OBJECTIVE To examine modifiable risk factors in relation to the presence of hyperuricemia and to estimate the proportion of hyperuricemia cases in the general population that could be prevented by risk factor modification, along with estimates of the variance explained. METHODS Using data obtained from 14,624 adults representative of the US civilian noninstitutionalized population, we calculated adjusted prevalence ratios for hyperuricemia, population attributable risks (PARs), and the variance explained according to the following 4 factors: body mass index (BMI; ≥25 kg/m2 ), alcohol intake, nonadherence to a Dietary Approaches to Stop Hypertension (DASH) diet, and diuretic use. RESULTS BMI, alcohol intake, adherence to a DASH-style diet, and diuretic use were all associated with serum urate levels and the presence of hyperuricemia in a dose-dependent manner. The corresponding PARs of hyperuricemia cases for overweight/obesity (prevalence 60%), nonadherence to a DASH-style diet (prevalence 82%), alcohol use (prevalence 48%), and diuretic use (prevalence 8%) were 44% (95% confidence interval [95% CI] 41%, 48%), 9% (95% CI 3%, 16%), 8% (95% CI 5%, 11%), and 12% (95% CI 11%, 14%), respectively, whereas the corresponding variances explained were 8.9%, 0.1%, 0.5%, and 5.0%. Our simulation study showed the variance nearing 0% as exposure prevalence neared 100%. CONCLUSION In this nationally representative study, 4 modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could be used to individually account for a notable proportion of hyperuricemia cases. However, the corresponding serum urate variance explained by these risk factors was very small and paradoxically masked their high prevalences, providing real-life empirical evidence for its limitations in assessing common risk factors.

中文翻译：

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可归因于高尿酸血症风险因素的人口影响。

目的探讨与高尿酸血症有关的可改变的危险因素，并估计高尿酸血症病例在普通人群中可通过危险因素改变而预防的比例，并解释其方差的估计。方法使用从美国非平民化人口中的14,624名成年人获得的数据，我们计算出高尿酸血症，人群归因风险（PARs）的调整后患病率，并根据以下4个因素解释了方差：体重指数（BMI;≥25 kg） / m2），酒精摄入量，不遵守阻止高血压（DASH）饮食的饮食习惯以及利尿剂的使用。结果BMI，酒精摄入量，坚持DASH饮食，和利尿剂的使用均与血清尿酸水平和高尿酸血症的存在呈剂量依赖关系。超重/肥胖（患病率60％），不坚持DASH饮食（患病率82％），饮酒（患病率48％）和利尿剂（患病率8％）的高尿酸血症病例的相应PARs为44％（95）置信区间百分比[95％CI] 41％，48％），9％（95％CI 3％，16％），8％（95％CI 5％，11％）和12％（95％CI 11％） ，分别为14％），而所解释的相应方差为8.9％，0.1％，0.5％和5.0％。我们的模拟研究表明，随着暴露发生率接近100％，方差接近0％。结论在这项全国代表性的研究中，可以使用4种可改变的危险因素（BMI，DASH饮食，饮酒和利尿剂）单独占高尿酸血症病例的显着比例。然而，