AB0120 EPIDEMIOLOGICAL INSIGHTS INTO HYPERURICEMIA PREVALENCE AND ASSOCIATED RISK FACTORS IN ADULT RURAL ROMANIAN POPULATION: A COMPREHENSIVE POPULATION-BASED STUDY (2024)

Abstract

Background: Hyperuricemia has emerged as a significant public health concern due to its high prevalence and associations with gout, cardiovascular diseases, and metabolic disorders. While historically considered a benign laboratory finding, recent research challenges this perception. New insights suggest that asymptomatic hyperuricemia is not only associated with an increased risk of cardiometabolic diseases but also plays a pro-inflammatory role in these conditions. In rural Romanian communities, where lifestyle factors and dietary habits may differ from urban settings, understanding the prevalence and potential risk factors of hyperuricemia becomes particularly relevant.

Objectives: The primary objective of this study was to assess the prevalence of hyperuricemia in an unselected rural population in Romania. Secondary objectives aimed to evaluate potential risk factors, including demographic factors, dietary habits, anthropometric measurements, and biomarkers associated with hyperuricemia.

Methods: Between March 2022 and November 2023, individuals from rural communities in Romania underwent blood tests, clinical evaluation, and responded to a comprehensive questionnaire covering dietary habits and known risk factors for hyperuricemia. Written informed consent was obtained from each participant. The exclusion criteria were age under 18 years, individuals with gout and those undergoing urate-lowering therapy. A total of 1602 participants were categorized into two groups: the hyperuricemia group and the control group (serum uric acid below the ULN). Hyperuricemia was defined as serum uric acid > 7.2 mg/dl in males and > 6 mg/dl in females, following the laboratory recommended range. Data analysis involved a combination of independent-samples t-tests, chi-square tests, linear and logistic regression.

Results: The study included 1602 participants aged between 18 and 91 years (mean age 54.25 ± 15.64 SD), with 29.6% males and 70.4% females. The prevalence of hyperuricemia was 17.6% (n=282), with a higher prevalence in males (30.5%) compared to females (17.8%). Statistically significant (p<0.05) non-modifiable risk factors for hyperuricemia included age and male gender. Linear regression analysis indicated a correlation between serum uric acid levels and age among females, but this association was not observed in males (Figure 1). Other observed associations included higher waist circumference (p=0.024), triglycerides (p<0.001), fasting blood glucose (p=0.005) and increased serum creatinine (p<0.001). Moreover, lymphocytes, CRP and GGT levels as well as the fatty liver index[1] were significantly increased (p<0.001) in the hyperuricemia group, suggesting an inflammatory response in individuals with hyperuricemia, potentially contributing to liver involvement. Participants with hyperuricemia also demonstrated higher mean values for weight, BMI, cholesterol, LDL-cholesterol, but without a statistically significant correlation (Table 1). Although creatinine levels were significantly higher in the hyperuricemia group, the correlation did not persist after calculating the MDRD eGFR Equation.

Conclusion: This population-based study reveals a considerable prevalence of hyperuricemia in rural communities in Romania, with age and male gender identified as significant non-modifiable risk factors. The outcomes also demonstrate an association between hyperuricemia and dietary factors, inflammation, and liver health. Further research is warranted to explore the causal relationships and emphasize the need for a holistic approach in understanding and managing hyperuricemia, moving beyond its historical characterization as a benign condition associated primarily with gout and kidney stones.

Acknowledgements: NIL.

Disclosure of Interests: None declared.