Hyperuricemia And Estimated Cardiovascular Risk Among Migrant and non-migrant Africans

Abstract Objective In the advent of rapid urbanization, migration and epidemiological transition, the extent to which serum uric acid (sUA) affects cardiovascular disease (CVD) risk among Africans is not well understood. We assessed differences in sUA levels and associations with estimated CVD risk among migrant Ghanaians in Europe, and non-migrant Ghanaians in rural and urban Ghana. Methods Baseline data from 633 rural, 916 urban and 2315 migrant RODAM study participants (40-70 years) were analyzed. Hyperuricemia was defined as sUA >7mg/dl in males and >6mg/dl in females. Elevated CVD risk was defined as pooled cohort equation estimates ≥ 7.5%. Logistic regressions were used to assess differences in hyperuricemia and associations with estimated CVD risk. Receiver operator curves were used to calculate sUA cut off values that maximised likelihood of elevated CVD risk. Results Prevalence for hyperuricemia in rural, urban and migrant participants were 17.4%, 19.1% and 31.7% for men, and 15.9%, 18.2% and 33.2% for women, respectively. Hyperuricemia was positively associated with elevated CVD risk among rural residents(adjusted OR for men 2.88, 95%CI, 1.20-6.88, 5.32, 95%CI, 2.86-9.95 for women), urban residents(1.26, 95%CI, 0.59-2.69 for men, 2.41, 95%CI, 1.56-3.73 for women) and migrants(2.39, 95%CI, 1.57-3.64) for men, 3.74, 95%CI, 2.78-5.02 for women). SUA cut-off values were 6.8mg/dl in men and 5.2mg/dl in women. Conclusions Our study shows variations of sUA levels in different African contexts. Hyperuricemia is associated with elevated estimated CVD risk in both migrants and non-migrants. Further studies should identify factors driving associations between SUA and CVD risk in Africans. Key messages Hyperuricemia is a risk factor for cardiovascular risk in both migrants and non-migrants. Cardiovascular risk is seen at low levels of serum uric acid levels in Africans.