Study On Hyperuricemia With Inflammatory Cytokines And Adipokines In Xinjiang Uygur, Kazakh And Han Etinicity

Objectives:With the economic developed and the improvement in the level of social well-off aswell as diet changes, the prevalence of hyperuricemia increased year by year, and theincidence getting younger and younger. Many of the clinical findings found thathyperuricemia is not only induced uric acid nephropathy, gouty arthritis, urolithiasis, gout,and they often coexist with obesity, diabetes, lipid metabolism disorders and high bloodpressure. Many study have shown that there are still some differences in different parts ofthe population incidence. In the pathogenesis of hyperuricemia studies have shown thatinflammatory factors and adipokines may also be associated with hyperuricemia. Thissubject used the rich resources of the national disease in Xinjiang, to analysis uric acidlevels and clinical characteristics of hyperuricemia among Xinjiang Uygur, Kazakh, Hanethnic groups, to analysis variation and ethnic heterogeneity of cytokine and adipokine inthe hyperuricemia, Explore the role and relevance of inflammatory factors and adipokinesin the pathogenesis of hyperuricemia, and to explore the pathogenesis of hyperuricemiafrom the immunological point, to provide a theoretical basis for taking effective measuresto prevent hyperuricemia, gout incidence and improve the quality of life in future, toprovide new ideas for prevention and treatment of hyperuricemia related metabolicdisorders.Methods:（1） By random sampling method to collect samples of Uygur, Kazak, Han inXinjiang, where ethnic minorities live in compact communities: the city of Altay, BurqinCounty, Habahe County Fuhai County, Nileke County and Xinyuan County and theUniversity Affiliated Hospitals to conduct epidemiological investigations;（2） To detecte general health indicators and biochemical parameters; （3） Measured by ELISA of inflammatory cytokines: TNF-α, IL-6and CRP andadipocytokines: FFA, Visfatin, APN, Leptin and Resistin.Results:（1） Clinical characteristics of hyperuricemia in Uygur, Kazak, Han:1) Uric acidlevels of different ethnic groups showed ethnic heterogeneity: Han’s is higher than theUygur’s, The Uygur’s is higher than the Kazak’s （F＝17.823, P＝0.000）;2) The levels ofuric acid and incidence of hyperuricemia showed gender differences on different nation:men’s is higher than women’s （t汉＝11.104, P＝0.000; t维＝8.607, P＝0.000; t哈＝6.484,P＝0.000）;3) The uric acid levels showed age trends on d ifferent ethnic: Men’s uric acidlevels changed little with age, especially Uygur age decreasing with uric acid levelsincreasing; but on the contrary, women’s uric acid levels after the age of30increasedwith age growth. Han women’s uric acid level has largest increase and marked increase inthe40-year-old; The uric acid levels of Uygur changed with age changed （P＜0.05）; andfound no trends between uric acid and age in Kazak; uric acid level in the Han populationchanged with age, but after gendering was only women have a significant trend;4)Hyperuricemia was with closely related to hypertension, high blood sugar, highcholesterol and obesity （P＜0.01）, the risk coefficient of hyperuricemia who suffer fromthose diseases is1.378,1.886,2.456and1.717times; There were still some differencesbetween the different ethnic groups: Hyperuricemia onUygur was closely related to highcholesterol, high blood sugar and obesity but hypertension （P＜0.01）; Hyperuricemia onKazak was closely related to hypertension, high cholesterol and obesity but high bloodsugar （P＜0.01）; The correlation between hyperuricemia on Han with high bloodpressure, high cholesterol, high blood sugar and obesity was statistically significant （P＜0.05）;（2） Relationship and ethnic heterogeneity between inflammatory cytokines andhyperuricemia:1) The difference of nflammatory cytokines was statistically significantamong three ethnics （P＜0.01）, in addition to CRP which was no significant differencebetween Uygur and Han （P＝0.094） that there were significant differences between anytwo ethnics on other cytokines （P＜0.05）. In the hyperuricemia group, in addition to theUygur and Kazak compare on TNF-α （P＝0.281）, Uygur and Han compare on CRP （P＝0.223）, Kazak and Han compare on CRP （P＝0.264）, there were significant differencesbetween the two ethnic on the remaining variables （P＜0.05）; In the control group, inaddition to the Uygur and Han compare on TNF-α （P＝0.486）, the Uygur and Han compare on IL-6（P＝0.468）, the Uygur and Han compare on CRP （P＝0.260）, the Kazakand Han compare on CRP （P＝0.092）, there were significant differences between the twoethnic on the remaining variables （P＜0.05）;2) There was significant difference betweenhyperuricemia group and control group of Uygur and Han on TNF-α （P＜0.05）, but thedifference in Kazakh between the two groups was not statistically significant （P＞0.05）.TNF-α and SUA was positively correlated Only in Uygur （P＜0.05）. There was onlywomen’s TNF-α was positively correlated with SUA in Han （P＜0.05）. There wassignificant difference between hyperuricemia group and control group of Uygur and Hanon IL-6（P＜0.05）.IL-6and SUA was positively correlated on three ethnic.There were nodirect correlation on CRP of three ethnic groups with hyperuricemia （P＞0.05）;3) TheTNF-α and IL-6are associated with CREA on Uygur （r＝0.138, P＝0.005and r＝0.139,P＝0.011）; There was a positive correlation between CRP and TG on men （r＝0.183, P＝0.011）; There was a positive correlation between TNF-α and BUN, CREA on womenof Uygur （r＝0.142, P＝0.045and r＝0.180, P＝0.011）; TNF-α and blood pressure isclosely related on Han （r＝0.146, P＝0.004and r＝0.116, P＝0.021）; There was apositive correlation between IL-6and BMI on Han （r＝0.121, P＝0.016）;4) Trendanalysis of various inflammatory factors in the classification of uric acid levels on thethree national found that with SUA levels increased the levels of TNF-α and IL-6wereincreased on Uygur;but only IL-6in Han and in the contrary of IL-6on Kazak （P＜0.01）;5) The HUA group associated with metabolic diseases which level of SUA were higherthan those of Simple HUA group among three ethnic: the level of SUA was highest onUygur when combined （HUA+DM）; when combined （HUA+DM+HL） on Kazak;whencombined obesity on Han;6) The differences of inflammatory factors among threeethnics when HUA combined with metabolic diseases: the levels of TNF-α and IL-6werelowest on simple HUA group on Uygur, there was highest level on TNF-α when HUAcombined with obesity and there was highest level on IL-6when HUA combined with（HUA+DM）; the levels of CRP and IL-6were lowest on simple HUA group on Han,there was highest level on TNF-α and CRP when HUA combined with （HUA+DM+HL）,and there was highest level on IL-6when HUA combined with obesity.（3） Relationship and ethnic heterogeneity between adipokines and hyperuricemia:1)The difference of adipokines was statistically significant among three ethnics （P＜0.01）,in addition to APN which was no significant difference between Uygur and Han thatthere were significant differences between any two ethnics on other cytokines （P＜0.05）;2) The comparation between Hyperuricemia group and the control group on three ethnics: The level of FFA on HUA group was higher than it on the control group in the Kazakh,and in the contray on Han （P＜0.05）, but no Statistically significant on Uygur; Therewere significant differences between HUA group and the control group with Visfatin onthree ethnics （P＜0.05）, the former was higher than the latter; The level of APN on HUAgroup was lower than it on the control group on Uygur, and in the contray on Kazak （P＜0.05）, there was no significant differences on Han. The level of Leptin on HUA groupwas higher than it on the control group on Uygur, and in the contray on Kazak （P＜0.05）,there was no significant differences on Han; The level of Resistin on HUA group washigher than it on the control group on Uygur, and in the contray on Kazak （P＜0.05）,there was no significant differences on Han;3) Gender differences found that OnlyVisfatin, APN and Leptin has differences: The level of Visfatin on men was higher thanwomen’s （t＝3.940, P＝0.000）; The level of APN and Leptin on men was lowerr thanwomen’s （t＝-2.440, P＝0.015, t＝-9.454, P＝0.000）; The were gender differences onUygur and Han but Kazak （P＞0.05）;4) In addition to FFA, the level of Visfatin, APN,Leptin, Resistin were significantly correlated with SUA （P＜0.05）（there was negativecorrelation between APN and SUA）; There were significantly correlation between SUAwith Visfatin, APN, Leptin on Kazak (r_Visfatin＝0.150, P＝0.010; rAPN＝0.219, P＝0.000;rLeptin＝-0.115, P＝0.048); There were significantly correlation between SUA with FFAand Visfatin on Han (r_FFA＝-0.184, P＝0.011; r_Visfatin＝0.310, P＝0.000).5) On theoccurrence of hyperuricemia, CRP influenced Resistin from varying degrees.Conclusions:（1） The Surem uric acid level of Han is higher than the Uygur, and Uygur’s is higherthan Kazakh, Han is relatively most vulnerable to happen hyperuricemia and Kazak iswith a low incidence; When the hyperuricemia occur with more metabolic abnormalitiesindicators, the serum uric acid level is higher than other group and the probability of theoccurrence of diseases is greater;（2） Analysis of difference gender, incidence of disease on men is much higher thanwomen in the three ethnic groups;（3） The serum uric acid changes with age in the Uygur and Kazak, There are norelationship between age and Kazakh hyperuricemia;（4） We suggested that serum uric acid was as an antioxidant in the Kazakh bodywhich may be trying to increased endogenous antioxidants to protect the body from freeradicalstoxic effects; when Kazakh serum uric acid level is higher than a certain standard （SUA-4） that the trend in this study will be weakened;（5） The differences were statistically significant by TNF-alpha, IL-6, CRP in threeinter-ethnic, To suggest that we should use different indicators in the prediction ofhyperuricemia in the different ethnic groups and clinics where necessary, and to select thecombined detection of a comprehensive judgment; inflammatory cytokines inhyperuricemia comparison with the control group showing ethnic differences; andmetabolic abnormalities indicators closely associated with metabolic abnormalitiesindicators, elevated levels of inflammation. When the the HUA with metabolicabnormalities indicators of the three national average higher than that HUA group, thereare differences among different ethnic groups, suggesting that inflammatory factorsinvolved in the occurrence of metabolic diseases and pathological changes in the process.We suggest to reduce the level of SUA, TNF-alpha, IL-6which can help prevent theoccurrence and development of metabolic diseases, but also to reduce the occurrence ofcardiovascular and cerebrovascular diseases;（6） The inflammatory cytokines affect the serum uric acid level in Uygur and Hanbut Kazakh;（7） Adipocytokines are different among different ethnic groups, different adipokinesthrough a variety of abnormal metabolic pathway related to serum uric acid level;Resistin may also be a tie link with obesity and hyperuricemia; the APN may be aprotective factor for hyperuricemia.