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Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Research Article

Sex-Specific Association Between Serum Uric Acid and Elevated Alanine Aminotransferase in a Military Cohort: The CHIEF Study

Author(s): Jia-Wei Lin, Kun-Zhe Tsai, Kai-Wen Chen, Fang-Ying Su, Yi-Hwei Li, Yen-Po Lin, Chih-Lu Han, Felicia Lin, Yu-Kai Lin, Chung-Bao Hsieh and Gen-Min Lin*

Volume 19, Issue 3, 2019

Page: [333 - 340] Pages: 8

DOI: 10.2174/1871530319666181129163802

Price: $65

Abstract

Aim: The study was conducted in order to examine the sex-specific association of serum uric acid (SUA) levels with elevated serum alanine aminotransferase (ALT) in a Taiwanese military cohort.

Methods: We made a cross-sectional examination of the sex-specific relationship using 6728 men and 766 women, aged 18-50 years from a large military cohort in Taiwan. SUA levels within the reference range (<7.0 mg/dL for men and <5.7 mg/dL for women respectively) were divided into quartiles and SUA levels greater than the upper reference limits were defined as hyperuricemia. Elevated ALT levels were defined as ≥40 U/L. Multivariate logistic regression analysis was performed to determine the association between each SUA category and elevated ALT levels in men and women, respectively.

Results: The prevalence of hyperuricemia and elevated ALT in men were 18.7% and 12.7%, respectively, and in women were 3.3% and 2.1%, respectively. As compared with the lowest SUA quartile, hyperuricemia was associated with elevated ALT in men (odds ratios (OR): 1.62, 95% confidence intervals (CI): 1.19-2.20) after controlling for age, service specialty, body mass index, metabolic syndrome components, current cigarette smoking, alcohol intake status, and weekly exercise times, but the associations for the other SUA quartiles were null. By contrast, the associations of hyperuricemia (OR: 0.81, 95% CI: 0.10-6.64) and the other SUA quartiles with elevated ALT were null in women.

Conclusion: Our findings suggest that the relationship between each SUA level and elevated ALT may differ by sex among military young adults. The mechanism for the sex difference requires further investigations.

Keywords: Alanine aminotransferase, military cohort, serum uric acid, sex difference, hyperuricemia, aminocarbonyl radicals.

Graphical Abstract

[1]
Zhang, J.X.; Zhang, Y.P.; Wu, Q.N.; Chen, B. Uric acid induces oxidative stress via an activation of the renin-angiotensin system in 3T3-L1 adipocytes. Endocrine, 2015, 48(1), 135-142.
[2]
Maiuolo, J.; Oppedisano, F.; Gratteri, S.; Muscoli, C.; Mollace, V. Regulation of uric acid metabolism and excretion. Int. J. Cardiol., 2016, 213, 8-14.
[3]
Sautin, Y.Y.; Johnson, R.J. Uric acid: The oxidant-antioxidant paradox. Nucleosides Nucleotides Nucleic Acids, 2008, 27(6), 608-619.
[4]
Puddu, P.; Puddu, G.M.; Cravero, E.; Vizioli, L.; Muscari, A. Relationships among hyperuricemia, endothelial dysfunction and cardiovascular disease: molecular mechanisms and clinical implications. J. Cardiol., 2012, 59(3), 235-242.
[5]
Lin, G.M.; Li, Y.H.; Zheng, N.C.; Lai, C.P.; Lin, C.L.; Wang, J.H.; Jaiteh, L.E.; Han, C.L. Serum uric acid as an independent predictor of mortality in high-risk patients with obstructive coronary artery disease: Aa prospective observational cohort study from the ET-CHD registry, 1997-2003. J. Cardiol., 2013, 61(2), 122-127.
[6]
Asrih, M.; Jornayvaz, F.R. Metabolic syndrome and nonalcoholic fatty liver disease: Is insulin resistance the link? Mol. Cell. Endocrinol., 2015, 418(Pt 1), 55-65.
[7]
Chen, S.; Guo, X.; Yu, S.; Zhou, Y.; Li, Z.; Sun, Y. Metabolic syndrome and serum liver enzymes in the general Chinese population. Int. J. Environ. Res. Public Health, 2016, 13(2), 223.
[8]
Liu, Z.; Que, S.; Zhou, L.; Zheng, S. Dose-response rela tionship of serum uric acid with metabolic Syndrome and non-alcoholic fatty liver disease incidence: aA meta-analysis of prospective studies. Sci. Rep., 2015, 5, 14325.
[9]
Yuan, H.; Yu, C.; Li, X.; Sun, L.; Zhu, X.; Zhao, C.; Zhang, Z.; Yang, Z. serum uric acid levels and risk of metabolic syndrome: A dose-response meta-analysis of prospective studies. J. Clin. Endocrinol. Metab., 2015, 100(11), 4198-4207.
[10]
Liu, M.; He, Y.; Jiang, B.; Wu, L.; Yang, S.; Wang, Y.; Li, X. Association between serum uric acid level and metabolic syndrome and its sex difference in a Chinese community elderly population. Int. J. Endocrinol., 2014, 2014, 754678.
[11]
Zhang, H.; Li, Y.; Mao, Z.; Liu, X.; Zhang, X.; Yang, K.; Liu, R.; Qian, X.; Zhang, H.; Jiang, J.; Zhang, G.; Wang, C. Sex-specific associations of serum uric acid with metabolic syndrome in Chinese rural population: The RuralDiab study. Clin. Chim. Acta, 2018, 480, 119-125.
[12]
You, L.; Liu, A.; Wuyun, G.; Wu, H.; Wang, P. Prevalence of hyperuricemia and the relationship between serum uric acid and metabolic syndrome in the Asian Mongolian area. J. Atheroscler. Thromb., 2014, 21(4), 355-365.
[13]
Huang, S.; Liu, X.; Li, H.; Xu, W.; Jia, H. Sex difference in the association of serum uric acid with metabolic syndrome and its components: a cross-sectional study in a Chinese Yi population. Postgrad. Med., 2017, 129(8), 828-833.
[14]
Wu, S.J.; Zhu, G.Q.; Ye, B.Z.; Kong, F.Q.; Zheng, Z.X.; Zou, H.; Shi, K.Q.; Lin, L.; Braddock, M.; Huang, W.J.; Chen, Y.P.; Zheng, M.H. Association between sex-specific serum uric acid and non-alcoholic fatty liver disease in Chinese adults: a large population-based study. Medicine (Baltimore), 2015, 94(17), e802.
[15]
Lin, G.M.; Li, Y.H.; Lee, C.J.; Shiang, J.C.; Lin, K.H.; Chen, K.W.; Chen, Y.J.; Wu, C.F.; Lin, B.S.; Yu, Y.S.; Lin, F.; Su, F.Y.; Wang, C.H. Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan. World J. Cardiol., 2016, 8(8), 464-471.
[16]
Chen, Y.J.; Chen, K.W.; Shih, Y.L.; Su, F.Y.; Lin, Y.P.; Meng, F.C.; Lin, F.; Yu, Y.S.; Han, C.L.; Wang, C.H.; Lin, J.W.; Hsieh, T.Y.; Li, Y.H.; Lin, G.M. Chronic hepatitis B, nonalcoholic steatohepatitis and physical fitness of military males: CHIEF study. World J. Gastroenterol., 2017, 23(25), 4587-4594.
[17]
Chen, K.W.; Meng, F.C.; Shih, Y.L.; Su, F.Y.; Lin, Y.P.; Lin, F.; Lin, J.W.; Chang, W.K.; Lee, C.J.; Li, Y.H.; Hsieh, C.B.; Lin, G.M. Sex-specific association between metabolic abnormalities and elevated alanine aminotransferase levels in a military cohort: the CHIEF study. Int. J. Environ. Res. Public Health, 2018, 15(3), pii: E545.
[18]
Zhu, Y.; Pandya, B.J.; Choi, H.K. Prevalence of gout and hyperuricemia in the US general population: the national health and nutrition examination survey 2007-2008. Arthritis Rheum., 2011, 63, 3136-3141.
[19]
Ruhl, C.E.; Everhart, J.E. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the United States. Gastroenterology, 2003, 124, 71-79.
[20]
Lombardi, R.; Pisano, G.; Fargion, S. Role of serum uric acid and ferritin in the development and progression of NAFLD. Int. J. Mol. Sci., 2016, 17(4), 548.
[21]
Chen, S.; Guo, X.; Zhang, X.; Yu, S.; Yang, H.; Jiang, M.; Sun, G.; Sun, Y. Association between elevated serum alanine aminotransferase and cardiometabolic risk factors in rural Chinese population: a cross-sectional study. BMC Cardiovasc. Disord., 2015, 15, 65.
[22]
Brady, C.W. Liver disease in menopause. World J. Gastroenterol., 2015, 21(25), 7613-7620.
[23]
Zelber-Sagi, S.; Ben-Assuli, O.; Rabinowich, L.; Goldstein, A.; Magid, A.; Shalev, V.; Shibolet, O.; Chodick, G. The association between the serum levels of uric acid and alanine aminotransferase in a population-based cohort. Liver Int., 2015, 35(11), 2408-2415.
[24]
Hamaguchi, M.; Kojima, T.; Ohbora, A.; Takeda, N.; Fukui, M.; Kato, T. Aging is a risk factor of nonalcoholic fatty liver disease in premenopausal women. World J. Gastroenterol., 2012, 18(3), 237-243.
[25]
Yang, J.D.; Abdelmalek, M.F.; Pang, H.; Guy, C.D.; Smith, A.D.; Diehl, A.M.; Suzuki, A. Gender and menopause impact severity of fibrosis among patients with nonalcoholic steatohepatitis. Hepatology, 2014, 59(4), 1406-1414.
[26]
Yoneda, M.; Thomas, E.; Sumida, Y.; Eguchi, Y.; Schiff, E.R. The influence of menopause on the development of hepatic fibrosis in nonobese women with nonalcoholic fatty liver disease. Hepatology, 2014, 60(5), 1792.

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