Association of hyperuricemia with dietary patterns and alcohol consumption in the adult population. Results of the ESSE-RF epidemiological study

Aim. To study the associations of hyperuricemia (HU) with dietary patterns and alcohol consumption in the Russian population.

Material and methods. Representative samples of male and female population aged 25-64 years (17929 people, including 6593 men and 11336 women) from 13 Russian regions were examined. The response rate was ~80%. The dietary pattern was studied by the consumption rate of the main food groups. HU was diagnosed at a uric acid (UA) level >400 μmol/l for men and >360 μmol/l for women. The results are presented as odds ratio (OR) and 95% confidence interval (CI).

Results. People with HU more often consume fish (men by 28% and women by 34%) (p<0,005), less often — sweets (by 22 and 21%, respectively) (p<0,001) and cheese (by 13 and 14%, respectively) (p<0,05). In the diet of individuals with HU, excess sugar consumption is lower by 19 and 23% in men and women, respectively (p<0,001). Women with HU also have 13% lower red meat consumption, 36% lower legume consumption, 28% higher poultry consumption (p<0,001) and 25% lower low-fat dairy products (p<0,05), as well as 15% lower animal fat use in cooking (p=0,008) compared to individuals without HU. Individuals with HU do not discontinue alcohol, but its consumption is lower than in individuals without HU. In men, the amount of alcohol consumed has a linear association with the UA level of and HU risk. In general, among male alcohol consumers, the risk of HU is 1,32 [1,13-1,54] (p=0,001). In men with low alcohol consumption, the risk of HU is 1,24 [1,05-1,45] (p=0,009), with moderate and high consumption — 1,61 [1,32-1,97] (p<0,001) and 1,64 [1,27-2,12] (p<0,001), respectively.

Conclusion. The diet of individuals with HU differs significantly from the diet of individuals without HU, which is more pronounced among women. In men, the risk of HU increases linearly with the amount of alcohol consumed.

1. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med. 2008;359(17):1811-21. doi:10.1056/NEJMra0800885.

2. Johnson RJ, Kivlighn SD, Kim YG, et al. Reappraisal of the pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. Am J Kidney Dis. 1999;33(2):225-34. doi:10.1016/s0272-6386(99)70295-7.

3. Drapkina OM, Mazurov VI, Martynov AI, et al. "Focus on hyperuricemia". The resolution of the Expert Council. Cardiovascular Therapy and Prevention. 2023;22(4):3564. (In Russ.) doi:10.15829/1728-8800-2023-3564.

4. Shalnova SA, Imaeva AE, Kutsenko VA, et al. Hyperuricemia and hypertension in working-age people: results of a population study. Cardiovascular Therapy and Prevention. 2023;22(9S): 3783. (In Russ.) doi:10.15829/1728-8800-2023-3783.

5. Drapkina OM, Kontsevaya AV, Kalinina AM, et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022;21(4):3235. (In Russ.) doi:10.15829/1728-88002022-3235.

6. Shalnova SA, Deev AD, Artamonov GV, et al. Hyperuricemia and its correlates in the Russian population (results of ESSE-RF epidemiological study). Rational Pharmacotherapy in Cardiology. 2014;10(2):153-9. (In Russ.) doi:10.20996/1819-64462014-10-2-153-159.

7. Wang J, Chen S, Zhao J, et al. Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES. BMC Public Health. 2022;22(1):1981. doi:10.1186/s12889-022-14357-5.

8. De Becker B, Borghi C, Burnier M, et al. Uric acid and hypertension: a focused review and practical recommendations. J Hypertens. 2019;37(5):878-83. doi:10.1097/HJH.0000000000001980.

9. Zhang Y, Qiu H. Dietary magnesium intake and hyperuricemia among US adults. Nutrients. 2018;10(3):296. doi:10.3390/nu1003029.

10. Zeng C, Wang YL, Wei J, et al. Association between low serum magnesium concentration and hyperuricemia. Magnes Res. 2015;28(2):56-63. doi:10.1684/mrh.2015.0384.

11. Zhang Y, Liu Y, Qiu H. Association between dietary zinc intake and hyperuricemia among adults in the United States. Nutrients. 2018;10(5):568. doi:10.3390/nu10050568.

12. Wang H, Qin S, Li F, et al. (2023) A cross-sectional study on the association between dietary inflammatory index and hyperuricemia based on NHANES 2005-2018. Front Nutr. 10:1218166. doi:10.3389/fnut.2023.1218166.

13. Kiyohara C, Kono S, Honjo S, et al. Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males. Br J Nutr. 1999;82(2):125-30. doi:10.1017/S0007114599001270.

14. Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey. Arthritis Rheum. 2007;57(5):816-21. doi:10.1002/art.22762.

15. Juraschek SP, Miller ER 3rd, Gelber AC. Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken). 2011;63(9):1295-306. doi:10.1002/acr.20519.

16. Huang T, Li K, Asimi S, et al. Effect of vitamin B-12 and n-3 polyunsaturated fatty acids on plasma homocysteine, ferritin, C-reaction protein, and other cardiovascular risk factors: a randomized controlled trial. Asia Pac J Clin Nutr. 2015; 24(3):403-11. doi:10.6133/apjcn.2015.24.3.19.

17. Boytsov SA, Chazov EI, Shlyakhto EV, et al. Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study. Russian Journal of Preventive Medicine. 2013;16(6):25-34. (In Russ.)

18. Karamnova NS, Rytova AI, Shvabskaya OB, et al. Associations of eating and drinking habits with cardiovascular disease and diabetes in the adult population: data from the ESSE-RF epidemiological study. Cardiovascular Therapy and Prevention. 2021;20(5):2982. (In Russ.) doi:10.15829/1728-8800-2021-2982.

19. Karamnova NS, Rytova AI, Shvabskaia OB, et al. Association of alcohol consumption and dietary patterns in the adult population: data from the ESSE-RF study. Cardiovascular Therapy and Prevention. 2021;20(4):2883. (In Russ.) doi:10.15829/1728-8800-2021-2883.

20. Karamnova NS, Shalnova SA, Rytova AI, et al. Associations of dietary patterns and abdominal obesity in the adult population. Results of the Russian epidemiological ESSE-RF study. Russian Journal of Cardiology. 2021;26(5):4363. (In Russ.) doi:10.15829/1560-4071-2021-4363.

21. Shvabskaia OB, Izmailova OV, Karamnova NS, Drapkina OM. Hyperuricemia: Features of the Diet. Rational Pharmacotherapy in Cardiology. 2021;17(6):889-99. (In Russ.) doi:10.20996/1819-6446-2021-12-04.

22. Eliseev MS, Zhelyabina OV, Cheremushkina EV. Frequency and quantity comparison of meat and fish products consumption in patients with gout and asymptomatic hyperuricemia (preliminary data of the pilot study). Russian Medical Inquiry. 2023; 7(7):445-51. (In Russ.) doi:10.32364/2587-6821-2023-7-7-7.