Prevalence and risk factors associated with hyperuricemia among working population at high altitudes: a cross-sectional study in Western China

  • Yang Shen
  • Yanling Wang
  • Chun ChangEmail author
  • Suning Li
  • Weihao Li
  • Bingying Ni
Original Article


Chronic exposure to high altitude may lead to hyperuricemia. We investigated the prevalence of hyperuricemia and its risk factors among employees in high-altitude areas. A cross-sectional survey with cluster sampling was performed at 23 worksites on the Qinghai-Tibet Plateau. Subjects were evaluated by using questionnaires, anthropometric and laboratory measurements, and abdominal ultrasound. A multilevel logistic regression model and restricted cubic spline were used to explore the associated factors of hyperuricemia. Of the 4198 employees included in the study, the age-standardized prevalence of hyperuricemia was 28.1% (95% confidence interval (CI) 26.7–29.5), with 31.9% (95%CI 30.2–33.6) in men and 17.9% (95%CI 15.7–20.1) in women. Hypertension, hyperlipidemia, and a meat-food pattern were positively associated with hyperuricemia in both sexes, while diabetes, shift work, body mass index, non-alcoholic fatty liver disease, and low intake of fruits and vegetables were significantly associated with hyperuricemia only in men. Furthermore, a nonlinear dose-response association between the number of cardiovascular risk factors (CRFs) and hyperuricemia was observed. Compared with those having 0 CRFs, the full-adjusted odds ratios (ORs) and 95%CIs for 1, 2, and ≥ 3 CRFs were 1.76 (95%CI 1.25–2.47), 2.54 (95%CI 1.81–3.55), and 3.05 (95%CI 2.16–4.31) in men, respectively, and 2.13 (95%CI 1.43–3.17), 2.78 (95%CI 1.71–4.53), and 3.13 (95%CI 1.50–6.55) in women, respectively. Hyperuricemia is common in employees at high-altitude areas. However, working at higher altitudes does not mean necessarily higher risk of hyperuricemia, as dietary factors and clustered CRFs are more significant. Thus, workplace-based lifestyle modifications should be promoted.


Epidemiology High altitude Hyperuricemia Prevalence Risk factor Worksite 



Serum uric acid


Cardiovascular risk factors


Blood pressure


Body mass index


Systolic blood pressure


Diastolic blood pressure


Total cholesterol




Fasting blood glucose


Non-alcoholic fatty liver disease


Odds ratio


Confidence interval



We would like to acknowledge all the employees who participated in the study and investigators for their valuable help in data collection.

Author contribution

CC and YW conceived and designed the study, YS analyzed the data and wrote the paper, CC reviewed and edited the paper, SL helped in preparing the database and helped in the data analysis, WL and BN edited the paper, and all authors read and approved the final manuscript.

Compliance with ethical standards



Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Yang Shen
    • 1
  • Yanling Wang
    • 1
  • Chun Chang
    • 1
    Email author
  • Suning Li
    • 2
  • Weihao Li
    • 1
  • Bingying Ni
    • 1
  1. 1.Department of Social Medicine and Health Education, School of Public HealthPeking UniversityBeijingChina
  2. 2.Division of Prevention and Community Health, National Center for Cardiovascular DiseaseFuwai Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijingChina

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