Sex Disparities in the Association of Serum Uric Acid With Kidney Stone: A Cross-Sectional Study in China

Jin-Zhou Xu; Jun-Lin Lu; Liu Hu; Yang Xun; Zheng-Ce Wan; Qi-Dong Xia; Xiao-Yuan Qian; Yuan-Yuan Yang; Sen-Yuan Hong; Yong-Man Lv; Shao-Gang Wang; Xiao-Mei Lei; Wei Guan; Cong Li

doi:10.3389/fmed.2022.774351

Sex Disparities in the Association of Serum Uric Acid With Kidney Stone: A Cross-Sectional Study in China

Front Med (Lausanne). 2022 Feb 9:9:774351. doi: 10.3389/fmed.2022.774351. eCollection 2022.

Authors

Jin-Zhou Xu¹, Jun-Lin Lu^{1

2}, Liu Hu³, Yang Xun¹, Zheng-Ce Wan³, Qi-Dong Xia¹, Xiao-Yuan Qian¹, Yuan-Yuan Yang¹, Sen-Yuan Hong¹, Yong-Man Lv³, Shao-Gang Wang¹, Xiao-Mei Lei³, Wei Guan¹, Cong Li¹

Affiliations

¹ Department of Urology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
² Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
³ Health Management Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background and aims: Urolithiasis is characterized by high rates of prevalence and recurrence. Hyperuricemia is related to various diseases. We hope to determine the association between serum uric acid (UA) level and kidney stone (KS).

Methods: In this population-based cross-sectional study, a total of 82,017 Chinese individuals who underwent a comprehensive examination in 2017 were included. The KS was diagnosed based on ultrasonography examination outcomes. Fully adjusted odds ratio (OR) for KS, and mean difference between the two groups were applied to determine the association of UA level with KS.

Results: Among the 82,017 participants included in this study (aged 18~99 years), 9,435 participants (11.5%) are diagnosed with KS. A proportion of 56.3% of individuals is male. The mean UA level of overall participants is 341.77 μmol/L. The participants with KS report higher UA level than the participants without KS [mean UA level 369.91 vs. 338.11 μmol/L; mean difference (MD), 31.96 (95% CI, 29.61~34.28) μmol/L]. In men, the OR for KS significantly increases from 330 μmol/L UA level. Every 50 μmol/L elevation of UA level increases the risk of KS formation by about 10.7% above the UA level of 330 μmol/L in men. The subgroup analysis for male is consistent with the overall result except for the participants presenting underweight [adjusted OR, 1.035 (0.875~1.217); MD, -5.57 (-16.45~11.37)], low cholesterol [adjusted OR, 1.088 (0.938~1.261); MD, 8.18 (-7.93~24.68)] or high estimated glomerular filtration rate (eGFR) [adjusted OR, 1.044 (0.983~1.108); MD, 5.61 (-1.84~13.36)]. However, no significant association is observed in women between UA and KS either in all female participants or in female subgroups.

Conclusion: Among Chinese adults, UA level is associated with KS in a dose-response manner in men but not in women. However, the association becomes considerably weak in male participants with malnutrition status.

Keywords: cross-sectional study; kidney stone; malnutrition; restricted cubic splines; sex disparities; uric acid.