Korean J Fam Pract 2020; 10(3): 208-214  https://doi.org/10.21215/kjfp.2020.10.3.208
Relationship between Serum Uric Acid Level and Low-Density Lipoprotein Cholesterol in Korea Adults: Korea National Health and Nutrition Examination Survey 2017
Seungyong Lim, Nayeon Moon*
Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea
Nayeon Moon
Tel: +82-2-3784-1120, Fax: +82-2-2225-4374
E-mail: utodise0210@naver.com
ORCID: http://orcid.org/0000-0003-1578-4947
Received: September 9, 2019; Accepted: May 13, 2020; Published online: June 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Over the last few decades, the incidence of hyperuricemia has increased. Recently, the incidences of gout and asymptomatic hyperuricemia have been rapidly increasing in Korea. A correlation between serum uric acid (SUA) level and low-density lipoprotein cholesterol has already been identified, but it has been rarely studied in the Korean population. This study aimed to evaluate the correlation between serum uric acid level and LDL cholesterol using data from the Korea National Health and Nutrition Examination Survey (2017).
Methods: This was a cross-sectional study of 8,127 Korean adults aged 19–79 years. Individuals were cancer excluded. Participants were classified as having hyperuricemia if SUA levels were ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. The correlation between SUA level and LDL cholesterol was analyzed by complex sample linear regression analysis.
Results: In men, LDL cholesterol was higher in participants with hyperuricemia (120.6±1.61) than in normal individuals (114.3±0.84) (P<0.001). In women, LDL cholesterol was higher in participants with hyperuricemia (125.6±3.25) than in normal individuals (117.6±0.69) (P=0.0149). We used 3 models with progressive degrees of adjustment. Model 1 was adjusted for age, gender, alcohol, smoking, and body mass index. Model 2 was further adjusted for hypertension and diabetes. Model 3 was further adjusted for dyslipidemia, stroke, myocardial infarction or angina, and liver cirrhosis. After adjusting for potential confounders, LDL cholesterol was higher in the hyperuricemic group than in the normal group (P<0.001).
Conclusion: The study results confirm that a positive correlation exists between serum uric acid level and LDL cholesterol.
Keywords: Uric Acid; Low-Density Lipoprotein Cholesterol; Lipid Profile; Korean Adults
References
  1. Lee CH, Sung NY. The prevalence and features of Korean gout patients using the National Health Insurance Corporation database. J Rheum Dis 2011; 18: 94-100.
    CrossRef
  2. Park JS, Lee CH, Park KH, Park HJ, Kang MJ. The prevalence, incidence and metabolic syndrome associated risk factors of gout patients using national health insurance corporation database [Internet]. Goyang: National Health Insurance Service Ilsan Hospital; 2017 [cited 2017 Dec 30 ].
  3. Sharaf El Din UAA, Salem MM, Abdulazim DO. Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: a review. J Adv Res 2017; 8: 537-48.
    Pubmed KoreaMed CrossRef
  4. Forman JP, Choi H, Curhan GC. Plasma uric acid level and risk for incident hypertension among men. J Am Soc Nephrol 2007; 18: 287-92.
    Pubmed CrossRef
  5. Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007; 120: 442-7.
    Pubmed CrossRef
  6. Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA 2000; 283: 2404-10.
    Pubmed CrossRef
  7. Alderman MH, Cohen H, Madhavan S, Kivlighn S. Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension 1999; 34: 144-50.
    Pubmed CrossRef
  8. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63(25 Pt B): 2889-934.
  9. Lloyd-Jones DM, Morris PB, Ballantyne CM, Birtcher KK, Daly DD Jr, DePalma SM, et al. 2017 Focused update of the 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology task force on expert consensus decision pathways. J Am Coll Cardiol 2017; 70: 1785-822.
    Pubmed CrossRef
  10. Kuwabara M, Borghi C, Cicero AFG, Hisatome I, Niwa K, Ohno M, et al. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia: a five-year cohort study in Japan. Int J Cardiol 2018; 261: 183-8.
    Pubmed CrossRef
  11. Ali N, Rahman S, Islam S, Haque T, Molla NH, Sumon AH, et al. The relationship between serum uric acid and lipid profile in Bangladeshi adults. BMC Cardiovasc Disord 2019; 19: 42.
    Pubmed KoreaMed CrossRef
  12. Peng TC, Wang CC, Kao TW, Chan JY, Yang YH, Chang YW, et al. Relationship between hyperuricemia and lipid profiles in US adults. Biomed Res Int 2015; 2015: 127596.
    Pubmed KoreaMed CrossRef
  13. Dawson J, Walters M. Uric acid and xanthine oxidase: future therapeutic targets in the prevention of cardiovascular disease? Br J Clin Pharmacol 2006; 62: 633-44.
    Pubmed KoreaMed CrossRef
  14. Rho YH, Zhu Y, Choi HK. The epidemiology of uric acid and fructose. Semin Nephrol 2011; 31: 410-9.
    Pubmed KoreaMed CrossRef
  15. Lanaspa MA, Sanchez-Lozada LG, Choi YJ, Cicerchi C, Kanbay M, RoncalJimenez CA, et al. Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress: potential role in fructose-dependent and -independent fatty liver. J Biol Chem 2012; 287: 40732-44.
    Pubmed KoreaMed CrossRef
  16. Cicerchi C, Li N, Kratzer J, Garcia G, Roncal-Jimenez CA, Tanabe K, et al. Uric acid-dependent inhibition of AMP kinase induces hepatic glucose production in diabetes and starvation: evolutionary implications of the uricase loss in hominids. FASEB J 2014; 28: 3339-50.
    Pubmed KoreaMed CrossRef
  17. Kratzer JT, Lanaspa MA, Murphy MN, Cicerchi C, Graves CL, Tipton PA, et al. Evolutionary history and metabolic insights of ancient mammalian uricases. Proc Natl Acad Sci U S A 2014; 111: 3763-8.
    Pubmed KoreaMed CrossRef
  18. Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 2006; 290: F625-31.
    Pubmed CrossRef


This Article

e-submission

Archives