Geographical distribution of hyperuricemia in mainland China: a comprehensive systematic review and meta-analysis

Huang, Jiayun; Ma, Zheng Feei; Zhang, Yutong; Wan, Zhongxiao; Li, Yeshan; Zhou, Hang; Chu, Anna; Lee, Yeong Yeh

doi:10.1186/s41256-020-00178-9

Global Health Research and Policy

Table 1 Characteristics of the included studies in the systematic review and meta-analysis

From: Geographical distribution of hyperuricemia in mainland China: a comprehensive systematic review and meta-analysis

No.	Study	Study type	Provinces (cities)/municipalities/autonomous regions	Region	Age (years)^c	Case	Sample size	Prevalence (%)	Diagnostic cut-offs	Gender
1	Ma, Chen & Li (1999) [14]	CS	Guangdong	South Central	55–82	452	2041	22.1	>420 μmol/L	Both
						364	1696	21.5	>420 μmol/L	Male
						88	345	25.5	>420 μmol/L	Female
2	Shao et al. (2003) [15]	CS	Nanjing	East	≥18	1038	7778	13.3	NS	Both
						688	3790	17.6	≥417 μmol/L	Male
						370	3988	9.3	≥357 μmol/L	Female
3	Chen et al. (2004) [16]	CC	Anhui	East	45 ± 12	105	430	24.4	NS	Both
						70	227	30.8	>420 μmol/L	Male
						35	203	17.2	>360 μmol/L	Female
4	Wu et al. (2005) [17]	CS	Guangzhou, Guangdong	South Central	> 55	197	642	30.7	NS	Both
						46	152	30.3	>420 μmol/L	Male
						151	490	30.8	>350 μmol/L	Female
5	Yang et al. (2005) [18]	CS	Shandong	East	18–54	537	8640	6.2	NS	Both
						459	6289	7.3	≥416 μmol/L	Male
						78	2351	3.3	≥357 μmol/L	Female
6	Wang et al. (2006) [19]	CS	Shandong	East	20–80	269	2605	10.3	> 350 μmol/L	Female
7	Li et al. (2008) [20]	CH	China^a	NA^a	45–54	10	274	3.6	NS	Both
						5	90	5.6	≥416 μmol/L	Male
						5	184	2.7	≥356 μmol/L	Female
					55–64	18	307	5.9	NS	Both
						13	138	9.4	≥416 μmol/L	Male
						5	169	3.0	≥356 μmol/L	Female
					65–74	21	229	9.2	NS	Both
						12	116	10.3	≥416 μmol/L	Male
						9	113	8.0	≥356 μmol/L	Female
8	Fan et al. (2009) [118]	CS	Xinyang, Henan	South Central	40–75	738	5235	14.1	NS	Both
						379	1763	21.5	≥420 μmol/L	Male
						354	3472	10.2	≥360 μmol/L	Female
9	Lu et al. (2010) [21]	CS	Tianjin	North	22–53	19	151	12.6	≥410 μmol/L	Male
10	Yu et al. (2010) [22]	CS	Foshan, Guangdong	South Central	20–88	1117	7403	15.1	NS	Both
						714	3581	19.9	≥417 μmol/L	Male
						403	3822	10.5	≥357 μmol/L	Female
11	Yuan et al. (2011) [23]	CS	Guiyang	Southwest	> 60	399	2600	15.3	≥420 μmol/L	Both
						227	1430	15.9	NS	Male
						172	1170	14.7	NS	Female
12	Zhang & Zhang (2011) [24]	CS	China^a	NA^a	≥18	427	5774	7.4	NS	Both
13	Guo et al. (2012) [25]	CS	Taiyuan, Shanxi	Northwest	23–87	371	4228	8.8	NS	Both
						249	1308	19.0	≥420 μmol/L	Male
						122	2920	4.2	≥420 μmol/L	Female
14	Wang et al. (2012) [26]	CS	Yinchuan, Ningxia	Northwest	≥18	926	5921	15.6	NS	Both
						1352	7322	18.5	NS	Both
						1635	8717	18.8	NS	Both
15	Chen et al. (2013) [27]	CS	Guangxi	South Central	≥18	319	927	34.4	NS	Both
						157	419	30.9	NS	Male
						162	508	38.7	NS	Female
16	Duan et al. (2013) [28]	CS	Xinjiang	Northwest	≥18	261	2046	12.8	NS	Both
						228	823	27.7	>417 μmol/L	Male
						33	1223	2.7	>357 μmol/L	Female
17	Li et al. (2013) [29]	CS	Quanzhou, Fujian	East	40–80	253	1358	18.6	NS	Both
						99	363	27.3	≥416 μmol/L	Male
						154	995	15.5	≥357 μmol/L	Female
18	Li & Cao (2013) [30]	CS	Karamay, Xinjiang	Northwest	≥18	310	2032	15.3	NS	Both
						268	1086	24.7	NS	Male
						42	946	4.4	NS	Female
19	Lv et al. (2013) [31]	CS	Yantai, Shandong	East	31–78	66	635	10.4	≥380 μmol/L	Both
20	Su et al. (2013) [32]	CS	Nanhai, Guangdong	South Central	45–80	415	2015	20.6	NS	Both
						271	1110	24.4	>420 μmol/L	Male
						144	905	16.9	>357 μmol/L	Female
21	Wang et al. (2013) [33]	CS	Shanghai	East	40–70	58	1928	3.0	NS	Both
						33	582	5.7	>420 μmol/L	Male
						25	1346	1.9	>357 μmol/L	Female
22	Zhang, Wu & Lv (2013) [34]	CS	Hebei	North	21–95	693	3232	21.4	NS	Both
						446	1897	23.5	≥428 μmol/L	Male
						247	1335	18.5	≥357 μmol/L	Female
23	Zhou & He (2013) [35]	CH	Shenyang, Liaoning	Northeast	50–70	8	70	34.8	NS	Both
24	Chen, Dai & Lin (2014) [36]	CS	Guangzhou, Guangdong	South Central	45–75	603	1176	51.3	NS	Both
						341	612	55.7	>420 μmol/L	Male
						262	564	46.5	>357 μmol/L	Female
25	Cui et al. (2014) [37]	CS	Hebei	North	≥20	1091	7083	15.4	NS	Both
						904	5357	16.9	≥417 μmol/L	Male
						187	1726	10.8	≥357 μmol/L	Female
26	Li, Zhao, Gao (2014) [38]	CS	Yunnan	Southwest	27–89	367	2947	12.5	NS	Both
						303	1827	16.6	>420 μmol/L	Male
						64	1120	5.7	>360 μmol/L	Female
27	Lin et al. (2014) [39]	CS	Guangdong	South Central	> 60	190	1036	18.3	NS	Both
						86	383	22.5	≥420 μmol/L	Male
						104	653	15.9	≥420 μmol/L	Female
28	Liu et al. (2014) [40]	CS	Jilin	Northeast	38 ± 10	3395	16,807	20.2	NS	Both
						2930	9736	30.1	NS	Male
						465	7071	6.6	NS	Female
29	Pan et al. (2014) [41]	CS	Jiangsu	East	35–70	573	3122	18.4	NS	Both
						362	1349	26.8	≥420 μmol/L	Male
						211	1773	11.9	≥380 μmol/L	Female
30	Song et al. (2014) [42]	CS	Jiangxi	East	> 40	795	3795	20.9	NS	Both
						488	1824	26.8	>420 μmol/L	Male
						307	1971	15.6	>350 μmol/L	Female
31	Yong & Ye (2014) [43]	CS	Hebei	North	≥18–20	813	5269	15.4	NS	Both
						769	2717	28.3	>420 μmol/L	Male
						44	2552	1.7	>350 μmol/L	Female
32	Zhu, Wang, Liu (2014) [44]	CS	Xinjiang	Northwest	20–93	1489	10,025	14.9	NS	Both
33	Cao, Li & Yi (2015) [45]	CS	Guangzhou, Guangdong	South Central	20–80	290	988	29.4	NS	Both
						264	601	43.9	>420 μmol/L	Male
						26	387	6.7	>350 μmol/L	Female
34	Li et al. (2015a) [46]	CS	Gansu	Northwest	48 ± 15	392	2364	16.6	NS	Both
						256	1254	20.4	>420 μmol/L	Male
						136	1110	12.3	>360 μmol/L	Female
35	Li et al. (2015b) [47]	CS	Guangxi	South Central	≥20	14,181	51,206	27.7	NS	Both
						10,722	27,144	39.5	≥417 μmol/L	Male
						3459	24,062	14.4	≥357 μmol/L	Female
36	Li et al. (2015c) [48]	CS	Dongguan, Guangdong	South Central	≥18	519	1375	37.6	NS	Both
						366	657	26.6	>420 μmol/L	Male
						153	718	11.1	>350 μmol/L	Female
37	Liu et al. (2015) [11]	CS	Guangzhou, Guangdong	South Central	≥18	1334	4237	31.5	NS	Both
						859	2257	38.1	>420 μmol/L	Male
						475	1980	24.0	>360 μmol/L	Female
38	Lu (2015) [49]	CS	Shanghai	East	65–85	220	1128	19.5	NS	Both
						165	607	27.2	>420 μmol/L	Male
						63	511	12.3	>350 μmol/L	Female
39	Zhao (2015) [50]	CS	China^a	NA^a	20–60	4616	12,650	36.5	NS	Both
40	Zhou et al. (2015a) [51]	CS	Sichuan	Southwest	≥18	182	972	18.7	NS	Both
						123	452	27.2	≥420 μmol/L	Male
						59	520	11.3	≥360 μmol/L	Female
41	Zhou et al. (2015b) [52]	CS	Henan	South Central	20–60	1196	4916	24.3	NS	Both
						1128	4290	26.3	≥420 μmol/L	Male
						68	626	10.9	≥357 μmol/L	Female
42	Guli, He & Zhang (2016) [53]	CS	Gansu	Northwest	20–80	780	6400	12.2	>420 μmol/L	Both
43	Chen & Xing (2016) [54]	CS	Beijing	North	25–82	151	868	17.4	≥416 μmol/L	Male
44	Chen & Zhou (2016) [55]	CS	Zhejiang	East	> 60	691	4160	16.6	NS	Both
						393	2182	18.0	>420 μmol/L	Male
						298	1978	15.1	>360 μmol/L	Female
45	Fan et al. (2016) [56]	CS	Shanghai	East	≥18	5413	27,615	19.6	NS	Both
						3993	14,104	28.3	>420 μmol/L	Male
						1420	13,511	10.5	>357 μmol/L	Female
46	Feng et al. (2016) [57]	CS	Jiangsu	East	18–93	219	1352	16.2	NS	Both
						129	609	21.2	>420 μmol/L	Male
						90	743	12.1	>350 μmol/L	Female
47	Li (2016) [58]	CS	Tianjin	North	≥18	10,344	77,787	13.3	NS	Both
48	Li et al. (2016) [59]	CS	Chongqing	Southwest	39	1596	26,067	6.1	NS	Both
						1272	18,139	7.0	≥420 μmol/L	Male
						324	7928	4.1	≥357 μmol/L	Female
49	Liu et al. (2016) [60]	CS	Shanghai	East	≥18	8100	9653	83.9	NS	Both
						2872	3550	81.2	>420 μmol/L	Male
						5228	6103	85.9	>357 μmol/L	Female
50	Liu, Zhou & Yin (2016) [61]	CS	Yunnan	Southwest	32–60	131	390	33.6	NS	Both
						126	334	37.7	>420 μmol/L	Male
						5	56	9.1	>360 μmol/L	Female
51	Lu (2016) [62]	CS	Xinjiang	Northwest	≥60	233	986	23.6	NS	Both
52	Pu et al. (2016) [63]	CS	China^a	NA^a	20–91	1078	11,967	9.0	NS	Both
53	Wang (2016) [64]	CS	Hubei	South Central	18–22	358	4333	8.3	NS	Both
						294	2029	14.5	>420 μmol/L	Male
						64	2304	2.8	>350 μmol/L	Female
54	Xie et al. (2016) [65]	CS	Beijing; Tangshan and Zhangjiakou, Hebei	North	18–60	632	2782	22.7	NS	Both
						268	1830	14.6	>420 μmol/L	Male
						364	952	35.1	>357 μmol/L	Female
55	Yang, Wang & Wang (2016) [66]	CS	Tianjin	North	18–93	1165	8968	13.0	NS	Both
						959	5449	17.6	>417 μmol/L	Male
						206	3519	5.9	>357 μmol/L	Female
56	Zhang (2016) [67]	CS	China^a	NA^a	≥18	198	794	24.9	>420 μmol/L	Male
56	Zhang (2016) [67]	CS	Eastern China^a	East	≥18	58	202	31.3	>421 μmol/L	Male
57	Zhao et al. (2016a) [68]	CS	Lanzhou, Gansu	Northwest	≥45	37	175	21.1	NS	Both
58	Zhao et al. (2016b) [69]	CS	Beijing	North	20 ± 3	1716	6400	26.8	NS	Both
						1464	4198	34.9	>417 μmol/L	Male
						252	2202	11.4	>357 μmol/L	Female
59	Zhao et al. (2016c) [70]	CS	Beijing	North	20–89	1086	6690	16.2	NS	Both
						785	3339	23.5	>417 μmol/L	Male
						301	3351	10.0	>357 μmol/L	Female
60	Feng et al. (2017) [71]	CS	Beijing	North	range ≥ 18	2257	12,335	18.3	NS	Both
						1867	7681	24.3	>420 μmol/L	Male
						390	4654	8.4	>357 μmol/L	Female
61	Guo et al. (2017) [72]	CS	Heilongjiang	Northeast	20–59	419	1477	28.4	>420 μmol/L	Male
62	He (2017) [73]	CS	Dalian, Liaoning	Northeast	22–91	358	2002	17.9	NS	Both
						252	1044	24.1	>420 μmol/L	Male
						106	958	11.1	premenopausal>350 μmol/L postmenopausal>420 μmol/L	Female
63	Li et al. (2017) [74]	CC	Urumqi, Xinjiang	Northwest	18–78	221	1644	23.8	NS	Both
64	Li, Zhou & Pan (2017) [75]	CS	Guangdong	South Central	22–90	314	3071	10.2	NS	Both
65	Lin et al. (2017) [76]	CS	Yunnan	South Central	18–84	196	1682	11.7	NS	Both
						139	923	15.1	≥417 μmol/L	Male
						57	759	7.5	≥357 μmol/L	Female
66	Liu et al. (2017a) [77]	CS	Shanghai	East	≥18	148	908	16.3	NS	Both
						48	308	15.6	>420 μmol/L	Male
						100	600	16.7	>360 μmol/L	Female
67	Liu et al. (2017b) [78]	CS	Shanghai	East	20–80	1444	9294	15.5	NS	Both
						639	3393	18.8	>420 μmol/L	Male
						805	5901	13.6	>357 μmol/L	Female
68	Liu et al. (2017c) [79]	CS	Hunan	South Central	20–80	1435	5356	26.8	NS	Both
						1234	3489	35.4	NS	Male
						201	1867	10.8	NS	Female
69	Liu, Yan & Li (2017) [80]	CS	Hebei	North	≥18	698	6045	11.5	NS	Both
						488	3344	14.6	>416 μmol/L	Male
						210	2701	7.8	>357 μmol/L	Female
70	Liu & Yang (2017) [81]	CC	Beijing	North	21–67	204	1799	11.3	NS	Both
71	Min (2017)	CS	Shenyang, Liaoning	Northeast		74	282	26.2	NS	Both
72	Pan & Jiang (2017) [82]	CS	Fuzhou, Fujian	East	75	210	744	28.2	NS	Both
						196	618	31.7	>420 μmol/L	Male
						14	126	11.1	>420 μmol/L	Female
73	Wang & Bai (2017) [83]	CS	Ningxia	Northwest	22–60	121	1012	12.0	NS	Both
						99	757	13.1	>420 μmol/L	Male
						22	255	8.6	>357 μmol/L	Female
74	Wang & Bao (2017) [84]	CS	Shanghai	East	60–93	454	2426	18.7	NS	Both
						220	1076	20.5	>420 μmol/L	Male
						234	1350	17.3	>360 μmol/L	Female
75	Xie et al. (2017) [85]	CS	Guangdong	South Central	35–75	279	2587	10.8	NS	Both
						175	1410	12.4	>417 μmol/L	Male
						104	1177	8.8	>357 μmol/L	Female
76	Yu & Jie (2017) [86]	CS	Shandong	East	21–76	1191	10,743	11.1	NS	Both
						1116	6426	10.4	≥430 μmol/L	Male
						75	4317	0.7	≥375 μmol/L	Female
77	Zhang (2017a) [87]	CS	Liaoning	Northeast	21–50	121	500	24.2	NS	Both
78	Zhang (2017b) [88]	CS	Anhui	East	25–87	19	230	8.3	>420 μmol/L	Both
79	Zhang, Chen & Liu (2017) [89]	CS	Zhuhai, Guangdong	South Central	18–75	590	1834		NS	Both
						290	679	42.7	NS	Male
						300	1155	26.0	NS	Female
80	Zheng (2017) [90]	CS	China^a	NA^a	24 ± 6	432	1721	25.1	> 420 μmol/L	Male
81	Chen et al. (2018a) [91]	CS	Liaoning, Heilonjiang, Shandong, Henan, Hubei, Hunan, Jiangsu, Guizhou, Guangxi	NA^b	49 ± 17	1435	8785	16.3	NS	Both
						886	4110	21.6	≥420 μmol/L	Male
						549	4675	11.7	≥360 μmol/L	Female
82	Chen et al. (2018b) [92]	CS	Guangxi	South Central	> 60	161	817	19.7	>420 μmol/L	Both
83	Chen et al. (2018c) [93]	CS	Guangdong	South Central	≥18	328	981	33.4	>420 μmol/L	Male
84	Chen et al. (2018d) [94]	CS	Guangxi	South Central	65–96	241	1223	19.7	NS	Both
						163	629	25.9	≥420 μmol/L	Male
						78	594	13.1	≥360 μmol/L	Female
85	Fan, Mao & Chen (2018) [95]	CS	Ningbo, Zhejiang	East	≥45	750	3395	22.1	NS	Both
86	He (2018) [96]	CS	Henan	South Central	25–89	410	2193	18.7	NS	Both
						305	1156	26.4	>420 μmol/L	Male
						105	1037	10.1	>350 μmol/L	Female
87	Hu et al. (2018) [97]	CS	Guangxi	South Central	20–70	1035	6241	16.6	NS	Both
						755	3271	23.1	> 420 μmol/L	Male
						280	2970	9.4	> 360 μmol/L	Female
88	Huang & Huang (2018) [98]	CS	Guangzhou, Guangdong	South Central	51–82	55	338	16.3	NS	Both
						49	289	17.0	NS	Male
						6	49	12.2	NS	Female
89	Huang et al. (2018) [99]	CS	Guizhou	Southwest	18–75	26,341	143,687	18.3	NS	Both
						15,387	75,364	20.4	≥417 μmol/L	Male
						20,954	68,323	16.0	≥357 μmol/L	Female
90	Li, Wang & Xu (2018) [100]	CS	Beijing	North	18–80	255	1700	15.0	NS	Both
						116	620	18.7	NS	Male
						139	1080	12.9	NS	Female
91	Lin et al. (2018a) [101]	CS	Fujian	East	18–63	666	2666	25.0	NS	Both
						411	1251	43.9	>417 μmol/L	Male
						255	1415	18.0	>357 μmol/L	Female
92	Lin et al. (2018b) [102]	CS	Guangzhou, Guangdong	South Central	≥18	1642	5603	29.3	NS	Both
						1590	5281	30.1	>420 μmol/L	Male
						53	322	16.5	>350 μmol/L	Female
93	Lu (2018a) [103]	CS	Zhejiang	East	55	147	1200	12.3	NS	Both
						93	597	15.6	> 420 μmol/L	Male
						54	603	9.0	> 350 μmol/L	Female
94	Lu (2018b) [104]	CH	Inner Mongolia	North	≥35	383	2554	15.0	NS	Both
						331	1632	20.3	>420 μmol/L	Male
						52	922	5.6	>360 μmol/L	Female
						477	2554	18.7	NS	Both
						413	1632	25.3	>420 μmol/L	Male
						64	922	6.9	>360 μmol/L	Female
						511	2554	20.0	NS	Both
						446	1632	27.3	>420 μmol/L	Male
						65	922	7.6	>360 μmol/L	Female
						530	2554	20.8	NS	Both
						465	1632	28.5	>420 μmol/L	Male
						65	922	8.0	>360 μmol/L	Female
95	Su et al. (2018) [105]	CS	Zhejiang	East	range ≥ 18	694	3905	17.8	NS	Both
						364	1797	20.3	NS	Male
						330	2108	15.7	NS	Female
96	Tuo et al. (2018) [106]	CS	Gansu	Northwest	20–80	768	4263	18.0	NS	Both
						432	1783	24.2	≥420 μmol/L	Male
						336	2480	13.6	≥350 μmol/L	Female
97	Wang et al. (2018a) [107]	CS	Beijing; Xi’an, Shaanxi; Harbin, Heilongjiang; Chengdu, Sichuan; Chongqing; Changsha, Hunan; Shanghai	NA^b	≥60	754	5351	14.1	NS	Both
						304	2304	13.2	≥420 μmol/L	Male
						450	3047	14.8	≥360 μmol/L	Female
98	Wang et al. (2018b) [108]	CS	Liaoning; Heilongjiang; Jiangsu; Shandong; Henan; Hubei; Hunan; Guangxi	NA^b	≥18	555	4111	13.5	NS	Both
						361	1871	19.3	> 418 μmol/L	Male
						194	2240	8.7	> 357 μmol/L	Female
99	Wang & Ma (2018) [109]	CS	Liaoning	Northeast	22–65	432	1481	29.2	> 420 μmol/L	Male
100	Yang et al. (2018) [110]	CS	China^a	NA^a	≥18	3855	24,095	16.0	NS	Both
101	Yu et al. (2018) [111]	CS	Xinjiang	Northwest	30–81	2648	14,426	18.4	NS	Both
102	Zhang et al. (2018) [112]	CS	Ningxia	Northwest	≥18	3880	19,356	20.0	NS	Both
						3180	12,115	26.2	>420 μmol/L	Male
						700	7241	9.7	>350 μmol/L	Female
103	Zhou et al. (2018) [113]	CS	Ningxia	Northwest	≥35	279	1743	16.0	NS	Both
						193	1044	18.5	NS	Male
						86	699	12.3	NS	Female
104	Hu, Zhao & Shang (2019) [114]	CS	Tibet	Northwest	20–49	170	1669	10.2	NS	Both
						114	952	12.0	NS	Male
						56	717	7.8	NS	Female
105	Tian et al. (2019) [115]	CS	Beijing	North	18–97	10,795	52,673	20.5	NS	Both
						8524	27,419	31.1	NS	Male
						2271	25,254	9.0	NS	Female
106	Wang et al. (2019) [123]	CC	China^a	NA^a	≥18	2977	22,983	13.0	NS	Both
						1999	10,787	18.5	NS	Male
						978	12,796	7.6	NS	Female
107	Yang (2019) [116]	CH	Guilin, Guangxi	South Central	20–68	160	1545	10.4	NS	Both
108	Yu et al. (2019) [117]	CS	Shenyang, Liaoning	Northeast	≥18	7705	14,323	53.7	NS	Both

CS Cross-sectional, CC Case control, CH Cohort study, NA Not applicable, NS Not stated
^aNo specific provinces were reported
^bMore than one region was involved
^cMean used unless range reported

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ISSN: 2397-0642

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