Joint Effect of Multiple Metals on Hyperuricemia and Their Interaction with Obesity: A Community-Based Cross-Sectional Study in China
Abstract
:1. Introduction
2. Methods
2.1. Study Settings and Participant Selection
2.2. Data Collection and Biological Sample Testing
2.3. Outcome and Covariation Evaluation
2.4. Whole Blood Metal Concentration Detection
2.5. Statistical Analyses
3. Results
3.1. Participant Characteristics and Whole Blood Metal Levels
3.2. Associations of Whole Blood Metal Quartiles with Hyperuricemia Risk
3.3. Dose–Response Relationships of Whole Blood Metal Levels and Hyperuricemia Risk
3.4. BKMR Analyses
3.5. Subgroup and Interaction Analyses
4. Discussion
4.1. Vanadium
4.2. Cobalt
4.3. Chromium
4.4. Other Metals
4.5. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables a | Total | p-Value | |
---|---|---|---|
No Hyperuricemia (n = 2275) | Hyperuricemia (n = 754) | ||
Age (years) | 51.97 ± 0.32 | 54.72 ± 0.53 | <0.001 * |
Gender (%) | <0.001 * | ||
Male | 939 (41.3) | 433 (57.4) | |
Female | 1336 (58.7) | 321 (42.6) | |
Residence area (%) | 0.702 | ||
Coastal | 1240 (54.5) | 417 (55.3) | |
Inland | 1035 (45.5) | 337 (44.7) | |
Education level (%) | 0.120 | ||
Below high school | 1694 (74.5) | 536 (71.1) | |
High school | 363 (16.0) | 144 (19.1) | |
Over high school | 218 (9.5) | 74 (9.8) | |
Alcohol use (%) | 0.002 * | ||
Drinker | 799 (35.1) | 311 (41.2) | |
Non-drinker | 1476 (64.9) | 443 (58.8) | |
Smoking status (%) | 0.002 * | ||
Current smokers | 562 (24.7) | 232 (30.8) | |
Former smokers | 142 (6.2) | 52 (6.9) | |
Nonsmokers | 1571 (69.1) | 470 (62.3) | |
Sitting time (%) | 0.362 | ||
<4 h/day | 925 (40.7) | 284 (37.7) | |
4 to <6 h/day | 643 (28.3) | 212 (28.1) | |
6 to <8 h/day | 324 (14.2) | 122 (16.2) | |
≥8 h/day | 383 (16.8) | 136 (18.0) | |
Physical activity (%) | 0.023 * | ||
Yes | 379 (16.7) | 153 (20.3) | |
No | 1896 (83.3) | 601 (79.7) | |
WHt R | 0.50 (0.46, 0.54) | 0.52 (0.49, 0.57) | <0.001 * |
BMI (kg/m2) | 22.66 (20.64, 24.91) | 24.24 (22.11, 26.74) | <0.001 * |
UA (μmol/L) | 301.20 (256.50, 343.20) | 448.30 (415.33, 497.75) | <0.001 * |
Log2UA | 8.19 ± 0.01 | 8.83 ± 0.01 | <0.001 * |
TC (mmol/L) | 4.98 (4.34, 5.61) | 5.20 (4.57, 5.97) | <0.001 * |
TG (mmol/L) | 0.96 (0.68, 1.44) | 1.43 (0.98, 2.11) | <0.001 * |
Diabetes mellitus (%) | 0.005 * | ||
Yes | 176 (7.7) | 83 (11.0) | |
No | 2099 (92.3) | 671 (89.0) | |
Hypertension (%) | <0.001 * | ||
Yes | 730 (32.1) | 360 (47.7) | |
No | 1545 (67.9) | 394 (52.3) | |
Central obesity (%) | <0.001 * | ||
Yes | 834 (36.7) | 411 (54.5) | |
No | 1441 (63.3) | 343 (45.5) | |
Blood metals (μg/L) | |||
V | 0.97 (0.52, 1.51) | 1.02 (0.35, 1.62) | 0.287 |
Cr | 4.87 (3.71, 6.29) | 5.26 (3.86, 7.07) | <0.001 * |
Mn | 13.87 (10.73, 17.93) | 14.14 (10.70, 17.97) | 0.466 |
Co | 0.28 (0.14, 0.40) | 0.28 (0.14, 0.37) | 0.163 |
Ni | 2.24 (1.29, 4.03) | 2.21 (1.22, 3.92) | 0.483 |
Cu | 943.11 (844.56, 1055.08) | 945.20 (848.19, 1044.35) | 0.954 |
Zn | 5500.30 (4717.59, 6400.11) | 5812.56 (4926.99, 6698.70) | <0.001 * |
As | 4.38 (2.61, 6.90) | 4.87 (2.81, 7.74) | <0.001 * |
Se | 164.27 (137.04, 193.00) | 168.57 (140.39, 201.59) | 0.005 * |
Mo | 1.05 (0.71, 2.05) | 1.09 (0.71, 2.27) | 0.164 |
Cd | 2.23 (1.33, 4.27) | 2.33 (1.23, 4.54) | 0.691 |
Tl | 0.14 (0.14, 0.14) | 0.14 (0.14, 0.14) | 0.535 |
Pb | 38.29 (25.49, 58.64) | 42.34 (29.29, 62.24) | <0.001 * |
Whole Blood Metals a | Q1 | Q2 | Q3 | Q4 | p-Trend (p-FDR) b |
---|---|---|---|---|---|
Male | |||||
Cr | Ref | 0.95 (0.64, 1.41) | 1.08 (0.73, 1.60) | 1.70 (1.18, 2.45) * | 0.001 * (0.005 *) |
Co | Ref | 1.34 (0.91, 1.96) | 1.39 (0.99, 1.95) | 1.76 (1.26, 2.46) * | 0.002 * (0.005 *) |
Cu | Ref | 0.81 (0.56, 1.16) | 1.14 (0.80, 1.64) | 1.30 (0.90, 1.89) | 0.054 (0.09) |
Zn | Ref | 1.47 (1.02, 2.11) * | 1.08 (0.74, 1.56) | 1.40 (0.97, 2.04) | 0.245 (0.245) |
As | Ref | 0.75 (0.52, 1.09) | 0.99 (0.69, 1.41) | 1.27 (0.87, 1.85) | 0.157 (0.196) |
Female | |||||
V | Ref | 0.55 (0.38, 0.81) * | 0.66 (0.44, 0.98) * | 0.68 (0.47, 0.99) * | 0.108 |
Blood Metals (μg/L) | Group | Group PIPs | Con PIPs |
---|---|---|---|
V | 1 | 0.932 | 0.814 |
Cr | 1 | 0.932 | 1.000 |
Mn | 2 | 0.986 | 0.894 |
Co | 2 | 0.986 | 0.920 |
Zn | 3 | 0.490 | 0.490 |
Q1 | Q2 | Q3 | Q4 | p-Trend a | |
---|---|---|---|---|---|
Male | |||||
Cr (μg/L) | ≤3.84 | 3.85–5.11 | 5.12–6.84 | ≥6.85 | |
Hyperuricemia/total | 92/338 | 93/344 | 110/343 | 138/341 | |
BMI <28 kg/m2 | Ref | 0.96 (0.64, 1.46) | 1.08 (0.72, 1.64) | 1.66 (1.13, 2.44) * | 0.005 * |
BMI ≥28 kg/m2 | Ref | 1.81 (0.39, 8.43) | 2.11 (0.55, 8.08) | 8.38 (1.71, 41.00) * | 0.012 * |
WHt R <0.6 | Ref | 0.93 (0.62, 1.39) | 1.07 (0.72, 1.59) | 1.58 (1.09, 2.30) * | 0.008 * |
WHt R ≥ 0.6 | Ref | 1.27 (0.05, 33.69) | 6.72 (0.38, 119.71) | 165.77 (2.57, 10,707.79) * | 0.015 * |
Non-central obesity | Ref | 1.04 (0.60, 1.81) | 1.17 (0.67, 2.03) | 1.82 (1.10, 3.02) * | 0.012 * |
Central obesity | Ref | 0.79 (0.44, 1.44) | 1.03 (0.59, 1.81) | 1.74 (0.99, 3.06) | 0.031 * |
Co (μg/L) | ≤0.14 | 0.15–0.25 | 0.26–0.34 | ≥0.35 | |
Hyperuricemia/total | 140/493 | 72/218 | 102/321 | 119/340 | |
BMI < 28 kg/m2 | Ref | 1.37 (0.92, 2.04) | 1.34 (0.93, 1.92) | 1.65 (1.17, 2.35) * | 0.006 * |
BMI ≥ 28 kg/m2 | Ref | 0.68 (0.14, 3.30) | 0.90 (0.23, 3.60) | 1.56 (0.39, 6.16) | 0.609 |
WHt R < 0.6 | Ref | 1.30 (0.88, 1.93) | 1.37 (0.97, 1.95) | 1.64 (1.16, 2.31) * | 0.005 * |
WHt R ≥ 0.6 | Ref | 0.01 (0.01, 4.74) | 0.07 (0.01, 3.52) | 0.12 (0.01, 1.86) | 0.123 |
Non-central obesity | Ref | 1.53 (0.90, 2.61) | 1.58 (0.99, 2.53) | 1.62 (1.03, 2.55) * | 0.041 * |
Central obesity | Ref | 1.09 (0.62, 1.92) | 1.17 (0.70, 1.96) | 1.98 (1.18, 3.34) * | 0.238 |
Cu (μg/L) | ≤811.13 | 811.14–898.60 | 898.61–1005.97 | ≥1005.98 | |
Hyperuricemia/total | 99/343 | 99/343 | 113/343 | 122/343 | |
BMI < 28 kg/m2 | Ref | 0.84 (0.57, 1.24) | 1.09 (0.75, 1.60) | 1.26 (0.85, 1.86) | 0.121 |
BMI ≥ 28 kg/m2 | Ref | 0.57 (0.16, 1.99) | 0.80 (0.20, 3.20) | 1.76 (0.42, 7.43) | 0.431 |
WHt R < 0.6 | Ref | 0.85 (0.59, 1.24) | 1.17 (0.81, 1.70) | 1.25 (0.85, 1.82) | 0.105 |
WHt R ≥ 0.6 | Ref | 0.06 (0.01, 3.40) | 0.06 (0.01, 4.84) | 8.03 (0.12, 517.39) | 0.156 |
Non-central obesity | Ref | 1.05 (0.63, 1.76) | 1.27 (0.77, 2.11) | 1.94 (1.17, 3.23) * | 0.007 * |
Central obesity | Ref | 0.59 (0.34, 1.02) | 0.91 (0.52, 1.60) | 0.78 (0.44, 1.38) | 0.796 |
Zn (μg/L) | ≤5141.11 | 5141.12–5906.57 | 5906.58–6781.64 | ≥6781.65 | |
Hyperuricemia/total | 91/343 | 113/343 | 103/343 | 126/343 | |
BMI < 28 kg/m2 | Ref | 1.47 (1.00, 2.15) * | 1.07 (0.73, 1.59) | 1.28 (0.86, 1.90) | 0.536 |
BMI ≥ 28 kg/m2 | Ref | 1.07 (0.28, 4.04) | 1.39 (0.34, 5.73) | 4.44 (0.99, 19.89) | 0.056 |
WHt R < 0.6 | Ref | 1.45 (1.00, 2.11) * | 1.13 (0.77, 1.65) | 1.37 (0.93, 2.01) | 0.285 |
WHt R ≥ 0.6 | Ref | 2.09 (0.10, 46.04) | 2.55 (0.13, 50.67) | 51.42 (0.53, 5013.22) | 0.187 |
Non-central obesity | Ref | 1.27 (0.77, 2.09) | 1.04 (0.62, 1.73) | 1.10 (0.65, 1.86) | 0.955 |
Central obesity | Ref | 1.59 (0.91, 2.75) | 1.09 (0.62, 1.92) | 1.74 (1.00, 3.02) | 0.138 |
As (μg/L) | ≤2.74 | 2.75–4.60 | 4.61–7.31 | ≥7.31 | |
Hyperuricemia/total | 109/344 | 88/343 | 111/342 | 125/343 | |
BMI < 28 kg/m2 | Ref | 0.73 (0.50, 1.08) | 1.03 (0.71, 1.50) | 1.33 (0.89, 1.98) | 0.090 |
BMI ≥ 28 kg/m2 | Ref | 0.30 (0.06, 1.48) | 0.29 (0.07, 1.24) | 0.30 (0.06, 1.49) | 0.152 |
WHt R < 0.6 | Ref | 0.70 (0.48, 1.02) | 0.94 (0.66, 1.36) | 1.28 (0.87, 1.88) | 0.133 |
WHt R ≥ 0.6 | Ref | 0.01 (0.01, 2.67) | 1.06 (0.05, 21.33) | 0.69 (0.04, 11.77) | 0.911 |
Non-central obesity | Ref | 0.96 (0.59, 1.56) | 0.89 (0.54, 1.46) | 1.07 (0.63, 1.82) | 0.914 |
Central obesity | Ref | 0.46 (0.26, 0.83) * | 1.13 (0.65, 1.95) | 1.37 (0.77, 2.42) | 0.091 |
Female | |||||
V (μg/L) | ≤0.53 | 0.54–0.98 | 0.99–1.55 | ≥1.56 | |
Hyperuricemia/total | 97/408 | 63/407 | 79/408 | 77/407 | |
BMI < 28 kg/m2 | Ref | 0.58 (0.39, 0.87) * | 0.73 (0.47, 1.12) | 0.67 (0.45, 1.00) * | 0.121 |
BMI ≥ 28 kg/m2 | Ref | 0.39 (0.13, 1.13) | 0.38 (0.12, 1.15) | 0.69 (0.24, 1.93) | 0.479 |
WHt R < 0.6 | Ref | 0.55 (0.37, 0.83) * | 0.68 (0.44, 1.05) | 0.73 (0.49, 1.09) | 0.273 |
WHt R ≥ 0.6 | Ref | 0.64 (0.23, 1.77) | 0.68 (0.24, 1.90) | 0.42 (0.11, 1.53) | 0.321 |
Non-central obesity | Ref | 0.39 (0.21, 0.71) * | 0.56 (0.30, 1.05) | 0.74 (0.43, 1.29) | 0.657 |
Central obesity | Ref | 0.69 (0.42, 1.13) | 0.75 (0.44, 1.26) | 0.63 (0.38, 1.04) | 0.103 |
n (Hyperuricemia/Non-Hyperuricemia) | OR (95% CI) | OR- Int a | RERI b (95% CI) | AP b (95% CI) | S b (95% CI) | |
---|---|---|---|---|---|---|
Zn-BMI | 2.28 (1.02, 5.06) * | 1.67 (0.02, 3.33) * | 0.56 (0.23, 0.88) * | 6.02 (0.52, 69.37) | ||
Low Zn + BMI < 28 | 178/446 | Ref | ||||
Low Zn + BMI ≥ 28 | 26/36 | 1.37 (0.77, 2.43) | ||||
High Zn + BMI < 28 | 188/432 | 0.97 (0.74, 1.26) | ||||
High Zn + BMI ≥ 28 | 41/25 | 3.01 (1.70, 5.31) * | ||||
Cr-BMI | 1.62 (0.73, 3.6) | 1.58(−0.36,3.53) | 0.44(0.08,0.81) * | 2.62 (0.82, 8.4) | ||
Low Cr + BMI < 28 | 160/467 | Ref | ||||
Low Cr + BMI ≥ 28 | 24/35 | 1.56 (0.87, 2.80) | ||||
High Cr + BMI < 28 | 206/411 | 1.41 (1.09, 1.82) * | ||||
High Cr + BMI ≥ 28 | 43/26 | 3.68 (2.12, 6.40) * |
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Share and Cite
Wu, S.; Huang, H.; Ji, G.; Li, L.; Xing, X.; Dong, M.; Ma, A.; Li, J.; Wei, Y.; Zhao, D.; et al. Joint Effect of Multiple Metals on Hyperuricemia and Their Interaction with Obesity: A Community-Based Cross-Sectional Study in China. Nutrients 2023, 15, 552. https://doi.org/10.3390/nu15030552
Wu S, Huang H, Ji G, Li L, Xing X, Dong M, Ma A, Li J, Wei Y, Zhao D, et al. Joint Effect of Multiple Metals on Hyperuricemia and Their Interaction with Obesity: A Community-Based Cross-Sectional Study in China. Nutrients. 2023; 15(3):552. https://doi.org/10.3390/nu15030552
Chicago/Turabian StyleWu, Shan, Huimin Huang, Guiyuan Ji, Lvrong Li, Xiaohui Xing, Ming Dong, Anping Ma, Jiajie Li, Yuan Wei, Dongwei Zhao, and et al. 2023. "Joint Effect of Multiple Metals on Hyperuricemia and Their Interaction with Obesity: A Community-Based Cross-Sectional Study in China" Nutrients 15, no. 3: 552. https://doi.org/10.3390/nu15030552