Associations of serum uric acid with cardiovascular disease risk factors: a retrospective cohort study in Southeastern China

Objective: To evaluate the associations between serum uric acid (SUA)
levels and cardiovascular disease (CVDs) risk factors, focusing on
potential sex-specific differences. Design: A retrospective cohort study.
Setting: A large community-based survey was conducted every two years from
2010 to 2018 in Hangzhou, Zhejiang Province, Southeastern China.
Participants: 6119 participants aged 40 years and above who underwent at
least three times of physical examinations were enrolled. Methods:
Participants were categorized into four groups (Q1-Q4) based on baseline
SUA quartiles within the normal range, with hyperuricemia (HUA) as the
fifth group. The Q1 was the reference. By stratifying participants by
gender, the relationships between SUA levels and systolic blood pressure
(SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and
total cholesterol (TC) were investigated using linear regression models in
the generalized estimating equation (GEE). Additionally, the associations
of elevated SUA levels and HUA with hypertension, hyperglycemia, and
dyslipidemia were correspondingly examined using multivariate logistic
regression models. Results: After adjusting for confounding variables, we
found positive associations between SUA levels and SBP, DBP, FBG, and TC
in women, and with TC in men (P < 0.01). Likewise, Elevated SUA
quartiles and HUA were linked to increased dyslipidemia risk in both
sexes, and increased hyperglycemia risk only in women, with HRs (95%CI) of
1.64 (1.05-2.55) and 2.37 (1.47-3.81) in the Q4 and HUA group,
respectively. Women with HUA had higher hypertension risk (HR=1.45, 95% CI
1.21-1.73), while no such association was observed in men. Stratified
analyses revealed significant associations between elevated SUA levels and
CVDs risk factors in postmenopausal and non-obese women. Conclusions:
Elevated SUA levels increase the risk of dyslipidemia in both sexes. SUA
levels within normal-range and HUA are positively associated with
hyperglycemia and hypertension in postmenopausal women, but not in men.