Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES

Juping Wang; Shuting Chen; Junkang Zhao; Jie Liang; Xue Gao; Qian Gao; Simin He; Tong Wang

doi:10.1186/s12889-022-14357-5

Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES

BMC Public Health. 2022 Oct 28;22(1):1981. doi: 10.1186/s12889-022-14357-5.

Authors

Juping Wang^{1

2}, Shuting Chen¹, Junkang Zhao¹, Jie Liang¹, Xue Gao¹, Qian Gao¹, Simin He¹, Tong Wang³

Affiliations

¹ Department of Health Statistics, School of Public Health, Shanxi Medical University, No.56 Xinjian South Road, Taiyuan, 030001, China.
² Department of Mathematics, School of Basic Medical Science, Shanxi Medical University, Taiyuan, China.
³ Department of Health Statistics, School of Public Health, Shanxi Medical University, No.56 Xinjian South Road, Taiyuan, 030001, China. tongwang@sxmu.edu.cn.

Abstract

Background: Diet has long been hypothesized to play an important role in hyperuricemia, and weight gain is a factor that is strongly associated with the rise in serum urate. We aimed to clarify the mediating role of obesity in the relationship between diet and hyperuricemia and to determine whether a weight-loss diet is an effective way to prevent hyperuricemia.

Methods: This cross-sectional study analysed representative samples of United States (n = 20,081; NHANES 2007-2016) adults. Nutrient patterns were derived with two methods: principal component analysis (PCA) and reduced rank regression (RRR) with obesity. Logistic regression and multivariable linear regression were applied to analyse the association between nutrient patterns in obesity and hyperuricemia. Mediation analyses were used to determine whether four obesity indicators, including body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI) and lipid accumulation product index (LAP), mediated the relationship between nutrient patterns and hyperuricemia.

Results: PCA revealed three nutrient patterns (including "Low energy diet", "Lower vitamin A, C, K pattern" and "Vitamin B group"), and only Vitamin B group had a total effect on hyperuricemia. RRR revealed one main nutrient pattern associated with obesity, which was characterized by High fat and low vitamin levels and was significantly associated with hyperuricemia. Mediation analysis showed that obesity mostly or even completely mediated the relationship between nutrient patterns and hyperuricemia, especially traditional obesity indicators, which played a key intermediary effect. The proportions of indirect effects for BMI and WC were as high as 53.34 and 59.69, respectively.

Conclusions: Our findings suggest that the direct effect of diet on hyperuricemia is weak, and obesity plays a critical mediating role in the relationship between diet and hyperuricemia, which confirms that a weight-loss diet such as a "Low fat and high vitamin diet" may be useful in preventing hyperuricemia.

Keywords: Hyperuricemia; Mediation analysis; Obesity; Principal component analysis; Reduced rank regression.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Body Mass Index
Cross-Sectional Studies
Humans
Hyperuricemia* / epidemiology
Mediation Analysis
Nutrients
Nutrition Surveys
Obesity / complications
Obesity / epidemiology
Vitamins
Waist Circumference

Substances

Vitamins