Association of dietary patterns and hyperuricemia: a cross-sectional study of the Yi ethnic group in China

  • Xirun Liu
  • Shanshan Huang
  • Wangdong Xu
  • Aijing Zhou
  • Hui Li
  • Rong Zhang
  • Ya Liu
  • Yan Yang
  • Hong Jia
Keywords: dietary pattern, hyperuricemia, factor analysis, cross-sectional study, the Yi ethnic group


Background: Diet plays an important role in the development of hyperuricemia (HUA), but evidence for association between overall dietary patterns and HUA is scarce and inconsistent. The present study aims to explore association of dietary patterns and HUA among the Yi ethnic group of China.

Methods: This is a cross-sectional study involving people aged more than 18 years. Principal component factor analysis (PCFA) on food groups from a semi-quantitative 52-item food frequency questionnaire was applied to identify dietary patterns. HUA status was regressed on tertiles of factor scores to estimate prevalence ratio (PR) by using log-binomial model.

Results: Of the 1,893 participants (18–96 years), 398 (21.0%) were diagnosed with HUA. Three dietary patterns were identified: ‘plant-based’, ‘animal products’, and ‘mixed food’. The ‘animal products’ was characterized by high intake of fish, animal giblets, fresh meat, and wheat products. After adjustment for potential confounders, the highest tertile of ‘animal products’ pattern score was associated with higher prevalence of HUA when compared with the lowest tertile (PR: 1.34, 95% CI: 1.06–1.70). The other two patterns were not related to HUA.

Conclusions: ‘Animal products’ dietary pattern was correlated with HUA among the Yi ethnic group of China.


Download data is not yet available.


  1. Yokokawa H, Fukuda H, Suzuki A, Fujibayashi K, Naito T, Uehara Y, et al. Association between serum uric acid levels/hyperuricemia and hypertension among 85,286 Japanese workers. J Clin Hypertens 2016; 18(1): 53–9.

  2. Krishnan E, Pandya BJ, Chung L, Hariri A, Dabbous O. Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study. Am J Epidemiol 2012; 176(2): 108–16.

  3. Braga F, Pasqualetti S, Ferraro S, Panteghini M. Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis. Clin Chem Lab Med 2016; 54(1): 7–15.

  4. Wei CY, Sun CC, Wei CC, Tai HC, Sun CA, Chung CF, et al. Association between hyperuricemia and metabolic syndrome: an epidemiological study of a Labor Force Population in Taiwan. Biomed Res Int 2015; 2015(7): 369179.

  5. Rui L, Cheng H, Di W, Xia X, Gu J, Guan H, et al. Prevalence of hyperuricemia and gout in Mainland China from 2000 to 2014: a systematic review and meta-analysis. Biomed Res Int 2015; 2015(15 Suppl): 1–12.

  6. Kuwata H, Okamura S, Hayashino Y, Ishii H, Tsujii S. Serum uric acid levels are associated with a high risk of rapid chronic kidney disease progression among patients with type 2 diabetes: a prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 12)]. Diabetol Int 2016; 7(4): 1–9.

  7. Edwards NL. The role of hyperuricemia and gout in kidney and cardiovascular disease. Cleve Clin J Med 2008; 75(Suppl 5): S13.

  8. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum 2011; 63(10): 3136.

  9. Uaratanawong S, Suraamornkul S, Angkeaw S, Uaratanawong R. Prevalence of hyperuricemia in Bangkok population. Clin Rheumatol 2011; 30(7): 887.

  10. Liu H, Zhang XM, Wang YL, Liu BC. Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol 2014; 27(6): 653–8.

  11. Qiu L, Cheng XQ, Wu J, Liu JT, Xu T, Ding HT, et al. Prevalence of hyperuricemia and its related risk factors in healthy adults from Northern and Northeastern Chinese provinces. BMC Public Health 2013; 13(1): 664.

  12. Sari I, Akar S, Pakoz B, Sisman AR, Gurler O, Birlik M, et al. Hyperuricemia and its related factors in an urban population, Izmir, Turkey. Rheumatol Int 2009; 29(8): 869–74.

  13. Zykova SN, Storhaug HM, Toft I, Chadban SJ, Jenssen TG7, White SL. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J 2015; 14(1): 49. doi: 10.1186/s12937-015-0032-1

  14. Naja F, Nasreddine L, Itani L, Adra N, Sibai AM, Hwalla N. Association between dietary patterns and the risk of metabolic syndrome among Lebanese adults. Eur J Nutr 2013; 52(1): 97–105.

  15. Mazidi M, Pennathur S, Afshinnia F. Link of dietary patterns with metabolic syndrome: analysis of the National Health and Nutrition Examination Survey. Nutr Diabetes 2017; 7(3): e255.

  16. Rodríguez-Monforte M, Flores-Mateo G, Sánchez E. Dietary patterns and CVD: a systematic review and meta-analysis of observational studies. Br J Nutr 2015; 114(9): 1341–59.

  17. Batis C, Mendez MA, Gordonlarsen P, Sotres-Alvarez D, Adair L, Popkin B. Using both principal component analysis and reduced rank regression to study dietary patterns and diabetes in Chinese adults. Public Health Nutr 2016; 19(2): 195.

  18. Paradis AM, Godin G, Pérusse L, Vohl MC. Associations between dietary patterns and obesity phenotypes. Int J Obes 2009; 33(12): 1419–26.

  19. Tsai YT, Liu JP, Tu YK, Lee MS, Chen PR, Hsu HC, et al. Relationship between dietary patterns and serum uric acid concentrations among ethnic Chinese adults in Taiwan. Asia Pac J Clin Nutr 2012; 21(2): 263–70.

  20. Choi HK, Curhan G. Beer, liquor, and wine consumption and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2004; 51(6): 1023–9.

  21. Gan Y, Cao LS, Tian HM, Ran XW, Cheng T, Gao Y. The relationship of metabolic syndrome and hyperuricemia of Yi-people in Xichang city. J Southwest Med University 2010; 33(6): 634–6. Chinese.

  22. Zhou AJ, Pan Q, Li AL, Qie YL, Wang QX, Gong Y. Predictive value of obesity and metabolism indexes for hyperuricemia among rural adult Yi residents in Liangshan region. Chinese J Public Health 2015; 31(12): 1646–50. Chinese.

  23. Liu B, Wang T, Zhao HN, Yue WW, Yu HP, Liu CX, et al. The prevalence of hyperuricemia in China: a meta-analysis. BMC Public Health 2011; 11(1): 1–10.

  24. Huang S, Liu X, Li H, Xu W, Jia H. Sex difference in the association of serum uric acid with metabolic syndrome and its components: a cross-sectional study in a Chinese Yi population. Postgrad Med 2017; 129(8): 828–33.

  25. Nagahama K, Iseki K, Inoue T, Touma T, Ikemiya Y, Takishita S. Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan. Hypertens Res 2004; 27(4): 227–33.

  26. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640–5.

  27. Zhang M, Chang H, Gao Y, Wang X, Xu W, Liu D, et al. Major dietary patterns and risk of asymptomatic hyperuricemia in Chinese adults. J Nutr Sci Vitaminol 2012; 58(5): 339–45.

  28. Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheumatol 2005; 52(1): 283–9.

  29. Xiong Z, Zhu C, Qian X, Zhu J, Wu Z, Chen L. Serum uric acid is associated with dietary and lifestyle factors in elderly women in suburban Guangzhou in Guangdong province of south China. J Nutr Health Aging 2013; 17(1): 30–4.

  30. Villegas R, Xiang YB, Elasy T, Xu WH, Cai H, Cai Q, et al. Purine-rich foods, protein intake, and the prevalence of hyperuricemia: the Shanghai Men’s Health Study. Nutr Metab Cardiovasc Dis 2012; 22(5): 409–16.

  31. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004; 350(11): 1093–103.

  32. Krízek V. Serum uric acid in relation to body weight. Ann Rheum Dis 1966; 25(25): 456–8.

  33. Carey DGP. Abdominal obesity. Curr Opin Lipidol 1998; 9(1): 35–40.

  34. Kontogianni MD, Chrysohoou C, Panagiotakos DB, Tsetsekou E, Zeimbekis A, Pitsavos C, et al. Adherence to the Mediterranean diet and serum uric acid: the ATTICA study. Scand J Rheumatol 2012; 41(6): 442–9.

  35. Li X, Song P, Li J, Wang P, Li G. Relationship between hyperuricemia and dietary risk factors in Chinese adults: a cross-sectional study. Rheumatol Int 2015; 35(12): 2079–89.

  36. Huang HY, Appel LJ, Choi MJ, Gelber AC, Charleston J, Norkus EP, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum 2005; 52(6): 1843–7.

  37. Gao X, Curhan G, Forman JP, Ascherio A, Choi HK. Vitamin C intake and serum uric acid concentration in men. J Rheumatol 2008; 35(9): 1853–8.

  38. Sorensen LF. Gout secondary to chronic renal disease: studies on urate metabolism. Ann Rheum Dis 1980; 39(5): 424–30.

How to Cite
Liu X, Huang S, Xu W, Zhou A, Li H, Zhang R, Liu Y, Yang Y, Jia H. Association of dietary patterns and hyperuricemia: a cross-sectional study of the Yi ethnic group in China. fnr [Internet]. 2018Apr.25 [cited 2018Oct.21];620. Available from:
Original Articles