TY - JOUR
T1 - Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia
T2 - A Novel Application of a Partial Least Squares-Structural Equation Model
AU - Dyah Kurniasari, Maria
AU - Karwur, Ferry Fredy
AU - Rayanti, Rosiana Eva
AU - Huruta, Andrian Dolfriandra
AU - Lin, Yu Huei
AU - Weng, Shuen Fu
AU - Tsai, Hsiu Ting
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Ministry of Science and Technology, Taiwan supported this research work (MOST 106-2314-B-038-013-MY3 and MOST 109-2314-B-038-110-).
Publisher Copyright:
© The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Background: Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. Objective: We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. Method: A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. Result: We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48–7.09) and an AOR of 4.44 (95% CI: 3.07–6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02–0.08], p < 0.001). Conclusion: Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.
AB - Background: Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. Objective: We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. Method: A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. Result: We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48–7.09) and an AOR of 4.44 (95% CI: 3.07–6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02–0.08], p < 0.001). Conclusion: Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.
KW - blood pressure
KW - gout
KW - Indonesia
KW - systolic
KW - urate
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U2 - 10.1177/10998004211029044
DO - 10.1177/10998004211029044
M3 - Article
AN - SCOPUS:85111913502
SN - 1099-8004
VL - 24
SP - 40
EP - 47
JO - Biological Research for Nursing
JF - Biological Research for Nursing
IS - 1
ER -