Table_1_Serum Uric Acid Might Be Positively Associated With Hypertension in Chinese Adults: An Analysis of the China Health and Nutrition Survey.DOCX

Background: Previous studies have clarified the relationship between serum uric acid (SUA) and hypertension; most of previous studies suggest that elevated uric acid levels are associated with an increased risk of hypertension, while in China, there are relatively few studies to explore above association. The objective of this longitudinal study is to investigate the correlation of SUA and hypertension in Chinese adults with a nationwide large-scale sample.
Methods: Data from the China Health and Nutrition Survey 2009, 2011, and 2016 were used; a total of 8,469 participants (3,973 men and 4,496 women) were involved. This study was conducted separately by gender. Clinical characteristics of the participants among different uric acid groups are compared. The binary logistic regression analysis was conducted to examine the association between SUA and hypertension. Restricted cubic spline analysis with three knots of the SUA concentration were used to characterize the dose-response relationship. Additionally, we compared the incidence of hypertension in the different baseline uric acid groups during follow-up in 2011 and 2015.
Results: After the covariates were fully adjusted, we found that elevated uric acid levels were correlated with increased risk of hypertension in both males (p < 0.01) and females (p < 0.01). With 2-year or 6-year of follow-up, we found participants with higher baseline uric acid levels had a higher incidence of hypertension (p < 0.01). In stratified analysis by obesity, above relationship remained significant in nonobesity population (males: p < 0.05, females: p < 0.01) and became nonsignificant in obesity people. In stratified analysis by age, above positively correlation remained significant in middle-aged men (p < 0.05) and elderly women (p < 0.01). Restricted cubic spline revealed the dose-response relationship between SUA and hypertension; we also found that above relationship was much stronger in females.
Conclusion: This study suggests that elevated SUA levels might be positively associated with an increased risk of hypertension in general Chinese adults.

背景：既往研究已阐明血清尿酸（serum uric acid, SUA）与高血压之间的关联；多数既往研究提示尿酸水平升高与高血压发病风险增加相关，但国内针对该关联的探索性研究相对较少。本项纵向研究旨在依托全国性大样本队列，探究中国成年人血清尿酸（SUA）与高血压的相关性。
方法：本研究采用2009年、2011年及2016年中国健康与营养调查（China Health and Nutrition Survey, CHNS）的数据，共纳入8469名研究对象（男性3973名，女性4496名），并按性别分别开展分析。首先比较不同尿酸分组研究对象的临床特征；采用二元logistic回归分析检验血清尿酸（SUA）与高血压的关联；采用含3个节点的限制性立方样条分析，刻画SUA浓度与高血压的剂量-反应关系。此外，对比了2011年及2015年随访期间，不同基线尿酸分组人群的高血压发病情况。
结果：经协变量全调整后，男性（p<0.01）与女性（p<0.01）群体中，尿酸水平升高均与高血压发病风险升高呈显著相关。在2年或6年随访周期中，基线尿酸水平更高的研究对象高血压发病率显著更高（p<0.01）。按肥胖状态分层分析显示，该关联在非肥胖人群中仍具有统计学意义（男性：p<0.05，女性：p<0.01），而在肥胖人群中无显著关联。按年龄分层分析显示，这种正相关在中年男性（p<0.05）及老年女性（p<0.01）中仍显著存在。限制性立方样条分析验证了SUA与高血压的剂量-反应关系，同时发现该关联在女性群体中更为显著。
结论：本研究表明，在中国普通成年人群中，血清尿酸（SUA）水平升高可能与高血压发病风险升高呈正相关。