Relationship of Visceral Adiposity Index with New-Onset Hyperuricemia in Hypertensive Patients

Research Article

Austin Crit Care J. 2022; 9(1): 1041.

Relationship of Visceral Adiposity Index with New-Onset Hyperuricemia in Hypertensive Patients

Zhang S1,2#, Li Q1,2#, Li R1,2, Zhang Y3, Li H3, He P3, Liu C1,2, Li J3, Zhang Y4, Huo Y5, Qin X1,2,3*, Xu X1* and Wang B1,2,6*

1Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China

2Institute of Biomedicine, Anhui Medical University, Hefei, China

3Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China

4Department of Cardiology, Peking University First Hospital, Beijing, China

5Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China

6Shenzhen Evergreen Medical Institute, Shenzhen, China

#Contributed Equally to this manuscript

*Corresponding author: Xianhui Qin, Institute of Biomedicine, Anhui Medical University, Hefei 230032, China

Xiping Xu, Institute of Biomedicine, Anhui Medical University, Hefei, China

Binyan Wang, Institute of Biomedicine, Anhui Medical University, Hefei 230032, China

Received: January 24, 2022; Accepted: February 21, 2022; Published: February 28, 2022

Abstract

Background: Visceral adiposity index is a new type of indicator that accurately reflects distribution and function of visceral fat. The relation between VAI and new-onset hyperuricemia remains largely understudied.

Purpose: This study sought to further investigate the prospective association between VAI and the risk of hyperuricemia by examining possible effect modifies in hypertensive patients.

Methods: We enrolled 10,513 hypertensive patients with normal uric acid (UA) concentrations (<357 μmol/L (6 mg/dL)) who participated the UA Sub-study of the China Stroke Primary Prevention Trial (CSPPT). Our primary outcome was new-onset hyperuricemia, which was defined as a UA concentration ≥417 μmol/L (7 mg/dL) in men or ≥357 μmol/L (6 mg/dL) in women at the exit visit.

Results: Over a median follow-up of 4.4 years, 1,642 (15.6%) participants developed new-onset hyperuricemia. When VAI was assessed as quartiles, a significantly higher risk of new-onset hyperuricemia was found in participants in quartile 4 (≥2.98; odds ratio, 1.17; 95% CI: 1.01-1.36) compared with those in quartile 1-3 (<2.98). Furthermore, we discovered that the positive relation was independent of abnormal VAI components or numbers of abnormal VAI components (all P-interactions > 0.05).

Conclusion: There was a positive relationship between baseline VAI and the risk of new-onset hyperuricemia in a sample of Chinese hypertensive individuals.

Keywords: Visceral adiposity index; Uric acid; New-onset hyperuricemia

Introduction

In recent years, an increasing trend in the prevalence of hyperuricemia has been observed in epidemiological studies [1,2]. Patients with hyperuricemia sustained increasing risk of gout, cardiovascular diseases (CVD), diabetes and chronic kidney disease (CKD) [3-6]. Hence, the discovery of more modifiable risk factors related to hyperuricemia is important for preventing hyperuricemia and reducing the risk of its related diseases.

Obesity is a major global health challenge and is also an important risk factor for cancer, diabetes and CKD [7-9]. Several studies have suggested that it is not the extent of obesity but the distribution of adiposity tissue that plays a decisive role in the impact of obesity on these diseases [10,11]. In addition, previous study has found that the an increase in visceral adiposity is associated with the higher risk prevalence of hyperuricemia [12].

There are several traditional methods like body mass index (BMI), waist-to-height ratio, waist circumference (WC), waist-tohip ratio, but none of these can measure visceral adiposity accurately [13]. The visceral adiposity index (VAI) is as accurate as magnetic resonance imaging (the gold standard method) in measuring visceral adiposity [14], and therefore, can be used as a valuable indicator of lipid accumulation and visceral adipose function for its convenience and accuracy. However, several cross-sectional studies [15,16] and only one prospective study [17] have evaluated the association between VAI and hyperuricemia, and reported inconsistent findings. Furthermore, few studies have been conducted in hypertensive population, who are proved to be at high risk for hyperuricemia [18].

To address the aforementioned gaps in the existing literature, we aimed to further investigate the prospective association between VAI and the risk of hyperuricemia by examining possible effect modifies in hypertensive patients who joined the UA Sub-study of the China Stroke Primary Prevention Trial (CSPPT) [19].

Methods

Study design and population

The study procedures have been described in previous studies [19-23], and are therefore only briefly explained here. The CSPPT was a multi-community, randomized, double-blind controlled trial with 20,702 hypertensive adults in 32 communities in Jiangsu and Anhui provinces of China, which was conducted from May 19, 2008 to August 24, 2013.

The UA sub-study of the CSPPT enrolled 15,364 eligible participants with complete data on UA and without the usage of UAlowering drugs at baseline from 20 communities in Jiangsu province. The current study is a post-hoc analysis of the UA Sub-study. The flow of the participants is presented in Supplemental Figure 1.