Study On Thegender Difference And Function Of Sex Hormone And Adipocyte Factors In The Pathogenesis Of Hyperuricemia

Objective: To investigate current prevalence of primary hyperuricemia and uric acidlevel in differentgender of Han and Uyghur populations in Urumqi city. To explore thechange law of related environmental factors, glucose metabolism, fat metabolism, bloodpressure and obesity in primary hyperuricemia and make clear the probably function ofE₂, T, LPT, TNF-alpha, APN, IL-6, CRP and SHBG for pathogenesis of primaryhyperuricemia. Methods: A cross-sectional studywas conducted in a cohort of42,467individuals （38,108han and4,359Uyghur） who participated in annual healthexaminations at the First Affiliated Hospital and Affiliated TCM Hospital of XinjiangMedical University from January2008to January2010. Case-Control analysiswasconducted in971random samples （622men and349women） to evaluate the influence ofbodygeneral index, diet and lifestyle, glucose and fat metabolism index, family historyand sex hormone against primary hyperuricemia. ABS-ELISAwas conducted in randomselected207cases （109men and98women） and200controls （104men and96women） toanalyse the relationship between hyperuricemia and change law of E₂, T, LPT, TNF-alpha,APN, IL-6, CRP and SHBG. Results:1) The overall prevalence of hyperuricemiawas14.2%, The prevalence of hyperuricemia in Han and Uyghur populationswas14.7%and10.8%respectively. In Han and Uyghur populationswhose age is20～60, theprevalencewas higher in men than inwomen （11.5%vs.2.0%in Han；22.5%vs.8.4%inUyghur, P＜0.001）. The prevalence of men age20～50was higher in Han than in Uyghurpopulation, but it descend significantly in Han and Uyghur populationswhen their ageover50or60respectively. The prevalence ofwomen age over50increased rapidly andshowed difference significantly in Han and Uyghur populations.2) The results of theLogistic Regression showed that FINS,2hPBG, family history, hypertensionwere the riskfactors of hyperuricemia. Their odds ratiowas1.053in men and1.039inwomen,1.681inmen and1.579inwomen,1.975in men and2.579inwomen and6.292in men and2.816 inwomen respectively. They all increase the risk of hyperuricemia. However, HDLdecrease the risk of hyperuricemia and its odds ratiowas0.344in men and0.317inwomen. The risk factors in differentgender are different. In men, the extra factors liketriglyceride, obesity, more meat, hyperlipidemia increase the risk but like more vegetableand fruits, more dairy products decrease the risk. Their odds ratiowas1.049,11.936,2.534,2.898and0.361repectively. Inwomen, cholesterol, obesity judged by2007CALIP,more broth and menopausewere risk factors of hyperuricemia. Their odds ratiowas1.615,3.611,3.298and2.797repectively.3) In men, SHBG, APN, Twere significantly higher incasegroup than in controlgroup, but TNF-alpha and IL-6were significantly low. Inwomen,SHBG, APN and E₂/Twere significantly higher but TNF-alpha, LPT and IL-6weresignificantly lower in casegroup than in controlgroup. SHBG and Twere protectivefactors and IL-6was the risk factor of hyperuricemia in men. SHBGwas the protectivefactor and menopause, LPT and IL-6were risk factors of hyperuricemia inwomen. In men,LPTwith systolic pressure, diastolic pressure, BMI and triglyceride, CRPwith fastingbloodglucose, IL-6withwaist circumference, Twith HDL showed positive correlationwithhyperuricemia, but APNwith triglyceride, SHBGwith diastolic pressure, BMI, waistcircumference, triglyceride, fasting insulin, Twith diastolic pressure, BMI, waistcircumference, triglyceride, fasting insulin, E₂/Twith fasting insulin, HDL showednegative correlationwith hyperuricemia. Inwomen, LPTwith diastolic pressure, BMI,waist circumference, fasting bloodglucose, triglyceride and cholesterol, IL-6with fastingbloodglucose, E₂with HDL, E₂/Twith HDL, TwithwHR and cholesterol showed positivecorrelationwith hyperuricemia, but APNwith triglyceride, SHBGwith BMI, waistcircumference, WHR, triglyceride, fasting insulin, E₂with systolic pressure, diastolicpressure, BMI, waist circumference, fasting bloodglucose, E₂/Twith systolic pressure,diastolic pressure andwaist circumference showed negative correlationwithhyperuricemia. Conclusions:1) The prevalence of hyperuricemia show obviousdifference in men andwomen. It is higher in men than inwomen in Han and Uyghurpopulations. The prevalence of Han male, Han female and Uyghur female showvarietywith the change of age, it maybe due to different sex hormones, diet and lifestylein differentgender.2) Abdominal obesity （WHR in men andwaist circumferenceinwomen）, glucose metabolism abnormality, fat metabolism abnormality, hypertension,high purine dietary are closely relatedwith hyperuricemia in men andwomen. Diet,lifestyle and triglyceride are significant risk factors of hyperuricemia in men, but the riskfactor inwomen is cholesterol.3) E₂and T show different function for the pathogenesis of hyperuricemia in differentgender. T is main factor in men, but the co acting of E₂and T ismore important inwomen. Sex hormones and fat factors cause the occurrence ofhyperuricemia through their influence to distribution of fat and metabolism ofglucose andfat. In adipocyte factors, SHBG and IL-6are closely relatedwith hyperuricemia in menandwomen. LPT level is relatedwith hyperuricemia inwomen. In inflammatory factors,IL-6and TNF-alpha are correlatedwith hyperuricemia.