Prevalence of Hyperuricemia Among Chinese Adults: Findings from Two Nationally Representative Cross-Sectional Surveys in 2015–16 and 2018–19

Background: Recent studies have shown an increase in the prevalence of hyperuricemia (HUA) worldwide. However, representative national data suggesting national trends of HUA in China are lacking. Methods: Using a multi-stage, stratified, cluster-randomized sampling design, two cross-sectional surveys (representative of national and provincial information) were conducted in 31 provinces (autonomous regions and municipalities) in mainland China, with 166,861 Chinese adults in 2015–16 and 168,351 in 2018–19. Serum uric acid (SUA) levels of all participants were measured after a >10-hour overnight fast. HUA was defined when SUA was >420 μmol/L. Prevalence estimates were weighted to represent the total population considering the complex sampling design. Multivariable logistic regression models estimated factors associated with HUA. Findings: The overall HUA prevalence in the Chinese adult population was 11.1% (95% CI, 10.3–11.8%) in 2015–16 and 14.0% (95% CI, 13.1-14.8%) in 2018–19; an alarming rise was observed in the three years. HUA was more common in men with 19.3% (95% CI, 17.9–20.7%) in 2015–16 and 24.4% (95% CI, 23.0–25.8%) in 2018–19. The HUA prevalence also escalated from 2.8% (95% CI, 2.5-3.0%) in 2015–16 to 3.6% (95% CI, 3.2–4.0%) in 2018–19 in women. Various risk factors, including urban culture, settlement in the East, Zhuang descent, high education, heavy or frequent beer drinking, high red meat intake, physical inactivity, high BMI, central obesity, hypertension, hyperlipidemia, and low eGFR, were significantly associated with HUA. Interpretation: The estimated HUA prevalence among Chinese adults was 14.0% in 2018–19; significant escalating trends were observed between 2015 and 2019. Therefore, HUA is a public health problem in China. Funding: Chinese Central Government and National Key R&D Program of China. Declaration of Interest: We declare no competing interests. Ethical Approval: The ethical review committee of the Chinese Center for Disease Control and Prevention (China CDC) approved the 2015 CCDRFS (approval number 201519- A) and that of the National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC approved the 2018 CCDRFS (approval number 201819).