title: Attenuating the mortality risk of high serum uric acid: the role of physical activity underused.
abstract: BACKGROUND
  High serum uric acid (sUA) has been associated with increased mortality risks, but its clinical treatment varied with potential side effects. The role of physical activity has received limited attention.
  
  
  METHODS
  A cohort, consisting of 467 976 adults, who went through a standard health screening programme, with questionnaire and fasting blood samples, was successively recruited between 1996 and 2008. High sUA is defined as uric acid above 7.0 mg/dL. Leisure time physical activity level was self-reported, with fully active defined as those with 30 min per day for at least 5 days a week. National death file identified 12 228 deaths with a median follow-up of 8.5 years. Cox proportional model was used to analyse HRs, and 12 variables were controlled, including medical history, life style and risk factors.
  
  
  RESULTS
  High sUA constituted one quarter of the cohort (25.6%). Their all-cause mortality was significantly increased [HR: 1.22 (1.15-1.29)], with much of the increase contributed to by the inactive (HR: 1.27 (1.17-1.37)), relative to the reference group with sUA level of 5-6 mg/dL. When they were fully active, mortality risks did not increase, but decreased by 11% (HR: 0.89 (0.82-0.97)), reflecting the benefits of being active was able to overcome the adverse effects of high sUA. Given the same high sUA, a 4-6 years difference in life expectancy was found between the active and the inactive.
  
  
  CONCLUSIONS
  Physical activity is a valuable alternative to pharmacotherapy in its ability to reduce the increases in mortality risks from high sUA. By being fully active, exercise can extend life span by 4-6 years, a level greater than the 1-4 years of life-shortening effect from high sUA.
authors: School of Medicine, China Medical University, Taichung, Taiwan Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Jiunn-Horng
authors: JH
authors: Chen
authors: School of Medicine, China Medical University, Taichung, Taiwan Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Chi Pang
authors: CP
authors: Wen
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Shiuan Bei
authors: SB
authors: Wu
authors: School of Medicine, China Medical University, Taichung, Taiwan Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Joung-Liang
authors: JL
authors: Lan
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Min Kuang
authors: MK
authors: Tsai
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Ya-Ping
authors: YP
authors: Tai
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: June Han
authors: JH
authors: Lee
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Chih Cheng
authors: CC
authors: Hsu
authors: MJ Health Management Institution, Taipei, Taiwan.
authors: Chwen Keng
authors: CK
authors: Tsao
authors: Physiology Research, Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan.
authors: Jackson Pui Man
authors: JP
authors: Wai
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan Department of Health Risk Management, College of Management, China Medical University, Taichung, Taiwan.
authors: Po Huang
authors: PH
authors: Chiang
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Wen Han
authors: WH
authors: Pan
authors: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors: Chao Agnes
authors: CA
authors: Hsiung
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D002423:Cause of Death; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D033461:Hyperuricemia / Q000453:epidemiology*; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009043:Motor Activity; D011236:Prediabetic State / Q000453:epidemiology; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid
keywords: Cardiovascular Disease; Epidemiology; Gout