Ann Rheum Dis doi:10.1136/annrheumdis-2014-205312
  • Clinical and epidemiological research
  • Extended report

Attenuating the mortality risk of high serum uric acid: the role of physical activity underused

  1. Chao Agnes Hsiung3
  1. 1School of Medicine, China Medical University, Taichung, Taiwan
  2. 2Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
  3. 3Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
  4. 4MJ Health Management Institution, Taipei, Taiwan
  5. 5Physiology Research, Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
  6. 6Department of Health Risk Management, College of Management, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr Chi Pang Wen, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan; cwengood{at}
  • Received 28 January 2014
  • Revised 17 June 2014
  • Accepted 28 June 2014
  • Published Online First 22 July 2014


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.

Findings 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.

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