Attenuating the mortality risk of high serum uric acid: the role of physical activity underused

• Published in: Annals of the rheumatic diseases Vol. 74; no. 11; pp. 2034 - 2042
• Main Authors: Chen, Jiunn-Horng, Wen, Chi Pang, Wu, Shiuan Bei, Lan, Joung-Liang, Tsai, Min Kuang, Tai, Ya-Ping, Lee, June Han, Hsu, Chih Cheng, Tsao, Chwen Keng, Wai, Jackson Pui Man, Chiang, Po Huang, Pan, Wen Han, Hsiung, Chao Agnes
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2015
• Subjects: Adult; Aged; Asymptomatic; Asymptomatic Diseases; Body mass index; Cause of Death; Cholesterol; Cohort Studies; Diabetes; Diabetes Mellitus - epidemiology; Exercise; Female; Follow-Up Studies; Humans; Hyperlipidemias - epidemiology; Hypertension; Hypertension - epidemiology; Hyperuricemia - epidemiology; Leisure Activities; Life expectancy; Male; Medical screening; Metabolic syndrome; Middle Aged; Mortality; Motor Activity; Physical fitness; Prediabetic State - epidemiology; Proportional Hazards Models; Questionnaires; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Risk Reduction Behavior; Sedentary Lifestyle; Self report; Smoking - epidemiology; Taiwan - epidemiology; Triglycerides; Uric acid; Uric Acid - blood; Young Adult; Taiwan; Cardiovascular Disease; Epidemiology; Gout
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2014-205312

BackgroundHigh serum uric acid (sUA) has been associated with increased mortality risks, but its clinical treatment varied with potential side effects. The role of physical activity has received limited attention.MethodsA cohort, consisting of 467 976 adults, who went through a standard health screening programme, with questionnaire and fasting blood samples, was successively recruited between 1996 and 2008. High sUA is defined as uric acid above 7.0 mg/dL. Leisure time physical activity level was self-reported, with fully active defined as those with 30 min per day for at least 5 days a week. National death file identified 12 228 deaths with a median follow-up of 8.5 years. Cox proportional model was used to analyse HRs, and 12 variables were controlled, including medical history, life style and risk factors.FindingsHigh sUA constituted one quarter of the cohort (25.6%). Their all-cause mortality was significantly increased [HR: 1.22 (1.15–1.29)], with much of the increase contributed to by the inactive (HR: 1.27 (1.17–1.37)), relative to the reference group with sUA level of 5–6 mg/dL. When they were fully active, mortality risks did not increase, but decreased by 11% (HR: 0.89 (0.82–0.97)), reflecting the benefits of being active was able to overcome the adverse effects of high sUA. Given the same high sUA, a 4–6 years difference in life expectancy was found between the active and the inactive.ConclusionsPhysical activity is a valuable alternative to pharmacotherapy in its ability to reduce the increases in mortality risks from high sUA. By being fully active, exercise can extend life span by 4–6 years, a level greater than the 1–4 years of life-shortening effect from high sUA.