Distribution Of Serum Uric Acid In Centenarians And Its Association With Related Chronic Diseases And Mortality: Based On China Hainan Centenarians Cohort Study (CHCCS)

IntroductionWith social progress and development,aging has become an important issue facing all over the world,including China.Centenarians,as individuals with a relatively long life-span,are known as the "template population" of healthy aging study.Its health-related characteristics have important guiding significance for the elderly with other age groups to maintain better life quality and prolonged life span.Serum uric acid has been proved to be associated with a variety of chronic diseases and death,but there is little evidence about the distribution characteristics of serum uric acid in centenarians and its association with chronic diseases and death.This study intends to use the data from China Hainan Centenarians Cohort Study to study the distribution characteristics of blood uric acid level and its association with related chronic diseases and deaths in centenarians in Hainan,China.Purpose1 To describe the distribution characteristics of blood uric acid and the prevalence of hyperuricemia in Hainan centenarians in China,and explore the possible related factors;2 Multivariate analysis was used to explore the relationship between serum uric acid and related common chronic diseases in centenarians in Hainan,China;3 To explore the relationship between serum uric acid and the risk of all-cause death and cardiovascular death based on the 7 years’ cohort study in centenarians in Hainan,China.MethodsBased on the research of China Hainan centenarian cohort study(CHCCS),the following analysis contents are carried out by using the questionnaire survey,physical measurement,biological sample examination,follow-up outcome and other relevant information:1 Based on the data of 1002 Hainan centenarians from the baseline survey,the distribution characteristics of blood uric acid and the prevalence of hyperuricemia in Hainan centenarians in China were described,and the possible influencing factors were discussed by logistic regression;2 Correlation analysis was used to describe the relationship between blood uric acid and blood pressure,blood glucose and blood lipid;Logistic regression was used to describe the association between hyperuricemia and hypertension,diabetes,and dyslipidemia.3 The Cox regression was used to explore the association between hyperuricemia and all-cause/cardiovascular death based on the 7 years’ cohort follow-up.Results1 Epidemiological characteristic and related risk factors of serum uric acid in centenarians in HainanThe 1002 centenarians included 180 male centenarians,accounting for 18.0%;822female centenarians,accounting for 82.0%.The age was from 100 to 116 years,with an average age of 102.77 ± 2.75 years.Blood uric acid showed a skewed distribution(Kolmogorov Smirnov test,p< 0.001),the median(interquartile range)was 325.00(264.00-384.00)μmol/L.A total of 164 people(16.4%)had hyperuricemia,while male had a higher prevalence(30.0%)than female(13.4%).Male and abdominal obesity were associated with hyperuricemia prevalence in centenarians.The odds ratio(OR)of male for hyperuricemia was 2.985(95%CI:2.037-4.386)compared with female;the OR of abdominal obesity was 2.087(95% CI: 1.144-3.355)compared with those with normal waist circumference.2 Relationship between serum uric acid and related chronic diseases in centenarians in HainanFor hypertension,the ORs of serum uric acid was 1.001(95% CI: 0.999-1.002),and the OR of hyperuricemia was 1.304(95% CI: 0.871-1.953).For diabetes,the OR of serum uric acid was 1.001(95% CI:0.998-1.002),and the OR of hyperuricemia was 1.295(95%CI:0.760-2.206),with no statistical difference.For different types of dyslipidemia,the ORs of serum uric acid with hypertriglyceridemia,low high density lipoprotein cholesterol and dyslipidemia was 1.005(95% CI: 1.002-1.008),1.003(95% CI: 1.001-1.005)and 1.004(95%CI: 1.002-1.005)respectively.The ORs of serum uric acid associated with hypercholesterolemia was 1.002(95% CI: 1.000-1.004).The association between hyperuricemia and hypertriglyceridemia,low high density lipoprotein cholesterol and dyslipidemia showed statistical differences,and the ORs were 2.928(95% CI: 1.419-6.042),2.251(95% CI: 1.481-3.424)and 1.908(1.308-2.783),respectively.The ORs of hyperuricemia associated with hypercholesterolemia and mixed hyperlipidemia was 1.124(95% CI: 0.588-2.149)and 1.455(95% CI: 0.860-2.462).3 Association between blood uric acid and all-cause or cardiovascular-specific death in centenarians in HainanBy the end of April 2021,522 centenarians had died out of 1002 centenarians.The density of all-cause death was 152/1000 person years,and the median survival time was 4.2(1.3 ～ 5.0)years.Taking the death of centenarians as the dependent variable and blood uric acid and hyperuricemia as independent variables,Cox regression analysis showed that blood uric acid and hyperuricemia had no statistically significant association with all-cause death.When taking cardiovascular death as the dependent variable,each increase in blood uric acid(μmol/L),the hazard risk of cardiovascular death increased by 0.2%.Compared with those with normal blood uric acid,the hazard risk of cardiovascular death among those with hyperuricemia was 1.619(95% CI: 1.007-2.602).ConclusionsThe distribution level of serum uric acid and the prevalence of hyperuricemia in centenarians in Hainan are lower than other elderly with younger age and lower than those in certain foreign centenarians.The prevalence may be related to male and abdominal obesity.Hyperuricemia in Hainan centenarians is related with dyslipidemia but not hypertension or diabetes.Besides,hyperuricemia may increase the risk of cardiovascular death.