the nutrition literacy scale for Chinese gout patients

BACKGROUND

Nutrition literacy is essential for the self-management and treatment of gout patients. However, to date, there is no appropriate scale to measure the level of nutrition literacy gout patients in China.

OBJECTIVE

This study objective to develop and psychometric nutrition literacy scale for patients with gout.

METHODS

Using item development and psychological assessment. First, literature review, brainstorming, delphi study, and pr-survey were used to construct draft of the nutrition literacy scale for patients with gout. Second, 526 patients with gout underwent scale-based surveys. Item analysis and exploratory factors were used to optimize the scale. Confirmatory factor analysis was used to verify the structure of the scale, including the goodness of fit of the model, convergent validity, and discriminant validity. Subsequently, the reliability of the scale was tested using cronbach's α coefficient and test-retest reliability.

RESULTS

The formal scale contains 5 dimensions: nutrition belief, nutrition knowledge, nutrition information acquisition ability, nutrition information interaction ability, nutrition information criticism ability, and 26 items. The overall content validity of the scale is 0.933. Exploratory factor analysis extracted 5 factors with a cumulative variance contribution of 82.18%. Confirmatory factor analysis showed that the scale structure was well fitted, with good convergent and discriminant validity. The overall cronbach's α coefficient of this scale was 0.873, and the cronbach's α coefficients of the dimensions were 0.861 ~ 0.980, and the overall re-test reliability was 0.864, and the re-test reliabilities of the dimensions were 0.881 ~ 0.981.

CONCLUSION

Nutrition Literacy Scale for Gout Patients has good reliability and validity. It is suitable for the evaluation of nutrition literacy level in relevant population.

Association of alcohol abstinence with risk of hyperuricemia in rural Chinese adults: the Henan Rural Cohort Study

BACKGROUND

Alcohol drinking can cause hyperuricemia (HUA), but few studies have explored alcohol abstinence's health effects, particularly the abstinence duration on HUA. This study aimed to evaluate the associations of abstinence with HUA in rural Chinese adults.

METHODS

This was a cross-sectional study of 38,855 participants (15,371 males and 23,484 females) using the baseline data (2015-2017) from the Henan Rural Cohort Study. A questionnaire survey collected information on alcohol consumption patterns. Multivariate logistic regression analyses were used to evaluate the associations of type of alcoholic beverages, abstinence status and abstinence duration with HUA, respectively. Restricted cubic spline models were applied to visualize the dose-response trend of HUA risk with increasing abstinence duration.

RESULTS

3,978 cases of 38,855 participants were identified with HUA. Total alcohol intake, including beer, liquor and rice wine intake was significantly associated with the increased risk of HUA, especially for male participants. Compared with current drinkers, former drinkers and non-drinkers presented lower ORs (95%CIs) of 0.686 (0.676, 0.844) and 0.718 (0.649, 0.793) for HUA. Furthermore, the aORs (95%CIs) for those former drinkers with < 5, 6-10 and ≥ 11 years abstinence duration were 0.868 (0.693, 1.086), 0.753 (0.519, 1.092) and 0.717 (0.517, 0.990), respectively. In addition, the risk of HUA decreased with the increasing years of abstinence duration (P for trend < 0.050) and negative linear dose-response associations were observed.

CONCLUSION

Former drinkers were associated with a reduced risk of HUA compared with current drinkers. Moreover, sustained alcohol abstinence could be beneficial for preventing HUA.

CLINICAL TRIAL REGISTRATION

The Henan Rural Cohort Study was registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06 http://www.chictr.org.cn/showproj.aspx?proj=11375 .

A study on the correlation between hyperuricemia and lifestyle and dietary habits

This study aimed to compare whether differences in lifestyle and dietary habits have an impact on hyperuricemia and to provide a reliable basis for the health management of citizens in our city. A total of 10,883 subjects who did not suffer from hyperuricemia, was anticipated in this study in 2018. After 2 years of follow-up, 7727 did not suffer from hyperuricemia and 3156 suffered from hyperuricemia. Dietary habits and lifestyle were collected by questionnaire. Multivariate logistic regression was used to identify the risk factors of hyperuricemia. For the analysis of the amount of change in uric acid (UA) before and after 2 years, t-tests and spearman correlation were used to explore the differences between the groups, and the trend effect of each variable on the amount of change in uric acid was analyzed by linear regression equations. The results showed that the prevalence of hyperuricemia varied by sex, high-fat food, smoked and fried food, milk and soy products, sugary drinks, sleep time, and the degree of smoking and drinking. Among them, infrequent consumption of milk and soy products, and short sleep time were risk factors for hyperuricemia, and men were more likely to have elevated uric acid levels after 2 years. It is recommended that people with hyperuricemia should actively limit their intake of fried foods, alcohol, and purine-rich foods, increase their intake of milk and soy foods, increase their sleep time, and seek to improve kidney and liver function.

A comprehensive analysis of trends in the burden of gout in China and globally from 1990 to 2021

Gout is a prevalent metabolic disorder characterized by urate crystal accumulation in joints, leading to acute arthritis and tophi formation. Despite advancements in management, the incidence and prevalence of gout have been increasing globally, particularly in China. This study analyzed data from the Global Burden of Disease Injuries and Risk Factors Study (GBD) to evaluate trends in gout from 1990 to 2021. Statistical analyses were conducted using R and Joinpoint software, while the ARIMA model was employed for forecasting future trends. Our findings revealed a global increase in gout incidence from 93.097 per 100,000 in 1990 to 109.075 per 100,000 in 2021, with cases rising from 3,983,109 to 9,401,585. In China, incidence increased from 122.522 to 151.612 per 100,000, with cases growing from 1,182,498 to 3,079,836. Similarly, global prevalence rose from 536.545 to 653.816 per 100,000, while in China, it increased from 640.679 to 810.359 per 100,000. Disability metrics, including YLDs and DALYs, also demonstrated significant increases both globally and in China. Our analysis indicated that middle-aged and elderly populations, particularly males, are at higher risk for gout. These findings underscore the urgent need for enhanced prevention and management strategies, specifically targeting high-risk populations. Effective public health policies and interventions are crucial to mitigate the escalating burden of gout and improve the quality of life for affected individuals. This study relied on secondary data from the GBD, which may be subject to biases in data collection and reporting. Additionally, variations in diagnostic practices and healthcare access across regions could influence the accuracy of reported trends. Future research should address these limitations by incorporating primary data and exploring region-specific factors contributing to gout prevalence and incidence.

Inverse relationship of oxidative balance score with hyperuricemia among Chinese adults: a population-based cross-sectional study

BACKGROUND

The oxidative balance score (OBS) is a composite metric highlights pro-oxidants and antioxidants balance, representing the overall burden of oxidative stress. This study aims to examine the association between OBS and hyperuricemia in a Chinese population.

METHODS

This study was based on population-based cross-sectional survey data of Fujian province from August 2020 to April 2021. OBS was determined based on 10 food and lifestyle OBS components. The association between OBS and hyperuricemia was investigated using logistic regression analysis. Subgroup analyses identified sensitive populations. Restricted cubic spline (RCS) was performed to examine the potential dose-response relationship.

RESULTS

A total of 9464 participants were included in the final analysis. An inverse association between OBS and hyperuricemia was observed and remained after adjusting for potential confounders. Each additional unit of OBS was associated with a 4% and 7% reduction in the risk of hyperuricemia in men [OR: 0.96(0.94,0.99)] and women [OR: 0.93(0.90,0.96)], respectively. Participants in the highest quartile had a 22% and 37% lower risk of hypertension compared with the lowest quartile of OBS in men [0.78(0.62,0.97)] and women [OR: 0.63(0.49,0.79)], respectively. There were significant interactions between OBS and gender, hypertension, and dyslipidemia on hyperuricemia (Pinteraction < 0.05), except for age, education, and diabetes (Pinteraction > 0.05). A linear dose-response relationship between OBS and the risk of hyperuricemia (Pnonlinear = 0.7854) was observed.

CONCLUSIONS

An inverse association as well as dose-response relationship between OBS and hyperuricemia were observed. Increasing antioxidant levels through lifestyle modification may be an effective way to prevent hyperuricemia, especially in women. Large prospective cohort studies and randomized controlled trials are required to verify the effect of OBS on hyperuricemia and elucidate its causal mechanism.

The association between body roundness index and new-onset hyperuricemia in Chinese population: the Kailuan cohort study

BACKGROUND

This study aimed to investigate the potential relationship between the newly defined adiposity metric, the Body Roundness Index (BRI), which assesses central obesity, and the development of new-onset hyperuricemia.

METHODS

In the Kailuan cohort study from 2006 to 2019, 91,804 eligible participants were included. A multivariate Cox regression model was used to test the correlation between BRI and hyperuricemia. At the same time, the restricted cubic spline was applied to solve the dose-response relationship between BRI and the risk of hyperuricemia.Then, stratified analysis was carried out using multivariate Cox regression according to age, sex, hs-CRP level, TG level, education level, smoking status and hypertension status.

RESULTS

The results showed that the risk of new-onset hyperuricemia was significantly increased in the highest quartile compared with the lowest quartile. After adjusting for confounders, compared with Q1, the HR (95% CI) for new-onset hyperuricemia was 1.24 (1.18-1.30), 1.32 (1.25-1.40), and 1.40 (1.29-1.52) for Q2, Q3, and Q4, respectively. Restricted cubic spline analysis showed a J-curve relationship between baseline BRI levels and new-onset hyperuricaemia. Age, sex, hs-CRP level, TG level, income level, education level, smoking, and hypertension each had a multiplicative interaction with BRI at baseline.

CONCLUSION

We found that elevated BRI increased the risk of developing new-onset hyperuricaemia. In addition, the association between elevated BRI and the risk of new-onset hyperuricemia showed dependency on age, sex, hs-CRP level, TG level, education level, smoking status and hypertension status.

A Hospital-Based, Single-Center, Cross-Sectional Study to Investigate the Status Quo of Hyperuricaemia in a Booming Seaside City with Young Population from 2020 to 2021 in China

Background

This is a hospital-based, single-center, cross-sectional study to investigate the status quo of hyperuricaemia (HUA) in general adults in Shenzhen, a booming seaside city in the South China.

Methods

All health adults (≥18 years old) undergoing health examination from 2020 Oct 1 to 2021 September 30 in a general hospital were enrolled. Their medical records were investigated and analyzed.

Results

Total 4604 participants (2938 males and 1756 females) were included and analyzed. We found that although the participants in Shenzhen were younger than the people included the analogous study in the adjacent cities (total 38.41 ± 10.33 years, 39.11 ± 10.18 in males and 37.24 ± 10.47 in females), the prevalence of HUA reached to amazing 34.7% (43.5% in males and 20.1% in females). Moreover, great HUA-related gender difference was found in terms of age-related variation trends of HUA prevalence (P < 0.001), indices of laboratory examination (P < 0.01) and influence factors (P < 0.001).

Conclusion

These results raise alarm bells for the HUA problem in the booming seaside city with young population like Shenzhen in China (2020-2021). Effective measures are appealed to reduce the high prevalence of HUA of Shenzhen. In addition, during analyses of the data, we found that both the prevalence of HUA and age of the population need to be seriously considered. Accordingly, we propose a more representative index, namely "Prevalence-Age Index (PAI = Prevalence of HUA/Average age)" to be used in the future HUA-related investigations.

The association of visceral fat metabolism score with hyperuricemia-evidence from NHANES 1999-2018

Objectives

Despite substantial evidence that visceral obesity is an epidemiological risk factor for hyperuricemia (HUA), studies on the connection between the Metabolic Score for Visceral Fat (METS-VF) and HUA remain insufficient. This research focused on METS-VF's potential role as a risk factor for HUA.

Methods

Notably, 8,659 participants from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were enrolled in this study. Propensity score matching (PSM), multivariate logistic regression analysis, subgroup analysis, interaction test, and restricted cubic spline (RCS) analysis were implemented to identify the correlation between METS-VF and HUA.

Results

In the fully adjusted model, the results of the multiple logistic regression analysis indicated that METS-VF was related to an elevated prevalence of HUA [before PSM: odds ratio (OR) = 3.51 (2.88, 4.27), p < 0.001; after PSM: OR = 2.90 (2.36, 3.58), p < 0.001]. In RCS analysis, a non-linear positive correlation was observed between METS-VF and the incidence of HUA (before PSM: p-non-linear <0.001; after PSM: p-non-linear = 0.0065). Subgroup analysis and interaction tests revealed that the impact of METS-VF on HUA was modified by sex and ethnicity.

Conclusion

There is a significant positive correlation between METS-VF and HUA in adults in the United States. METS-VF could serve as a valuable metric for assessing the development and progression of HUA.

Assessment of public literacy in TB prevention and control in the National 13th Five-Year plan for Tuberculosis Prevention and Control (2016-2020) in China

BACKGROUND

China has always been a country with a high burden of tuberculosis. In order to end TB, the Chinese government launched three plans for TB prevention and control. The Chinese government implemented the National 13th Five-Year plan for Tuberculosis Prevention and Control (2016-2020) to promote TB prevention and control from policy, technology, health promotion and other aspects from 2016 to 2020. The objective of this study was to assess public TB literacy in health promotion in the National 13th Five-Year plan for Tuberculosis Prevention and Control (2016-2020), and provide a basis for the next plan. Compared with previous studies on TB literacy, this study increased the sample size to cover all provinces in China, which is more representative.

METHODS

A cross-sectional study covering all provinces in China was conducted in 2020. 47,728 questionnaires were collected. Logistic regression was used to analyze the overall awareness of TB health literacy among people with different demographic characteristics. Multicollinearity and outliers were checked using VIF and box plots, respectively.

RESULTS

In the TB key information, the total awareness rate of TB key information was 82.51%. Participants had poor awareness that TB is a chronic infectious disease, and if the whole course of treatment is standardized, the vast majority of patients can be cured and can avoid infecting others. Participants who received public education on TB had better awareness of TB key information. Participants who were over 60 years old, had a primary school or below degree, students, and did not receive public education on TB were less likely to know all TB key information. In the public education methods, participants were more likely and preferred to receive public education on TB through television or radio (67.93%) and Internet (33.85%) more and preferred television or radio (65.39%) and Internet (54.60%). Compared with participants aged below 60, participants aged 60 and above were more likely to receive public education on TB through relatives or friends (16.80%) (P < 0.001) and preferred to receive public education on TB through television or radio (68.15%), doctor consultation (42.19), relatives or friends (16.15%) (P < 0.001). Participants were more likely to query health-related information through self-media platforms (41.55%) and search engines (31.41%) on the Internet, but the elderly (60 years old and above) and participants with primary school or below degree were more likely to not to query health-related information (56.27%, 59.30%) on the Internet. In the public education materials, participants preferred audiovisual (40.69%), text and images (39.51%) public education materials. Participants preferred video (60.12%), text and image (51.78%) health-related information on the Internet.

CONCLUSIONS

The overall public TB literacy was considered high, but the awareness of some TB key information did not reach the target, and it is necessary to strengthen public education on TB for the elderly, people with low education and students. In the future, audiovisual media and the Internet should be the main methods of public education on TB for all people. Relatives or friends dissemination and doctor consultation are also suitable public education methods for older people. More health-related information should be promoted on the Internet, especially on self-media and search engine. TB public education materials and health-related information should use more audio-visual types.

The Association of Persistent Hyperuricemia With Liver Function and the Management of Uric Acid Levels: Insights From a Three-Year Prospective Cohort Study

OBJECTIVE

The association of long-term hyperuricemia with liver function remains less well understood. This prospective cohort study aimed to investigate the relationship between hyperuricemia and liver function as well as other metabolic and cardiovascular parameters.

METHODS

We enrolled 375 participants with hyperuricemia and 599 normouricemic controls. Participants were followed up for 3 years, and data on liver indicators, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasonography were collected. Additionally, we assessed other parameters, such as renal function, lipid profile, blood pressure, fasting blood-glucose (FBG), and body mass index (BMI).

RESULTS

The highest prevalence of hyperuricemia was observed in the 20-29 age groups for the participants. Among the comorbidities of patients with hyperuricemia, the proportion of dyslipidemia is the highest (58.13%), followed by fatty liver (50.13%) and liver function impairment (33.07%). During the three-year follow-up period, compared to the baseline, patients with persistent hyperuricemia showed significant increases in BMI, triglycerides, total cholesterol, AST, and ALT levels (p < 0.05). Meanwhile, patients with improved hyperuricemia for 2 years exhibited significant decreases in FBG, total cholesterol, serum creatinine (p < 0.05), along with a significant increase in eGFR (p < 0.05). Correlation analysis revealed that levels of uric acid were positively correlated with ALT, FBG, and triglycerides in persistent hyperuricemia (p < 0.05).

CONCLUSION

Hyperuricemia shows a notable trend of younger age onset. Persistent hyperuricemia, correlated with elevated ALT levels, indicates an increasing risk of liver damage that should be concerned about. Effective management of hyperuricemia could improve metabolic disorders and renal dysfunction.

Gouty arthritis patients' diagnostic, biochemical, and hematological characteristics study: a single-center retrospective study

OBJECTIVE

This study aims to investigate the diagnostic, biochemical, and hematological characteristics of patients with gouty arthritis and analyze their correlations with baseline characteristics to guide clinical practice, develop personalized treatment strategies, and improve patient outcomes.

METHODS

A single-center retrospective analysis was conducted on 8,344 patients with acute gouty arthritis admitted to our hospital between January 2014 and December 2023. Baseline characteristics and laboratory data, including uric acid, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP), white blood cell count, neutrophil count, lymphocyte count, monocyte count, fibrinogen, and serum albumin, were collected. General linear and Pearson correlation analyses were performed to identify significant relationships.

RESULTS

Significant correlations were observed between baseline characteristics (age, body mass index (BMI), smoking, and drinking status) and uric acid levels. High uric acid levels were positively correlated with inflammatory markers (hs-CRP, white blood cell count, and neutrophil count) and metabolic indicators (triglycerides, LDL-C, and creatinine) but negatively correlated with HDL-C. Notable differences in blood and biochemical indicators were identified across age, gender, and BMI groups.

CONCLUSION

This study highlights key laboratory characteristics of gouty arthritis, emphasizing the need for individualized treatment strategies. Comprehensive interventions focusing on managing inflammation and metabolic disturbances in patients with elevated uric acid levels are critical for optimizing prognosis and improving quality of life.

Integrated Data Mining and Animal Experiments to Investigate the Efficacy and Potential Pharmacological Mechanism of a Traditional Tibetan Functional Food Terminalia chebula Retz. in Hyperuricemia

Background

Hyperuricemia (HUA), a common metabolic disorder associated with gout, renal dysfunction, and systemic inflammation, necessitates safer and more comprehensive therapeutic approaches. Traditional Tibetan medicine has a rich history of treating HUA. This study aimed to identify novel anti-hyperuricemic herb derived from traditional Tibetan medicine.

Methods

Traditional Tibetan medicine prescriptions for HUA were analyzed using data mining techniques, identifying T. chebula as a high-frequency herb. Its phytochemical composition was characterized by UPLC-QE-Orbitrap-MS. Hyperuricemic rat models were treated with T. chebula to assess its effects on serum uric acid (UA) levels, renal inflammation, intestinal barrier integrity, and gut microbiota composition. Molecular and histological analyses evaluated its impact on key biomarkers.

Results

Through data mining, we identified T. chebula as a promising candidate for HUA treatment. T. chebula demonstrated dose-dependent inhibition of xanthine oxidase (XOD) in vitro and significantly reduced serum UA levels and XOD activity in vivo. It restored gut barrier function by upregulating tight junction proteins (ZO-1, Occludin, Claudin-1) and reduced pro-inflammatory cytokines (IL-6, TNF-α). T. chebula improved renal function, reducing serum creatinine (Cre) and blood urea nitrogen (BUN) levels. Gut microbiota analysis revealed a favorable shift in microbial composition, with reductions in harmful bacteria (eg, Clostridium spp.) and increases in beneficial bacteria (eg, Roseburia). These effects aligned with the modulation of the gut-kidney axis.

Conclusion

This study highlights the multi-target therapeutic potential of T. chebula in HUA management. By regulating the gut-kidney axis, T. chebula alleviates systemic inflammation, enhances intestinal and renal health, and addresses critical aspects of HUA pathology. These findings underscore the value of integrating traditional medicine with modern scientific methodologies to develop innovative treatments.

Mechanism of intestinal flora affecting SLC2A9 transport function to promote the formation of hyperuricemia

Objective

To investigate the structural characteristics of the intestinal flora in obese-hyperuricemic (HUA-W) patients and the mechanisms by which they promote the formation of hyperuricemia.

Methods

120 human fecal samples (60 cases in HC, 30 cases in HUA-N, and 30 cases in HUA-W) and 40 cases in the colonic tissues (20 cases in HC, 10 cases in HUA-N, and 10 cases in HUA-W) were collected. The intestinal flora of faeces was detected by 16s rRNA method; and the expression of SLC2A9 on human colon tissues was detected by RT-qPCR method and immunofluorescence method. 40 obese-hyperuricemia rat models were established (10 rats in Model, 10 rats in HC-FT, 10 rats in HUA-N-FT, and 10 rats in HUA-W-FT), and 10 rats were set up in Control; and the level of uric acid in rat serum, the levels of xanthine oxidase (XOD) activity and uric acid in intestinal fluid were examined. SLC2A9+ Caco-2 cells were produced to simulate the Transwell uric acid transport model, and the Caco-2 cells and SLC2A9+ Caco-2 cells were grown in five different culture media (Blank, Germ-free, HC-germ, HUA-N-germ and HUA-W-germ), and the uric acid levels in the upper and lower layers of the chambers were detected.

Results

The HUA-W intestinal flora showed significant specificity, with a decrease in Bacteroidota and Bacteroidia and an increase in Escherichia and Ruminococcus. There were no significant differences in the fluorescence intensity of the SLC2A9 protein and the SLC2A9 mRNA levels in the colon tissues of the HUA-N and HUA-W (P = 0.447, P = 0.152, P = 0.4799 and P = 0.965, respectively). In rat animal experiments, uric acid levels were significantly higher (P < 0.05) and XOD activity was significantly higher (P < 0.05) in intestinal fluid of HUA-W-FT. In Transwell experiments with SLC2A9+ Caco-2 cells, uric acid levels were increased in the upper compartment and decreased in the lower compartment of HUA-W-germ.

Conclusion

HUA-W intestinal flora may increase XOD activity in the intestinal tract and improve the ability of uric acid transporter protein SLC2A9 to reabsorb uric acid, providing a new theoretical basis for the pathogenesis of hyperuricemia.

Protective effect of xylosma congesta extract on renal injury in hyperuricemic rats

Background

The purpose of this study was to investigate the protective effect of xylosma congesta extract on kidney injury in hyperuricemic rats.

Methods

The rats were fed yeast extract and intraperitoneal injections of potassium oxonate for 3 weeks to establish the hyperuricemia model. And then the rats were treated with allopurinol and different doses of oak extract. The contents of uric acid in urine and serum, creatinine, and urea nitrogen in serum were detected by biochemical methods. TUNEL was used to detect cell apoptosis in renal tissue. The protein expression of TLR4 and NF- kappa B (NF-κB) p65 and the proportion of CD68 and CD206 positive cells in renal tissue were detected by pathological method.

Results

The xylosma congesta group showed decreased renal tubular dilatation, decreased renal interstitial inflammatory cell infiltration, decreased serum creatinine content, and decreased apoptotic cell count as compared to the model group. And positive expression of TLR4 and NF-κB decreased with each dose. Additionally, the xylosma congesta groups showed a significant rise in CD206 and a considerable decrease in CD68.

Conclusion

The extract from xylosma congesta has the ability to lower serum uric acid and creatinine levels while also providing protection against kidney damage caused by hyperuricemia.

9-Hydroxy-8-oxypalmatine, a novel liver-mediated oxymetabolite of palmatine, alleviates hyperuricemia and kidney inflammation in hyperuricemic mice

ETHNOPHARMACOLOGICAL RELEVANCE

Palmatine is a main bioactive alkaloid of Cortex Phellodendri, which has been commonly prescribed for the treatment of hyperuricemia (HUA) in China. The metabolites of palmatine were crucial to its prominent biological activity. 9-Hydroxy-8-oxypalmatine (9-OPAL) is a novel liver-mediated secondary oxymetabolite of palmatine.

AIM OF THE STUDY

The current study was to assess the efficacy of 9-OPAL, a novel liver-mediated secondary oxymetabolite of palmatine derived from Cortex Phellodendri, in experimental HUA mouse model and further explore its underlying mechanism.

MATERIALS AND METHODS

An in vitro metabolic experiment with oxypalmatine was carried out using liver samples. We separated and identified a novel liver metabolite, and investigated its anti-HUA effect in mice. HUA mice were induced by potassium oxonate and hypoxanthine daily for one week. After 1 h of modeling, mice were orally administered with different doses of 9-OPAL (5, 10 and 20 mg/kg). The pathological changes of the kidneys were evaluated using hematoxylin-eosin staining (H&E). The acute toxicity of 9-OPAL was assessed. The effects of 9-OPAL on serum levels of uric acid (UA), adenosine deaminase (ADA), xanthine oxidase (XOD), creatinine (CRE), blood urea nitrogen (BUN) and inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA) or biochemical method. Furthermore, Western blot, quantitative real-time PCR (qRT-PCR) and molecular docking were used to investigate the effect of 9-OPAL on the expression of renal urate transporters and NLRP3 signaling pathway in HUA mice.

RESULTS

9-OPAL had been discovered to be a novel liver-mediated oxymetabolite of palmatine for the first time. Treatment with 9-OPAL significantly reduced the UA, CRE as well as BUN levels, and also effectively attenuated abnormal renal histopathological deterioration with favorable safety profile. Besides, 9-OPAL significantly decreased the serum and hepatic activities of XOD and ADA, dramatically inhibited the up-regulation of UA transporter protein 1 (URAT1) and glucose transporter protein 9 (GLUT9), and reversed the down-regulation of organic anion transporter protein 1 (OAT1). Additionally, 9-OPAL effectively mitigated the renal inflammatory markers (TNF-α, IL-1β, IL-6 and IL-18), and downregulated the transcriptional and translational expressions of renal Nod-like receptor family pyrin domain containing 3 (NLRP3), caspase-1, apoptosis-associated speck-like (ASC) and IL-1β in HUA mice. Molecular docking results revealed 9-OPAL bound firmly with XOD, OAT1, GLUT9, URAT1, NLRP3, caspase-1, ASC and IL-1β.

CONCLUSIONS

9-OPAL was found to be a novel liver-mediated secondary metabolite of palmatine with favorable safety profile. 9-OPAL had eminent anti-hyperuricemic and renal-protective effects, and the mechanisms might be intimately associated with repressing XOD activities, modulating renal urate transporter expression and suppressing the NLRP3 inflammasome activation. Our investigation might also provide further experimental evidence for the traditional application of Cortex Phellodendri in the treatment of HUA.

Uric acid reference values for children and adolescents should be stratified by pubertal stage

BACKGROUND AND AIM

To establish reference values for hyperuricemia (HUA) in children and adolescents.

METHODS AND RESULTS

The study enrolled 4807 students from "The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen study." Utilizing quantile regression, associations between age, body mass index (BMI), pubertal stage, and serum uric acid (SUA) were examined, alongside the relationship between SUA and cardiovascular disease (CVD) risk factors. Reference values for SUA were explored using receiver operating characteristic analysis, considering sex and pubertal stage. The prevalence of HUA was 34.3 % for boys and 29 % for girls (using the adult HUA diagnostic criteria: >420 μmol/L for males, >360 μmol/L for females), increasing with higher BMI, age, and pubertal stage. Pubertal stage had the largest influence on SUA in boys, while nutritional status was the most significant factor affecting SUA in girls. Adjusting for age and pubertal stage, higher SUA levels correlated with an increased risk of CVD risk factors. Proposed reference values included >360 μmol/L for girls ages 6-17 years and prepubertal boys. For pubertal boys, reference values varied based on age: >392 μmol/L for ages 9-11 in early-middle puberty, >429 μmol/L for ages 12-14 in early-middle puberty, >478 μmol/L for ages 12-14 in late puberty, and >505 μmol/L for ages 15-17 in late puberty.

CONCLUSIONS

Stratifying HUA reference values by pubertal stage, particularly for boys, is crucial. Long-term follow-up of individuals with high SUA levels may aid in refining SUA reference values.

A cross-sectional study of the association between blood metal mixtures exposure and hyperuricemia

OBJECTIVES

To determine the association between blood metal mixture and HUA risk.

METHODS

A cross-sectional study was performed based on the populations from Kailuan cohort trial in China. Inductively coupled plasma mass spectrometry was utilized to detect the blood concentrations of iron (Fe), lead (Pb), calcium (Ca), copper (Cu), magnesium (Mg), zinc (Zn), selenium (Se), and manganese (Mn). Multivariate logistic regression (MLR) models and weighted quantile sum (WQS) regression models were employed to assess the relationships.

RESULTS

There were 3706 participants included in this study, and 464 (12.52%) were with HUA. The mean level of uric acid was 485.60 μmol/L in the subjects with HUA, which was remarkably increased compared to those without HUA (293.10 μmol/L). The multivariate-adjusted odds ratios (95% confidence intervals) of HUA were 2.15 (1.40, 3.29) for Pb, 3.42 (2.24, 5.23) for Fe, 1.61 (1.15, 2.25) for Ca, 3.06 (2.04, 4.59) for Mg, and 1.69 (1.26, 2.28) for Zn by comparing the highest and lowest metal quartiles using the single-metal logistic regression model. Meanwhile, the WQS regression models demonstrated a positive association between metal mixtures and HUA risk, to which, Fe, Mg, Pb, and Zn were the major contributors. Pb, Fe, and Zn were still robust in multiple-metal models. Age, gender, weight, smoking, and drinking status could modify these relationships with significant interactions.

CONCLUSIONS

Co-exposure to Fe, Pb, Ca, Cu, Zn, Mg, Se, and Mn were related to increased HUA risk in Chinese adults, of with, Pb, Fe, and Zn appeared to have greater impacts. These relationships were more obvious in adults aged < 60 years, or women, or overweight, or non-smoking, or drinking with significant interactions. Key Points • Increased Fe, Pb, Mg, Ca, and Zn were related to increased HUA risk in dose-response fashion among Chinese adults. • The metal mixture dominated by Fe, Mg, Pb, and Zn was positively associated with HUA risk. Fe, Pb, and Zn were still robust in MM model. • Such association was stronger showed in adults aged < 60 years, or women, or overweight, or non-smoking, or drinking with significant interactions.

Establishment and optimization of a novel mouse model of hyperuricemic nephropathy

Hyperuricemia is a metabolic disorder characterized by elevated serum uric acid levels. Soluble urate can activate immune responses, and the excessive accumulation of urate in the kidneys results in hyperuricemic nephropathy (HN). However, the lack of an established HN model is a major obstacle to advancing research into the pathogenesis of HN and the development of novel drugs. In this study, we generated and evaluated an optimized mouse model of HN by the combined administration of potassium oxonate and hypoxanthine at various dosages. Our results demonstrated that intraperitoneal injection of 200 mg/kg potassium oxonate with gavage of 500 mg/kg hypoxanthine caused renal injury in mice, as evidenced by the elevation in serum uric acid, serum creatinine, and 24 h albuminuria levels, as well as pathological changes in renal histology. Intraperitoneal injection of 200 mg/kg potassium oxonate with gavage of 500 mg/kg hypoxanthine markedly increased the production of uric acid, inhibited uricase activity, and disrupted uric acid transporters. This led to supersaturated urate deposition in the kidneys, triggering renal inflammation and fibrosis, thereby promoting HN progression. In conclusion, we successfully established a stable and efficient mouse model that can mimic the pathogenesis of HN. This novel model may facilitate the discovery of therapeutic targets and the development of new drugs for the treatment of HN.

CRISPR/Cas9 Mediated Deletion of the Uox Gene Generates a Mouse Model of Hyperuricemia with Multiple Complications

Hyperuricemia is a common metabolic disorder with severe complications. We aimed to develop a mouse model for spontaneous hyperuricemia. Uox-/- mouse model was generated on C57BL/6J background by deleting exon 2-4 of Uox using the CRISPR/Cas9 system. The prototypic Uox -/-mice had 5.5-fold increased serum uric acid (1351.04±276.58μmol/L) as compared to the wild type mice (P<0.0001), but died by 4 weeks. After allopurinol (3ug/g) intervention, they all survived > 8 weeks. The serum uric acid was 612.55±146.98μmol/L in the 8-week-old allopurinol-rescued Uox -/-mice, which manifested multiple complications including severe renal insufficiency, hypertension, left ventricular remodeling and systolic dysfunction, aortic endothelial dysfunction, hepatic steatosis and elevated liver enzymes, as well as hyperglycemia and hypercholesteremia. The present Uox-/- mice developed spontaneous hyperuricemia complicated with urate nephropathy, cardiovascular disease and cardiometabolic disorders, and may provide a novel tool to study hyperuricemia associated early-onset cardiovascular disorders in human.

Association between mitophagy and NLRP3 inflammasome in uric acid nephropathy

OBJECTIVE

This study was recruited to investigate the role of mitophagy in activating NLRP3 inflammasome in the kidney of uric acid (UA) nephropathy (UAN) rats.

METHODS

This study developed a uric acid nephropathy (UAN) rat model divided into five groups: Negative control (NC), UAN model (M), UAN + autophagy inhibitor (3-MA), UAN + lysosome inhibitor (CQ), and ROS scavenger (N-acetylcysteine, N). H&E staining assessed renal structure, ROS levels were measured with 2, 7-dichlorofluorescin diacetate, and ELISA measured serum markers (creatinine, UA, cystatin C, NGAL, IL-1β, IL-18). Western blot and qRT-PCR evaluated autophagy and inflammation-related protein (LC3 II/I, p62, Pink1, Parkin, NLRP3, Caspase1, IL-1β) expression. NRK-52E cells treated with uric acid and shRNA were analyzed by western blot.

RESULTS

Renal injury in UAN rats was aggravated by ROS accumulation, which promoted mitophagy and activated the NLRP3 inflammasome. Eliminating ROS reduced mitophagy, inhibited NLRP3 activation, lowered IL-1β and IL-18 levels, and alleviated renal injury. Notably, inhibiting mitophagy increased ROS accumulation, up-regulated NLRP3, Caspase1, and IL-1β expression, further worsening renal injury. In vitro, uric acid treatment of NRK-52E cells altered autophagy-related protein and pro-inflammatory cytokine levels, highlighting the interplay between mitophagy and inflammation in uric acid nephropathy.

CONCLUSION

Mitophagy influences renal injury in uric acid nephropathy (UAN) by regulating ROS accumulation and NLRP3 inflammasome activation, suggesting that mitophagy may serve as a potential therapeutic target for UAN.

Decoding the fatty liver-hyperuricemia link in the obese and nonobese hypertensive patients: insights from a cohort study

Metabolic-dysfunction-associated fatty liver disease (MAFLD) and serum uric acid are closely related to cardiovascular and cerebrovascular diseases. However, the causal association between MAFLD and serum uric acid remains unclear. A total of 3417 patients without hyperuricemia were included in the final analysis. MAFLD was defined as fatty liver index (FLI) ≥ 30. Multivariate Cox regression analysis was used to explore the association between FLI and new-onset hyperuricemia. Restricted cubic splines and threshold saturation effect analysis were used to detect nonlinear associations. The mean age was 62.8 ± 8.3 year, and 68.5% were women. A total of 738 (21.6%) hypertensive patients developed new-onset hyperuricemia, 388 (11.4%) new-onset hyperuricemia10 and 190 (5.6%) new-onset hyperuricemia20 during the 4-year midday follow-up period. In the fully adjusted model, compared with the Q1 (FLI ≤ 8.5) group, the risk of hyperuricemia increased by 56% (HR: 1.56; 95% CI: 1.02, 2.38) in the Q4 (FLI > 39.4) group, new-onset hyperuricemia10 increased by 108% (HR: 2.08; 95% CI: 1.15, 3.78), and new-onset hyperuricemia20 increased by 156% (HR: 2.56; 95% CI: 1.11, 5.94), respectively. Saturation effects showed a nonlinear association between FLI and new-onset hyperuricemia (p for log likelihood ratio test < 0.05). Subgroup analysis and stratified analysis showed that there had a significantly higher risk of new-onset hyperuricemia in the patients with normal body mass index (< 24 kg/m2) (p for interaction: 0.018) and non-central obesity (p for interaction: 0.024). MAFLD is an independent risk factor for hyperuricemia in hypertensive patients, especially in patients with normal body mass index and non-central obesity.

Gender-specific relationships between hyperuricemia and idiopathic deep venous thrombosis in the Chinese population: a case‒control study

BACKGROUND

Many studies have indicated that hyperuricemia is positively correlated with secondary deep venous thrombosis (DVT); however, the risk factors for idiopathic DVT based on gender differences, such as serum uric acid (SUA) and hyperuricemia, have not been fully examined.

OBJECTIVES

To investigate the association between hyperuricemia and the occurrence of idiopathic lower extremity DVT based on gender differences.

METHODS

This was a retrospective analysis of 4299 patients who were hospitalized at the Affiliated Hospital of Qingdao University from January 2012 to October 2021 and who underwent ultrasound of the lower limbs. A total of 930 patients were diagnosed in the DVT group, and 3369 patients were diagnosed in the control group without DVT. The baseline SUA and other important baseline data were compared between the two groups, and sex was stratified. Multivariate logistic regression analysis models adjusted for potential confounders were used to investigate the associations between hyperuricemia and idiopathic lower extremity DVT.

RESULTS

The SUA level in patients with idiopathic DVT was significantly greater than that in patients without DVT (total: 6.00 ± 1.75 vs. 5.40 ± 1.56 mg/dL, respectively; male: 6.42 ± 1.60 vs. 5.87 ± 1.57 mg/dL, respectively; female: 5.58 ± 1.79 vs. 4.72 ± 1.27 mg/dL, respectively; all P < 0.001). The proportion of patients with hyperuricemia in the idiopathic DVT group was significantly greater than that in the control group (total: 29.03% vs. 16.10%, respectively; male: 35.26% vs. 23.19%, respectively; female: 22.73% vs. 5.74%, respectively; all P < 0.001). The incidence of DVT in patients with hyperuricemia was significantly greater than patients with normouricemia (33.29% vs. 18.92%, respectively), and this difference was particularly prominent among women (58.01%). According to the univariate model, hyperuricemia was significantly associated with a grester risk of idiopathic DVT. After adjustment for potential confounders, this association remained significant. The risk of idiopathic lower extremity DVT in patients with hyperuricemia was 2.643-fold greater than that in patients with normouricemia (Model 3: OR: 2.643, 95% CI: 2.165-3.228). After stratification by sex, the risk of idiopathic lower extremity DVT in female patients with hyperuricemia was 7.482-fold greater than that in patients with normouricemia (Model 3, OR: 7.482, 95% CI: 4.999-11.199).

CONCLUSION

In the Chinese population, hyperuricemia is closely related to an increased risk of idiopathic lower extremity DVT, especially in female patients.