Open Access Open Badges Research article

The association between hyperuricemia and betel nut chewing in Taiwanese men: a cross-sectional study

Tsai-Sung Tai1, Chih-Cheng Hsu23, Hsiang-Chu Pai4, Wen-Hsin Liu5 and Yueh-Han Hsu467*

Author Affiliations

1 Division of Endocrinology and Metabolism, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan

2 Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County 350, Taiwan

3 Department of Health Services Administration, China Medical University and Hospital, Taichung City 404, Taiwan

4 Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan City 736, Taiwan

5 Division of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan

6 Department of Health Services Administration, China Medical University, Taichung City 404, Taiwan

7 Division of Nephrology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Chung Hsiao Road, Chia-Yi City 600, Taiwan

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BMC Public Health 2013, 13:1136  doi:10.1186/1471-2458-13-1136

Published: 5 December 2013



Studies have associated betel nut chewing with cancers, metabolic syndrome, cardiovascular disorders, chronic kidney disease, and proteinuria. This study investigated whether hyperuricemia is associated with betel nut chewing in men who participated in a health check-up program.


From hospital records, we identified a total of 11,991 men who participated in the health check-up program from 2003 to 2009. They were divided into hyperuricemic group and non-hyperuricemic group. Laboratory tests, medical history, and status of cigarette smoking, alcohol consumption, and betel nut chewing were compared between the 2 groups. We calculated odds ratio (OR) and 95% confidence interval (CI) of hyperuricemia in association with betel nut consumption and other factors.


Compared with the non-hyperuricemic group, the hyperuricemic group was slightly older (59.4 vs. 58.6 years) but less prevalent with betel nut use (11.8 vs. 13.6%, pā€‰=ā€‰0.003). Multivariable logistic regression analysis showed that hyperuricemia was negatively associated with betel nut chewing (OR 0.75, 95% CI 0.66-0.84), older age (OR 0.84, 95% CI 0.77-0.93), and diabetes mellitus (OR 0.57, 95% CI 0.50-0.64). On the other hand, hyperuricemia was positively associated with body mass index (OR 1.75, 95% CI 1.62-1.90), drinking (OR 1.36, 95% CI 1.25-1.49), hypertension (OR 1.41, 95% CI 1.30-1.52), mixed hyperlipidemia (OR 1.84, 95% CI 1.33-2.54), chronic kidney disease (OR 3.28, 95% CI 2.94-3.65), and proteinuria (OR 1.22, 95% CI 1.08-1.38). Smoking, hypercholesterolemia, and hypertriglyceridemia had no significant association with hyperuricemia.


Our data suggest that betel nut chewing is negatively associated with hyperuricemia.

Betel nut; Chronic kidney disease; Comorbidity; Hyperuricemia; Logistic regression analysis