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Previous schistosome infection and the risk of incident hyperuricemia: A prospective cohort study
Congyue Wang1,2, Zijian Tian3, Ying Yang1
1Nosocomial Infection Management Department, Kunshan First People's Hospital, Suzhou, Jiangsu, China.
Introduction:
Although prior research in China has linked previous schistosome infection (PSI) to lower risks of metabolic syndrome and cardiorenovascular conditions, the association between PSI and hyperuricemia, a recognized risk factor for these conditions, remains unclear. This study examines the relationship between PSI and hyperuricemia and identifies factors associated with hyperuricemia incidence in individuals with PSI.
Methods:
This prospective cohort study included 23,051 adults from eight health centers in Kunshan (2018-2021). Exposure was defined by self-reported PSI, validated by liver B-ultrasound. The primary outcome was hyperuricemia. Baseline and follow-up data encompassed height, weight, blood pressure, serum uric acid, glucose, renal function parameters, liver function, and lipid profiles. Cox proportional hazard models were employed to analyze the relationship between PSI and hyperuricemia, adjusting for demographic, lifestyle, and clinical variables.
Results:
Among the 23,051 participants included in this study, 4,677 (20.29%) had a history of schistosome infection, and 87.53% of those with PSI were over the age of 64. During 60,335 person-years of follow-up, 4,417 incident cases of hyperuricemia were recorded. The incidence rate was 64.91 per 1,000 person-years in the PSI group and 75.38 per 1,000 person-years in the non-PSI group. The overall cumulative hazard differed significantly among individuals, with the incidence of hyperuricemia being 17.36% (95% CI: 16.28-18.48%) and 19.62% (95% CI: 19.05-20.20%) in PSI and Non-PSI groups. After adjusting for confounders, PSI was associated with an 11% lower risk of hyperuricemia (HR: 0.89, 95% CI: 0.82-0.97, p = 0.005).
Conclusions:
In this prospective cohort study, PSI was observed to be associated with a lower risk of incident hyperuricemia. This finding reflects an observational association and does not establish causality. From a public health standpoint, schistosome infection remains a serious disease requiring continued prevention and control. Further investigations are needed to clarify the underlying mechanisms linking PSI to hyperuricemia.
