The validity of the uric acid excretion fraction (FEua) of spot urine in the diagnosis of underexcretion-type hyperuricemia

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  • 排泄低下型高尿酸血症の診断におけるスポット尿の尿酸排泄分画（FEua）の妥当性

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<p>The validity of using the uric acid excretion fraction by spot urine (FEua spot) has not yet been clarified. Using the deta of "Reference interval of urinary clearance and excretion of urate in Japan (RICE-U)" study and the previously reported cut-off value of FEua spot, 60-minute uric acid clearance (Cua 60 min) or 24-hour uric acid clearance (Cua 24 hr), we examined the degree of agreement of diagnosis by these three types of indicators, the accuracy of each indicator, and the correlation between the indicators. The subjects were indoor workers aged 20 to 65 who participated in the RICE-U study and were not excluded due to lifestyle-related habits or illness. The homology in the diagnosis of underexcretion-type hyperuricemia between each index was evaluated using the kappa coefficient. Also, the coefficient of variation was calculated to compare each test's accuracy, and the correlation between each test was examined. The analysis subjects were 796 people, including 446 males and 350 females. Of the total, 75 people (9.4%) showed hyperuricemia, all of which were males. The concordance rate and κ coefficient for the diagnosis of underexcretion-type hyperuricemia were 71.0% and 0.43 for FEua spot and Cua 24 hr, 72.4% and, 0.42 for FEua spot and Cua 60 min, and 76.0% and 0.48 for Cua 24 hr and Cua 60 min, respectively. The compatibility was all moderate. The coefficient of variation of the three indicators by gender was about the same as 30 to 35%, and a significant positive correlation was observed between the indicators. Three types of renal uric acid excretion index could be substituted for each other. Furthermore, from the viewpoint of versatility, the validity of popularizing the FEua spot, which is excellent convenience, was inferred.</p>

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