Table 1 Baseline characteristics of participants (N =4319).
Characteristic
|
Serum uric acid Quartiles (mg/dL)
|
P value
|
Q1
|
Q2
|
Q3
|
Q4
|
No. of participants
|
1035
|
1055
|
1067
|
1162
|
|
Age (years, mean ± sd)
|
45.24 ± 16.63
|
44.28 ± 17.27
|
48.95 ± 17.42
|
48.16 ± 18.18
|
<0.0001
|
Gender (%)
|
|
|
|
|
<0.0001
|
Male
|
14.80
|
39.08
|
60.74
|
77.73
|
|
Female
|
85.20
|
60.92
|
39.26
|
22.27
|
|
Race (%)
|
|
|
|
|
0.0759
|
Mexican American
|
10.45
|
9.20
|
9.25
|
9.55
|
|
Other Hispanic
|
8.01
|
7.29
|
6.64
|
5.98
|
|
Non-Hispanic White
|
63.19
|
63.89
|
66.53
|
61.37
|
|
Non-Hispanic Black
|
10.41
|
9.81
|
8.90
|
11.35
|
|
Other Race
|
7.95
|
9.81
|
8.69
|
11.76
|
|
Marital status (%)
|
|
|
|
|
0.1955
|
Married or living with partner
|
62.89
|
57.44
|
60.44
|
60.99
|
|
Single
|
33.75
|
38.47
|
36.69
|
35.66
|
|
Other
|
3.36
|
4.08
|
2.87
|
3.36
|
|
Education level (%)
|
|
|
|
|
0.0893
|
Below high school education
|
9.96
|
9.37
|
9.15
|
10.64
|
|
High school graduate
|
22.89
|
26.55
|
29.25
|
24.99
|
|
College graduate
|
63.78
|
59.99
|
58.64
|
60.98
|
|
Not recorded
|
3.36
|
4.09
|
2.96
|
3.39
|
|
BMI (%)
|
|
|
|
|
<0.0001
|
<30(kg/m2)
|
72.74
|
61.89
|
52.05
|
43.61
|
|
≥30
|
27.26
|
38.11
|
47.95
|
56.39
|
|
Smoking behavior (%)
|
|
|
|
|
<0.0001
|
Yes
|
33.84
|
40.59
|
44.12
|
43.24
|
|
No
|
66.16
|
59.41
|
55.88
|
56.76
|
|
Alcohol intake (%)
|
|
|
|
|
<0.0001
|
Low
|
28.35
|
29.17
|
24.52
|
24.73
|
|
Medium
|
26.76
|
22.80
|
19.80
|
20.44
|
|
High
|
44.89
|
48.03
|
55.68
|
54.83
|
|
Glycohemoglobin (%)
|
|
|
|
|
0.0080
|
<6.5(%)
|
92.49
|
90.66
|
90.90
|
88.19
|
|
≥6.5
|
7.51
|
9.34
|
9.10
|
11.81
|
|
Fasting glucose (%)
|
|
|
|
|
0.0010
|
<7.0(mmol/L)
|
95.61
|
96.33
|
92.84
|
93.95
|
|
≥7.0
|
4.39
|
3.67
|
7.16
|
6.05
|
|
Alb (g/L, mean ± sd)
|
40.57 ± 3.03
|
40.86 ± 3.29
|
41.27 ± 3.08
|
41.36 ± 3.27
|
<0.0001
|
Globulin (g/L, mean ± sd)
|
29.93 ± 3.95
|
29.93 ± 3.95
|
29.83 ± 4.05
|
29.95 ± 4.03
|
0.8887
|
SCr (umol/L, mean ± sd)
|
66.48 ± 27.83
|
72.88 ± 19.69
|
80.15 ± 19.75
|
91.12 ± 43.23
|
<0.0001
|
ALT (IU/L, mean ± sd)
|
18.09 ± 12.55
|
20.61 ± 17.00
|
23.50 ± 13.67
|
28.70 ± 21.01
|
<0.0001
|
GGT (IU/L, mean ± sd)
|
23.77 ± 35.02
|
24.86 ± 31.06
|
28.73 ± 27.16
|
37.70 ± 53.24
|
<0.0001
|
LDH (IU/L, mean ± sd)
|
152.94 ± 29.16
|
155.82 ± 32.20
|
157.76 ± 30.12
|
159.54 ± 32.99
|
<0.0001
|
TBi (umol/L, mean ± sd)
|
6.90 ± 3.97
|
7.53 ± 4.36
|
8.94 ± 5.60
|
8.72 ± 4.69
|
<0.0001
|
HDL (mmol/L, mean ± sd)
|
1.52 ± 0.38
|
1.44 ± 0.40
|
1.32 ± 0.36
|
1.26 ± 0.37
|
<0.0001
|
Cholesterol (mmol/L, mean ± sd)
|
4.80 ± 0.97
|
4.88 ± 1.06
|
4.89 ± 1.02
|
4.97 ± 1.08
|
0.0022
|
LSM (kpa, mean ± sd)
|
4.98 ± 3.21
|
5.55 ± 4.99
|
5.91 ± 5.40
|
6.68 ± 5.94
|
<0.0001
|
CAP (dB/m, mean ± sd)
|
239.24 ± 57.55
|
253.91 ± 60.73
|
274.44 ± 62.01
|
286.39 ± 63.56
|
<0.0001
|
Abbreviations: BMI, body mass index; Alb, albumin; SCr, serum creatinine; ALT, alanine aminotransferase; GGT, gamma-glutamyl transaminase; LDH, lactate dehydrogenase; TBi, total bilirubin; HDL, high-density lipoprotein; LSM, liver stiffness measurement; CAP, controlled attenuation parameter.
Table 2: Univariate analysis for controlled attenuation parameter.
|
Statistics, n (%)
|
β (95%CI)
|
P-value
|
Age(year)
|
48.8 ± 18.6
|
0.8 (0.7, 0.9)
|
<0.001
|
Gender
|
|
|
|
Male
|
2088 (48.3%)
|
Reference
|
|
Female
|
2231 (51.7%)
|
-21.0 (-24.7, -17.2)
|
<0.001
|
Race
|
|
|
|
Mexican American
|
656 (15.2%)
|
Reference
|
|
Other Hispanic
|
421 (9.7%)
|
-22.1 (-31.5, -12.7)
|
<0.001
|
Non-Hispanic White
|
1571 (36.4%)
|
-14.9 (-21.4, -8.3)
|
<0.001
|
Non-Hispanic Black
|
920 (21.3%)
|
-29.1 (-37.6, -20.6)
|
<0.001
|
Other Race
|
751 (17.4%)
|
-16.0 (-24.6, -7.4)
|
<0.001
|
Marital status
|
|
|
|
Married or Living with partner
|
2417 (56.0%)
|
Reference
|
|
Single
|
1677 (38.8%)
|
-17.6 (-21.6, -13.7)
|
<0.001
|
Other
|
225 (5.2%)
|
-48.1 (-58.5, -37.7)
|
<0.001
|
BMI (kg/m2)
|
|
|
|
<30
|
2510 (58.1%)
|
Reference
|
|
≥30
|
1809 (41.9%)
|
62.4 (59.0, 65.8)
|
<0.001
|
Smoking behavior
|
|
|
|
Yes
|
1723 (39.9%)
|
Reference
|
|
No
|
2596 (60.1%)
|
-13.9 (-17.8, -10.1)
|
<0.001
|
Alcohol intake
|
|
|
|
Low
|
1053 (24.4%)
|
Reference
|
|
Medium
|
843 (19.5%)
|
-3.6 (-9.1, 1.8)
|
0.191
|
High
|
2423 (56.1%)
|
3.5 (-1.0, 8.1)
|
0.126
|
Education level
|
|
|
|
Below high school education
|
769 (17.8%)
|
Reference
|
|
High school graduate
|
979 (22.7%)
|
3.1 (-4.0, 10.2)
|
0.392
|
College graduate
|
2343 (54.2%)
|
-4.8 (-11.3, 1.7)
|
0.149
|
Not recorded
|
228 (5.3%)
|
-44.2 (-56.0, -32.4)
|
<0.001
|
Glycohemoglobin (%)
|
|
|
|
<6.5
|
3732 (86.4%)
|
Reference
|
|
≥6.5
|
587 (13.6%)
|
59.7 (53.5, 66.0)
|
<0.001
|
Fasting glucose(mmol/L)
|
|
|
|
<7.0
|
4000 (92.6%)
|
Reference
|
|
≥7.0
|
319 (7.4%)
|
56.0 (47.7, 64.3)
|
<0.001
|
Albumin (g/L)
|
40.7 ± 3.3
|
-2.5 (-3.1, -1.9)
|
<0.001
|
Globulin (g/L)
|
30.8 ± 4.3
|
1.4 (1.0, 1.9)
|
<0.001
|
Scr (umol/L)
|
79.3 ± 41.4
|
0.1 (0.0, 0.2)
|
0.003
|
ALT (IU/L)
|
22.2 ± 17.2
|
1.1 (1.0, 1.2)
|
<0.001
|
GGT (IU/L)
|
30.5 ± 42.8
|
0.3 (0.3, 0.4)
|
<0.001
|
LDH (IU/L)
|
157.9 ± 33.6
|
0.2 (0.1, 0.2)
|
<0.001
|
TBi (umol/L)
|
7.9 ± 4.7
|
-0.5 (-0.9, -0.1)
|
0.008
|
Cholesterol (mmol/L)
|
4.8 ± 1.1
|
5.3 (3.5, 7.1)
|
<0.001
|
HDL (mmol/L)
|
1.4 ± 0.4
|
-52.9 (-57.5, -48.3)
|
<0.001
|
LSM(Kpa)
|
6.0 ± 5.3
|
3.4 (3.0, 3.7)
|
<0.001
|
SUA (mg/dL)
|
5.4 ± 1.5
|
13.5 (12.2, 14.7)
|
<0.001
|
Abbreviations: BMI, body mass index; Alb, albumin; SCr, serum creatinine; ALT, alanine aminotransferase; GGT, gamma-glutamyl transaminase; LDH, lactate dehydrogenase; TBi, total bilirubin; HDL, high-density lipoprotein; LSM, liver stiffness measurement; SUA, serum uric acid.
Table 3 Relationship between SUA and controlled attenuation parameter in different models.
Variable
|
Crude Model
|
|
Model Ⅰ
|
|
Model Ⅱ
|
β (95%CI)
|
P-value
|
|
β (95%CI)
|
P-value
|
|
β (95%CI)
|
P-value
|
SUA
|
13.5 (12.2, 14.7)
|
<0.001
|
|
11.8 (10.4, 13.2)
|
<0.001
|
|
5.4 (4.1, 6.6)
|
<0.001
|
SUA(quartile)
|
|
|
|
|
|
|
|
|
Q1
|
Reference
|
|
|
Reference
|
|
|
Reference
|
|
Q2
|
14.7 (9.5, 19.8)
|
<0.001
|
|
13.8 (8.7, 18.9)
|
<0.001
|
|
6.5 (2.3, 10.7)
|
0.002
|
Q3
|
35.2 (30.1, 40.4)
|
<0.001
|
|
29.0 (23.6, 34.3)
|
<0.001
|
|
14.7 (10.2, 19.3)
|
<0.001
|
Q4
|
47.2 (42.0, 52.3)
|
<0.001
|
|
40.4 (34.8, 46.1)
|
<0.001
|
|
17.6 (12.7, 22.5)
|
<0.001
|
P for trend
|
<0.001
|
|
<0.001
|
|
<0.001
|
Abbreviations: CI, confidence interval; SUA, serum uric acid.
Crude model adjust for none. Model I adjust for gender, age, race. Model II adjust for gender, age, race, education level, marital status, alanine aminotransferase, albumin, serum creatinine, globulin, gamma-glutamyl transaminase, lactate dehydrogenase, total bilirubin, serum cholesterol, smoking behavior, fasting glucose, HDL-cholesterol, liver stiffness measurement, alcohol intake, body mass index, glycohemoglobin.
Table 4 Threshold effect analysis of serum uric acid and controlled attenuation parameter using a Piece-wise Linear Regression.
Inflection point (mg/dL)
|
Effect size (β )
|
95%CI
|
P value
|
log likelihood ratio
|
< 4.3
|
10.6
|
6.3 to 14.8
|
<0.001
|
0.012
|
≥ 4.3
|
4.3
|
2.9 to 5.8
|
<0.001
|
Abbreviations: CI, confidence interval
Gender, age, race, marital status, alanine aminotransferase, albumin, serum creatinine, globulin, gamma-glutamyl transaminase, lactate dehydrogenase, total bilirubin, serum cholesterol, smoking behavior, liver stiffness measurement, HDL-cholesterol, alcohol intake, education level, body mass index, glycohemoglobin, fasting glucose were adjusted.
Table 5 Effect size of serum uric acid and controlled attenuation parameter in prespecified and exploratory subgroups in each subgroup
|
N
|
β(95%CI)
|
P -value
|
P for interaction
|
Age (year)
|
|
|
|
0.0467
|
<60
|
2834
|
6.6 (5.1, 8.1)
|
<0.001
|
|
≥60
|
1485
|
3.9 (1.9, 5.9)
|
<0.001
|
|
Gender
|
|
|
|
0.0002
|
Male
|
2088
|
3.5 (1.7, 5.3)
|
<0.001
|
|
Female
|
2231
|
9.3 (7.4, 11.2)
|
<0.001
|
|
Smoking behavior
|
|
|
|
0.0445
|
Yes
|
1723
|
4.7 (2.7, 6.7)
|
<0.001
|
|
No
|
2596
|
7.5 (5.9, 9.0)
|
<0.001
|
|
Alcohol intake
|
|
|
|
0.1709
|
Low
|
1053
|
6.0 (3.5, 8.5)
|
<0.001
|
|
Medium
|
843
|
7.8 (5.0, 10.7)
|
<0.001
|
|
High
|
2423
|
5.8 (4.2, 7.4)
|
<0.001
|
|
Glycohemoglobin (%)
|
|
|
|
0.0024
|
<6.5
|
3732
|
7.3 (6.0, 8.6)
|
<0.001
|
|
≥6.5
|
587
|
2.0 (-0.8, 4.8)
|
0.162
|
|
Fasting glucose (mmol/L)
|
|
|
|
0.0141
|
<7.0
|
4000
|
6.8 (5.5, 8.0)
|
<0.001
|
|
≥7.0
|
319
|
0.6 (-3.4, 4.5)
|
0.784
|
|
Abbreviations: CI, confidence interval.
Above model adjusted for race, education level, marital status, alanine aminotransferase, albumin, serum creatinine, globulin, gamma-glutamyl transaminase, lactate dehydrogenase, total bilirubin, serum cholesterol, HDL-cholesterol, liver stiffness measurement and body mass index except the subgroup variable.