Risk Prediction Models Of Hyperuricemia And Relationship Between Serum Uric Acid And Metabolic Syndrome

Hyperurcemia(HUA)is a condition that causes elevated uric acid in the blood due to purine metabolic disorders and/or uric acid metabolic disorders.In rencet years,both the incidence and prevalence of HUA have increased significantly,at the same time,the various health impact caused by HUA also has aroused much attention of people.Many studies have shown that HUA is not only the physiological basis of gout,but also the risk factor of kidney damage.At the same time,a number of studies have shown that serum uric acid levels are strongly asscociated with metabolic syndrome(MetS)and its components,cardiovascular disease.Therefore,it is helpful to study the risk factors of hyperuricemia and to construct its predictive model not only for early prevention of gout or kidney damage,but also for early prediction of MetS and cardiovascular disease.On the other hand,the relationship between serum uric acid level and MetS and its components is inconclusive,yet lack of evidence of whether to prevent MetS and cardiovascular disease through the intervention of serum uric acid levels.Materials and Methods:1.Relied on the "Shandong multi-center health management longitudinal observation cohort",we construct the follow-up cohort of HUA.Firstly,using the Cox proportional hazards regression model to select the predictors of HUA,and then built the risk prediction model.2.Relied on the "Shandong multi-center health management longitudinal observation cohort",we construct the follow-up cohort of MetS for women.In order to control the role of confounding factors,we limited the study objects to women.The rs11722228 locus was used as a tool variable in the sub-gene SLC2A9.The causal relationship between serum uric acid level and metabolic syndrome and its components were deduced by Mendelian randomization.Res,ults:1.Risk prediction model of HU A(1)There were 58542 persons in the study cohort of HUA,including 34980 males and 23562 females,with a mean follow-up of 2.5 years.At the end of follow-up,7135 people had HU A,including 5581 males and 1554 females.The incidence density of HUA was 49.60/1000,including 64.62/1000 person years for males and 27.12/1000 person years for females,the difference between males and females was statistically significant(U=32.05,P<0.05).(2)In the HUA group and non-HUA group,the baseline indicators:body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,triglyceride,glutamatepyruvate transaminase,serum creatinine,serum uric acid were diffenent,and the difference was statistically significant.(3)Finally,the final predictors of the risk prediction model for males were age,systolic blood pressure,body mass index and serum uric acid;The final predictors of the risk prediction model for females were systolic blood pressure,body mass index,serum uric acid and triglyceride.(4)The Cox regression model was used to predict three-year risk of HUA,the area under the ROC curve:male 0.783(95%CI:0.777～0.786),female 0.784(95%CI:0.778～0.789);after internal validation:the AUC value was 0.7827 for males,the AUC value was 0.7832 for females.2.Relationship between serum uric acid and MetS(1)There were 1381 persons in the women MetS study cohort,the cumulative incidence of MetS was 61 persons and the incidence density of MetS was 19.964/1000 person years,with a mean follow-up of 2.3years.(2)In the MetS population and non-MetS population,the baseline indicators age,body mass index,systolic blood pressure,diastolic blood pressure,fasting blood glucose,triglyceride,total,cholesterol,lowdensity cholesterol,high density cholesterol,γ-glutamyltransferase,glutamate pyruvate transaminase,serum uric acid red cell counts were diffenent,and the difference was statistically significant.(3)Age body mass index,systolic blood pressure,diastolic blood pressure,fasting blood glucose,triglyceride,total cholesterol,low density cholesterol,high density cholesterol,y-glutamyltransferase,glutamate pyruvate transaminase,serum uric acid red cell counts did not vary with the SLC2A9(rs11722228)genotype.The SLC2A9(rsl 1722228)polymorphism was linearly correlated with the level of serum uric acid,and for each additional gene T,standardized uric acid increased by 0.255 units;there was no correlation between the SLC2A9(rs11722228)polymorphism and the metabolic syndrome of the study outcome.(4)Using the Mendelian randomization method,SLC2A9(rs11722228)as a tool variable to explore the causal relationship between serum uric acid and metabolic syndrome and its components.The RR of uric acid was 0.993(95%CI:0.959～1.007),0.989(95%CI:0.957～1.021),1.007(95%CI:0.984～1.031),0.998(95%CI:0.972～1.026),0.998(95%CI:0.972～1.025).The results are not statistically significant,there is no causal relationship between serum uric acid and metabolic syndrome and its components.Conclusions:1.The incidence density of HUA in both male and female changed with age:the incidence density of HUA increased with age in males and the incidence density of HUA decreased with age in females.The gender-specific risk prediction models of HUA were developed,the predicton effect were good.2.In contrast to most of the traditional observational findings,the use of the Mendelian randomization tool variable method,using SLC2A9(rs11722228)as a tool variable to obtain that uric acid is not the cause of metabolic syndrome and its components.