Lihua Hu 1 , Guiping Hu 2,3 , Benjamin Ping Xu 4 , Lingjuan Zhu 5 , Wei Zhou 5 , Tao Wang 5 , Huihui Bao 1,5 , Xiaoshu Cheng 1,5 Show Affiliations »
Abstract
BACKGROUND: In addition to the controversy regarding the association of hyperuricemia with mortality, uncertainty also remains regarding the association between low serum uric acid (SUA) and mortality. We aimed to assess the relationship between SUA and all-cause and cause-specific mortality. METHODS: This cohort study included 9,118 US adults from NHANES (1999-2002). Multivariable Cox proportional hazards models were used to evaluate the relationship between SUA and mortality. Our analysis included the use of a generalized additive model (GAM) and smooth curve fitting (penalized spline method), and two-piecewise Cox proportional hazards models, to address the nonlinearity between SUA and mortality. RESULTS: During a median follow-up of 5.83 years, 448 all-cause deaths occurred, with 100 cardiovascular disease (CVD) deaths, 118 cancer deaths and 37 respiratory disease deaths. Compared to the reference group, there was a increased risk of all-cause, CVD, cancer and respiratory disease mortality for participants in the first and third tertile of SUA. We further found a nonlinear and U-shaped association between SUA and mortality. The inflection point for the curve was found at a SUA level of 5.7 mg/dL. The HRs (95%CIs) for all-cause mortality were 0.80 (0.65, 0.97) and 1.24 (1.10, 1.40) to the left and right of the inflection point, respectively. This U-shaped association was observed in both sexes; the inflection point for SUA was 6 mg/dL in males and 4 mg/dL in females. CONCLUSION: Both low and high SUA levels were associated with increased all-cause and cause-specific mortality, supporting a U-shaped association between SUA and mortality. © Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
BACKGROUND: In addition to the controversy regarding the association of hyperuricemia with mortality , uncertainty also remains regarding the association between low serum uric acid (SUA ) and mortality . We aimed to assess the relationship between SUA and all-cause and cause-specific mortality . METHODS: This cohort study included 9,118 US adults from NHANES (1999-2002). Multivariable Cox proportional hazards models were used to evaluate the relationship between SUA and mortality . Our analysis included the use of a generalized additive model (GAM) and smooth curve fitting (penalized spline method), and two-piecewise Cox proportional hazards models, to address the nonlinearity between SUA and mortality . RESULTS: During a median follow-up of 5.83 years, 448 all-cause deaths occurred, with 100 cardiovascular disease (CVD ) deaths , 118 cancer deaths and 37 respiratory disease deaths . Compared to the reference group, there was a increased risk of all-cause, CVD , cancer and respiratory disease mortality for participants in the first and third tertile of SUA . We further found a nonlinear and U-shaped association between SUA and mortality . The inflection point for the curve was found at a SUA level of 5.7 mg/dL. The HRs (95%CIs) for all-cause mortality were 0.80 (0.65, 0.97) and 1.24 (1.10, 1.40) to the left and right of the inflection point, respectively. This U-shaped association was observed in both sexes; the inflection point for SUA was 6 mg/dL in males and 4 mg/dL in females. CONCLUSION: Both low and high SUA levels were associated with increased all-cause and cause-specific mortality , supporting a U-shaped association between SUA and mortality . © Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Entities: Chemical
Disease
Species
Keywords:
U-shaped curve; US adults; mortality; serum uric acid
Year: 2019
PMID： 31650159 DOI： 10.1210/clinem/dgz068
Source DB: PubMed Journal: J Clin Endocrinol Metab ISSN： 0021-972X Impact factor: 5.958