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BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

The association between hyperuricemia and betel nut chewing in Taiwanese men: a cross-sectional study

Authors: Tsai-Sung Tai, Chih-Cheng Hsu, Hsiang-Chu Pai, Wen-Hsin Liu, Yueh-Han Hsu

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

Studies have associated betel nut chewing with cancers, metabolic syndrome, cardiovascular disorders, chronic kidney disease, and proteinuria. This study investigated whether hyperuricemia is associated with betel nut chewing in men who participated in a health check-up program.

Methods

From hospital records, we identified a total of 11,991 men who participated in the health check-up program from 2003 to 2009. They were divided into hyperuricemic group and non-hyperuricemic group. Laboratory tests, medical history, and status of cigarette smoking, alcohol consumption, and betel nut chewing were compared between the 2 groups. We calculated odds ratio (OR) and 95% confidence interval (CI) of hyperuricemia in association with betel nut consumption and other factors.

Results

Compared with the non-hyperuricemic group, the hyperuricemic group was slightly older (59.4 vs. 58.6 years) but less prevalent with betel nut use (11.8 vs. 13.6%, p = 0.003). Multivariable logistic regression analysis showed that hyperuricemia was negatively associated with betel nut chewing (OR 0.75, 95% CI 0.66-0.84), older age (OR 0.84, 95% CI 0.77-0.93), and diabetes mellitus (OR 0.57, 95% CI 0.50-0.64). On the other hand, hyperuricemia was positively associated with body mass index (OR 1.75, 95% CI 1.62-1.90), drinking (OR 1.36, 95% CI 1.25-1.49), hypertension (OR 1.41, 95% CI 1.30-1.52), mixed hyperlipidemia (OR 1.84, 95% CI 1.33-2.54), chronic kidney disease (OR 3.28, 95% CI 2.94-3.65), and proteinuria (OR 1.22, 95% CI 1.08-1.38). Smoking, hypercholesterolemia, and hypertriglyceridemia had no significant association with hyperuricemia.

Conclusion

Our data suggest that betel nut chewing is negatively associated with hyperuricemia.
Literature
1.
Gupta PC, Warnakulasuriya S: Global epidemiology of areca nut usage. Addict Biol. 2002, 7 (1): 77-83. 10.1080/13556210020091437.PubMed
2.
Gupta PC, Ray CS: Epidemiology of betel quid usage. Ann Acad Med Singapore. 2004, 33 (4 Suppl): 31-36.PubMed
3.
Ko YC, Chiang TA, Chang SJ, Hsieh SF: Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. J Oral Pathol Med. 1992, 21 (6): 261-264. 10.1111/j.1600-0714.1992.tb01007.x.PubMed
4.
Wang LY, You SL, Lu SN, Ho HC, Wu MH, Sun CA, Yang HI, Chien-Jen C: Risk of hepatocellular carcinoma and habits of alcohol drinking, betel quid chewing and cigarette smoking: a cohort of 2416 HBsAg-seropositive and 9421 HBsAg-seronegative male residents in Taiwan. Cancer Causes Control. 2003, 14 (3): 241-250. 10.1023/A:1023636619477.PubMed
5.
Yen AMF, Chiu YH, Chen LS, Wu HM, Huang CC, Boucher BJ, Chen THH: A population-based study of the association between betel-quid chewing and the metabolic syndrome in men. Am J Clin Nutr. 2006, 83: 1153-1160.PubMed
6.
Lin WY, Chiu TY, Lee LT, Lin CC, Huang CY, Huang KC: Betel nut chewing is associated with increased risk of cardiovascular disease and all-cause mortality in Taiwanese men. Am J Clin Nutr. 2008, 87 (5): 1204-1211.PubMed
7.
Yen AMF, Chen LS, Chiu YH, Boucher BJ, Chen TH: A prospective community-population-registry based cohort study of the association between betel-quid chewing and cardiovascular disease in men in Taiwan (KCIS no. 19). Am J Clin Nutr. 2008, 87 (1): 70-78.PubMed
8.
Heck JE, Marcotte EL, Argos M, Parvez F, Ahmed A, et al: Betel quid chewing in rural Bangladesh: prevalence, predictors and relationship to blood pressure. Int J Epidemiol. 2012, 41: 462-471. 10.1093/ije/dyr191.PubMed
9.
Hsu YH, Liu WH, Chen W, Kuo YC, Hsiao CY, Hung PH, Jong IC, Chiang PC, Hsu CC: Association of betel nut chewing with chronic kidney disease: a retrospective 7-year study in Taiwan. Nephrology (Carlton). 2011, 16 (8): 751-757. 10.1111/j.1440-1797.2011.01489.x.
10.
Liu WH, Hsu CC, Hsu YH: Chewing areca nut as an independent risk factor for proteinuria in middle-aged men. Gaoxiong Yi Xue Ke Xue Za Zhi. 2013, 29 (4): 214-220.PubMed
11.
Choi HK, Ford ES: Prevalence of the metabolic syndrome in individual with hyperuricemia. Am J Med. 2007, 120 (5): 442-447. 10.1016/j.amjmed.2006.06.040.PubMed
12.
Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P: Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension. 2000, 36 (6): 1072-1078. 10.1161/01.HYP.36.6.1072.PubMed
13.
Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, Weiss ST, Litonjua AA: Uric acid and the development of hypertension: the normative aging study. Hypertension. 2006, 48 (6): 1031-1036. 10.1161/01.HYP.0000248752.08807.4c.PubMed
14.
Chang HY, Tung CW, Lee PH, Lei CC, Hsu YC, Chang HH, Yang HF, Lu LC, Jong MC, Chen CY, et al: Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population. Am J Med Sci. 2010, 339 (6): 509-515.PubMed
15.
National Kidney Foundation: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002, 39 (2 Suppl 1): S1-S266.
16.
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): 3136-3141. 10.1002/art.30520.PubMed
17.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, et al: The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003, 289 (19): 2560-2572. 10.1001/jama.289.19.2560.PubMed
18.
The International Expert Committee: International expert committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009, 32 (7): 1327-1334.PubMedCentral
19.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002, 106 (25): 3121-3143.
20.
Lord GA, Lim CK, Warnakulasuriya S, Peters TJ: Chemical and analytical aspects of areca nut. Addict Biol. 2002, 7 (1): 99-102. 10.1080/13556210120091455.PubMed
21.
Kanbara A, Seyama I: Effect of urine pH on uric acid excretion by manipulating food materials. Nucleosides Nucleotides Nucleic Acids. 2011, 30 (12): 1066-1071. 10.1080/15257770.2011.596498.PubMed
22.
Kanbara A, Hakoda M, Seyama I: Urine alkalization facilitates uric acid excretion. Nutr J. 2010, 9: 45-10.1186/1475-2891-9-45.PubMedPubMedCentral
23.
Yuan HJ, Yang XG, Shi XY, Tian R, Zhao ZG: Association of serum uric acid with different levels of glucose and related factors. Chin Med J. 2011, 124 (10): 1443-1448.PubMed
24.
Bandaru P, Shankar A: Association between serum uric acid levels and diabetes mellitus. Int J Endocrinol. 2011, 2011: 604715-PubMedPubMedCentral
25.
Oda E, Kawai R, Sukumaran V, Watanabe K: Uric acid is positively associated with metabolic syndrome but negatively associated with diabetes in Japanese men. Intern Med. 2009, 48 (20): 1785-1791. 10.2169/internalmedicine.48.2426.PubMed
26.
Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q: Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes Res Clin Pract. 2007, 76 (1): 68-74. 10.1016/j.diabres.2006.07.022.PubMed
27.
Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H: Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol. 1988, 127 (2): 321-336.PubMed
28.
Herman JB, Medalie JH, Goldbourt U: Diabetes, prediabetes and uricaemia. Diabetologia. 1976, 12 (1): 47-52. 10.1007/BF01221964.PubMed
29.
Tu YK, Chien KL, Burley V, Gilthorpe MS: Unravelling the effects of age, period and cohort on metabolic syndrome components in a Taiwanese population using partial least squares regression. BMC Med Res Methodol. 2011, 11: 82-10.1186/1471-2288-11-82.PubMedPubMedCentral
30.
Ogura T, Matssra K, Matsumoto Y, Mimura Y, Kishida M, Otsuka F, Tobe K: Recent trends of hyperuricemia and obesity in Japanese male adolesents, 1991 through 2002. Metab Clin Exp. 2004, 53 (4): 448-453. 10.1016/j.metabol.2003.11.017.PubMed
31.
Grayson PC, Kim SY, LaValley M, Choi HK: Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011, 63 (1): 102-110. 10.1002/acr.20344.
32.
Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, Krotova K, Block ER, Prabhakar S, Johnson RJ: Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005, 67 (5): 1739-1742. 10.1111/j.1523-1755.2005.00273.x.PubMed
33.
Farquharson CA, Butler R, Hill A, Belch JJ, Struthers AD: Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation. 2002, 106 (2): 221-226. 10.1161/01.CIR.0000022140.61460.1D.PubMed
34.
Rao GN, Corson MA, Berk BC: Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem. 1991, 266 (13): 8604-8608.PubMed
35.
Perlstein TS, Gumieniak O, Hopkins PN, Murphey LJ, Brown NJ, Williams GH, Hollenberg NK, Fisher ND: Uric acid and the state of the intrarenal renin-angiotensin system in humans. Kidney Int. 2004, 66 (4): 1465-1470. 10.1111/j.1523-1755.2004.00909.x.PubMed
36.
Vargas SL, Toma I, Kang JJ, Meer EJ, Peti-Peterdi J: Activation of the succinate receptor GPR91 in macula densa cells causes renin release. J Am Soc Nephrol. 2009, 20 (5): 1002-1011. 10.1681/ASN.2008070740.PubMedPubMedCentral
37.
Mazzali M, Hughes J, Kim YG, Jefferson JA, Kang DH, Gordon KL, Lan HY, Kivlighn S, Johnson RJ: Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001, 38 (5): 1101-1106. 10.1161/hy1101.092839.PubMed
38.
Collantes Estevez E, Pineda Priego M, Anon Barbudo J, Sanchez Guijo P: Hyperuricemia-hyperlipemia association in the absence of obesity and alcohol abuse. Clin Rheumatol. 1990, 9 (1): 28-31. 10.1007/BF02030237.PubMed
39.
Collantes Estevez E, Tinahones Madueno FJ, Gonzalez Ruiz A, Anon Barbudo J, Pineda Priego M, Sanchez Guijo P: Renal excretion of urate by hyperuricaemic-hyperlipidemic patients. Clin Rheumatol. 1992, 11 (4): 498-501. 10.1007/BF02283105.PubMed
40.
Nakagawa T, Mazzali M, Kang DH, Kanellis J, Watanabe S, Sanchez-Lozada LG, Rodriguez-Iturbe B, Herrera-Acosta J, Johnson RJ: Hyperuricemia causes glomerular hypertrophy in the rat. Am J Nephrol. 2003, 23 (1): 2-7. 10.1159/000066303.PubMed
41.
Chonchol M, Shlipak MG, Katz R, Sarnak MJ, Newman AB, Siscovick DS, Kestenbaum B, Carney JK, Fried LF: Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007, 50 (2): 239-247. 10.1053/j.ajkd.2007.05.013.PubMed
42.
Cain L, Shankar A, Ducatman AM, Steenland K: The relationship between serum uric acid and chronic kidney disease among Appalachian adults. Nephrol Dial Transplant. 2010, 25 (11): 3593-3599. 10.1093/ndt/gfq262.PubMedPubMedCentral
43.
Tseng CH: Correlation of uric acid and urinary albumin excretion rate in patients with type 2 diabetes mellitus in Taiwan. Kidney Int. 2005, 68 (2): 796-801. 10.1111/j.1523-1755.2005.00459.x.PubMed
44.
Mazzali M, Kanellis J, Han L, Feng L, Xia YY, Chen Q, Kang DH, Gordon KL, Watanabe S, Nakagawa T, et al: Hyperuricemia induces a primary renal arteriolopathy in rats by a blood pressure-independent mechanism. Am J Physiol Renal Physiol. 2002, 282 (6): F991-F997.PubMed
45.
Kang DH, Nakagawa T, Feng L, Watanabe S, Han L, Mazzali M, Truong L, Harris R, Johnson RJ: A role for uric acid in the progression of renal disease. Clin J Am Soc Nephrol. 2002, 13 (12): 2888-2897. 10.1097/01.ASN.0000034910.58454.FD.
46.
Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa T, Wamsley A, Sheikh-Hamad D, Lan HY, Feng L, et al: Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension. 2003, 41 (6): 1287-1293. 10.1161/01.HYP.0000072820.07472.3B.PubMed
47.
Kang DH, Nakagawa T: Uric acid and chronic renal disease: possible implication of hyperuricemia on progression of renal disease. Semin Nephrol. 2005, 25 (1): 43-49. 10.1016/j.semnephrol.2004.10.001.PubMed
Metadata
Title
The association between hyperuricemia and betel nut chewing in Taiwanese men: a cross-sectional study
Authors
Tsai-Sung Tai
Chih-Cheng Hsu
Hsiang-Chu Pai
Wen-Hsin Liu
Yueh-Han Hsu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-1136

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