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Uric Acid Variability and All-Cause Mortality: A Prospective Cohort Study in Northern China
1Shouling Wu, Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China, E-mail: drwusl@163.com; Hao Xue, Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China,
Insights
Elevated uric acid variability (UAVIM) is linked to a higher risk of all-cause mortality. This finding suggests UAVIM is an independent risk factor for mortality in community populations.
Area of Science:
- Clinical Medicine
- Epidemiology
- Biochemistry
Background:
- Uric acid (UA) is associated with cardiovascular disease.
- The link between UA variability and all-cause mortality remains largely unknown.
Purpose of the Study:
- To investigate the relationship between UA variability and all-cause mortality.
- This study focused on the Kailuan cohort in northern China.
Main Methods:
- A cohort study involving 55,717 participants followed biennially from 2006 to 2010.
- Calculated UA variation independent of mean (UAVIM) and grouped participants into quartiles.
- Used Cox regression to assess the association between UAVIM groups and all-cause mortality.
Main Results:
- Over a median follow-up of 6.83 years, 2,926 deaths occurred.
- Higher UAVIM quartiles showed progressively increased all-cause mortality rates.
- Adjusted analyses revealed that the highest UAVIM quartile (Q4) had a significantly increased risk of all-cause mortality (HR: 1.353, 95% CI: 1.220–1.501) compared to the lowest quartile (Q1).
Conclusions:
- Elevated UAVIM is associated with increased all-cause mortality.
- UAVIM is an independent risk factor for all-cause mortality.
- Findings were consistent across sensitive and subgroup analyses.
Objectives:
Uric acid(UA) is related with cardiovascular disease, but the association of UA variability with all-cause mortality is rarely known. This study aimed to investigate the relationship between UA variability and all-cause mortality in Kailuan cohort study in northern China.
Design:
Cohort study.
Setting:
Kailuan community hospitals in Tangshan, Hebei province, Northern China.
Participants:
A total of 55717 participants from Kailuan Study were enrolled, and our study followed up biennially from 2006 to 2010.
Measurements:
Clinical records of the participants enrolled were analyzed. UA variation independent of mean (UAVIM) values were calculated and all the participants were quartile grouped into four groups as: Q1(UAVIM<0.68), Q2(0.68≤UAVIM<1.10), Q3(1.10≤UAVIM<1.67) and Q4(UAVIM≥1.67). The endpoint event was all-cause death. Cox regression model was performed to evaluate the hazard ratios(HRs) of all-cause mortality based on UAVIM groups.
Results:
During a median follow-up of 6.83 years, 2926 deaths occurred. The accumulated mortality rates were 4.6%, 4.8%, 5.4% and 6.1% in group Q1, Q2, Q3 and Q4 respectively. When adjusted potential confounders, the highest risk for all-cause mortality was in group Q4 and the adjusted HRs and 95% confidence intervals(CIs) of group Q2-Q4 for all-cause death were 1.044(0.937, 1.164), 1.182(1.064, 1.314) and 1.353(1.220, 1.501) compared with group Q1, respectively. Further analysis showed that the risk for all-cause death increased as UAVIM value increased. Sensitive analysis still showed the similar results when excluding participants with hyperuricemia or severe chronic kidney diseases. Sub-group analysis by age, gender, BMI or hypertension history also indicated analogous results.
Conclusion:
Elevated UAVIM was related with increased all-cause mortality and UAVIM was an independent risk factor for all-cause mortality in the community cohort study.
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