Research on the comorbidity of hyperuricemia in middle-aged and young male and exploration of prevention and treatment strategies

Objective To investigate the comorbidities of hyperuricemia(HUA) and the effect relationship for providing theoretical reference for early intervention and treatment of HUA.Methods A cross-sectional study were adopted and a total of 37 175 middle-aged and young male participants were selected from the health examinee database in Xuzhou Central Hospital in 2021. HUA was defined as those with fasting serum uric acid (SUA) >420μmol/L. Univariate analysis and Logistic regression analysis were used to screen comorbidities of HUA. The aggregation between different levels of SUA and combined related factors were demonstrated using comprehensive attribution risk analysis, frequency analysis and correspondence analyses. The mediating effects were verified using analysis of intermediary effect analysis.Results The prevalence of HUA in middle-aged and young male participants was 10.37%(95% CI:10.06%~10.69%). The results of univariant analysis showed that the age, occupation groups, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), blood urea nitrogen(BUN), creatinine(Cr), estimated glomerular filtration rate(eGFR), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein(HDL_C), low-density lipoprotein(LDL_C), plasma viscosity(PV) were significantly related to HUA (P<0.001). Logistic regression analysis showed that the high level of TC, TG, DBP and low level of eGFR were comorbidities of HUA (P<0.001). Correspondence analysis showed that during the gradual increase of SUA, TC was the first to appear abnormal, followed by DBP and eGFR following a path of “metabolism-blood pressure-renal function”. The mediating effect of TC on eGFR mediated by DBP was 23.89%. The mediating effect of DBP on SUA mediated by eGFR was only 8.23%.Conclusion The prevalence of HUA in middle-aged and young male is high. SUA levels increase using over-intake and less-excretion pathways. DBP plays a mediating role between TC and renal dysfunction. The cause of elevated SUA led by eGFR was less 10%. The most part of the elevated SUA due to the intake of high purine foods. Developing healthy life habits and comprehensively control TC, TG, SUA, and blood pressure levels is key measures which not only helps to control metabolic diseases but also protects kidney function.