The Relationship between Hyperuricemia and Anemia in Postmenopausal Korean Women

Authors

Keywords:

anemia, uric acid, hyperuricemia, women, menopause

Abstract

Objective  The present study was conducted to assess the association of hyperuricemia and anemia in premenopausal and postmenopausal Korean women.

Methods  Data from 9,239 adults (aged ≥ 20 years) in the Korean National Health and Nutrition Examination Survey VII (2016–2018) were analyzed.

Results After adjustment for related variables (including age), the odds ratio (OR) of hyperuricemia (uric acid [UA] < 6.0 mg/dL), using the normal group (hemoglobin [Hb] ≥ 12.0 g/dL) as a reference, was statistically significantly positively associated with the anemia group (Hb < 12.0 g/dL) in postmenopausal women (OR, 1.615; 95% CI, 1.187–2.198).  In premenopausal women, after adjustment for the related variables (except age), the OR of hyperuricemia, with a normal group as a reference, was significantly inversely associated with the anemia group (OR, 0.583; 95% CI, 0.348–0.975). However, with further adjustment for age, hyperuricemia was no longer associated with anemia (OR, 0.679; 95% CI, 0.402–1.148).

Conclusions Hyperuricemia is positively associated with anemia in postmenopausal women but not in premenopausal women. 

References

Eun Y, Han K, Kim D, Kim I, Park E, Lee S, et al. Association between anemia and hyperuricemia: results from the Korean National Health and Nutrition Examination Survey. Sci Rep. 2019;9:19067. PubMed PMID: 31836793.

Smith E, March L. Global Prevalence of Hyperuricemia: A Systematic Review of Population-Based Epidemiological Studies [abstract]. Arthritis Rheumatol [Internet]. 2015; 67 (supple ment_10). Available from: https://acrabstracts.org/abstract/global-prevalence-of-hyperuricemia-a-systematic-review-of-population-based-epidemiological-studies/

Chen-Xu M, Yokose C, Rai S, Pillinger M, Choi H. Contemporary prevalence of gout and hyperuricemia in the united states and decadal trends: the national health and nutrition examination survey, 2007-2016. Arthritis Rheumatol. 2019;71:991–9.

Kim Y, Kang J, Kim G. Prevalence of hyperuricemia and its associated factors in the general Korean population: an analysis of a population-based nationally representative sample. Clin Rheumatol. 2018;37:2529–38.

Kim J, Kwak S, Lee H, Kim S, Choe J, Park S. Prevalence and incidence of gout in Korea: data from the national health claims database 2007-2015. Rheumatol Int. 2017;37:1499–506.

Kuwabara M. Hyperuricemia, cardiovascular disease, and hypertension. Pulse (Basel). 2016;3:242–52.

Oh T, Choi H, Kim C, Bae E, Ma S, Sung S, et al. Hyperuricemia has increased the risk of progression of chronic kidney disease: propensity score matching analysis from the KNOW-CKD study. Sci Rep. 2019;9:6681. PubMed PMID: 31040373

McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, who vitamin and mineral nutrition information system, 1993-2005. Public Health Nutr. 2009;12:444–54.

World Health Organization [Internet]. Iron deficiency anaemia: assessment, prevention, and control. A guide for Programme Managers. 2001 [cited 2024 Jun 28]. Available from: https://www.who.int/publications/m/item/iron-children-6to23--archived-iron-deficiency-anaemia-assessment-prevention-and-control

Cases A, Coll E, Collado S. Anemia en la insuficiencia renal crónica y sus implicaciones cardiovasculares [Anemia in chronic kidney disease and its cardiovascular implications]. Med Clin (Barc). 2009;132(Supplement_1):38–42.

Johnson R, Bakris G, Borghi C, Chonchol M, Feldman D, Lanaspa M, et al. Hyperuricemia, acute and chronic kidney disease, hypertension, and cardiovascular disease: report of a scientific workshop organized by the national kidney foundation. Am J Kidney Dis. 2018;71:851–65.

Song Y, Tang L, Han J, Gao Y, Tang B, Shao M, et al. Uric acid provides protective role in red blood cells by antioxidant defense: a hypothetical analysis. Oxid Med Cell Longev. 2019;2019:3435174. PubMed PMID: 31049132

Seo H, Mun C, Park C, Choi S, Hwang J, Lee J, et al. The relationship between hyperuricemia and anemia and metabolic syndrome in Korean adults: The Korea National Health and Nutrition Examination Survey 2019. Prim Care Diabetes. 2023;17:91–7.

Park S, Gi M, Cha J, Sung H, Park S, Park C, et al. The relationship between anemia and hyperuricemia and hypertension in Korean adults: the Korea National Health and Nutrition Examination Survey 2016-2018. Curr Med Res Opin. 2023;39:819–25.

Park C, Sung H, Jung E, Moon A, Kim H, Yoon H. Gender difference in the relationship between uric acid and pulse pressure among Korean adults. Clin Exp Hypertens. 2019;41:499–504.

Zhao L, Cao L, Zhao T, Yang X, Zhu X, Zou H, et al. Cardiovascular events in hyperuricemia population and a cardiovascular benefit-risk assessment of urate-lowering therapies: a systematic review and meta-analysis. Chin Med J (Engl). 2020;133:982-93.

Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014;15:122. PubMed PMID: 25064611

Wu J, Qiu L, Cheng X, Xu T, Wu W, Zeng X, et al. Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population. Sci Rep. 2017;7:5456. PubMed PMID: 28710367

Perez-Ruiz F, Becker M. Inflammation: a possible mechanism for a causative role of hyperuricemia/gout in cardiovascular disease. Curr Med Res Opin. 2015;31 (Supplement_2):9–14.

Hak A, Choi H. Menopause, postmenopausal hormone use and serum uric acid levels in US women--the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10:R116. PubMed PMID: 18822120

Jung J, Song G, Lee Y, Kim J, Hyun M, Choi S. Serum uric acid levels and hormone therapy type: a retrospective cohort study of postmenopausal women. Menopause. 2018;25:77–81.

Li X, He T, Yu K, Lu Q, Alkasir R, Guo G, et al. Markers of iron status are associated with risk of hyperuricemia among Chinese adults: nationwide population-based study. Nutrients. 2018;10:191. PubMed PMID: 29425155

Su P, Hong L, Zhao Y, Sun H, Li L. The Association Between Hyperuricemia and Hematological Indicators in a Chinese Adult Population. Medicine (Baltimore). 2016;95:e2822. PubMed PMID: 26886635

McAdams-DeMarco M, Maynard J, Coresh J, Baer A. Anemia and the onset of gout in a population-based cohort of adults: atherosclerosis risk in communities study. Arthritis Res Ther. 2012;14:R193. PubMed PMID: 22906142

Rodgers J, Jones J, Bolleddu S, Vanthenapalli S, Rodgers L, Shah K, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019;6:19. PubMed PMID: 31035613

Guo S, Liu Y, He S, Wu M, Tseng W, Wu R, et al. Differential relationship of uric acid to mortality and clinical biomarkers of aging according to grip strength in older adults: a cohort study. Aging (Albany NY). 2021;13:10555-83.

Chen Y, Liu Y, Wu P, Huang J, Su H, Chen S, et al. Synergetic association between anemia and hyperuricemia on new-onset chronic kidney disease in a large taiwanese population follow-up study. Int J Environ Res Public Health. 2023;20:1421. PubMed PMID: 36674173

Tandon V, Mahajan A, Sharma S, Sharma A. Prevalence of cardiovascular risk factors in postmenopausal women: A rural study. J Midlife Health. 2010;1:26–9.

Spiga R, Marini M, Mancuso E, Di Fatta C, Fuoco A, Perticone F, et al. Acid is associated with inflammatory biomarkers and induces inflammation via activating the NF-кB signaling pathway in HepG2 cells. Arterioscler Thromb Vasc Biol. 2017;37:1241–9.

Zhou Y, Zhao M, Pu Z, Xu G, Li X. Relationship between oxidative stress and inflammation in hyperuricemia: Analysis based on asymptomatic young patients with primary hyperuricemia. Medicine (Baltimore). 2018;97(49):e13108. PubMed PMID: 30544373

Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood. 2003;101:2461–3.

Kanamori Y, Murakami M, Sugiyama M, Hashimoto O, Matsui T, Funaba M. Hepcidin and IL-1. vitam horm. 2019;110:143–56.

Ganz T. Molecular pathogenesis of anemia of chronic disease. Pediatr Blood Cancer. 2006;46:554–7.

Bek S, Üstüner B, Eren N, Sentürk Z, Gönüllü B. The effect of hepcidin on components of metabolic syndrome in chronic kidney disease: a cross-sectional study. Rev Assoc Med Bras (1992). 2020;66:1100–7.

Patel S, Homaei A, Raju AB, Meher BR. Estrogen: The necessary evil for human health, and ways to tame it. Biomed Pharmacother. 2018;102:403-11.

Cho SK, Winkler CA, Lee SJ, Chang Y, Ryu S. The prevalence of hyperuricemia sharply increases from the late menopausal transition stage in middle-aged women. J Clin Med. 2019;8:296. PubMed PMID: 30832319

Qian Y, Yin C, Chen Y, Zhang S, Jiang L, Wang F, et al. Estrogen contributes to regulating iron metabolism through governing ferroportin signaling via an estrogen response element. Cell Signal. 2015;27:934–42.

Yang Q, Jian J, Katz S, Abramson S, Huang X. 17-Estradiol inhibits iron hormone hepcidin through an estrogen responsive element half-site. Endocrinology. 2012;153:3170–8.

Downloads

Published

2024-12-16

How to Cite

1.
Yoon H, Kim SG, Gi MY, Cha JA, Park SY, Park CH, Sung HH, Han ES. The Relationship between Hyperuricemia and Anemia in Postmenopausal Korean Women. BSCM [Internet]. 2024 Dec. 16 [cited 2024 Dec. 22];64(1). Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271857

Issue

Section

Original Article