Fructose plays an important role in the complex metabolism of uric acid in the human body. However, high blood uric acid concentration, known as hyperuricemia, is the main risk factor for development of gout. Therefore, we conducted an updated meta-analysis on the prevalence and geographical distribution of hyperuricemia among the general population in mainland China using systematic literature search. Five electronic databases were used to search for relevant articles published until 2019. All calculations were conducted using the Comprehensive Meta-Analysis (CMA) software. We included 108 eligible articles (172 studies by sex, 95 studies by regions, and 107 studies by study type) and an overall sample size of > 808,505 participants. The pooled prevalence of hyperuricemia among the general population in mainland China was 17.4% (95% CI: 15.8–19.1%). Our subgroup analysis indicated that the pooled prevalence by regions ranged from 15.5 to 24.6%. Those living Northeast region and being males had the highest prevalence (P   20%), particularly in males. An increasing prevalence was reported since 2005–2009 until 2015–2019. No publication of bias was observed as indicated by a symmetrical funnel plot and Begg and Mazumdar rank correlation (P = 0.392). Prevalence of hyperuricemia is increasing in China, and future studies should investigate the association between the prevalence of hyperuricemia and its risk factors in order to tackle the issue, particularly among the vulnerable groups. Also, our study was the first comprehensive study to investigate the overall prevalence of hyperuricemia in mainland China covering the six different regions.

/pdf/geographical-distribution-of-hyperuricemia-in-mainland-china-2o72l4jcd0.pdf

Geographical distribution of hyperuricemia in mainland China: a comprehensive systematic review and meta-analysis.

The Role of Platelets in Non-Alcoholic Fatty Liver Disease: From Pathophysiology to Therapeutics.

Objective To determine the prevalences and risk factors of hyperuricemia(HUA)and gout among residents aged≥20 years in Shandong coastal areas.Methods A random stratified cluster sampling was conducted,and 5003 inhabitants were investigated for prevalences of HUA and gout in Qingdao,Yantai,Weihai, Rizhao and Dongying.Results (1)The prevalence of HUA was 13.19%,after standardization according to the Shandong population in 2000,standardized rate was 13.27%,in which the prevalence in males was 18.32% and females 8.56%.The prevalence of gout was 1.14% and the standardized rate was 1.10%,in which the prevalence in males was 1.94% and females 0.42%;(2)Serum uric acid was(343.4±84.5)μmol/L in normal males and (258.9±70.9)μmol/L in normal females.Serum uric acid was(469.4±48.1)μmol/L in males with HUA and (399.7±104.9)μmol/L in females with HUA.In gout group,serum uric acid in males and females was respectively(502.4±106.8)μmol/L and(403.5±52.7)μmol/L;(3)The prevalence of gout in patients with HUA was 8.64%;(4)Non-conditional logistic regression analysis showed that frequency and quantity of alcohol intake were independent risk factors for males in the HUA group,while HDL-C and farming were protective factors. As for females,age and hypertension were independent risk factors of HUA.Similarly,HDL-C was a protective factor;(5)In HUA patients,65% had hypertension,53% hyperlipidemia,30% glucose metabolic disorder,48% overweight and 10% obesity.In gout patients,57% had hypertension,61% hyperlipidemia,20% glucose metabolic disorder,56% overweight and 7% obesity.Conclusion The prevalences of HUA and gout are significantly increased in Shandong coastal areas in recent years.Restricting the intake of sea foods rich in purine such as seashell,reducing the intake of alcohol especially beer,reducing body weight and abdominal obesity, correcting lipid metabolic disorder and controlling hypertension are important measures in preventing and treating hyperuricemia and gout.

Epidemiological survey of hyperuricemia and gout in coastal areas of Shandong Province

Gut microbiota plays a significant role in the development and treatment of gouty arthritis. Simiao decoction has been shown to alleviate gouty arthritis by inhibiting inflammation, regulating NLRP3 inflammasome, and altering gut microbiota. However, there is no evidence to prove whether gut microbiota directly mediates the therapeutic efficiency of Simiao decoction in treating gout arthritis.In this study, fecal microbiota transplantation (FMT) was used to transfer the gut microbiota of gout arthritis mice treated with Simiao decoction or allopurinol to blank gout arthritis mice, in order to investigate whether FMT had therapeutic effects on gout arthritis.Both Simiao decoction and allopurinol effectively reduced the levels of serum uric acid, liver XOD activity, foot thickness, serum IL-1β, and G-CSF in gout arthritis mice. However, Simiao decoction also had additional benefits, including raising the pain threshold, reducing serum TNF-α and IL-6, alleviating gut inflammation, and repairing intestinal pathology, which were not observed with allopurinol treatment. Moreover, Simiao decoction had a greater impact on gut microbiota than allopurinol, as it was able to restore the abundance of phylum Proteobacteria and genus Helicobacter. After transplantation into gout arthritis mice, gut microbiota altered by Simiao decoction exhibited similar therapeutic effects to those of Simiao decoction, but gut microbiota altered by allopurinol showed no therapeutic effect.These findings demonstrates that Simiao decoction can alleviate gout arthritis symptoms by regulating gut microbiota. 

/pdf/gut-microbiota-mediated-the-therapeutic-efficiency-of-simiao-309wnpgc.pdf

Gut microbiota mediated the therapeutic efficiency of Simiao decoction in the treatment of gout arthritis mice

Objective To investigate the prevalence of hyperuricaemia and gout in the residents aged over 20 years and living in the coastal areas of Haiyang City of Shandong Province,and their related factors. Methods Investigation was performed in 5 372 residents with a standard questionnaire,including occupation,gender,age,seafood consumption, alcohol drinking,and blood uric acid measurement. Body weight,height and blood pressure were measured for those with hyperuricemia,and blood lipid and sugar levels and renal function were measured,and B-type ultrasonography for the urinary system was performed for those with gout.Results Prevalence of hyperuricaemia was 12.08%(649/ 5 372), 16.85% (424/2 517) in men and 7.88% (225/2 855) in women,repectively.In total,23 cases of gout were detected from 5 372 residents,21 in men (0.83%,21/2 517) and two in women (0.07%,2/2 855),respectively. Univariate analysis showed that there was significant difference in BMI,prevalence of hypertension and seafood consumption between those with and without hyperuricaemia,matched on gender and age,either in men or in women,but the difference in alcohol drinking could only be found in men (P0.01 or 0.05). Conclusions Prevalence of hyperuricaemia in the residents living in the coastal areas was higher,and their body mass index (BMI),prevalence of high blood pressure, alcohol drinking and consumption of seafood with high-purine content were risk factors for hyperuricaemia.

An epidemiologic study on hyperuricaemia and gout in residents of coastal areas of Haiyang City in Shandong

Association between hypertension and nonalcoholic fatty liver disease: a cross-sectional and meta-analysis study

Gout is a common inflammatory joint disease. Although China is a developing country, it is an ethnically diverse country with regional economic disparities. To date, there are limited studies that investigated the gout prevalence from representative populations in mainland China. Therefore, we performed an updated systematic review and meta-analysis in order to comprehensively review all the relevant published data that reported the prevalence of gout in mainland China from 1998 to 2019. The electronic databases including PubMed and Medline were searched for peer-reviewed articles published in the selected period. Meta-analyses were conducted by using the Comprehensive Meta-Analysis software. After screening and checking for eligibility, we included 67 articles with a total of > 394,768 participants. The pooled estimate of prevalence in the general population was 1.6% (95% CI, 1.2–2.2%). Gout prevalence rates varied from 0.8 to 5% by regions. The lowest and highest prevalence of gout was found in the Northwest (0.8%) and Southwest (5.0%), respectively. The prevalence rate was higher in males than in females (1.9% (95% CI, 1.5–2.4%) vs. 0.5% (95% CI, 0.3–0.8%) (P < 0.001). All funnel plots were symmetrical and no indication of publication bias was observed for all analyses. In conclusion, the prevalence of gout was reported to be on the rise. In addition, the burden of gout is also increasing in China. With the increasing aging populations and obesity rate in mainland China, the evidence from this updated systematic review and meta-analysis will be significant to prompt for optimizing management and treatment of gout at individual and population levels.

Epidemiology and Prevalence of Gout in Mainland China: an Updated Systematic Review and Meta-Analysis

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Association between hypertension and nonalcoholic fatty liver disease: a cross-sectional and meta-analysis study

Epidemiology and Prevalence of Gout in Mainland China: an Updated Systematic Review and Meta-Analysis