Demographic characteristics
A total of 7,806 participants (4,180 female, 53.54% and 3,626 male, 46.45%) aged 18–94 years with average age 50 (15) years were included in the study. Among all participants, 70.52% were from rural areas, and 88.39% had an education level of high school or below. Participants were from communities with an average urban index of 66.83 (19.40). Participants’ average BMI and physical activity range were 23.36 (3.47) kg/m2 and 0–31,830.00, respectively. The details of food intake, nutrient intake, and serum uric acid levels among participants are shown in Tables 4 and 5.
The correlation of participants’ serum uric acid levels with BMI and urban index were all positive, with correlation coefficients r = 0.092 and r = 0.185 (P < 0.001), respectively. The correlation of participants’ serum uric acid levels with the physical activity was negative, with correlation coefficient r = −0.023 (P = 0.040). Participants who were older, male, separated, from urban areas, ever smokers, and those with higher education levels had significantly higher serum uric acid levels (P < 0.01). See Table 1 for details.
Table 1 Participants’ demographic characteristics and the distribution of serum uric acid levels (n=7806)
Characteristic
|
N(N%)
|
Serum uric acid level (mg/mL)
|
Mean (SD)
|
t/F
|
P
|
Age
18-59 years
60- years
|
5627 (72.08)
2179 (27.91)
|
5.09 (1.86)
5.39 (4.56)
|
7.131
|
<0.001
|
Gender
Female
Male
|
4180 (53.54)
3626 (46.45)
|
4.48 (1.36)
5.96 (1.89)
|
39.152
|
<0.001
|
Marital status
Unmarried
Married
Divorced
Widowed
Separated
|
445 (5.70)
6625 (84.87)
79 (1.01)
609 (7.80)
48 (0.61)
|
5.46 (2.31)
5.15 (1.77)
5.00 (1.48)
5.18 (1.52)
5.64 (1.57)
|
4.202
|
0.002
|
Education level
Illiterate/primary
Middle school/high school
Above
|
3443 (44.11)
3457 (44.29)
906 (11.61)
|
5.06 (1.67)
5.18 (1.75)
5.58 (2.27)
|
12.000
|
<0.001
|
Registered resident type
Urban
Rural
|
2301 (29.48)
5505 (70.52)
|
5.39 (1.94)
5.08 (1.71)
|
6.572
|
<0.001
|
Smoking
None
Ever
Current
|
5400 (69.18)
255 (3.27)
2151 (27.56)
|
4.88 (1.70)
5.91 (1.62)
5.83 (1.81)
|
257.677
|
<0.001
|
Latent profiles of dietary patterns
We examined latent profiles of participants’ plant-based dietary patterns. The LPA model fitting parameters are listed in Table 2. Model fit information for the five different models is listed, ranging from Profile 2 to Profile 5. In terms of the Lo–Mendell–Rubin likelihood ratio (LMRT) and bootstrap likelihood ratio (BLRT), P-values for the Profile 2 and Profile 3 models were both <0.05 (statistically significant). Profile 3 had lower Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values compared with Profile 2. The entropy in Profile 3 was 0.937 > 0.800. We found that the accuracy of classification was greater than 90.00% [29]. The Profile 3 model was better than the other models in this study.
Table 2 Fit indices for Profile 2 through 5 models
Profiles
|
LogL
|
AIC
|
BIC
|
aBIC
|
Entropy
|
LMRT
|
BLRT
|
2
|
-236220.541
|
472473.082
|
472584.485
|
472533.640
|
0.954
|
0.018
|
<0.01
|
3
|
-234906.914
|
469857.828
|
470011.006
|
469941.095
|
0.935
|
<0.001
|
<0.001
|
4
|
-233765.886
|
467587.773
|
467782.727
|
467693.749
|
0.937
|
0.435
|
<0.001
|
5
|
-232925.060
|
465918.121
|
466154.851
|
466046.806
|
0.933
|
0.115
|
<0.001
|
The latent profiles of participants’ animal-based dietary patterns were examined. The LPA model fitting parameters are listed in Table 3. The model fit information for the five different models is listed, ranging from Profile 2 to Profile 5. In terms of the LMRT and BLRT, P-values for the Profile 2 and Profile 3 models were both <0.05 (statistically significant). Profile 3 had lower AIC and BIC values compared with Profile 2. The entropy in Profile 3 was 0.968 > 0.800. The accuracy of classification was greater than 90.00% [29]. The Profile 3 model was better than the other models in this study.
Table 3 Fit indices for Profile 2 through 5 models
Profiles
|
LogL
|
AIC
|
BIC
|
aBIC
|
Entropy
|
LMRT
|
BLRT
|
2
|
-201762.416
|
403556.832
|
403668.234
|
403617.389
|
0.999
|
0.321
|
<0.01
|
3
|
-200530.816
|
401105.632
|
401258.811
|
401188.899
|
0.968
|
0.047
|
<0.001
|
4
|
-199170.235
|
398396.470
|
398591.424
|
398502.445
|
0.966
|
0.483
|
<0.001
|
5
|
-198071.225
|
396210.449
|
396447.179
|
396339.134
|
0.957
|
0.426
|
<0.001
|
Food and nutrient intake in different latent profiles of dietary patterns
The food and nutrient intakes for each identified profile of plant-based dietary patterns are shown in Tables 4 and 5.
We found that participants with a Profile 2 dietary pattern had higher intake of cereals and cereal products, tuber starches and products, and vegetables and vegetable products than those with Profiles 1 and 3 (P < 0.001). Participants with a Profile 3 dietary pattern had higher intakes of dried legumes and legume products, and fruit and fruit products than those with Profiles 1 and 2 (P < 0.001). Participants with a Profile 1 dietary pattern had lower intakes of tuber starches and products, and vegetables and vegetable products than those with Profiles 2 and 3 (P < 0.001). See Table 4 for details.
Participants with a Profile 1 dietary pattern had the highest intakes of vitamin A and calcium (P < 0.01). We also found that Profile 3 had the highest intake of energy, lipids, carbohydrate, protein, dietary fiber, thiamine, riboflavin, niacin, vitamin C, vitamin E, phosphorus, potassium, sodium, magnesium, iron, zinc, selenium, copper, and manganese (P < 0.01). Profile 2 had higher intakes of protein, lipids, thiamine, riboflavin, niacin, vitamin C, vitamin E, phosphorus, potassium, sodium, iron, zinc, selenium, copper, and manganese than Profile 1 (P < 0.01). See Table 5 for details.
The characteristics of the Profile 1 dietary pattern comprised the lowest intakes of tuber starches and products and of vegetables and vegetable products. The characteristics of the dietary pattern in Profile 2 showed higher intakes of cereals and cereal products, tubes starches and products, and vegetables and vegetable products. The characteristics of the dietary patterns in Profile 3 included the highest intake of dried legumes and legume products and fruit and fruit products. Based on the characteristics of these plant-based dietary pattern profiles, we denoted Profile 1–6 dietary patterns as the low tuber starches and vegetable plant-based diet (LTVP), high cereal, tuber starches, and vegetable plant-based diet (HCTVP), and high legume and fruit plant-based diet (HLFP), respectively. See Table 4 for details.
Table 4 Daily dietary food intakes in latent profiles of plant-based dietary patterns
|
All
|
Latent Dietary Patterns (P50)
|
Food intakes
|
P25
|
P50
|
P75
|
Pattern 1
LTVP
|
Pattern 2
HCTVP
|
Pattern 3
HLFP
|
Cereals and cereal products
|
283.330
|
366.670
|
480.000
|
363.330
|
444.830
|
318.335
|
Tubers starches and products
|
0
|
0
|
56.670
|
0
|
166.670
|
33.330
|
Dried legumes and legume products
|
0
|
33.330
|
83.330
|
33.330
|
8.330
|
50.000
|
Vegetables and vegetable products
|
200.000
|
300.000
|
408.330
|
300.000
|
333.330
|
306.670
|
Fruit and fruit products
|
0
|
0
|
66.670
|
0
|
0
|
330.000
|
Table 5 Daily dietary nutrient intakes in latent profiles of plant-based dietary patterns
|
All
|
Latent Dietary Patterns (P50)
|
Nutrients intake
|
P25
|
P50
|
P75
|
LTVP
|
HCTVP
|
HLFP
|
Energy (kcal)
|
2953.00
|
3571.00
|
4302.50
|
3556.00
|
3575.00
|
3769.50
|
Protein (g)
|
84.20
|
107.30
|
139.20
|
108.20
|
100.40
|
109.75
|
Lipid (g)
|
12.00
|
21.10
|
40.00
|
21.80
|
14.90
|
26.00
|
Carbohydrate (g)
|
612.10
|
755.40
|
890.90
|
752.00
|
772.80
|
794.80
|
Dietary fiber (g)
|
19.90
|
27.40
|
39.70
|
27.10
|
26.00
|
33.15
|
Cholesterol (mg)
|
0.00
|
0.00
|
0.00
|
0.00
|
0.00
|
0.00
|
Vitamin A (mg)
|
295.00
|
644.00
|
1201.00
|
684.00
|
384.00
|
638.00
|
Thiamine (mg)
|
1.34
|
1.73
|
2.30
|
1.71
|
1.77
|
1.90
|
Riboflavin (mg)
|
0.96
|
1.19
|
1.52
|
1.19
|
1.13
|
1.34
|
Niacin (mg)
|
19.50
|
23.80
|
28.91
|
23.50
|
24.92
|
25.38
|
Vitamin C (mg)
|
151.00
|
226.00
|
334.00
|
221.00
|
243.00
|
269.50
|
Vitamin E (mg)
|
14.67
|
23.05
|
38.86
|
22.87
|
19.85
|
32.29
|
Calcium (mg)
|
538.00
|
757.00
|
1047.00
|
772.00
|
597.00
|
771.50
|
Phosphorus (mg)
|
1421.00
|
1787.00
|
2345.00
|
1792.00
|
1667.00
|
1832.00
|
Potassium (mg)
|
2664.75
|
3449.00
|
4418.25
|
3368.00
|
3756.00
|
4141.00
|
Sodium (mg)
|
365.48
|
637.05
|
1083.30
|
647.00
|
544.00
|
661.05
|
Magnesium (mg)
|
494.75
|
630.00
|
844.00
|
625.00
|
620.00
|
698.50
|
Iron (mg)
|
31.60
|
39.90
|
52.60
|
40.10
|
37.20
|
40.90
|
Zinc (mg)
|
15.98
|
19.50
|
24.14
|
19.53
|
18.55
|
20.47
|
Selenium (mg)
|
36.92
|
52.68
|
71.72
|
53.00
|
50.60
|
51.49
|
Copper (mg)
|
3.23
|
4.17
|
5.45
|
4.13
|
4.04
|
4.93
|
Manganese (mg)
|
11.43
|
14.32
|
18.03
|
14.41
|
13.26
|
14.54
|
The intakes of foods and nutrients in each identified profile of animal-based dietary patterns are shown in Tables 6 and 7.
Participants with a Profile 1 dietary pattern had higher intakes of milk and milk products and eggs and egg products than those with Profile 2 and 3 dietary patterns (P < 0.001). Participants with a Profile 3 dietary pattern had higher intakes of meat and meat products and fish shellfish, and mollusks. Participants with a Profile 2 dietary pattern had lower intakes of eggs and egg products, fish shellfish, and mollusks than those with Profiles 1 and 3 (P < 0.001). See Table 6 for details.
Participants with a Profile 1 dietary pattern had the highest intakes of energy, carbohydrate, cholesterol, vitamin A, thiamine, riboflavin, vitamin C, calcium, phosphorus, potassium, sodium, and selenium (P < 0.01). The Profile 3 dietary pattern had the highest intake of protein, lipids, niacin, vitamin E, magnesium, iron, zinc, copper, and manganese (P < 0.01). See Table 7 for details.
The characteristics of the Profile 1 dietary pattern included highest intakes of milk and milk products and eggs and egg products. The characteristics of the dietary patterns in Profile 2 included the lowest intakes of eggs and egg products and fish, shellfish, and mollusks. The characteristics of the dietary patterns in Profile 3 included the highest intakes of meat and meat products and fish, shellfish, and mollusks. Based on the characteristics of these animal-based dietary pattern profiles, we denoted the Profile 1–6 dietary patterns as the high milk and egg animal-based diet (HMiEA), low egg and fish animal-based diet (LEFA), and high meat and fish animal-based diet (HMeFA), respectively. See Table 6 for details.
Table 6 Daily dietary food intakes in latent profiles of animal-based dietary patterns
|
All
|
Latent Dietary Patterns (P50)
|
Food intakes
|
P25
|
P50
|
P75
|
Pattern 1
HMiEA
|
Pattern 2
LEFA
|
Pattern 3
HMeFA
|
Meat and meat products
|
16.670
|
60.000
|
108.330
|
66.670
|
60.000
|
73.330
|
Poultry and poultry products
|
0
|
0
|
0
|
0
|
0
|
0
|
Milk and milk products
|
0
|
0
|
0
|
222.000
|
0
|
0
|
Eggs and egg products
|
0
|
20.000
|
48.330
|
40.000
|
20.000
|
26.670
|
Fish shellfish and mollusc
|
0
|
0
|
50.000
|
28.330
|
0
|
180.000
|
Table 7 Daily dietary nutrient intakes in latent profiles of animal-based dietary patterns
|
All
|
Latent Dietary Patterns (P50)
|
Nutrients intake
|
P25
|
P50
|
P75
|
HMiEA
|
LEFA
|
HMeFA
|
Energy (kcal)
|
600.00
|
1212.00
|
1940.00
|
1757.00
|
1150.00
|
1734.00
|
Protein (g)
|
39.90
|
78.85
|
120.83
|
122.10
|
71.20
|
133.70
|
Lipid (g)
|
39.50
|
91.60
|
154.83
|
120.60
|
86.85
|
124.40
|
Carbohydrate (g)
|
5.60
|
11.10
|
18.60
|
28.10
|
10.20
|
18.80
|
Dietary fiber (g)
|
0.00
|
0.00
|
0.00
|
0.00
|
0.00
|
0.00
|
Cholesterol (mg)
|
505.00
|
1065.00
|
1755.00
|
1626.00
|
985.00
|
1608.00
|
Vitamin A (mg)
|
126.00
|
346.50
|
628.00
|
648.00
|
324.00
|
532.00
|
Thiamine (mg)
|
0.38
|
0.78
|
1.36
|
1.21
|
0.74
|
1.02
|
Riboflavin (mg)
|
0.52
|
0.91
|
1.40
|
1.65
|
0.85
|
1.38
|
Niacin (mg)
|
6.00
|
14.00
|
23.70
|
20.05
|
12.65
|
22.10
|
Vitamin C (mg)
|
0.00
|
0.00
|
0.00
|
2.00
|
0.00
|
0.00
|
Vitamin E (mg)
|
2.19
|
4.40
|
7.25
|
6.96
|
4.04
|
9.10
|
Calcium (mg)
|
62.00
|
137.00
|
259.00
|
516.00
|
121.00
|
385.00
|
Phosphorus (mg)
|
422.00
|
810.00
|
1248.50
|
1414.00
|
746.00
|
1398.00
|
Potassium (mg)
|
559.00
|
1060.00
|
1702.25
|
1961.00
|
970.00
|
1934.00
|
Sodium (mg)
|
244.60
|
441.20
|
789.00
|
875.50
|
400.40
|
813.80
|
Magnesium (mg)
|
42.00
|
89.00
|
148.00
|
161.00
|
80.00
|
188.00
|
Iron (mg)
|
5.00
|
9.40
|
15.40
|
14.90
|
8.80
|
15.60
|
Zinc (mg)
|
4.26
|
8.97
|
14.68
|
14.05
|
8.24
|
14.11
|
Selenium (mg)
|
35.91
|
66.90
|
105.51
|
108.69
|
61.50
|
130.75
|
Copper (mg)
|
0.27
|
0.50
|
0.88
|
0.87
|
0.46
|
0.97
|
Manganese (mg)
|
0.10
|
0.20
|
0.36
|
0.37
|
0.18
|
0.51
|
Relationship between individual serum uric acid levels and dietary patterns
There was no significant difference in participants’ serum uric acid levels according to different types of plant-based dietary patterns (F = 1.176, P > 0.05). We found a significant difference in serum uric acid levels between different types of animal-based dietary patterns (F = 32.792, P < 0.001). Participants who followed an HMeFA diet (participants’ mean serum uric acid 5.82mg/mL) had higher serum uric acid levels than those who had an HMiEA diet (participants’ mean serum uric acid 5.12) and LEFA diet (participants’ mean serum uric acid 5.12) (P<0.01).
Table 8 shows the association between the plant/animal-based dietary pattern and participants’ serum uric acid levels. In the unadjusted model, significant coefficients for serum uric acid levels were observed for the HEMA diet (β = 0.027, P = 0.018) and the HMeFA diet (β = 0.089, P < 0.001). Furthermore, in the adjusted model, significant coefficients for participants’ serum uric acid levels were observed for the HCTVP diet (β = −0.022, P = 0.031) and HMeFA diet (β = 0.061, P < 0.001).
Table 8. Association between dietary patterns and serum uric acid levels
Model^
|
Serum uric acid level
|
Plant-based dietary pattern
|
Animal-based dietary pattern
|
LTVP
|
HCTVP
|
HLFP
|
HMiEA
|
LEFA
|
HMeFA
|
Model I†
|
β
|
0.017
|
-
|
-0.003
|
0.027
|
-
|
0.089
|
P
|
0.252
|
-
|
0.823
|
0.018
|
-
|
<0.001
|
Model II‡
|
β
|
-
|
-0.022
|
<0.001
|
0.016
|
-
|
0.061
|
P
|
-
|
0.031
|
0.998
|
0.110
|
-
|
<0.001
|
† Pattern HCTVP and LEFA was the reference. ‡ Pattern LTVP and LEFA was the reference. Pattern HCTVP and LEFA was the reference Model I was unadjusted model. Model II was adjusted for gender, age, martial status, education level, registered resident type, urban index, BMI, smoking and physical activity.