Table 1. Baseline characteristics of selected cohort population, stratified by gender
|
Demographic
|
Total population
|
MS-free population*
|
Male
|
Female
|
Male
|
Female
|
n (freq %)
|
n (freq %)
|
n (freq %)
|
n (freq %)
|
Age (years), n (%)
|
|
|
|
|
<30
|
1,513 (8.21)
|
633 (5.48)
|
1,137 (12.52)
|
533 (8.29)
|
30~
|
3,026 (16.42)
|
1,436 (12.44)
|
1,926 (21.20)
|
1,188 (18.49)
|
40~
|
6,850 (37.17)
|
5,047 (43.72)
|
3,573 (39.33)
|
3,349 (52.12)
|
50~
|
2,964 (16.08)
|
2,171 (18.81)
|
1,105 (12.16)
|
860 (13.38)
|
60~
|
2,476 (13.43)
|
1,763 (15.27)
|
859 (9.46)
|
421 (6.55)
|
70~
|
1,319 (7.16)
|
472 (4.09)
|
402 (4.43)
|
72 (1.12)
|
≥80
|
283 (1.54)
|
21 (0.18)
|
82 (0.90)
|
3 (0.05)
|
Education, n (%)
|
|
|
|
|
Uneducated
|
464 (2.52)
|
546 (4.73)
|
164 (1.81)
|
131 (2.04)
|
High school or less
|
11,495 (62.37)
|
7,210 (62.48)
|
5,220 (57.48)
|
3,575 (55.66)
|
Undergraduate
|
6,314 (34.26)
|
3,701 (32.07)
|
3,607 (39.72)
|
2,650 (41.26)
|
Graduated or above
|
156 (0.85)
|
83 (0.72)
|
91 (1.00)
|
67 (1.04)
|
Smoking index (pack-year), n (%)**
|
|
|
|
|
No
|
5,284 (28.67)
|
11,412 (98.87)
|
2,708 (29.81)
|
6,364 (99.04)
|
0~6.62
|
3,103 (16.84)
|
76 (0.66)
|
1,838 (20.23)
|
37 (0.58)
|
6.63~14.07
|
3,272 (17.75)
|
28 (0.24)
|
1,661 (18.28)
|
13 (0.20)
|
14.08~23.28
|
3,150 (17.09)
|
19 (0.16)
|
1,509 (16.61)
|
9 (0.14)
|
≥23.29
|
3,622 (19.65)
|
8 (0.07)
|
1,368 (15.06)
|
3 (0.05)
|
Alcohol index (kilogram-year), n (%)†
|
|
|
|
|
No
|
11,324 (61.44)
|
11,217 (97.18)
|
5,908 (65.04)
|
6,244 (97.17)
|
0~72.26
|
1,548 (8.40)
|
269 (2.33)
|
896 (9.86)
|
155 (2.41)
|
72.27~167.53
|
1,743 (9.46)
|
34 (0.29)
|
801 (8.82)
|
20 (0.31)
|
167.54~380.11
|
1,877 (10.18)
|
14 (0.12)
|
803 (8.84)
|
3 (0.05)
|
≥380.12
|
1,939 (10.52)
|
9 (0.08)
|
676 (7.44)
|
4 (0.06)
|
Exercise, n (%) ‡
|
|
|
|
|
No
|
2,103 (11.41)
|
1,033 (8.95)
|
1,089 (11.99)
|
650 (10.12)
|
Occasionally
|
7,939 (43.07)
|
4,648 (40.27)
|
4,201 (46.25)
|
2,896 (45.07)
|
Often
|
8,389 (45.52)
|
5,862 (50.78)
|
3,794 (41.77)
|
2,880 (44.82)
|
BMI Categories, n (%)
|
|
|
|
|
≤18.5
|
600 (3.26)
|
785 (6.80)
|
448 (4.93)
|
615 (9.57)
|
18.5~
|
8,312 (45.10)
|
7,088 (61.41)
|
4,823 (53.09)
|
4,432 (68.97)
|
24.0~
|
7,707 (41.82)
|
2,908 (25.19)
|
3,277 (36.07)
|
1,193 (18.57)
|
≥28
|
1,812 (9.83)
|
762 (6.60)
|
536 (5.90)
|
186 (2.89)
|
Total Cholesterol (mmol/L) §
|
4.69±0.90
|
4.76±0.88
|
4.26±0.56
|
4.31±0.54
|
HDL cholesterol (mmol/L)
|
1.32±0.37
|
1.49±0.40
|
1.32±0.36
|
1.52±0.38
|
LDL cholesterol (mmol/L)
|
2.89±0.95
|
2.66±0.90
|
2.66±0.72
|
2.49±0.72
|
Triglyceride (mmol/L)
|
1.97±1.46
|
1.52±1.00
|
1.63±0.98
|
1.25±0.69
|
Serum fasting blood-glucose (mmol/L)
|
5.71±1.71
|
5.44±1.31
|
5.23±0.67
|
5.10±0.58
|
Serum Lactate Dehydrogenase-L (U/L)
|
195.46±41.21
|
192.04±37.83
|
190.49±39.55
|
182.71±34.75
|
Serum Uric Acid (μmol/L)
|
348.21±73.91
|
270.47±64.66
|
336.41±69.40
|
254.78±57.45
|
*: MS-free population refers to those population did not have any metabolic syndromes except for hyperuricemia at baseline.
**: Smoking index was categorized by the quartile distribution of pack-year based on the distribution of CVD-free population at baseline.
†: Alcohol index was categorized by the quartile distribution of alcohol intake weight based on the distribution of the CVD-free population at baseline.
‡: Exercise last more than 30 minutes was defined as a valid exercise; Occasionally exercise was defined as exercise less than 3 times per week; Often exercise is defined as at least 3 times per week, each time lasts more than 30 minutes.
§: Bio-chemistry data related to metabolism were presented as mean ± standard deviation in each subgroup.
Table 2. Overall CHD, stroke, and CVD risk associated with hyperuricemia with or without hyperuricemia-related comorbidities
|
|
|
With hyperuricemia-related comorbidities
|
Without hyperuricemia-related comorbidities
|
Outcomes
|
Hyperuricemia
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
CHD
|
No
|
550
|
24,688
|
471.99
|
1.00
|
1.00
|
156
|
13,671
|
241.76
|
1.00
|
1.00
|
Yes
|
151
|
4,585
|
597.74
|
1.29 (1.11-1.50)
|
1.07 (0.91-1.25)
|
32
|
1,807
|
335.19
|
1.34 (0.97-1.84)
|
1.11 (0.79-1.55)
|
Stroke
|
No
|
321
|
25,238
|
329.47
|
1.00
|
1.00
|
82
|
13,671
|
167.08
|
1.00
|
1.00
|
Yes
|
96
|
4,640
|
418.34
|
1.41 (1.16-1.71)
|
1.18 (0.95-1.44)
|
21
|
1,839
|
241.93
|
1.66 (1.11-2.49)
|
1.20 (0.79-1.84)
|
CVD
|
No
|
831
|
25,238
|
657.60
|
1.00
|
1.00
|
231
|
13,671
|
427.99
|
1.00
|
1.00
|
Yes
|
231
|
4,836
|
812.01
|
1.31 (1.16-1.48)
|
1.08 (0.94-1.23)
|
50
|
1,839
|
576.03
|
1.41 (1.09-0.82)
|
1.12 (0.85-1.46)
|
*: Age-standardized Incidence Rate: Standardized by The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
†: Represent the crude hazard ratio
‡: Hazard ratio were adjusted by Age at diagnosis(<30, 30-39, 40-49, 50-59, 60-69, >=70), gender (male/female), BMIs (<18.5, 18.5-23.9, 24.0-27.9, >=28.0), physical exercise (no, occasionally, often), smoking index, pack-year (no smoking, 0-6.3, 6.4-14.0, 14.1-23.2, >=23.3), lifetime total alcohol intake, kilogram-year (no drinking, 0-72.2, 72.3-167.5, 167.5-380.1, >=380.1), diabetes status (yes/no), hypertension stage (normal, elevated, stage I, stage II), triglyceride (<1.80 mmol/L, 1.80~2.20 mmol/L, >=2.20 mmol/L), high-density lipoprotein (Male: <1.16 mmol/L, 1.16-1.42 mmol/L, >=1.43 mmol/L, Female: <1.29 mmol/L, 1.29-1.55 mmol/L, >=1.56 mmol/L) and low-density lipoprotein (<2.60 mmol/L, 2.60-4.11 mmol/L, >=4.12 mmol/L).
Table 3. Age-standardized incidence rate and hazard ratio of CHD and stroke associated with different SUA stratums, total population at baseline
|
|
CHD incidence
|
Stroke incidence
|
SUA stratums
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Normal
|
553
|
25,783
|
444.87
|
1.00
|
1.00
|
335
|
26,336
|
269.50
|
1.00
|
1.00
|
Quartile 1
|
26
|
803
|
664.47
|
1.21 (0.87-1.69)
|
1.11 (0.79-1.54)
|
15
|
829
|
383.35
|
1.12 (0.73-1.73)
|
1.02 (0.66-1.58)
|
Quartile 2
|
42
|
901
|
943.62
|
1.70 (1.31-2.21)
|
1.45 (1.11-1.90)
|
21
|
943
|
471.81
|
1.36 (0.94-1.97)
|
1.16 (0.80-1.69)
|
Quartile 3
|
26
|
905
|
591.67
|
1.07 (0.77-1.49)
|
0.87 (0.62-1.21)
|
16
|
931
|
364.11
|
1.05 (0.70-1.61)
|
0.85 (0.55-1.30)
|
Quartile 4
|
54
|
881
|
1223.60
|
2.17 (1.71-2.74)
|
1.70 (1.34-2.16)
|
30
|
935
|
679.78
|
1.96 (1.43-2.68)
|
1.55 (1.13-2.13)
|
*: Age-standardized Incidence Rate: Standardized by The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
†: Represent the crude hazard ratio
‡: Hazard ratio were adjusted by Age at diagnosis(<30, 30-39, 40-49, 50-59, 60-69, >=70), gender (male/female), BMIs (<18.5, 18.5-23.9, 24.0-27.9, >=28.0), physical exercise (no, occasionally, often), smoking index, pack-year (no smoking, 0-6.3, 6.4-14.0, 14.1-23.2, >=23.3), lifetime total alcohol intake, kilogram-year (no drinking, 0-72.2, 72.3-167.5, 167.5-380.1, >=380.1), diabetes status (yes/no), hypertension stage (normal, elevated, stage I, stage II), triglyceride (<1.80 mmol/L, 1.80~2.20 mmol/L, >=2.20 mmol/L), high-density lipoprotein (Male: <1.16 mmol/L, 1.16-1.42 mmol/L, >=1.43 mmol/L, Female: <1.29 mmol/L, 1.29-1.55 mmol/L, >=1.56 mmol/L) and low-density lipoprotein (<2.60 mmol/L, 2.60-4.11 mmol/L, >=4.12 mmol/L).
Table 4. Age-standardized incidence rate and hazard ratio of CHD and stroke associated with different SUA stratums, male population with comorbidities at baseline
|
|
CHD incidence
|
Stroke incidence
|
SUA stratums
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Normal
|
337
|
15,733
|
453.81
|
1.00
|
1.00
|
233
|
15,733
|
313.76
|
1.00
|
1.00
|
Quartile 1
|
16
|
626
|
541.51
|
0.98 (0.65-1.50)
|
0.98 (0.65-1.50)
|
12
|
626
|
406.13
|
1.04 (0.64-1.69)
|
1.03 (0.63-1.68)
|
Quartile 2
|
23
|
697
|
699.12
|
1.28 (0.90-1.93)
|
1.20 (0.84-1.72)
|
16
|
697
|
486.35
|
1.24 (0.81-1.90)
|
1.17 (0.76-1.80)
|
Quartile 3
|
19
|
687
|
585.94
|
1.05 (0.71-1.54)
|
0.93 (0.63-1.38)
|
12
|
687
|
370.07
|
0.92 (0.57-1.50)
|
0.83 (0.51-1.36)
|
Quartile 4
|
41
|
688
|
1262.56
|
2.13 (1.62-2.79)
|
1.94 (1.47-2.56)
|
20
|
688
|
615.88
|
1.47 (1.01-2.15)
|
1.34 (0.91-1.97)
|
*: Age-standardized Incidence Rate: Standardized by The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
†: Represent the crude hazard ratio
‡: Hazard ratio were adjusted by Age at diagnosis(<30, 30-39, 40-49, 50-59, 60-69, >=70), gender (male/female), BMIs (<18.5, 18.5-23.9, 24.0-27.9, >=28.0), physical exercise (no, occasionally, often), smoking index, pack-year (no smoking, 0-6.3, 6.4-14.0, 14.1-23.2, >=23.3), lifetime total alcohol intake, kilogram-year (no drinking, 0-72.2, 72.3-167.5, 167.5-380.1, >=380.1), diabetes status (yes/no), hypertension stage (normal, elevated, stage I, stage II), triglyceride (<1.80 mmol/L, 1.80~2.20 mmol/L, >=2.20 mmol/L), high-density lipoprotein (Male: <1.16 mmol/L, 1.16-1.42 mmol/L, >=1.43 mmol/L, Female: <1.29 mmol/L, 1.29-1.55 mmol/L, >=1.56 mmol/L) and low-density lipoprotein (<2.60 mmol/L, 2.60-4.11 mmol/L, >=4.12 mmol/L).
Table 5. Age-standardized incidence rate and hazard ratio of CHD and Stroke associated with different SUA stratums, female population with comorbidities at baseline
|
|
CHD incidence
|
Stroke incidence
|
SUA stratums
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
HR‡ (95%)
|
Normal
|
216
|
10,603
|
431.60
|
1.00
|
1.00
|
102
|
10603
|
203.81
|
1.00
|
1.00
|
Quartile 1
|
10
|
203
|
1043.67
|
1.79 (1.05-3.05)
|
1.38 (0.81-2.36)
|
3
|
203
|
313.10
|
1.13 (0.43-2.96)
|
0.89 (0.34-2.36)
|
Quartile 2
|
19
|
246
|
1636.35
|
2.80 (1.89-4.16)
|
1.80 (1.21-2.70)
|
5
|
246
|
430.62
|
1.56 (0.73-3.31)
|
1.06 (0.50-2.28)
|
Quartile 3
|
7
|
244
|
607.81
|
1.08 (0.57-2.03)
|
0.67 (0.35-1.27)
|
4
|
244
|
347.32
|
1.28 (0.55-2.96)
|
0.86 (0.37-2.02)
|
Quartile 4
|
13
|
247
|
1115.08
|
2.12 (1.33-3.39)
|
1.71 (1.03-2.35)
|
10
|
247
|
857.75
|
3.48 (2.02-6.00)
|
2.02 (1.14-3.58)
|
*: Age-standardized Incidence Rate: Standardized by The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
†: Represent the crude hazard ratio
‡: Hazard ratio were adjusted by Age at diagnosis(<30, 30-39, 40-49, 50-59, 60-69, >=70), gender (male/female), BMIs (<18.5, 18.5-23.9, 24.0-27.9, >=28.0), physical exercise (no, occasionally, often), smoking index, pack-year (no smoking, 0-6.3, 6.4-14.0, 14.1-23.2, >=23.3), lifetime total alcohol intake, kilogram-year (no drinking, 0-72.2, 72.3-167.5, 167.5-380.1, >=380.1), diabetes status (yes/no), hypertension stage (normal, elevated, stage I, stage II), triglyceride (<1.80 mmol/L, 1.80~2.20 mmol/L, >=2.20 mmol/L), high-density lipoprotein (Male: <1.16 mmol/L, 1.16-1.42 mmol/L, >=1.43 mmol/L, Female: <1.29 mmol/L, 1.29-1.55 mmol/L, >=1.56 mmol/L) and low-density lipoprotein (<2.60 mmol/L, 2.60-4.11 mmol/L, >=4.12 mmol/L).
Table 6. Age-standardized incidence rate and hazard ratio of CVD incidence associated with different SUA stratums, stratified by age groups
|
|
<50
|
50-69
|
>=70
|
SUA stratums
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
Incidence cases, n
|
Total, n
|
ASIR* (1/100k)
|
HR† (95%)
|
Normal
|
125
|
16,797
|
157.67
|
1.00
|
468
|
7,916
|
1252.56
|
1.00
|
251
|
1,623
|
3276.52
|
1.00
|
Quartile 1
|
5
|
424
|
249.84
|
1.20 (0.56-2.55)
|
25
|
323
|
1639.82
|
1.10 (0.78-1.54)
|
9
|
82
|
2325.34
|
0.59 (0.33-1.03)
|
Quartile 2
|
2
|
467
|
90.73
|
0.45 (0.14-1.46)
|
38
|
361
|
2230.15
|
1.39 (1.05-1.83)
|
20
|
115
|
3684.60
|
0.97 (0.65-1.44)
|
Quartile 3
|
4
|
435
|
194.82
|
0.86 (0.37-2.00)
|
25
|
393
|
1347.74
|
0.86 (0.61-1.21)
|
10
|
103
|
2056.94
|
0.52 (0.31-0.89)
|
Quartile 4
|
3
|
382
|
166.39
|
0.73 (0.28-1.92)
|
38
|
381
|
2113.08
|
1.43 (1.08-1.89)
|
39
|
172
|
4803.90
|
1.24 (1.13-1.47)
|
*: Age-standardized Incidence Rate: Standardized by The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
†: Hazard ratio were adjusted by Age at diagnosis(<30, 30-39, 40-49, 50-59, 60-69, >=70), gender (male/female), BMIs (<18.5, 18.5-23.9, 24.0-27.9, >=28.0), physical exercise (no, occasionally, often), smoking index, pack-year (no smoking, 0-6.3, 6.4-14.0, 14.1-23.2, >=23.3), lifetime total alcohol intake, kilogram-year (no drinking, 0-72.2, 72.3-167.5, 167.5-380.1, >=380.1), diabetes status (yes/no), hypertension stage (normal, elevated, stage I, stage II), triglyceride (<1.80 mmol/L, 1.80~2.20 mmol/L, >=2.20 mmol/L), high-density lipoprotein (Male: <1.16 mmol/L, 1.16-1.42 mmol/L, >=1.43 mmol/L, Female: <1.29 mmol/L, 1.29-1.55 mmol/L, >=1.56 mmol/L) and low-density lipoprotein (<2.60 mmol/L, 2.60-4.11 mmol/L, >=4.12 mmol/L).