Introduction
Materials and methods
Study participants
Ascertainment of HUA
Pancreatic β-cells function assessment
Assessment of covariates
Race/ethnicity, family income status, education status, smoking, alcohol intake, physical activity, hypertension, diabetes, and hyperlipidemia
TC, TG, HDL, LDL, HbA1c and estimated glomerular filtration rate
Blood pressure, body mass index and waist circumference
Statistical analysis
Results
Basic characteristics of study participants
Uric Acid Status | |||||||
---|---|---|---|---|---|---|---|
Characteristicsa | Total (n = 5596) | Non-HUA (n = 4396) | HUAb(n = 1200) | P value | |||
No. (%)/Mean | SE | No. (%)/Mean | SE | No. (%)/Mean | SE | ||
Age, year | 46.2 | 0.4 | 45.2 | 0.5 | 50.1 | 0.6 | < 0.001 |
Sex | 0.007 | ||||||
Male | 2820(49.1) | 0.5 | 2206(48.0) | 0.6 | 614(53.2) | 1.6 | |
Female | 2776(50.9) | 0.5 | 2190(52.0) | 0.6 | 586(46.8) | 1.6 | |
Race/ethnicity | 0.056 | ||||||
Non-Hispanic white | 2902(72.5) | 1.9 | 2234(71.9) | 1.8 | 668(74.7) | 2.5 | |
Non-Hispanic black | 995(10.5) | 1.1 | 759(10.4) | 1.1 | 236(10.9) | 1.4 | |
Others | 1699(17.0) | 1.7 | 1403(17.7) | 1.7 | 296(14.4) | 2.2 | |
Education status | 0.001 | ||||||
Less than high school | 1779(20.2) | 0.8 | 1395(20.1) | 0.9 | 384(20.4) | 1.3 | |
High school | 1297(26.0) | 1.0 | 988(24.8) | 0.9 | 309(30.6) | 1.9 | |
College or higher | 2520(53.8) | 1.2 | 2013(55.1) | 1.3 | 507(49.0) | 1.9 | |
Smoking | < 0.001 | ||||||
Never smoked | 2820(49.6) | 1.2 | 2248(50.4) | 1.2 | 572(46.7) | 2.0 | |
Formerly smoked | 1545(26.1) | 1.0 | 1135(24.3) | 1.0 | 410(33.0) | 1.8 | |
Currently smoked | 1231(24.3) | 1.0 | 1013(25.3) | 1.2 | 218(20.3) | 1.5 | |
BMI, kg/m2 | 28.1 | 0.1 | 27.1 | 0.1 | 31.6 | 0.3 | < 0 .001 |
WC, cm | 96.3 | 0.3 | 93.8 | 0.3 | 105.9 | 0.6 | < 0.001 |
eGFR, mL/min/1.73 m2 | 98.3 | 0.7 | 100.5 | 0.7 | 89.9 | 1.0 | < 0 .001 |
Alcohol intake | 0.002 | ||||||
None | 1629(27.3) | 1.6 | 1278(26.9) | 1.5 | 351(28.7) | 2.4 | |
Moderate | 3203(62.5) | 1.4 | 2525(63.7) | 1.4 | 678(58.0) | 2.1 | |
Heavy | 479(10.2) | 0.7 | 354(9.4) | 0.7 | 125(13.3) | 1.5 | |
Physical activity | < 0 .001 | ||||||
Inactive | 2451(36.6) | 1.1 | 1875(35.3) | 1.2 | 576(41.5) | 1.6 | |
Active | 3145(63.4) | 1.1 | 2521(64.7) | 1.2 | 624(58.5) | 1.6 | |
Family income status | 0.716 | ||||||
0.0–1.3 | 1377(20.2) | 1.2 | 1075(20.3) | 1.4 | 302(19.7) | 1.4 | |
> 1.3–3.5 | 2032(37.0) | 1.2 | 1596(36.6) | 1.2 | 437(38.6) | 2.6 | |
> 3.5 | 1730(42.8) | 1.6 | 1360(43.1) | 1.7 | 370(41.7) | 2.6 | |
SBP, mmHg | 122.6 | 0.4 | 121.2 | 0.4 | 128.0 | 0.6 | < 0 .001 |
DBP, mmHg | 72.2 | 0.3 | 71.7 | 0.3 | 74.1 | 0.5 | < 0.001 |
TG, mg/dL | 147.1 | 2.8 | 136.1 | 2.8 | 188.5 | 6.8 | < 0.001 |
TC, mg/dL | 201.4 | 1.0 | 199.4 | 1.0 | 207.9 | 1.7 | < 0 .001 |
HDL, mg/dL | 51.8 | 0.3 | 52.8 | 0.4 | 48.0 | 0.6 | < 0 .001 |
LDL, mg/dL | 120.8 | 0.7 | 119.8 | 0.8 | 125.1 | 1.4 | 0.002 |
Fasting blood glucose, mmol/L | 5.6 | 0.0 | 5.6 | 0.0 | 5.8 | 0.0 | < 0 .001 |
C- peptide, nmol/L | 0.8 | 0.0 | 0.7 | 0.0 | 1.1 | 0.0 | < 0 .001 |
HbA1c (%) | 5.5 | 0.0 | 5.4 | 0.0 | 5.6 | 0.0 | < 0 .001 |
Hypertension | < 0.001 | ||||||
No | 3214(64.3) | 1.0 | 2726(68.9) | 1.0 | 488(46.8) | 2.2 | |
Yes | 2382(35.7) | 1.0 | 1670(31.1) | 1.0 | 712(53.2) | 2.2 | |
Diabetes | < 0 .001 | ||||||
No | 4915(90.2) | 0.5 | 3926(91.7) | 0.5 | 989(84.6) | 1.3 | |
Yes | 681(9.8) | 0.5 | 470(8.3) | 0.5 | 211(15.4) | 1.3 | |
Hyperlipidemia | < 0 .001 | ||||||
No | 1289(24.5) | 0.8 | 1129(27.7) | 1.0 | 160(12.6) | 1.3 | |
Yes | 4307(75.5) | 0.8 | 3267(72.3) | 1.0 | 1040(87.4) | 1.3 | |
HOMA2-%B | 118.3 | 1.0 | 113.9 | 1.0 | 134.9 | 1.6 | < 0 .001 |
HOMA2-%S | 69.9 | 1.1 | 75.2 | 1.4 | 50.1 | 1.1 | < 0 .001 |
Disposition index | 73.9 | 0.7 | 77.1 | 0.8 | 61.8 | 1.0 | < 0 .001 |
Associations between HOMA2-%B and HUA
HOMA2-%B, OR (95% CI) | P for trend a | ||||
---|---|---|---|---|---|
Q1 < 90.85 | Q2 90.85–112.30 | Q3 112.30–138.30 | Q4 ≥ 138.30 | ||
Model 1b | 1.00 | 1.28(0.94,1.74) | 1.96(1.50,2.58) | 4.41(3.38,5.75) | < 0 .001 |
Model 2c | 1.00 | 1.11(0.81,1.51) | 1.40(1.05,1.87) | 2.33(1.77,3.07) | < 0 .001 |
Model 3d | 1.00 | 1.22(0.88,1.67) | 1.55(1.15,2.08) | 2.55(1.89,3.43) | < 0 .001 |
HOMA2-%B, OR (95% CI) | P for trend b | P for interaction | ||||
---|---|---|---|---|---|---|
Variable | Q1 | Q2 | Q3 | Q4 | ||
Sex | 0.559 | |||||
Male | 1.00 | 1.27(0.85–1.89) | 1.68(1.17–2.41) | 2.68(1.81–3.96) | < 0.001 | |
Female | 1.00 | 1.17(0.71–1.94) | 1.53(0.94–2.50) | 2.64(1.56–4.46) | < 0.001 | |
Age groups, years | 0.233 | |||||
≤ 60 | 1.00 | 1.21(0.81–1.81) | 1.38(0.97–1.97) | 2.47(1.75–3.49) | < 0.001 | |
> 60 | 1.00 | 1.28(0.90–1.82) | 2.56(1.69–3.86) | 3.77(2.45–5.80) | < 0.001 | |
BMI (kg/m2) | 0.918 | |||||
< 25 | 1.00 | 1.27(0.71–2.28) | 1.36(0.74–2.53) | 2.46(1.20–5.05) | 0.022 | |
≥ 25 | 1.00 | 1.24(0.89–1.73) | 1.63(1.27–2.10) | 2.66(1.94–3.64) | < 0.001 | |
Glycemic status | 0.003 | |||||
Normal | 1.00 | 1.12(0.70–1.80) | 1.20(0.72–1.99) | 2.44(1.47–4.05) | < 0.001 | |
Prediabetes c | 1.00 | 1.18(0.65–2.14) | 1.86(1.15–3.01) | 3.23(1.91–5.46) | < 0.001 | |
Diabetes | 1.00 | 1.81(1.03–3.19) | 3.56(1.71–7.41) | 1.58(0.68–3.67) | 0.018 |
Associations between HOMA2-%S and HUA
HOMA2-%S, OR (95% CI) | P for trenda | ||||
---|---|---|---|---|---|
Q1 < 41.5 | Q2 41.5–58.8 | Q3 58.8–81.4 | Q4 ≥ 81.4 | ||
Model 1b | 8.69(6.39, 11.84) | 3.49(2.54, 4.81) | 2.02(1.50, 2.73) | 1.00 | < 0 .001 |
Model 2c | 4.21(3.00, 5.90) | 2.08(1.50, 2.89) | 1.57(1.15, 2.15) | 1.00 | < 0 .001 |
Model 3d | 3.87(2.74, 5.45) | 1.89(1.35, 2.63) | 1.51(1.10, 2.07) | 1.00 | < 0 .001 |
HOMA2-%S, OR (95% CI) | P for trend b | P for interaction | ||||
---|---|---|---|---|---|---|
Variable | Q1 | Q2 | Q3 | Q4 | ||
Sex | < 0.001 | |||||
Male | 3.04(2.04–4.54) | 1.61(1.06–2.45) | 1.36(0.93–1.99) | 1.00 | < 0.001 | |
Female | 5.61(3.15–9.96) | 2.29(1.36–3.87) | 1.63(1.01–2.64) | 1.00 | < 0.001 | |
Age groups, years | 0.372 | |||||
≤ 60 | 3.64(2.48–5.33) | 1.59(1.11–2.26) | 1.33(0.94–1.87) | 1.00 | < 0.001 | |
> 60 | 4.96(2.76–8.92) | 2.93(1.63–5.25) | 2.21(1.21–4.02) | 1.00 | < 0.001 | |
BMI (kg/m2) | 0.811 | |||||
< 25 | 4.03(1.85–8.77) | 1.62(0.81–3.25) | 1.45(0.86–2.44) | 1.00 | 0.009 | |
≥ 25 | 3.84(2.64–5.59) | 1.91(1.31–2.80) | 1.50(1.05–2.12) | 1.00 | < 0.001 | |
Glycemic status | 0.539 | |||||
Normal | 4.00(2.64–6.05) | 1.70(1.15–2.51) | 1.42(1.02–1.97) | 1.00 | < 0.001 | |
Prediabetes c | 4.96(2.45–10.03) | 2.30(1.13–4.67) | 1.97(1.00–3.86) | 1.00 | < 0.001 | |
Diabetes | 2.60(0.75–9.00) | 1.61(0.41–6.30) | 0.66(0.18–2.50) | 1.00 | 0.006 |
Associations between DI and HUA
Disposition Index, OR (95% CI) | P for trend a | ||||
---|---|---|---|---|---|
Q1 < 53.30 | Q2 53.30–69.22 | Q3 69.22–86.00 | Q4 ≥ 86.00 | ||
Model 1b | 4.74(3.44, 6.54) | 2.79(2.07, 3.76) | 1.81(1.35, 2.43) | 1.00 | < 0 .001 |
Model 2c | 2.00(1.37, 2.91) | 1.49(1.09, 2.04) | 1.23(0.87, 1.69) | 1.00 | < 0 .001 |
Model 3d | 1.98(1.32, 2.97) | 1.37(0.99, 1.88) | 1.20(0.87, 1.65) | 1.00 | 0.001 |
Disposition Index, OR (95% CI) | P for trend b | P for interaction | ||||
---|---|---|---|---|---|---|
Variable | Q1 | Q2 | Q3 | Q4 | ||
Sex | < 0.001 | |||||
Male | 1.58(0.94–2.68) | 1.07(0.65–1.76) | 1.30(0.79–2.12) | 1.00 | 0.165 | |
Female | 2.45(1.39–4.34) | 1.65(1.03–2.62) | 0.91(0.61–1.37) | 1.00 | < 0.001 | |
Age groups, years | 0.944 | |||||
≤ 60 | 1.66(1.05–2.62) | 1.09(0.77–1.56) | 1.07(0.76–1.50) | 1.00 | 0.064 | |
> 60 | 1.88(1.11–3.17) | 1.54(0.87–2.74) | 1.12(0.63–2.01) | 1.00 | 0.005 | |
BMI (kg/m2) | 0.703 | |||||
< 25 | 1.59(0.88–2.87) | 0.95(0.53–1.70) | 1.28(0.72–2.27) | 1.00 | 0.381 | |
≥ 25 | 2.08(1.31–3.29) | 1.42(0.98–2.07) | 1.15(0.77–1.74) | 1.00 | < 0.001 | |
Glycemic status | 0.153 | |||||
Normal | 1.63(0.37–7.14) | 1.51(1.04–2.19) | 1.15(0.80–1.65) | 1.00 | 0.049 | |
Prediabetes c | 0.85(0.40–1.79) | 0.48(0.23–1.01) | 0.41(0.16–1.10) | 1.00 | 0.015 | |
Diabetes | 2.25(0.28–18.34) | 0.91(0.08–10.89) | 2.53(0.23–27.89) | 1.00 | 0.322 |