DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20200477

Hyperuricemia prevalence in Indian subjects with underlying comorbidities of hypertension and/or type 2 diabetes: a retrospective study from subjects attending hyperuricemia screening camps

Himanshu Patel, Dhiren Shah

Abstract


Background: To determine the prevalence of HU in Indian subjects attending the HU screening camps and in subjects with type 2 Diabetes Mellitus (T2DM), Hypertension (HTN), and T2DM+HTN.

Methods: This was a retrospective, non-interventional study where medical records of subjects attending HU screening camps across 592 locations in India, between June 2017 to May 2018, were analyzed.

Results: A total of 197097 subjects (T2DM: 19.69%; HTN: 14.08%; T2DM+HTN: 21.60%) attended the screening camps. Mean age of the study participants was 48.43±13.38 years (Male: 53.80%). A total of 48606(24.66%) subjects had HU. In the overall population, a higher proportion of subjects with T2DM + HTN (7.36%) had HU in comparison to subjects with T2DM (5.63%) and HTN (4.25%) alone. Similar results were reported when the data was evaluated only in HU subjects (T2DM+HTN: 29.85%; T2DM: 22.82%; HTN: 17.22%). Proportion of HU subjects increased with age, with the maximum prevalence evident in subjects aged >50 years (12.94%), followed by 30-50 years (10.65%) and <30 years (1.07%). Gender-wise, a slightly higher proportion of males (14.13%) were found to be hyperuricemic than females (10.53%). Higher proportion of subjects with disease (T2DM and/or HTN) duration of 2-5 years were found to be hyperuricemic in comparison with subjects with disease duration of >5 years or <2 years. Similar results were reported when the data was evaluated in the overall HU subjects and by indication.

Conclusions: Authors observed a high prevalence of HU among subjects attending HU camps and those with associated comorbidities. The prevalence of HU was higher in males and has an increasing trend with age. Furthermore, the prevalence of HU was observed to be higher in subjects with 2-5 years of duration of T2DM and/or HTN.


Keywords


Comorbidities, Hypertension, Hyperuricemia, Serum uric acid, Type 2 diabetes mellitus

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References


Singh V, Gomez V, Swamy S. Approach to a Case of Hyperuricemia. Ind J Aerospace Med. 2010;54(1):40-6.

Johnson RJ, Rideout BA. Uric acid and diet-insights into the epidemic of cardiovascular disease. New Eng J Med. 2004 Mar 11;350(11):1071-3.

Eggebeen AT. Gout: an update. Am Fam Phys 2007;76(6):801-8.

Martillo MA, Nazzal L, Crittenden DB. The crystallization of monosodium urate. Curr Rheumatol Rep. 2014 Feb 1;16(2):400.

Chizynki K, Rozycka M. Hyperuricemia. Pol Merkur Lekarski. 2005;19(113):693-6.

Edwards NL. The role of hyperuricemia in vascular disorders. Curr Opin Rheumatol. 2009 Mar 1;21(2):132-7.

Smith E, March L. global Prevalence of Hyperuricemia: A Systematic Review of Population-based Epidemiological Studies: abstract Number: 2236. Arthr Rheumatol. 2015 Oct;67:2690-2.

Wang J, Chen RP, Lei L, Song QQ, Zhang RY, Li YB, et al. Prevalence and determinants of hyperuricemia in type 2 diabetes mellitus patients with central obesity in Guangdong Province in China. Asia Paci J Clin Nutr. 2013;22(4):590.

Lin CS, Lee WL, Hung YJ, Lee DY, Chen KF, Chi WC, et al. Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan. Inter J Cardiol. 2012 Apr 5;156(1):41-6.

Billa G, Dargad R, Mehta A. Prevalence of hyperuricemia in Indian subjects attending hyperuricemia screening programs: a retrospective study. J Assoc Phys Ind. 2018 Apr;66:43-6.

Luk AJ, Simkin PA. Epidemiology of hyperuricemia and gout. Am J Manag Care. 2005 Nov 1;11(15 Suppl):S435-42.

Campion EW, Glynn RJ, Delabry LO. Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. AmJ Med. 1987 Mar 1;82(3):421-6.

Agudelo CA, Wise CM. Crystal-associated arthritis. Clin Geriatr Med. 1998 Aug 1;14(3):495-514.

Becker MA, Mount DB. Asymptomatic hyperuricemia, 2019. Available at https://www.uptodate.com/contents/asymptomatic-hyperuricemia. Accessed 7 January 2020.

Mundhe SA, Mhasde DR. The study of prevalence of hyperuricemia and metabolic syndrome in type 2 diabetes mellitus. Int J Adv Med. 2016 Apr;3:241-9.

Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuricemia: a reality in the Indian obese. Obes Surg. 2012 Jun 1;22(6):945-8.

Shrivastav C, Kaur M, Suhalka ML, Sharma S, Basu A. Hyperuricaemia-A Potential Indicator to Diagnose the Risk of Essential Hypertension. J Clini Diag Res: JCDR. 2016 Mar;10(3):CC01.

Modan M, Halkin H, Karasik A, Lusky A. Elevated serum uric acid-a facet of hyperinsulinaemia. Diabetol. 1987 Sep 1;30(9):713-8.

Kerr G, Dowell S, Wells A, Haddad R, DeMarco P, Joseph J, et al. FRI0236 Associations between comorbidity and urate deposition in subjects with asymptomatic hyperuricemia: a pilot study Annal Rheum Dis. 2018;77:659.

Cho J, Kim C, Kang DR, Park JB. Hyperuricemia and uncontrolled hypertension in treated hypertensive patients: K-MetS Study. Medicine. 2016 Jul;95(28).

Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta‐analysis. Arthr Care Res. 2011 Jan;63(1):102-10.

Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014 Dec 1;15(1):122.

Lv Q, Meng XF, He FF, Chen S, Su H, Xiong J, et al. High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PloS One. 2013;8(2).

Viazzi F, Bonino B, Ratto E, Desideri G, Pontremoli R. Hyperuricemia, diabetes and hypertension. G Ital Nefrol. 2015;32(62).

Kuwabara M. Hyperuricemia, cardiovascular disease, and hypertension. Pulse. 2015;3(3-4):242-52.

Kuwabara M, Niwa K, Nishi Y, Mizuno A, Asano T, Masuda K, et al. Relationship between serum uric acid levels and hypertension among Japanese individuals not treated for hyperuricemia and hypertension. Hyper Res. 2014 Aug;37(8):785-9.

Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol. 1988 Feb 1;127(2):321-36.

Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F, et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Pub Health. 2004 Dec 1;4(1):9.

Ogbera AO, Azenabor AO. Hyperuricaemia and the metabolic syndrome in type 2 DM. Diabetol Metab Synd. 2010 Dec 1;2(1):24.

Mikkelsen WM, Dodge HJ, Valkenburg H, Himes S. The distribution of serum uric acid values in a population unselected as to gout or hyperuricemia: Tecumseh, Michigan 1959-1960. Am J Med. 1965 Aug 1;39(2):242-51.

Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Annal Inter Med. 1999 Jul 6;131(1):7-13.

Povoroznyuk VV, Dubetska GS. Hyperuricemia and age. Gerontol. 2012;13(3):149-53.

Kuwabara M, Niwa K, Nishi Y, Niinuma H, Nishihara S, Anzai H, et al. The positive relationship between uric acid and hypertension in Japanese people not taking antihypertensive drugs. J Hyper. 2011;29:e32-e33.

Agarwal V, Hans N, Messerli FH: Effect of allopurinol on blood pressure: a systematic review and metaanalysis. J Clin Hyper. 2013;15:435-42.

Anthonia O, Alfred O. Hyperuricemia and metabolic syndrome in type 2 DM. Diabetol Metab Syndr. 2010;2:24.

Kinsey D, Smithwick R, Walther R, Whitelaw G, SISE H. Incidence of hyperuricemia in 400 hypertensivepatients. Circulation. 1961;24(4):972.

Kolbel F, Gregorova I, Souka J. Serum uric acid in hypertensives. Lancet. 1965;1:519.

Kahn HA, Medalie JH, Neufeld HN, Riss E, Goldbourt U. The incidence of hypertension and associated factors: the Israel ischemic heart disease study. Am Heart J. 1972 Aug 1;84(2):171-82.

Shrivastav C, Kaur M, Suhalka ML, Sharma S, Basu A. Hyperuricaemia-A Potential Indicator to Diagnose the Risk of Essential Hypertension. J Clin Diag Res: JCDR. 2016 Mar;10(3):CC01.

Levy GD, Rashid N, Niu F, Cheetham TC. Effect of urate-lowering therapies on renal disease progression in patients with hyperuricemia. J Rheumatol. 2014 May 1;41(5):955-62.

Ali N, Perveen R, Rahman S, Mahmood S, Rahman S, Islam S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults. PloS One. 2018;13(11) ):e0206850.

You L, Liu A, Wuyun G, Wu H, Wang P. Prevalence of hyperuricemia and the relationship between serum uric acid and metabolic syndrome in the Asian Mongolian area. J Athero Throm. 2014 Apr 24;21(4):355-65.

Grassi D, Ferri L, Desideri G, Di Giosia P, Cheli P, Del Pinto R, et al. Chronic hyperuricemia, uric acid deposit and cardiovascular risk. Curr Pharma Design. 2013 Apr 1;19(13):2432-8.

Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, et al. Uric acid and the development of hypertension. Hypertension. 2006;48:1031-6.

Quinones Galvan A, Natali A, Baldi SI, Frascerra SI, Sanna GI, et al. Effect of insulin on uric acid excretion in humans. Am J Physiol-Endocrinol Metab. 1995 Jan 1;268(1):E1-5.

Messerli FH, Frohlich ED, Dreslinski GR, Suarez DH, Aristimuno GG. Serum uric acid in essential hypertension: an indicator of renal vascular involvement. Ann Intern Med 1980;93(6):817-21.

Woyesa SB, Hirigo AT, Wube TB. Hyperuricemia and metabolic syndrome in type 2 diabetes mellitus patients at Hawassa university comprehensive specialized hospital, South West Ethiopia. BMC Endo Dis. 2017 Dec 1;17(1):76.