Characteristics of hyperuricemia in older adults in China and possible associations with sarcopenia

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Abstract

Objective

This cross‐sectional study aimed to investigate the characteristics and epidemiology of hyperuricemia in older adults in China and evaluate possible associations between hyperuricemia and sarcopenia.

Methods

Three hundred and eighty‐eight study subjects (>60 years old) meeting the inclusion criteria received blood tests and standardized examinations for bone mineral density, muscle mass, muscle strength, and physical performance. Data including demographic and clinical characteristic and comorbidity were also collected. All data were analyzed retrospectively.

Results

In the study population, higher uric acid levels were significantly correlated with higher muscle mass, grip strength, and bone density, but were unrelated to physical performance. When uric acid levels were separated into quartiles and the population was divided by sex, the correlation of uric acid to muscle mass was retained in some quartiles for both men and women, and the correlation to handgrip was only retained for one quartile for men. The correlation to bone density was retained in women in all analyses.

Conclusion

In the population as a whole, higher uric acid levels were significantly correlated with higher muscle mass, grip strength, and bone density, but had no relationship to physical performance. Differences between men and women in these relationships need to be studied further.

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Most cited references 20

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Insulin resistance and sarcopenia: mechanistic links between common co-morbidities.

Philip Atherton, Pauline M Jamieson, Mark E Cleasby (2016)

Insulin resistance (IR) in skeletal muscle is a key defect mediating the link between obesity and type 2 diabetes, a disease that typically affects people in later life. Sarcopenia (age-related loss of muscle mass and quality) is a risk factor for a number of frailty-related conditions that occur in the elderly. In addition, a syndrome of 'sarcopenic obesity' (SO) is now increasingly recognised, which is common in older people and is applied to individuals that simultaneously show obesity, IR and sarcopenia. Such individuals are at an increased risk of adverse health events compared with those who are obese or sarcopenic alone. However, there are no licenced treatments for sarcopenia or SO, the syndrome is poorly defined clinically and the mechanisms that might explain a common aetiology are not yet well characterised. In this review, we detail the nature and extent of the clinical syndrome, highlight some of the key physiological processes that are dysregulated and discuss some candidate molecular pathways that could be implicated in both metabolic and anabolic defects in skeletal muscle, with an eye towards future therapeutic options. In particular, the potential roles of Akt/mammalian target of rapamycin signalling, AMP-activated protein kinase, myostatin, urocortins and vitamin D are discussed.

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Prevalence of the metabolic syndrome in individuals with hyperuricemia.

Hyon K Choi, Earl S. Ford (2007)

The link between hyperuricemia and insulin resistance has been noted, but the prevalence of the metabolic syndrome by recent definitions among individuals with hyperuricemia remains unclear. Our objective was to determine the prevalence of the metabolic syndrome according to serum uric acid levels in a nationally representative sample of US adults. By using data from 8669 participants aged 20 years and more in The Third National Health and Nutrition Examination Survey (1988-1994), we determined the prevalence of the metabolic syndrome at different serum uric acid levels. We used both the revised and original National Cholesterol Education Program Adult Treatment Panel (NCEP/ATP) III criteria to define the metabolic syndrome. The prevalences of the metabolic syndrome according to the revised NCEP/ATP III criteria were 18.9% (95% confidence interval [CI], 16.8-21.0) for uric acid levels less than 6 mg/dL, 36.0% (95% CI, 32.5-39.6) for uric acid levels from 6 to 6.9 mg/dL, 40.8% (95% CI, 35.3-46.4) for uric acid levels from 7 to 7.9 mg/dL, 59.7% (95% CI, 53.0-66.4) for uric acid levels from 8 to 8.9 mg/dL, 62.0% (95% CI, 53.0-66.4) for uric acid levels from 9 to 9.9 mg/dL, and 70.7% for uric acid levels of 10 mg/dL or greater. The increasing trends persisted in subgroups stratified by sex, age group, alcohol intake, body mass index, hypertension, and diabetes. For example, among individuals with normal body mass index (<25 kg/m2), the prevalence increased from 5.9% (95% CI, 4.8-7.0), for a uric acid level of less than 6 mg/dL, to 59.0%, (95% CI, 20.1-97.9) for a uric acid level of 10 mg/dL or greater. With the original NCEP/ATP criteria, the corresponding prevalences were slightly lower. These findings from a nationally representative sample of US adults indicate that the prevalence of the metabolic syndrome increases substantially with increasing levels of serum uric acid. Physicians should recognize the metabolic syndrome as a frequent comorbidity of hyperuricemia and treat it to prevent serious complications.

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Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study.

Yves Rolland, William Reynish, Daniel Riviere … (2003)

To determine whether calf circumference (CC), related to appendicular skeletal muscle mass, can be used as a measure of sarcopenia and is related to physical function. Retrospective analysis of data from 1992 to 1994 of the European Patient Information and Documentation Systems Study. Community setting in France. One thousand four hundred fifty-eight French women aged 70 and older without previous history of hip fracture were recruited from the electoral lists. Muscular mass was assessed using dual-energy x-ray absorptiometry (DEXA). CC was measured using a tape measure. Anthropometric measurements (height; weight; and waist, hip, and calf circumference), strength markers (grip strength), and self-reported physical function were also determined. Sarcopenia was defined (using DEXA) as appendicular skeletal muscle mass (weight (kg)/height (m2)) less than two standard deviations below the mean of a young female reference group. The prevalence of sarcopenia was 9.5%. CC was correlated with appendicular skeletal muscle mass (r = 0.63). CC under 31 cm was the best clinical indicator of sarcopenia (sensitivity = 44.3%, specificity = 91.4%). CC under 31 cm was associated with disability and self-reported physical function but not sarcopenia (defined using DEXA), independent of age, comorbidity, obesity, income, health behavior, and visual impairment. CC cannot be used to predict sarcopenia defined using DEXA but provides valuable information on muscle-related disability and physical function.

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Author and article information

Contributors

Yun‐mei Yang:

ORCID: http://orcid.org/0000-0002-6646-4954

1194070@zju.edu.cn

Journal

Journal ID (nlm-ta): Aging Med (Milton)

Journal ID (iso-abbrev): Aging Med (Milton)

Journal ID (doi): 10.1002/(ISSN)2475-0360

Journal ID (publisher-id): AGM2

Title: Aging Medicine

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Electronic): 2475-0360

Publication date (Electronic): 30 March 2018

Publication date Collection: June 2018

Volume: 1

Issue: 1 ( doiID: 10.1002/agm2.2018.1.issue-1 )

Pages: 23-34

Affiliations

[ ¹ ] Department of Geriatrics First Affiliated Hospital School of Medicine Zhejiang University Hangzhou China

Author notes

[*] [* ] Correspondence

Yun‐mei Yang, Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Email: 1194070@ 123456zju.edu.cn

Author information

Yun‐mei Yang http://orcid.org/0000-0002-6646-4954

Article

Publisher ID: AGM212004

DOI: 10.1002/agm2.12004

PMC ID: 6880708

PubMed ID: 31942476

SO-VID: 1c0afd40-3b63-437b-bcf3-1d48c9a09f55

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

History

Date received : 16 November 2017

Date accepted : 29 November 2017

Page count

Figures: 0, Tables: 5, Pages: 12, Words: 9798

Funding

Funded by: National Natural Science Foundation of China , open-funder-registry 10.13039/501100001809;

Award ID: 81771497

Custom metadata

source-schema-version-number 2.0

cover-date June 2018

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:12.11.2019

Keywords: bone mineral density,hyperuricemia,muscle mass,older adults,sarcopenia,uric acid

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Keywords: bone mineral density, hyperuricemia, muscle mass, older adults, sarcopenia, uric acid

Characteristics of hyperuricemia in older adults in China and possible associations with sarcopenia

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Abstract

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China Occupational Medicine

Most cited references 20

Insulin resistance and sarcopenia: mechanistic links between common co-morbidities.

Prevalence of the metabolic syndrome in individuals with hyperuricemia.

Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study.

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