[Associations between dietary approaches to stop hypertension diet and serum uric acid levels and the risk of hyperuricemia:the mediation role of systematic inflammation].

Objective: To investigate the association between adherence to the dietary approaches to stop hypertension(DASH)diet and serum uric acid levels, the risk of hyperuricemia, and the mediation role of systematic inflammation, among Chinese adults from 5 provinces.

Methods: China Nutrition and Health Follow-up Study(2021) was conducted based on a part of the participants in China Nutrition and Health Surveillance(2010-2012) and subsequently newly sampled participants. A total of 6963 Chinese adults were selected from and information on socioeconomic status, diet, body measurements, and laboratory examination were investigated. Using the DASH score to evaluate the adherence to the DASH diet, the participants were categorized into quintiles. Using multiple adjustment generalized linear regression and logistic regression analysis the association between DASH diet and serum uric acid level and the risk of hyperuricemia were explored. The mediation role of systematic inflammation on the above associations was evaluated among 2112 participants who were tested for serum high-sensitivity C-reactive protein(hs-CRP).

Results: In 6963 participants, the average serum uric acid level was 317.4 μmol/L, and the prevalence of hyperuricemia was 21.18%. The result showed that participants who were 18-44 years, female, overweight or obese, urban residents, higher education level, married, higher household income, non-smokers, higher physical activity level, non-hyperuricemia had higher adherence to the DASH diet(P<0.05). After adjusting for potential confounders, including age, gender, body mass index, living area, education level, marital status, household income, current smoking, excessive drinking, physical activity level, and condition of hypertension, diabetes mellitus, and dyslipidemia, the adherence to DASH diet had a negative association with serum uric acid levels(Q5 vs. Q1, relative concentration =0.93, 95%CI 0.91-0.94, P_(trend)<0.01) and with the risk of hyperuricemia(Q5 vs. Q1, OR =0.59, 95%CI 0.48-0.73, P_(trend)<0.01). Mediation analysis revealed that hs-CRP significantly mediated 17.69%(95%CI 10.22%-25.15%, P_(mediation)<0.01)of the association between DASH diet and serum uric acid level and 26.00%(95%CI 7.50%-44.49%, P_(mediation)<0.01)of the association between DASH score and the risk of hyperuricemia, respectively.

Conclusion: Adhering to the DASH diet had negative associations with serum uric acid levels and the risk of hyperuricemia among Chinese adults from 5 provinces. Systematic inflammation may be an important biological mechanism partially mediating the association between the DASH diet on serum uric acid levels and hyperuricemia.