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Hyperuricemia After Exposure to Polychlorinated Dibenzo-P-Dioxins and Dibenzofurans Near a Highly Contaminated Area

Chang, Jung-Wei; Ou, Horng-Yih; Chen, Hsiu-Ling; Su, Huey-Jen; Lee, Ching-Chang

doi: 10.1097/EDE.0b013e318294ef68

Background: Hyperuricemia (too much uric acid in the blood) is the predisposing condition for gout and is associated with hypertriglyceridemia, diabetes mellitus, and coronary artery disease. Polychlorinated dibenzo-p-dioxins and dibenzo-furans (PCDD/Fs) cause renal toxicity and elevate uric acid. The aim of this analysis was to investigate and clarify the effect of moderate-to-high PCDD/F exposure on hyperuricemia risk.

Methods: In this cross-sectional study, we recruited 1531 healthy participants living near a deserted pentachlorophenol factory. We measured serum levels of 17 2,3,7,8-substituted PCDD/Fs, and then examined associations between the main predictor variable, serum TEQDF-2005 (total PCDD/Fs 2005 World Health Organization [WHO] toxic equivalency [TEQ]), and dependent variables such as uric acid, glomerular filtration rates, and hyperuricemia risk.

Results: We observed a strong monotonic inverse relationship between serum TEQDF-2005 quartiles and the estimated glomerular filtration rate after adjusting for confounding factors (Men: β were 0, −4.7, −6.2, and −14.8; Women: β were 0, −6.7, −12.9, and −21.5). In addition, we observed a suggestive positive trend between serum TEQDF-2005 quartiles and uric acid only in men after adjusting for confounding factors (Men: β were 0, 0.40, 0.36, and 0.59; P for trend <0.05). Men with serum TEQDF-2005 higher than the reference group’s (<7.4 pg WHO2005–TEQDF/g lipid) had a higher hyperuricemia risk after adjusting for confounding factors (25th to <50th percentile, adjusted odds ratio [AOR] = 2.20 [95% confidence interval {CI} = 1.30–3.73]; 50th to <75th percentile, AOR = 1.86 [95% CI = 1.08–3.22]; ≥75th percentile, AOR = 3.00 [95% CI = 1.69–5.31]).

Conclusions: We conclude that serum TEQDF-2005 is an important determinant of serum uric acid levels and heightens the risk of hyperuricemia in general populations.

Supplemental Digital Content is available in the text.

From the aDepartment of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; bDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; cDepartment of Industrial Safety and Health, Hung Kuang University, Taichung, Taiwan; and dResearch Center for Environmental Trace Toxic Substances, National Cheng Kung University, Tainan, Taiwan.

Supported by grants from the Tainan City Bureau of Health.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Correspondence: Ching-Chang Lee, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan. E-mail:

Received May 10, 2012

Accepted January 8, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.