Background/Purpose: The association between high atmospheric particulate matter concentration and gout flare has been reported1, but the causality and mechanism of this association remain unknown. We studied the association between trajectories of particulate matter concentration and hyperuricemia.

Methods: The seventh Korean National Health and Nutrition Examination Survey (2016–2018) linked air pollution concentration data was used. Trajectories of atmospheric particulate matter ≤10 ㎛ (PM10) concentrations from the day of serum uric acid measurement to 14 days prior (a total of 15 days) were clustered based on measures selected from principal component analysis. Hyperuricemia was defined as ≥7.0 mg/dL for men and ≥6.0 mg/dL for women. The association between the prevalence of hyperuricemia and quartiles of mean PM10 concentration or trajectories of PM10 concentration in the previous 15 days was modeled using generalized additive models, including age, sex, household income, obesity, chronic kidney disease, alcohol intake, mean temperature (spline), and mean relative humidity (spline). The associations were tested using weighted logistic regression models.

Results: The prevalence of hyperuricemia was 20.5% (95% confidence interval [CI], 19.2%–21.9%) in men and 6.1% (95% CI 5.5%–6.8%) in women. Mean PM10 concentration in the 15 days was 48.6 ng/mL (95% CI 47.4–49.9). There were three short-term trajectories of atmospheric PM10 concentrations: decreasing (N&#3f4289, 32%), increasing (N&#3f4724, 34%), and rapidly increasing (N&#3f4688, 34%) (figure 1). There was no significant association between hyperuricemia and quartiles of mean PM10 concentration in prior 15 days; Q1: reference, Q2: odds ratio [OR] 0.81 (95% CI 0.69–0.96), Q3: OR 0.89 (95% CI 0.74–1.07), and Q4: OR 0.86 (95% CI 0.71–1.04). However, the short-term trajectory of PM10 levels was significantly associated with hyperuricemia. Compared with the decreasing trajectory, the increasing (OR 0.88 [95% CI 0.76–1.00], P = 0.056) and rapidly increasing (OR 0.85 [95% CI 0.74–0.97], P = 0.018) trajectories were negatively associated with hyperuricemia. When the association was analyzed using weighted generalized linear models, there was a similar trend for negative association between hyperuricemia and the rapidly increasing trajectory; decreasing trajectory: reference, increasing trajectory: OR 0.93 (95% CI 0.79–1.09, P-value 0.251), rapidly increasing trajectory: OR 0.89 (95% CI 0.75–1.07, P-value 0.081). In the receiver operating characteristic curve analysis, model discrimination was significantly better using the GAM model (Model 1 in figure 2, P < 0.001).

Conclusion: Compared with decreasing trajectory, rapidly increasing trajectory of atmospheric PM10 concentration was associated with lower prevalence of hyperuricemia. The results suggest that the mobilization of urate crystals may be the cause of gout flares associated with air pollution. This hypothesis must be validated through longitudinal studies.Reference 1. Ryu HJ, Seo MR, Choi HJ, Cho J, Baek HJ. Particulate matter (PM(10)) as a newly identified environmental risk factor for acute gout flares: A time-series study. Joint Bone Spine. 2021;88(2):105108.

Figure 1. Pointwise mean trajectories and 95% confidence intervals of particulate matter 10 concentration from the day of serum uric acid measurement to 14 days prior (The day when blood samples were obtained is 1 on the X-axis)

Figure 2. The receiver operating characteristic curve analysis of model discrimination by the generalized additive model (Model 1) and the logistic regression model (Model 2)

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-between-short-term-trajectory-of-atmospheric-particulate-matter-10-pm10-concentration-and-hyperuricemia/