Analysis Of The Prevalence Of Hyperuricemia And Its Correlation With Gut Microbiota In Health Cheek-up Population

Objective:Hyperuricemia is a metabolic disease caused by purine metabolism disorder.Current studies have found that gut microbiota is closely related to metabolic diseases.The purpose of this study was to analyze the prevalence of hyperuricemia and its correlation with gut microbiota in health cheek-up population.Methods:This study enrolled the health cheek-up subjects from the physical examination center of Zhejiang University Teaching Hospital from January 2018 and December 2019.Basic information was collected,such as gender,age and medical history,the measurement data of height,weight and blood pressure,the laboratory report of blood lipid,liver function,renal function,fasting plasma glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin(Hb A1c),high-sensitivity C-reactive protein(hs-CRP),the report of liver ultrasound,and the laboratory report of gut microbiota detection by fluorescent quantitative PCR assay were also collected.The gut dominant microbiota included the number of Atopobium,Lactobacillus,Enterobacter,Bacteroides,Enterococci,Clostridium leptum,Faecalibacterium prausnitzii,Bifidobacteria,Eubacterium rectale,Clostridium butyricum and B/E value.The serum uric acid level and gut microbiota were analyzed by SPSS 22.0 statistical software.Propensity Score Matching(PSM)was used to match the baseline data(age,gender,BMI)of the twogroups of people with high uric acid and normal uric acid.The difference of gut dominant microbiota between hyperuricemia and normal control group was compared,the association between hyperuricemia and gut microbiota were investigated and the influencing factors were analyzed by logistic regression analysis.Results:A total of 475 eligible subjects were included in this study,including 110 patients with hyperuricemia.The overall prevalence of hyperuricemia was 23.2%,and males presented a higher prevalence of hyperuricemia than females(33.3% vs 8.3%,P <0.001).Of all ages,the blood uric acid levels in males were higher than that in females(P < 0.05).And there was a difference in serum uric acid level between different age groups in females(P = 0.007),while there was no difference in serum uric acid level in males.There were statistically significant differences in BMI,blood pressure,blood glucose,blood lipids,liver enzymes,hs-CRP and other indicators between high uric acid population and normal uric acid population(P < 0.05).At the same time,the prevalence of overweight,obesity,dyslipidemia and fatty liver in people with high uric acid were higher than those with normal uric acid(P < 0.01).Under different age groups,there were statistically significant differences in the number of Bifidobacteria,Eubacterium rectale and B/E value among the groups(P <0.05).There were statistically significant differences in the number of Bifidobacteria and B/E value among groups with different concentrations of uric acid(P < 0.05).Under different BMI groups,there were statistically significant differences in the number of Faecalibacterium prausnitzii,Bifidobacteria and B/E value among the groups(P < 0.01).And there was no significant difference between male and female in the gut dominant microbiota.There was no significant difference in the baseline data(age,gender,BMI)between the the hyperuricemia group and normal control group after PSM.The comparison of gut dominant microbiota between the two groups showed that the number of Atopobium,Lactobacillus,Bifidobacterium and Clostridium butyricum in thehyperuricemia group was lower than that in the control group(P < 0.05).The correlation analysis showed that there was a negative correlation between serum uric acid and the number of Atopobium cluster and Bifidobacterium(r =-0.146,P = 0.041;r=-0.143,P = 0.044).The result of multivariate logistic regression analysis showed that alanine aminotransferase(ALT)was an independent risk factor for hyperuricemia(OR =1.018,95% CI: 1.001-1.035,P = 0.039),and the number of Bifidobacterium was an independent protective factor for hyperuricemia(OR = 0.826,95% CI: 0.691-0.988,P =0.036).Conclusion:The prevalence of hyperuricemia was high.The metabolic disturbance of glucose and lipid was obvious in hyperuricemia,and there were many metabolism-related diseases among hyperuricemia patients.Strengthening the monitoring of serum uric acid might be helpful for the prevention and risk prediction of metabolism-related diseases.Gut dominant microbiota varied with age,BMI and serum uric acid level.There were several alterations of gut microbiota in patients with hyperuricemia,which was manifested as the deficiency of Autopodium cluster,Lactobacillus,Bifidobacteria and Clostridium butyricum.ALT was an independent risk factor for hyperuricemia,and Bifidobacteria was an independent protective factor for hyperuricemia.Therefore,attention should be paid to the research of gut microecology in the pathogenesis of hyperuricemia and the application of gut microecology in the treatment of hyperuricemia should also be emphasized.