Association and Interaction between Heavy Metals and Hyperuricemia in a Taiwanese Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subject Recruitment
2.2. Collection of Demographic, Medical and Laboratory Data
2.3. Measurement of Heavy Metals in Blood and Urine
2.4. The LOQ of Each Heavy Metal
- Blood Pb: 82 μg/L (0.384 μmol/L);
- Urine Cd: 0.5 ppb (0.0044 μmol/L);
- Urine Cu: 1.0 ppb (0.0157 μmol/L);
- Urine Ni: 1.0 ppb (0.017 μmol/L);
- Urine As: 1.0 ppb (0.01335 μmol/L);
- Urine Cr: 0.2 ppb (0.0038 μmol/L);
- Urine Mn: 0.5 ppb (0.0091 μmol/L).
2.5. Definition of Hyperuricemia
2.6. Ethics Statement
2.7. Statistical Analysis
3. Results
3.1. Comparisons of the Characteristics between the Participants with and without Hyperuricemia
3.2. Determinants of Hyperuricemia
3.3. Interactions among Heavy Metals on Hyperuricemia
3.4. Determinants for Hyperuricemia in Subgroup Analysis according to Age and Sex
3.5. Determinants for As Using Linear Regression Analysis
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Lee, M.-S.; Lin, S.-C.; Chang, H.-Y.; Lyu, L.-C.; Tsai, K.-S.; Pan, W.-H. High prevalence of hyperuricemia in elderly Taiwanese. Asia Pac. J. Clin. Nutr. 2005, 14, 285–292. [Google Scholar] [PubMed]
- Chuang, S.Y.; Lee, S.C.; Hsieh, Y.T.; Pan, W.H. Trends in hyperuricemia and gout prevalence: Nutrition and Health Survey in Taiwan from 1993–1996 to 2005–2008. Asia Pac. J. Clin. Nutr. 2011, 20, 301–308. [Google Scholar] [PubMed]
- Kanellis, J.; Feig, D.I.; Johnson, R.J. Does asymptomatic hyperuricaemia contribute to the development of renal and cardiovascular disease? An old controversy renewed. Nephrology 2004, 9, 394–399. [Google Scholar] [CrossRef] [PubMed]
- Yu, K.H.; Chen, D.Y.; Chen, J.H.; Chen, S.Y.; Chen, S.M.; Cheng, T.T.; Hsieh, S.C.; Hsieh, T.Y.; Hsu, P.F.; Kuo, C.F.; et al. Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan. Int. J. Rheum. Dis. 2018, 21, 772–787. [Google Scholar] [CrossRef]
- Tseng, C.H. Correlation of uric acid and urinary albumin excretion rate in patients with type 2 diabetes mellitus in Taiwan. Kidney Int. 2005, 68, 796–801. [Google Scholar] [CrossRef]
- Segura, J.; Campo, C.; Ruilope, L. How relevant and frequent is the presence of mild renal insufficiency in essential hypertension? J. Clin. Hypertens. 2002, 4, 332–336. [Google Scholar] [CrossRef]
- Chiu, T.H.; Wu, P.Y.; Huang, J.C.; Su, H.M.; Chen, S.C.; Chang, J.M.; Chen, H.C. Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease. Diagnostics 2020, 10, 514. [Google Scholar] [CrossRef]
- Wei, C.Y.; Sun, C.C.; Wei, J.C.; Tai, H.C.; Sun, C.A.; Chung, C.F.; Chou, Y.C.; Lin, P.L.; Yang, T. Association between Hyperuricemia and Metabolic Syndrome: An Epidemiological Study of a Labor Force Population in Taiwan. Biomed Res. Int. 2015, 2015, 369179. [Google Scholar] [CrossRef]
- Manisalidis, I.; Stavropoulou, E.; Stavropoulos, A.; Bezirtzoglou, E. Environmental and Health Impacts of Air Pollution: A Review. Front. Public Health 2020, 8, 14. [Google Scholar] [CrossRef]
- Fu, Z.; Xi, S. The effects of heavy metals on human metabolism. Toxicol. Mech. Methods 2020, 30, 167–176. [Google Scholar] [CrossRef]
- Chen, H.; Zhan, C.; Liu, S.; Zhang, J.; Liu, H.; Liu, Z.; Liu, T.; Liu, X.; Xiao, W. Pollution Characteristics and Human Health Risk Assessment of Heavy Metals in Street Dust from a Typical Industrial Zone in Wuhan City, Central China. Int. J. Environ. Res. Public Health 2022, 19, 10970. [Google Scholar] [CrossRef] [PubMed]
- Wen, W.L.; Wang, C.W.; Wu, D.W.; Chen, S.C.; Hung, C.H.; Kuo, C.H. Associations of Heavy Metals with Metabolic Syndrome and Anthropometric Indices. Nutrients 2020, 12, 2666. [Google Scholar] [CrossRef] [PubMed]
- Kuo, C.C.; Weaver, V.; Fadrowski, J.J.; Lin, Y.S.; Guallar, E.; Navas-Acien, A. Arsenic exposure, hyperuricemia, and gout in US adults. Environ. Int. 2015, 76, 32–40. [Google Scholar] [CrossRef] [PubMed]
- Maiti, S.; Chattopadhyay, S.; Deb, B.; Samanta, T.; Maji, G.; Pan, B.; Ghosh, A.; Ghosh, D. Antioxidant and metabolic impairment result in DNA damage in arsenic-exposed individuals with severe dermatological manifestations in Eastern India. Environ. Toxicol. 2012, 27, 342–350. [Google Scholar] [CrossRef]
- Levey, A.S.; Stevens, L.A.; Schmid, C.H.; Zhang, Y.L.; Castro, A.F., 3rd; Feldman, H.I.; Kusek, J.W.; Eggers, P.; Van Lente, F.; Greene, T.; et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 2009, 150, 604–612. [Google Scholar] [CrossRef] [PubMed]
- Lee, J.W.; Kwon, B.C.; Choi, H.G. Analyses of the relationship between hyperuricemia and osteoporosis. Sci. Rep. 2021, 11, 12080. [Google Scholar] [CrossRef]
- Saravanabhavan, G.; Werry, K.; Walker, M.; Haines, D.; Malowany, M.; Khoury, C. Human biomonitoring reference values for metals and trace elements in blood and urine derived from the Canadian Health Measures Survey 2007–2013. Int. J. Hyg. Environ. Health 2017, 220, 189–200. [Google Scholar] [CrossRef] [PubMed]
- Šlejkovec, Z.; Bizjak, T.; Horvat, M.; Falnoga, I. No clear concerns related to health risks in the European population with low inorganic arsenic exposure (overview). Hum. Ecol. Risk Assess. Int. J. 2022, 29, 245–283. [Google Scholar] [CrossRef]
- Costa, M. Review of arsenic toxicity, speciation and polyadenylation of canonical histones. Toxicol. Appl. Pharmacol. 2019, 375, 1–4. [Google Scholar] [CrossRef]
- Williams, P.N.; Price, A.H.; Raab, A.; Hossain, S.A.; Feldmann, J.; Meharg, A.A. Variation in arsenic speciation and concentration in paddy rice related to dietary exposure. Environ. Sci. Technol. 2005, 39, 5531–5540. [Google Scholar] [CrossRef]
- Taylor, V.; Goodale, B.; Raab, A.; Schwerdtle, T.; Reimer, K.; Conklin, S.; Karagas, M.R.; Francesconi, K.A. Human exposure to organic arsenic species from seafood. Sci. Total. Environ. 2017, 580, 266–282. [Google Scholar] [CrossRef] [PubMed]
- Del Razo, L.M.; García-Montalvo, E.A.; Valenzuela, O.L. Arsenic exposure alters purine metabolism in rats, mice, and humans. In Arsenic Exposure and Health Effects V; Elsevier: Amsterdam, The Netherlands, 2003; pp. 135–145. [Google Scholar]
- Mershiba, S.D.; Dassprakash, M.V.; Saraswathy, S.D. Protective effect of naringenin on hepatic and renal dysfunction and oxidative stress in arsenic intoxicated rats. Mol. Biol. Rep. 2013, 40, 3681–3691. [Google Scholar] [CrossRef] [PubMed]
- Sioen, I.; De Henauw, S.; Van Camp, J.; Volatier, J.L.; Leblanc, J.C. Comparison of the nutritional-toxicological conflict related to seafood consumption in different regions worldwide. Regul. Toxicol. Pharmacol. 2009, 55, 219–228. [Google Scholar] [CrossRef] [PubMed]
- Krishnan, E.; Lingala, B.; Bhalla, V. Low-level lead exposure and the prevalence of gout: An observational study. Ann. Intern. Med. 2012, 157, 233–241. [Google Scholar] [CrossRef]
- Xu, J.; Zhu, X.; Hui, R.; Xing, Y.; Wang, J.; Shi, S.; Zhang, Y.; Zhu, L. Associations of metal exposure with hyperuricemia and gout in general adults. Front. Endocrinol. 2022, 13, 1052784. [Google Scholar] [CrossRef]
- Kasperczyk, S.; Dobrakowski, M.; Ostałowska, A.; Kasperczyk, A.; Wilczyiński, S.; Wyparło-Wszelaki, M.; Kiełtucki, J.; Birkner, E. Lead-elevated activity of xanthine oxidase in lead-exposed workers. Med. Pr. 2013, 64, 175–180. [Google Scholar] [CrossRef]
- Gonick, H.C. Nephrotoxicity of cadmium & lead. Indian J. Med. Res. 2008, 128, 335–352. [Google Scholar]
- Hambach, R.; Lison, D.; D’Haese, P.C.; Weyler, J.; De Graef, E.; De Schryver, A.; Lamberts, L.V.; van Sprundel, M. Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers. Toxicol. Lett. 2013, 222, 233–238. [Google Scholar] [CrossRef]
- Roels, H.; Lauwerys, R.; Konings, J.; Buchet, J.P.; Bernard, A.; Green, S.; Bradley, D.; Morgan, W.; Chettle, D. Renal function and hyperfiltration capacity in lead smelter workers with high bone lead. Occup. Environ. Med. 1994, 51, 505–512. [Google Scholar] [CrossRef]
- Pechova, A.; Pavlata, L. Chromium as an essential nutrient: A review. Veterinární Med. 2007, 52, 1. [Google Scholar] [CrossRef]
- Hossini, H.; Shafie, B.; Niri, A.D.; Nazari, M.; Esfahlan, A.J.; Ahmadpour, M.; Nazmara, Z.; Ahmadimanesh, M.; Makhdoumi, P.; Mirzaei, N.; et al. A comprehensive review on human health effects of chromium: Insights on induced toxicity. Environ. Sci. Pollut. Res. Int. 2022, 29, 70686–70705. [Google Scholar] [CrossRef]
- Costello, R.B.; Dwyer, J.T.; Bailey, R.L. Chromium supplements for glycemic control in type 2 diabetes: Limited evidence of effectiveness. Nutr. Rev. 2016, 74, 455–468. [Google Scholar] [CrossRef]
- Vincent, J.B. Effects of chromium supplementation on body composition, human and animal health, and insulin and glucose metabolism. Curr. Opin. Clin. Nutr. Metab. Care 2019, 22, 483–489. [Google Scholar] [CrossRef] [PubMed]
- Dai, X.; Deng, Q.; Guo, D.; Ni, L.; Li, J.; Chen, Z.; Zhang, L.; Xu, T.; Song, W.; Luo, Y.; et al. Association of urinary metal profiles with serum uric acid: A cross-sectional study of traffic policemen in Wuhan, China. BMJ Open 2019, 9, e022542. [Google Scholar] [CrossRef]
- Zeng, A.; Li, S.; Zhou, Y.; Sun, D. Association Between Low-Level Blood Cadmium Exposure and Hyperuricemia in the American General Population: A Cross-sectional Study. Biol. Trace Elem. Res. 2022, 200, 560–567. [Google Scholar] [CrossRef] [PubMed]
- Sun, H.; Wang, N.; Chen, C.; Nie, X.; Han, B.; Li, Q.; Zhu, C.; Chen, Y.; Xia, F.; Chen, Y.; et al. Cadmium exposure and its association with serum uric acid and hyperuricemia. Sci. Rep. 2017, 7, 550. [Google Scholar] [CrossRef] [PubMed]
- Park, J.; Kim, Y. Associations of Blood Heavy Metals with Uric Acid in the Korean General Population: Analysis of Data from the 2016-2017 Korean National Health and Nutrition Examination Survey. Biol. Trace Elem. Res. 2021, 199, 102–112. [Google Scholar] [CrossRef]
- Choe, S.Y.; Kim, S.J.; Kim, H.G.; Lee, J.H.; Choi, Y.; Lee, H.; Kim, Y. Evaluation of estrogenicity of major heavy metals. Sci. Total Environ. 2003, 312, 15–21. [Google Scholar] [CrossRef]
- Wedeen, R.P.; Qian, L.F. Chromium-induced kidney disease. Environ. Health Perspect. 1991, 92, 71–74. [Google Scholar] [CrossRef]
- She, D.; Wang, Y.; Liu, J.; Luo, N.; Feng, S.; Li, Y.; Xu, J.; Xie, S.; Zhu, Y.; Xue, Y.; et al. Changes in the prevalence of hyperuricemia in clients of health examination in Eastern China, 2009 to 2019. BMC Endocr. Disord. 2022, 22, 202. [Google Scholar] [CrossRef]
- Piao, W.; Zhao, L.; Yang, Y.; Fang, H.; Ju, L.; Cai, S.; Yu, D. The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015-2017. Nutrients 2022, 14, 4095. [Google Scholar] [CrossRef] [PubMed]
- Choi, H.K.; Atkinson, K.; Karlson, E.W.; Willett, W.; Curhan, G. Alcohol intake and risk of incident gout in men: A prospective study. Lancet 2004, 363, 1277–1281. [Google Scholar] [CrossRef] [PubMed]
- Liu, R.; Han, C.; Wu, D.; Xia, X.; Gu, J.; Guan, H.; Shan, Z.; Teng, W. Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014: A systematic review and meta-analysis. BioMed Res. Int. 2015, 2015, 762820. [Google Scholar] [CrossRef] [PubMed]
- Mumford, S.L.; Dasharathy, S.S.; Pollack, A.Z.; Perkins, N.J.; Mattison, D.R.; Cole, S.R.; Wactawski-Wende, J.; Schisterman, E.F. Serum uric acid in relation to endogenous reproductive hormones during the menstrual cycle: Findings from the BioCycle study. Hum. Reprod. 2013, 28, 1853–1862. [Google Scholar] [CrossRef] [PubMed]
- Yahyaoui, R.; Esteva, I.; Haro-Mora, J.J.; Almaraz, M.C.; Morcillo, S.; Rojo-Martínez, G.; Martínez, J.; Gómez-Zumaquero, J.M.; González, I.; Hernando, V.; et al. Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons. J. Clin. Endocrinol. Metab. 2008, 93, 2230–2233. [Google Scholar] [CrossRef]
- Li, R.; Yu, K.; Li, C. Dietary factors and risk of gout and hyperuricemia: A meta-analysis and systematic review. Asia Pac. J. Clin. Nutr. 2018, 27, 1344–1356. [Google Scholar] [CrossRef]
- Esser, N.; Legrand-Poels, S.; Piette, J.; Scheen, A.J.; Paquot, N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Res. Clin. Pract. 2014, 105, 141–150. [Google Scholar] [CrossRef]
- Li, C.; Hsieh, M.C.; Chang, S.J. Metabolic syndrome, diabetes, and hyperuricemia. Curr. Opin. Rheumatol. 2013, 25, 210–216. [Google Scholar] [CrossRef]
- Kim, I.Y.; Han, K.D.; Kim, D.H.; Eun, Y.; Cha, H.S.; Koh, E.M.; Lee, J.; Kim, H. Women with Metabolic Syndrome and General Obesity Are at a Higher Risk for Significant Hyperuricemia Compared to Men. J. Clin. Med. 2019, 8, 837. [Google Scholar] [CrossRef]
- Feng, X.; Yang, Y.; Xie, H.; Zhuang, S.; Fang, Y.; Dai, Y.; Jiang, P.; Chen, H.; Tang, H.; Tang, L. The Association Between Hyperuricemia and Obesity Metabolic Phenotypes in Chinese General Population: A Retrospective Analysis. Front. Nutr. 2022, 9, 773220. [Google Scholar] [CrossRef]
- Yao, S.; Zhou, Y.; Xu, L.; Zhang, Q.; Bao, S.; Feng, H.; Ge, W. Association between hyperuricemia and metabolic syndrome: A cross-sectional study in Tibetan adults on the Tibetan plateau. Front. Endocrinol. 2022, 13, 964872. [Google Scholar] [CrossRef] [PubMed]
- Chen, L.Y.; Zhu, W.H.; Chen, Z.W.; Dai, H.L.; Ren, J.J.; Chen, J.H.; Chen, L.Q.; Fang, L.Z. Relationship between hyperuricemia and metabolic syndrome. J. Zhejiang Univ. Sci. B 2007, 8, 593–598. [Google Scholar] [CrossRef] [PubMed]
- Wang, H.; Zhang, H.; Sun, L.; Guo, W. Roles of hyperuricemia in metabolic syndrome and cardiac-kidney-vascular system diseases. Am. J. Transl. Res. 2018, 10, 2749–2763. [Google Scholar]
- Tsushima, Y.; Nishizawa, H.; Tochino, Y.; Nakatsuji, H.; Sekimoto, R.; Nagao, H.; Shirakura, T.; Kato, K.; Imaizumi, K.; Takahashi, H.; et al. Uric Acid Secretion from Adipose Tissue and Its Increase in Obesity. J. Biol. Chem. 2013, 288, 27138–27149. [Google Scholar] [CrossRef] [PubMed]
- Fabbrini, E.; Serafini, M.; Colic Baric, I.; Hazen, S.L.; Klein, S. Effect of Plasma Uric Acid on Antioxidant Capacity, Oxidative Stress, and Insulin Sensitivity in Obese Subjects. Diabetes 2014, 63, 976–981. [Google Scholar] [CrossRef]
- Park, J.H.; Jo, Y.I.; Lee, J.H. Renal effects of uric acid: Hyperuricemia and hypouricemia. Korean J. Intern. Med. 2020, 35, 1291–1304. [Google Scholar] [CrossRef]
- Wang, Y.; Zhang, W.; Qian, T.; Sun, H.; Xu, Q.; Hou, X.; Hu, W.; Zhang, G.; Drummond, G.R.; Sobey, C.G.; et al. Reduced renal function may explain the higher prevalence of hyperuricemia in older people. Sci. Rep. 2021, 11, 1302. [Google Scholar] [CrossRef]
- Oh, T.R.; Choi, H.S.; Kim, C.S.; Bae, E.H.; Ma, S.K.; Sung, S.A.; Kim, Y.S.; Oh, K.H.; Ahn, C.; Kim, S.W. Hyperuricemia has increased the risk of progression of chronic kidney disease: Propensity score matching analysis from the KNOW-CKD study. Sci. Rep. 2019, 9, 6681. [Google Scholar] [CrossRef]
- Bobulescu, I.A.; Moe, O.W. Renal transport of uric acid: Evolving concepts and uncertainties. Adv. Chronic Kidney Dis. 2012, 19, 358–371. [Google Scholar] [CrossRef]
- Mende, C. Management of Chronic Kidney Disease: The Relationship Between Serum Uric Acid and Development of Nephropathy. Adv. Ther. 2015, 32, 1177–1191. [Google Scholar] [CrossRef]
- Tsimberidou, A.M.; Keating, M.J. Hyperuricemic syndromes in cancer patients. Hyperuricemic Syndr. Pathophysiol. Ther. 2005, 147, 47–60. [Google Scholar] [CrossRef]
- Lupușoru, G.; Ailincăi, I.; Frățilă, G.; Ungureanu, O.; Andronesi, A.; Lupușoru, M.; Banu, M.; Văcăroiu, I.; Dina, C.; Sinescu, I. Tumor Lysis Syndrome: An Endless Challenge in Onco-Nephrology. Biomedicines 2022, 10, 1012. [Google Scholar] [CrossRef] [PubMed]
- He, S.; Gu, H.; Yang, J.; Su, Q.; Li, X.; Qin, L. Hemoglobin concentration is associated with the incidence of metabolic syndrome. BMC Endocr. Disord. 2021, 21, 53. [Google Scholar] [CrossRef]
- Kang, D.H.; Chen, W. Uric acid and chronic kidney disease: New understanding of an old problem. Semin. Nephrol. 2011, 31, 447–452. [Google Scholar] [CrossRef] [PubMed]
Characteristics | Hyperuricemia (−) (n = 1821) | Hyperuricemia (+) (n = 626) | p |
---|---|---|---|
Age (years) | 54.2 ± 12.8 | 57.7 ± 13.9 | <0.001 |
Male (%) | 35.6 | 52.6 | <0.001 |
DM (%) | 10.2 | 11.2 | 0.495 |
Hypertension (%) | 22.1 | 34.8 | <0.001 |
Systolic BP (mmHg) | 130.6 ± 19.8 | 136.4 ± 19.2 | <0.001 |
Diastolic BP (mmHg) | 76.8 ± 11.5 | 79.8 ± 11.8 | <0.001 |
BMI (kg/m2) | 24.4 ± 3.8 | 26.8 ± 4.0 | <0.001 |
Laboratory parameters | |||
Uric acid (mg/dL) | 5.0 ± 1.0 | 7.7 ± 1.2 | <0.001 |
Fasting glucose (mg/dL) | 99.2 ± 27.3 | 101.9 ± 27.4 | 0.036 |
HbA1c (%) | 5.8 ± 1.0 | 5.9 ± 0.9 | 0.009 |
Hemoglobin (g/dL) | 13.9 ± 1.6 | 14.4 ± 1.6 | <0.001 |
Triglyceride (mg/dL) | 96 (68–137) | 131 (92.75–186.25) | <0.001 |
Total cholesterol (mg/dL) | 198.6 ± 37.0 | 202.6 ± 38.7 | 0.026 |
eGFR (mL/min/1.73 m2) | 91.3 ± 14.4 | 82.5 ± 19.5 | <0.001 |
Proteinuria (%) | 8.8 | 14.7 | <0.001 |
Heavy metals | |||
Blood | |||
Pb (μg/L) | 15 (10–21) | 17 (11–24) | <0.001 |
Urine | |||
Ni (μg/g creatinine) | 2.5 (1.6–3.9) | 2.3 (1.5–3.4) | 0.343 |
Cr (μg/g creatinine) | 0.1 (0.1, 0.1) | 0.1 (0.1, 0.1) | 0.179 |
Mn (μg/g creatinine) | 1.7 (0.9–3.0) | 1.8 (0.9–2.9) | 0.463 |
As (μg/g creatinine) | 75.1 (42.4–134.5) | 87.8 (53.4–156.6) | <0.001 |
Cu (μg/dg creatinine) | 1.4 (1.0–1.9) | 1.5 (1.1–2.0) | 0.004 |
Cd (μg/g creatinine) | 0.9 (0.5–1.4) | 0.8 (0.5–1.3) | 0.330 |
Occupational exposure a (%) | 21.3 | 20.2 | 0.638 |
Main source of drinking water | |||
Commercially available mineral water (%) | 18.2 | 21.5 | 0.151 |
RO reverse osmosis water (%) | 38.7 | 34.4 | 0.117 |
Groundwater (%) | 0.5 | 0.5 | 0.968 |
Tap water (%) | 15.3 | 15.4 | 0.972 |
Private water filling station (%) | 47.6 | 51.5 | 0.173 |
Drinking after boiling (%) | 91.2 | 89.4 | 0.278 |
Eat vegetables every day (%) | 66.2 | 62.1 | 0.132 |
Seafood consumption in recent 3 days (%) | 73.1 | 71.8 | 0.750 |
Variables | Univariable (Hyperuricemia) | |
---|---|---|
Odds Ratio (95% CI) | p | |
Age (per 1 year) | 1.021 (1.013–1.028) | <0.001 |
Male (vs. female) | 2.005 (1.668–2.410) | <0.001 |
DM | 1.107 (0.827–1.481) | 0.495 |
Hypertension | 1.886 (1.547–2.300) | <0.001 |
Systolic BP (per 1 mmHg) | 1.015 (1.010–1.019) | <0.001 |
Diastolic BP (per 1 mmHg) | 1.022 (1.014–1.030) | <0.001 |
BMI (per 1 kg/m2) | 1.167 (1.139–1.196) | <0.001 |
Laboratory parameters | ||
Fasting glucose (per 1 mg/dL) | 1.003 (1.000–1.006) | 0.037 |
HbA1c (per 1%) | 1.126 (1.029–1.233) | 0.010 |
Hemoglobin (per 1 g/dL) | 1.212 (1.143–1.286) | <0.001 |
Triglyceride (log per 1 mg/dL) | 10.929 (7.285–16.395) | <0.001 |
Total cholesterol (per 1 mg/dL) | 1.003 (1.000–1.005) | 0.022 |
eGFR (per 1 mL/min/1.73 m2) | 0.969 (0.964–0.974) | <0.001 |
Proteinuria | 1.776 (1.351–2.336) | <0.001 |
Blood | ||
Pb (log per 1 μg/L) | 2.179 (1.562–3.039) | <0.001 |
Urine | ||
Ni (log per 1 μg/g creatinine) | 0.930 (0.801–1.080) | 0.343 |
Cr (log per 1 μg/g creatinine) | 1.483 (0.878–2.504) | 0.140 |
Mn (log per 1 μg/g creatinine) | 0.939 (0.793–1.111) | 0.463 |
As (log per 1 μg/g creatinine) | 1.698 (1.322–2.181) | <0.001 |
Cu (log per 0.1 μg/g creatinine) | 1.676 (1.161–3.421) | 0.006 |
Cd (log per 1 μg/g creatinine) | 0.902 (0.732–1.110) | 0.329 |
Occupational exposure a | 0.935 (0.706–1.237) | 0.638 |
Main source of drinking water | ||
Commercially available mineral water | 1.225 (0.928–1.618) | 0.152 |
RO reverse osmosis water | 0.829 (0.655–1.048) | 0.117 |
Groundwater | 0.967 (0.194–4.182) | 0.968 |
Tap water | 1.006 (0.736–1.373) | 0.972 |
Private water filling station | 1.169 (0.934–1.463) | 0.173 |
Drinking after boiling | 0815 (0.562–1.180) | 0.279 |
Eat vegetables every day | 0.837 (0.664–1.055) | 0.132 |
Seafood consumption in recent 3 days | 0.937 (0.628–1.399) | 0.751 |
Variables | Multivariable (Hyperuricemia) | |
---|---|---|
Odds Ratio (95% CI) | p | |
Age (per 1 year) | 0.950 (0.934–0.965) | <0.001 |
Male (vs. female) | 1.623 (1.238–2.127) | <0.001 |
Hypertension | 1.045 (0.807–1.355) | 0.737 |
Systolic BP (per 1 mmHg) | 1.000 (0.992–1.008) | 0.997 |
Diastolic BP (per 1 mmHg) | 1.003 (0.991–1.015) | 0.642 |
BMI (per 1 kg/m2) | 1.139 (1.105–1.173) | <0.001 |
Laboratory parameters | ||
Fasting glucose (per 1 mg/dL) | 0.994 (0.987–1.001) | 0.109 |
HbA1c (per 1%) | 0.946 (0.762–1.175) | 0.616 |
Hemoglobin (per 1 g/dL) | 1.112 (1.019–1.213) | 0.018 |
Triglyceride (log per 1 mg/dL) | 4.870 (2.959–8.014) | <0.001 |
Total cholesterol (per 1 mg/dL) | 1.000 (0.997–1.003) | 0.834 |
eGFR (per 1 mL/min/1.73 m2) | 0.935 (0.923–0.946) | <0.001 |
Proteinuria | 1.051 (0.721–1.528) | 0.795 |
Blood | ||
Pb (log per 1 μg/L) | 1.221 (0.820–1.817) | 0.327 |
Urine | ||
As (log per 1 μg/g creatinine) | 1.888 (1.384–2.574) | <0.001 |
Cu (log per 0.1 μg/dg creatinine) | 0.705 (0.420–1.184) | 0.187 |
Heavy Metals | Interaction | |
---|---|---|
Odds Ratio (95% CI) | p | |
1.569 (1.026–2.399) | 0.038 | |
Cd | 0.260 (0.089–0.759) | 0.014 |
Cd | 3.152 (1.323–7.509) | 0.010 |
Ni | 0.888 (0.723–1.090) | 0.255 |
Cu | 0.927 (0.543–1.583) | 0.781 |
Cu | 0.387 (0.214–0.701) | 0.002 |
Cr | 1.813 (0.980–3.354) | 0.058 |
Cd | 8.576 (2.461–29.881) | 0.001 |
Cd | 9.090 (2.550–32.402) | 0.001 |
Heavy Metals | Multivariable (Forward) | |
---|---|---|
Odds Ratio (95% CI) | p | |
Men with age older than 50 years | ||
Blood Pb (log per 1 μg/L) | 2.089 (1.077–4.053) | 0.029 |
Urine As (log per 1 μg/g creatinine) | 2.293 (1.264–4.159) | 0.006 |
Women with age younger than 50 years | ||
Urine Cr (log per 1 μg/g creatinine) | 6.143 (1.332–28.318) | 0.020 |
Women with age older than 50 years | ||
Urine As (log per 1 μg/g creatinine) | 1.868 (1.158–3.013) | 0.010 |
Urine Cd (log per 1 μg/g creatinine) | 1.553 (1.020–2.362) | 0.040 |
Variables | Univariable | Multivariable | ||
---|---|---|---|---|
Unstandardized Coefficient β (95% CI) | p | Unstandardized Coefficient β (95% CI) | p | |
Age (per 1 year) | 0.009 (0.008, 0.010) | <0.001 | 0.011 (0.008, 0.015) | <0.001 |
Male (vs. female) | −0.056 (−0.086, −0.026) | <0.001 | −0.059 (−0.115, −0.002) | 0.044 |
DM | 0.077 (0.029, 0.125) | 0.002 | −0.007 (−0.143, 0.129) | 0.921 |
Hypertension | 0.104 (0.071, 0.138) | 0.002 | 0.007 (−0.071, 0.085) | 0.858 |
Systolic BP (per 1 mmHg) | 0.003 (0.002, 0.004) | <0.001 | 0 (−0.002, 0.002) | 0.923 |
Diastolic BP (per 1 mmHg) | 0 (−0.001, 0.001) | 0.758 | - | - |
BMI (per 1 kg/m2) | 0.003 (0, 0.007) | 0.075 | - | - |
Laboratory parameters | ||||
Fasting glucose (per 1 mg/dL) | 0.001 (0.001, 0.002) | <0.001 | −0.001 (−0.003, 0.001) | 0.350 |
HbA1c (per 1%) | 0.045 (0.029, 0.060) | <0.001 | 0.017 (−0.043, 0.076) | 0.577 |
Hemoglobin (per 1 g/dL) | −0.004 (−0.013, 0.005) | 0.352 | - | - |
Triglyceride (log per 1 mg/dL) | −0.045 (−0.107, 0.017) | 0.153 | - | - |
Total cholesterol (per 1 mg/dL) | 0.001 (0, 0.001) | 0.003 | 0 (−0.001, 0) | 0.357 |
eGFR (per 1 mL/min/1.73 m2) | −0.005 (−0.006, −0.004) | <0.001 | 0.003 (0, 0.007) | 0.047 |
Proteinuria | 0.007 (−0.041, 0.056) | 0.760 | - | − |
Occupational exposure a | −0.117 (−0.162, −0.073) | <0.001 | 0.008 (−0.059, 0.075) | 0.812 |
Main source of drinking water | ||||
Commercially available mineral water | −0.044 (−0.090, −0.002) | 0.063 | - | - |
RO reverse osmosis water | −0.089 (−0.126, −0.051) | <0.001 | −0.030 (−0.097, 0.036) | 0.369 |
Groundwater | 0.117 (−0.140, 0.373) | 0.373 | - | - |
Tap water | −0.006 (−0.044, 0.057) | 0.802 | - | - |
Private water filling station | 0.070 (0.034, 0.106) | <0.001 | 0.039 (−0.027, 0.105) | 0.248 |
Drinking after boiling | 0.073 (0.011, 0.135) | 0.022 | −0.006 (−0.090, 0.079) | 0.897 |
Eat vegetables every day | 0.050 (0.013, 0.088) | 0.009 | 0.042 (−0.013, 0.097) | 0.130 |
Seafood consumption in recent 3 days | 0.143 (0.081, 0.205) | <0.001 | 0.171 (0.110, 0.231) | <0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Lu, L.-H.; Tsai, C.-C.; Lin, C.-Y.; Wang, C.-W.; Wu, P.-Y.; Huang, J.-C.; Chen, S.-C.; Chang, J.-M. Association and Interaction between Heavy Metals and Hyperuricemia in a Taiwanese Population. Diagnostics 2023, 13, 1741. https://doi.org/10.3390/diagnostics13101741
Lu L-H, Tsai C-C, Lin C-Y, Wang C-W, Wu P-Y, Huang J-C, Chen S-C, Chang J-M. Association and Interaction between Heavy Metals and Hyperuricemia in a Taiwanese Population. Diagnostics. 2023; 13(10):1741. https://doi.org/10.3390/diagnostics13101741
Chicago/Turabian StyleLu, Lu-Heng, Chun-Chi Tsai, Chih-Yi Lin, Chih-Wen Wang, Pei-Yu Wu, Jiun-Chi Huang, Szu-Chia Chen, and Jer-Ming Chang. 2023. "Association and Interaction between Heavy Metals and Hyperuricemia in a Taiwanese Population" Diagnostics 13, no. 10: 1741. https://doi.org/10.3390/diagnostics13101741