Demographic, regional and temporal trends of hyperuricemia epidemics in mainland China from 2000 to 2019: a systematic review and meta-analysis

Figures & data

Figure 1. Flow diagram for literature screening

Table 1. Prevalence of hyperuricemia according to different categories

					Heterogeneity test		Publication bias
Category	Category	No. of Studies	Prevalence (95% CI, %)	No. of Participants	I^2 (%)	p (Q Test)	p(Begg’s Test)	p(Egger’s Test)
Total	Total	177	16.4 (15.3 ~ 17.6)	2,277,712	99.8	<0.001	0.755	0.872
Nationality	Han	168	16.6 (15.5 ~ 17.8)	2,244,635	99.8	<0.001	0.888	0.976
	Minority	9	13.4 (7.2 ~ 21.1)	33,077	99.7	<0.001	0.345	0.516
Gender	Male	177	20.4 (18.9 ~ 22.0)	1,304,353	99.8	<0.001	0.776	0.121
	Female	177	9.8 (8.9 ~ 10.8)	973,359	99.6	<0.001	0.445	0.942
Sample size	<4999	81	15.4 (13.9 ~ 17.1)	209,998	99.0	<0.001	0.987	0.802
	≥5000	96	17.3 (15.7 ~ 18.9)	2,067,714	99.9	<0.001	0.752	0.616
Onset age (yr)	15 ~ 19	51	15.6 (13.8 ~ 17.4)	1,099,992	99.8	<0.001	0.622	0.679
	20 ~ 39	96	17.1 (15.4 ~ 18.9)	1,041,320	99.8	<0.001	0.560	0.942
	30 ~ 49	11	12.1 (8.4 ~ 16.3)	46,758	99.4	<0.001	0.815	0.281
	40 ~ 59	9	18.6 (12.4 ~ 25.7)	33,762	99.6	<0.001	1.000	0.307
	50~	10	18.6 (16.4 ~ 21.0)	55,880	97.8	<0.001	0.929	0.774
Age-specific (yr)	15 ~ 29	89	13.7 (11.8 ~ 15.7)	194,668	99.3	<0.001	0.323	0.330
	30 ~ 39	103	16.5 (14.8 ~ 18.4)	331,839	99.5	<0.001	0.880	0.454
	40 ~ 49	116	17.9 (16.4 ~ 19.5)	352,469	99.3	<0.001	0.852	0.865
	50 ~ 59	116	19.4 (17.8 ~ 21.0)	256,954	99.1	<0.001	0.894	0.618
	60 ~ 69	108	20.5 (18.8 ~ 22.3)	166,876	98.7	<0.001	0.793	0.160
	70~	78	24.9 (22.9 ~ 27.1)	89,529	98.0	<0.001	0.759	0.103
Region	Eastern	52	14.3 (12.4 ~ 16.2)	768,298	99.8	<0.001	0.463	0.903
	Northern	28	13.8 (12.3 ~ 15.4)	707,593	99.6	<0.001	0.693	0.031
	Central	7	13.7 (10.3 ~ 17.4)	75,173	99.4	<0.001	0.881	0.656
	Southern	31	25.5 (22.1 ~ 29.0)	361,537	99.8	<0.001	0.377	0.946
	Southwestern	19	21.2 (17.4 ~ 25.3)	170,770	99.7	<0.001	0.327	0.513
	Northwestern	30	12.6 (10.4 ~ 15.0)	129,336	99.3	<0.001	0.205	0.114
	Northeastern	9	15.9 (13.0 ~ 19.0)	28,657	97.8	<0.001	0.532	0.440
Published year	2001 ~ 2005	4	11.3 (7.1 ~ 16.5)	34,942	99.5	<0.001	1.000	0.718
	2006 ~ 2010	41	14.7 (12.0 ~ 17.7)	316,903	99.8	<0.001	0.459	0.109
	2011 ~ 2015	81	16.6 (14.9 ~ 18.4)	1,009,523	99.8	<0.001	0.674	0.487
	2016 ~ 2019	51	18.0 (16.0 ~ 20.0)	916,344	99.8	<0.001	0.329	0.517

Figure 2. Forest plot of hyperuricemia prevalence for study initiated from 20 years old

Figure 3. Demographic and temporal trends of hyperuricemia prevalence

Figure 4. Regional distribution of hyperuricemia prevalence in mainland China

Table 2. Univariate and multivariable meta-regression for hyperuricemia prevalence

		Univariate analysis		Multivariable analysis
Category	Subgroup	Coefficient (95% CI)	p-value	Coefficient (95% CI)	p-value
Sex ratio	Continuous	0.007(−0.004 ~ 0.018)	0.224	0.005(−0.006 ~ 0.016)	0.389
Sample size	<4999 vs ≥5000	0.026(−0.004 ~ 0.057)	0.087	0.036(0.003 ~ 0.068)	0.032
Region	Northwestern vs Central	0.013(−0.063 ~ 0.090)	0.731	0.024(−0.055 ~ 0.102)	0.552
	Northwestern vs Northern	0.015(−0.033 ~ 0.064)	0.533	0.012(−0.040 ~ 0.064)	0.659
	Northwestern vs Eastern	0.022(−0.020 ~ 0.064)	0.300	0.025(−0.021 ~ 0.071)	0.281
	Northwestern vs Southwestern	0.113(0.060 ~ 0.166)	<0.001	0.112(0.055 ~ 0.168)	<0.001
	Northwestern vs Northeastern	0.045(−0.025 ~ 0.114)	0.207	0.084(0.012 ~ 0.156)	0.025
	Northwestern vs Southern	0.164(0.117 ~ 0.210)	<0.001	0.176(0.126 ~ 0.226)	<0.001
Nationality	Han vs Other	−0.046(−0.115 ~ 0.023)	0.189	−0.027(−0.095 ~ 0.042)	0.444
Onset age	15 ~ 19 vs 20 ~ 25	0.021(−0.015 ~ 0.057)	0.256	0.028(−0.006 ~ 0.063)	0.110
	15 ~ 19 vs 30 ~ 35	−0.051(−0.118 ~ 0.018)	0.151	0.000(−0.065 ~ 0.065)	0.995
	15 ~ 19 vs 40 ~ 45	0.041(−0.034 ~ 0.115)	0.284	0.058(−0.011 ~ 0.128)	0.100
	15 ~ 19 vs 50 ~ 65	0.041(−0.030 ~ 0.112)	0.262	0.078(0.011 ~ 0.144)	0.023
Published year	2001 ~ 2005 vs 2006 ~ 2010	0.051(−0.058 ~ 0.159)	0.359	0.098(−0.001 ~ 0.196)	0.050
	2001 ~ 2005 vs 2011 ~ 2015	0.078(−0.027 ~ 0.184)	0.146	0.114(0.019 ~ 0.209)	0.019
	2001 ~ 2005 vs 2016 ~ 2019	0.094(−0.013 ~ 0.201)	0.084	0.139(0.042 ~ 0.236)	0.005
Response rate	Continuous	0.262(−0.064 ~ 0.587)	0.115	−0.092(−0.424 ~ 0.241)	0.588
Quality score	Continuous	−0.022(−0.036~-0.008)	0.002	−0.015(−0.031 ~ 0.001)	0.055