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Sex-specific association between Chinese visceral adiposity index and hyperuricaemia among adults: a population-based cross-sectional study in Chongqing, China

Published online by Cambridge University Press:  04 April 2025

Youxing Luo ,
Rui Ding ,
Liling Chen ,
Yanqi Hu ,
Meng Xiao ,
Wenge Tang ,
Jinfu Qiu ,
Xiang Liu ,
Xianbin Ding  and
Xiaojun Tang Open the ORCID record for Xiaojun Tang [Opens in a new window]
Youxing Luo
Affiliation:
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, People’s Republic of China
Rui Ding
Affiliation:
First Clinical Medical College, Chongqing Medical University, Chongqing 400016, People’s Republic of China
Liling Chen
Affiliation:
Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400707, People’s Republic of China
Yanqi Hu
Affiliation:
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, People’s Republic of China
Meng Xiao
Affiliation:
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, People’s Republic of China
Wenge Tang
Affiliation:
Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400707, People’s Republic of China
Jinfu Qiu
Affiliation:
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, People’s Republic of China
Xiang Liu
Affiliation:
Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, People’s Republic of China
Xianbin Ding*
Affiliation:
Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400707, People’s Republic of China
Xiaojun Tang*
Affiliation:
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, People’s Republic of China
*
Corresponding authors: Xianbin Ding; Email: xianbinding@126.com; Xiaojun Tang; Email: tangxiaojun@cqmu.edu.cn
Corresponding authors: Xianbin Ding; Email: xianbinding@126.com; Xiaojun Tang; Email: tangxiaojun@cqmu.edu.cn
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Abstract

Research on the association between the Chinese visceral adiposity index (CVAI) and hyperuricaemia (HUA) is scarce, and whether the association differs by sex is unclear. This research aimed to explore sex-specific associations between CVAI and HUA and to compare CVAI’s predictive performance with other adiposity indices using data from 22 171 adults (30–79 years) in the China Multi-Ethnic Cohort study (Chongqing region). The prevalence of HUA was 20·9 % in men and 9·7 % in women. Multivariable logistic regression analyses were utilised to assess the adjusted OR and 95 % CI. After multivariable adjustment, CVAI was associated with HUA in men (OR Q4 v. Q1 = 3·31, 95 % CI 2·73, 4·03) and women (OR Q4 v. Q1 = 7·20, 95 % CI 5·12, 10·12). Moreover, significant interactions were observed between BMI and CVAI on HUA in both sexes (all Pinteraction < 0·001), with the strongest associations in those with BMI < 24·0 kg/m2. The OR (95 % CI) across different BMI groups (< 24·0, 24·0–27·9, ≥ 28·0 kg/m²) were 1·87 (1·63, 2·13), 1·65 (1·48, 1·85) and 1·30 (1·14, 1·49) for men and 2·76 (2·18, 3·51), 2·46 (1·98, 3·07) and 1·87 (1·47, 2·39) for women, respectively. Additionally, CVAI showed satisfactory predictive performance for HUA in women, with the largest area under the receiver operating characteristic curve of 0·735, but not in men (0·660). These findings suggest a close association between CVAI and HUA, particularly pronounced in those with BMI < 24·0 kg/m², and a stronger association in women than in men.

Keywords

Chinese visceral adiposity indexHyperuricaemiaAdiposity indicesAdultsCross-sectional study
Type
Research Article
Information
British Journal of Nutrition , First View , pp. 1 - 10
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Wu, XW, Lee, CC, Muzny, DM, et al. (1989) Urate oxidase: primary structure and evolutionary implications. Proc Natl Acad Sci 86, 9412–9416.Google Scholar
Singh, G, Lingala, B & Mithal, A (2019) Gout and hyperuricaemia in the USA: prevalence and trends. Rheumatology 58, 2177–2180.Google Scholar
Ting, K, Gill, TK, Keen, H, et al. (2016) Prevalence and associations of gout and hyperuricaemia: results from an Australian population-based study. Intern Med J 46, 566–573.Google Scholar
Dalbeth, N, Gosling, AL, Gaffo, A, et al. (2021) Gout. Lancet 397, 1843–1855.Google Scholar
Grayson, PC, Kim, SY, LaValley, M, et al. (2011) Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res 63, 102–110.Google Scholar
Zhao, G, Huang, L, Song, M, et al. (2013) Baseline serum uric acid level as a predictor of cardiovascular disease related mortality and all-cause mortality: a meta-analysis of prospective studies. Atherosclerosis 231, 61–68.Google Scholar
He, H, Pan, L, Ren, X, et al. (2021) The effect of body weight and alcohol consumption on hyperuricemia and their population attributable fractions: a national health survey in China. Obes Facts 15, 216–227.Google Scholar
Dehlin, M, Jacobsson, L & Roddy, E (2020) Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol 16, 380–390.Google Scholar
Song, P, Wang, H, Xia, W, et al. (2018) Prevalence and correlates of hyperuricemia in the middle-aged and older adults in China. Sci Rep 8, 4314.Google Scholar
Dong, X, Zhang, H, Wang, F, et al. (2020) Epidemiology and prevalence of hyperuricemia among men and women in Chinese rural population: the Henan Rural Cohort Study. Mod Rheumatol 30, 910–920.Google Scholar
Xiao, ML, Zhong, HL, Lin, HR, et al. (2022) Higher serum vitamin A is associated with a worsened progression of non-alcoholic fatty liver disease in adults: a prospective study. Food Funct 13, 970–977.Google Scholar
NCD Risk Factor Collaboration (NCD-RisC) (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet 387, 1377–1396.Google Scholar
Matsuura, F, Yamashita, S, Nakamura, T, et al. (1998) Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 47, 929–933.Google Scholar
Bai, R, Ying, X, Shen, J, et al. (2022) The visceral and liver fat are significantly associated with the prevalence of hyperuricemia among middle age and elderly people: a cross-sectional study in Chongqing, China. Front Nutr 9, 961792.Google Scholar
Takahashi, S, Yamamoto, T, Tsutsumi, Z, et al. (1997) Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism 46, 1162–1165.Google Scholar
Luo, Y, Ma, X, Shen, Y, et al. (2014) Positive relationship between serum low-density lipoprotein cholesterol levels and visceral fat in a Chinese nondiabetic population. PLoS One 9, e112715.Google Scholar
Qiao, T, Luo, T, Pei, H, et al. (2022) Association between abdominal obesity indices and risk of cardiovascular events in Chinese populations with type 2 diabetes: a prospective cohort study. Cardiovasc Diabetol 21, 225.Google Scholar
Deurenberg, P, Deurenberg-Yap, M & Guricci, S (2002) Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3, 141–146.Google Scholar
Camhi, SM, Bray, GA, Bouchard, C, et al. (2011) The relationship of waist circumference and BMI to visceral, subcutaneous, and total body fat: sex and race differences. Obesity (Silver Spring) 19, 402–408.Google Scholar
Xia, MF, Chen, Y, Lin, HD, et al. (2016) A indicator of visceral adipose dysfunction to evaluate metabolic health in adult Chinese. Sci Rep 6, 38214.Google Scholar
Li, B, Wang, J, Zhou, X, et al. (2022) Chinese visceral adiposity index is more closely associated with hypertension and prehypertension than traditional adiposity indices in Chinese population: results from the REACTION study. Front Endocrinol (Lausanne) 13, 921997.Google Scholar
Huang, YC, Huang, JC, Lin, CI, et al. (2021) Comparison of innovative and traditional cardiometabolic indices in estimating atherosclerotic cardiovascular disease risk in adults. Diagn (Basel) 11, 603.Google Scholar
Wan, H, Wang, Y, Xiang, Q, et al. (2020) Associations between abdominal obesity indices and diabetic complications: chinese visceral adiposity index and neck circumference. Cardiovasc Diabetol 19, 118.Google Scholar
Wang, D, Wang, X & Yin, F (2022) Correlation between Chinese visceral adipose index and type 2 diabetes mellitus complicated by hyperuricemia. Hebei Med J 44, 1699–1701,1705 (in Chinese).Google Scholar
Zhang, H, Qu, S, Qiu, H, et al. (2023) Predictive ability of different obesity index for hyperuricemia. Mod Prev Med 50, 1908–1915 (in Chinese).Google Scholar
Su, SY, Lin, TH, Liu, YH, et al. (2023) Sex difference in the associations among obesity-related indices with hyperuricemia in a large Taiwanese Population Study. Nutrients 15, 3419.Google Scholar
Zhao, X, Hong, F, Yin, J, et al. (2021) Cohort profile: the China Multi-Ethnic Cohort (CMEC) study. Int J Epidemiol 50, 721–721l.Google Scholar
Levey, AS, Stevens, LA, Schmid, CH, et al. (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150, 604–612.Google Scholar
Feig, DI, Kang, DH & Johnson, RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359, 1811–1821.Google Scholar
Amato, MC, Giordano, C, Galia, M, et al. (2010) Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 33, 920–922.Google Scholar
Wakabayashi, I & Daimon, T (2015) The ‘cardiometabolic index’ as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta 438, 274–278.Google Scholar
Kahn, HS (2005) The ‘lipid accumulation product’ performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord 5, 26.Google Scholar
Ao, L, Zhou, J, Han, M, et al. (2022) The joint effects of physical activity and air pollution on type 2 diabetes in older adults. BMC Geriatr 22, 472.Google Scholar
Ainsworth, BE, Haskell, WL, Whitt, MC, et al. (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32, S498–504.Google Scholar
Fung, TT, Chiuve, SE, McCullough, ML, et al. (2008) Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168, 713–720.Google Scholar
WS/T 428–2013 (2013) Criteria of Weight for Adults. Beijing, China: Standard Press of China.Google Scholar
Joint Committee for Guideline Revision (2019) 2018 Chinese guidelines for prevention and treatment of hypertension-a report of the revision committee of Chinese guidelines for prevention and treatment of hypertension. J Geriatr Cardiol 16, 182–241.Google Scholar
American Diabetes Association (2017) 2. Classification and diagnosis of diabetes. Diabetes Care 40, S11–S24.Google Scholar
Huang, X, Jiang, X, Wang, L, et al. (2019) Visceral adipose accumulation increased the risk of hyperuricemia among middle-aged and elderly adults: a population-based study. J Transl Med 17, 341.Google Scholar
Dong, X, Li, Y, Yang, K, et al. (2020) Mediation effect of body mass index on the association between spicy food intake and hyperuricemia in rural Chinese adults: the Henan rural cohort study. BMC Public Health 20, 1629.Google Scholar
DeLong, ER, DeLong, DM & Clarke-Pearson, DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44, 837–845.Google Scholar
Mirmiran, P, Bahadoran, Z & Azizi, F (2014) Lipid accumulation product is associated with insulin resistance, lipid peroxidation, and systemic inflammation in type 2 diabetic patients. Endocrinol Metab (Seoul) 29, 443–449.Google Scholar
Link, JC & Reue, K (2017) Genetic basis for sex differences in obesity and lipid metabolism. Annu Rev Nutr 37, 225–245.Google Scholar
Liu, XZ, Li, HH, Huang, S, et al. (2019) Association between hyperuricemia and nontraditional adiposity indices. Clin Rheumatol 38, 1055–1062.Google Scholar
Battelli, MG, Bortolotti, M, Polito, L, et al. (2018) The role of xanthine oxidoreductase and uric acid in metabolic syndrome. Biochim Biophys Acta Mol Basis Dis 1864, 2557–2565.Google Scholar
Tsushima, Y, Nishizawa, H, Tochino, Y, et al. (2013) Uric acid secretion from adipose tissue and its increase in obesity. J Biol Chem 288, 27138–27149.Google Scholar
Furuhashi, M, Koyama, M, Higashiura, Y, et al. (2020) Differential regulation of hypoxanthine and xanthine by obesity in a general population. J Diabetes Investig 11, 878–887.Google Scholar
Kanaya, AM, Harris, T, Goodpaster, BH, et al. (2004) Adipocytokines attenuate the association between visceral adiposity and diabetes in older adults. Diabetes Care 27, 1375–1380.Google Scholar
Tanaka, S, Togashi, K, Rankinen, T, et al. (2004) Sex differences in the relationships of abdominal fat to cardiovascular disease risk among normal-weight white subjects. Int J Obes Relat Metab Disord 28, 320–323.Google Scholar
Blaak, E (2001) Gender differences in fat metabolism. Curr Opin Clin Nutr Metab Care 4, 499–502.Google Scholar
Kong, M, Xu, M, Zhou, Y, et al. (2022) Assessing visceral obesity and abdominal adipose tissue distribution in healthy populations based on computed tomography: a large multicenter cross-sectional study. Front Nutr 9, 871697.Google Scholar
Kang, J, Baek, SE, Kim, T, et al. (2012) Impact of fat obesity on laparoscopic total mesorectal excision: more reliable indicator than body mass index. Int J Colorectal Dis 27, 497–505.Google Scholar
Fathallah-Shaykh, SA & Cramer, MT (2014) Uric acid and the kidney. Pediatr Nephrol 29, 999–1008.Google Scholar
Fryk, E, Olausson, J, Mossberg, K, et al. (2021) Hyperinsulinemia and insulin resistance in the obese may develop as part of a homeostatic response to elevated free fatty acids: a mechanistic case-control and a population-based cohort study. EBioMedicine 65, 103264.Google Scholar
Liu, H, Song, X, Zhu, J, et al. (2022) The elevated visceral adiposity index increases the risk of hyperuricemia in Chinese hypertensive patients: a cross-sectional study. Front Endocrinol (Lausanne) 13, 1038971.Google Scholar
Quiñones Galvan, A, Natali, A, Baldi, S, et al. (1995) Effect of insulin on uric acid excretion in humans. Am J Physiol 268, E1–5.Google Scholar
Seyed-Sadjadi, N, Berg, J, Bilgin, AA, et al. (2017) Visceral fat mass: is it the link between uric acid and diabetes risk? Lipids Health Dis 16, 142.Google Scholar
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