Premium
Population Impact Attributable to Modifiable Risk Factors for Hyperuricemia
Author(s) -
Choi Hyon K.,
McCormick Natalie,
Lu Na,
Rai Sharan K.,
Yokose Chio,
Zhang Yuqing
Publication year - 2020
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.41067
Subject(s) - hyperuricemia , medicine , dash diet , overweight , body mass index , population , obesity , diuretic , dash , confidence interval , risk factor , gout , demography , endocrinology , environmental health , uric acid , blood pressure , sociology , computer science , operating system
Objective To examine modifiable risk factors in relation to the presence of hyperuricemia and to estimate the proportion of hyperuricemia cases in the general population that could be prevented by risk factor modification, along with estimates of the variance explained. Methods Using data obtained from 14,624 adults representative of the US civilian noninstitutionalized population, we calculated adjusted prevalence ratios for hyperuricemia, population attributable risks ( PAR s), and the variance explained according to the following 4 factors: body mass index ( BMI ; ≥25 kg/m 2 ), alcohol intake, nonadherence to a Dietary Approaches to Stop Hypertension ( DASH ) diet, and diuretic use. Results BMI , alcohol intake, adherence to a DASH ‐style diet, and diuretic use were all associated with serum urate levels and the presence of hyperuricemia in a dose‐dependent manner. The corresponding PAR s of hyperuricemia cases for overweight/obesity (prevalence 60%), nonadherence to a DASH ‐style diet (prevalence 82%), alcohol use (prevalence 48%), and diuretic use (prevalence 8%) were 44% (95% confidence interval [95% CI ] 41%, 48%), 9% (95% CI 3%, 16%), 8% (95% CI 5%, 11%), and 12% (95% CI 11%, 14%), respectively, whereas the corresponding variances explained were 8.9%, 0.1%, 0.5%, and 5.0%. Our simulation study showed the variance nearing 0% as exposure prevalence neared 100%. Conclusion In this nationally representative study, 4 modifiable risk factors ( BMI , the DASH diet, alcohol use, and diuretic use) could be used to individually account for a notable proportion of hyperuricemia cases. However, the corresponding serum urate variance explained by these risk factors was very small and paradoxically masked their high prevalences, providing real‐life empirical evidence for its limitations in assessing common risk factors.