Gender-Specific and U-Shaped Relationship Between Serum Uric Acid and All-Cause Mortality Among Chinese Older Adults: A National Population-Based Longitudinal Study

Int J Public Health. 2023 May 3:68:1605934. doi: 10.3389/ijph.2023.1605934. eCollection 2023.

Abstract

Objectives: This study aimed to prospectively investigate gender-specific relationship between hyperuricemia and all-cause mortality among Chinese older adults. Methods: The study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018, a prospective nationwide cohort of older adults in China. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for all-cause mortality. Restricted cubic splines (RCS) were conducted to explore the dose-response relationship between SUA levels and all-cause mortality. Results: For older women, compared to the participants in the third quartile of SUA level, those in the highest quartile of SUA was associated with significantly higher risk of all-cause mortality in the fully adjusted model (HR: 1.41, 95% CI: 1.03-1.92). No significant associations between SUA levels and all-cause mortality were observed in older men. The present study further found a U-shaped non-linear relationship between SUA levels and all-cause mortality in both sexes of older population (P for non-linear <0.05). Conclusions: This study provided prospective epidemiological evidence for the predictive role of SUA on all-cause mortality among the Chinese aging population over 10 years of follow-up, while revealing considerable gender-related differences.

Keywords: cohort study; gender difference; mortality; older adults; serum uric acid.

MeSH terms

  • Aged
  • China / epidemiology
  • East Asian People*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mortality*
  • Prospective Studies
  • Risk Factors
  • Uric Acid* / blood

Substances

  • Uric Acid

Grants and funding

This work was funded by the National Key Research and Development Project, Ministry of Science and Technology of China (Grant Number 2020YFC2006400), Shanghai Municipal Health Commission Clinical Research Project (Grant Number 202140203), Shanghai 3-year Action Plan for Public Health under a grant (GWV-10.2-XD13, GWV-10.1-XK15, GWV-10.1-XK18), a strategic collaborative innovation team (SSMU-ZLCX20180601).