Background
Methods
Study design and participants
Evaluation of risk factors
Statistical analysis
Results
Baseline characteristics of participants by quintiles of baseline SUA/Cr
Characteristic | Quintile of baseline SUA/Cr | |||||
---|---|---|---|---|---|---|
First (n = 406) | Second (n = 402) | Third (n = 403) | Fourth (n = 406) | Fifth (n = 400) | P for trenda | |
Male sex | 202 (49.8) | 193 (48.0) | 166 (41.2) | 194 (47.8) | 161 (40.3) | 0.015 |
Age (yr) | 71.0 ± 9.0 | 69.0 ± 9.0 | 69.0 ± 9.0 | 66.0 ± 10.0 | 66.0 ± 10.0 | < 0.001 |
Body mass index (kg/m2) | 23.0 ± 3.0 | 23.6 ± 3.1 | 23.9 ± 3.2 | 24.3 ± 3.1 | 24.5 ± 3.5 | < 0.001 |
Smoking statusb | 0.019 | |||||
Nonsmoker | 66.7 | 67.9 | 74.2 | 64.0 | 63.2 | |
Ex-smoker | 15.1 | 16.4 | 11.2 | 14.8 | 16.8 | |
Light smoker (< 20 pack year) | 8.2 | 4.7 | 6.0 | 5.7 | 7.2 | |
Heavy smoker (≥ 20 pack year) | 10.1 | 10.9 | 8.7 | 15.5 | 12.8 | |
Drinking statusc | < 0.001 | |||||
Nondrinker | 60.3 | 57.0 | 58.6 | 51.0 | 50.7 | |
Occasional drinker (< 1 unit/day), | 23.5 | 24.6 | 19.1 | 21.7 | 20.5 | |
Daily light drinker (1–2 unit/day) | 11.4 | 9.5 | 13.2 | 14.3 | 15.5 | |
Daily heavy drinker (2–3 unit/day). | 5.0 | 9.0 | 9.2 | 13.11 | 13.3 | |
Cardiovascular disease | 50 (12.3) | 45 (11.2) | 36 (8.9) | 40 (9.9) | 44 (11.0) | 0.579 |
Systolic blood pressure (mmHg) | 152.0 ± 16.0 | 150.0 ± 16.0 | 152.0 ± 17.0 | 149.0 ± 17.0 | 149.0 ± 18.0 | 0.120 |
Diastolic blood pressure (mmHg) | 85.0 ± 10.0 | 85.0 ± 10.0 | 86.0 ± 10.0 | 86.0 ± 11.0 | 86.0 ± 11.0 | 0.257 |
Antihypertensive medication | 215 (53.0) | 233 (58.0) | 216 (53.6) | 225 (55.4) | 222 (55.5) | 0.646 |
Triglycerides (mg/dL) | 97 (69–136) | 90 (67–123) | 97 (73–133) | 99 (76–142) | 107 (79–153) | < 0.001 |
High-density lipoprotein cholesterol (mg/dL) | 62.0 ± 16.0 | 63.0 ± 15.0 | 63.0 ± 16.0 | 62.0 ± 16.0 | 63.0 ± 17.0 | 0.366 |
Low-density lipoprotein cholesterol (mg/dL) | 116.0 ± 30.0 | 119.0 ± 29.0 | 122.0 ± 30.0 | 120.0 ± 30.0 | 120.0 ± 33.0 | 0.119 |
Antilipidemic medication | 60 (14.8) | 59 (14.7) | 52 (12.9) | 38 (9.4) | 54 (13.5) | 0.138 |
Blood glucose (mg/dL) | 103 (93–117) | 105 (93–120) | 104 (94–118) | 103 (93–117) | 105 (95–119) | 0.800 |
Antidiabetic medication | 59 (14.5) | 47 (11.7) | 48 (11.9) | 42 (10.3) | 38 (9.5) | 0.216 |
Creatinine (mg/dL) | 0.86 ± 0.40 | 0.76 ± 0.18 | 0.70 ± 0.16 | 0.69 ± 0.15 | 0.62 ± 0.12 | < 0.001 |
SUA (mg/dL) | 4.20 ± 1.30 | 4.90 ± 1.20 | 5.20 ± 1.20 | 5.80 ± 1.20 | 6.30 ± 1.30 | < 0.001 |
SUA-lowering medication | 18 (4.4) | 17 (4.2) | 22 (5.5) | 28 (6.9) | 36 (9.0) | 0.025 |
SUA/Cr ratio | 5.00 ± 0.87 | 6.43 ± 0.30 | 7.40 ± 0.27 | 8.39 ± 0.33 | 10.20 ± 1.12 | < 0.001 |
eGFR (mL/min/1.73 m2/yr) | 65.00 ± 16.00 | 70.30 ± 12.50 | 74.30 ± 13.00 | 78.40 ± 13.70 | 84.60 ± 14.60 | < 0.001 |
Relationship between baseline SUA/Cr (continuous data) and characteristics
Baseline characteristic | Male (n = 916) | Female (n = 1,101) | Total (n = 2,017) | |||
---|---|---|---|---|---|---|
r
| P-value |
r
| P-value |
r
| P-value | |
Sexa | - | - | 0.071 | 0.002 | ||
Age | –0.268 | < 0.001 | –0.146 | < 0.001 | –0.199 | < 0.001 |
Body mass index | 0.035 | 0.289 | 0.259 | < 0.001 | 0.164 | < 0.001 |
Smoking statusb | 0.058 | 0.078 | 0.167 | < 0.001 | 0.031 | 0.158 |
Drinking statusc | 0.222 | < 0.001 | 0.145 | < 0.001 | 0.101 | < 0.001 |
Cardiovascular disease | –0.017 | 0.610 | 0.003 | 0.908 | –0.010 | 0.644 |
Systolic blood pressure | –0.033 | 0.314 | –0.051 | 0.090 | –0.039 | 0.076 |
Diastolic blood pressure | 0.128 | < 0.001 | 0.006 | 0.834 | 0.052 | 0.018 |
Antihypertensive medicationd | –0.083 | 0.012 | 0.076 | 0.012 | 0.005 | 0.811 |
Triglycerides | 0.097 | 0.003 | 0.106 | < 0.001 | 0.099 | < 0.001 |
High-density lipoprotein cholesterol | 0.038 | 0.250 | –0.014 | 0.654 | 0.020 | 0.380 |
Low-density lipoprotein cholesterol | –0.002 | 0.959 | 0.051 | 0.094 | 0.043 | 0.056 |
Antilipidemic medicationd | –0.065 | 0.051 | –0.006 | 0.832 | –0.020 | 0.363 |
Blood glucose | –0.069 | 0.038 | 0.063 | 0.037 | –0.008 | 0.721 |
Antidiabetic medicationd | –0.081 | 0.015 | 0.034 | 0.256 | –0.033 | 0.135 |
Estimated glomerular filtration rate | 0.501 | < 0.001 | 0.419 | < 0.001 | 0.456 | < 0.001 |
Serum uric acid lowering medicationd | 0.137 | < 0.001 | 0.073 | 0.015 | 0.087 | < 0.001 |
HRs and 95% CI of baseline SUA/Cr (continuous data) for all-cause mortality by sex
Baseline characteristic | All-cause mortality | |
---|---|---|
Hazard ratio (95% CI) | P-value | |
Male (n = 916) | ||
Nonadjusted | 0.90 (0.84–0.95) | < 0.001 |
Age and eGFR-adjusted | 1.05 (0.98–1.13) | 0.148 |
Multivariate-adjusteda | 1.05 (0.98–1.33) | 0.157 |
Female (n = 1,001) | ||
Nonadjusted | 0.98 (0.92–1.04) | 0.511 |
Age and eGFR-adjusted | 1.07 (1.00–1.14) | 0.046 |
Multivariate-adjusteda | 1.10 (1.02–1.18) | 0.013 |
Total (n = 2,017) | ||
Nonadjusted | 0.94 (0.90–0.98) | 0.002 |
Age, sex, and eGFR-adjusted | 1.07 (1.02–1.12) | 0.008 |
Multivariate-adjusteda | 1.08 (1.02–1.13) | 0.004 |
HRs and 95% CI for all-cause mortality in quintiles of baseline SUA/Cr by sex
Baseline characteristic | Quintile of baseline SUA/Cr | P for trend | ||||
---|---|---|---|---|---|---|
Firsta (n = 406) | Secondb (n = 402) | Thirdc (n = 403) | Fourthd (n = 406) | Fifthe (n = 400) | ||
Male (n = 916) | 0.020 | |||||
Prevalence | 89 (44.1) | 57 (29.5) | 65 (39.2) | 64 (33.0) | 52 (32.3) | |
Nonadjusted | 1.74 (1.24–2.42) | 1.00 | 1.23 (0.86–1.75) | 1.04 (0.73–1.48) | 0.88 (0.61–1.28) | < 0.001 |
Age and eGFR-adjusted | 1.35 (0.97–1.89) | 1.00 | 1.33 (0.93–1.91) | 1.43 (0.99–2.06) | 1.60 (1.07–2.38) | 0.186 |
Multivariate-adjustedf | 1.28 (0.91–1.80) | 1.00 | 1.38 (0.95–1.98) | 1.37 (0.94–2.00) | 1.57 (1.03–2.40) | 0.277 |
Female (n = 1,001) | 0.836 | |||||
Prevalence | 64 (31.7) | 55 (26.3) | 67 (28.3) | 58 (27.4) | 68 (28.5) | |
Nonadjusted | 1.08 (0.75–1.57) | 1.00 | 0.90 (0.63–1.29) | 0.91 (0.63–1.31) | 1.04 (0.73–1.49) | 0.786 |
Age and eGFR-adjusted | 0.93 (0.65–1.33) | 1.00 | 0.97 (0.68–1.39) | 1.30 (0.89–1.89) | 1.41 (0.98–2.05) | 0.099 |
Multivariate-adjustedf | 0.92 (0.64–1.33) | 1.00 | 1.04 (0.72–1.50) | 1.56 (1.06–2.30) | 1.59 (1.06–2.38) | 0.016 |
Total (n = 2,017) | 0.030 | |||||
Prevalence | 153 (37.7) | 112 (27.9) | 132 (32.8) | 122 (30.0) | 120 (30.0) | |
Nonadjusted | 1.38 (1.08–1.76) | 1.00 | 1.02 (0.80–1.32) | 0.97 (0.75–1.25) | 0.96 (0.74–1.24) | 0.010 |
Age, sex, and eGFR-adjusted | 1.13 (0.88–1.44) | 1.00 | 1.15 (0.89–1.48) | 1.37 (1.06–1.79) | 1.54 (1.17–2.02) | 0.018 |
Multivariate-adjustedf | 1.09 (0.85–1.39) | 1.00 | 1.19 (0.92–1.54) | 1.42 (1.09–1.86) | 1.61 (1.21–2.14) | 0.010 |
HRs and 95% CI for all-cause mortality in quintiles of baseline SUA/Cr by subanalysis
Baseline characteristic | No. of participants | Quintiles of baseline SUA/Cr Multivariable-adjusted hazard ratio (95% confidence interval) | P for trend | ||||
---|---|---|---|---|---|---|---|
First | Second | Third | Fourth | Fifth | |||
Age (yr) | |||||||
< 65 | 586 | 2.22 (0.89–5.56) | 1.00 | 2.16 (0.88–5.34) | 1.76 (0.72–4.26) | 3.27 (1.35–7.88) | 0.093 |
≥ 65 | 1,431 | 1.02 (0.79–1.32) | 1.00 | 1.14 (0.87–1.49) | 1.43 (1.08–1.90) | 1.48 (1.09–2.01) | 0.030 |
Body mass index (kg/m2) | |||||||
< 22.0 | 559 | 0.82 (0.55–1.23) | 1.00 | 0.89 (0.56–1.41) | 1.33 (0.82–2.14) | 1.62 (0.99–2.67) | 0.045 |
≥ 22.0 | 1,458 | 1.35 (0.98–1.86) | 1.00 | 1.35 (0.98–1.85) | 1.58 (1.13–2.19) | 1.64 (1.15–2.34) | 0.053 |
Chronic kidney disease | |||||||
eGFR < 60 mL/min/1.73 m2/yr | 275 | 1.84 (1.10–3.08) | 1.00 | 2.00 (1.10–3.61) | 0.96 (0.42–2.20) | 6.18 (2.27–16.8) | 0.002 |
eGFR ≥ 60 mL/min/1.73 m2/yr | 1,742 | 0.87 (0.64–1.17) | 1.00 | 1.08 (0.81–1.44) | 1.36 (1.02–1.82) | 1.39 (1.02–1.88) | 0.013 |
Serum uric acid lowering medication | |||||||
No | 1,896 | 1.07 (0.83–1.38) | 1.00 | 1.20 (0.92–1.57) | 1.47 (1.11–1.95) | 1.58 (1.17–2.14) | 0.011 |
Yes | 121 | 1.68 (0.48–5.92) | 1.00 | 1.56 (0.47–5.21) | 1.28 (0.44–3.78) | 2.30 (0.69–7.70) | 0.670 |
Time to death (day) | |||||||
< 1,095 | 50 | - | - | - | - | - | - |
≥ 1,095 | 1,967 | 1.11 (0.85–1.43) | 1.00 | 1.18 (0.90–1.54) | 1.42 (1.08–1.88) | 1.57 (1.16–2.12) | 0.025 |