Serum Phosphate and the Risk of New-Onset Hyperuricemia in Hypertensive Patients

The relationship of serum phosphate and new-onset hyperuricemia remains uncertain. We aimed to evaluate the relationship of serum phosphate with the risk of new-onset hyperuricemia, and to examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric Acid substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 10 612 participants with normal uric acid levels (<357 μmol/L [6 mg/dL]) at baseline were included in the current study. The primary outcome was new-onset hyperuricemia, which was defined as a uric acid concentration ≥417 μmol/L (7 mg/dL) in men or ≥357 μmol/L (6 mg/dL) in women. During a median follow-up of 4.4 years, 1663 (15.7%) participants developed new-onset hyperuricemia. Overall, there was a significant inverse association between serum phosphate and the risk of new-onset hyperuricemia (per SD increment; odds ratio, 0.71; 95% CI, 0.66-0.76). When serum phosphate was assessed as quartiles, a significantly lower risk of new-onset hyperuricemia was found in participants in quartile 4 (≥1.4 mmol/L; odds ratio, 0.48; 95% CI, 0.40-0.57) compared with those in quartile 1 (<1.2 mmol/L). Similar results were found in males and females. In summary, there was an inverse association between serum phosphate and the risk of new-onset hyperuricemia in hypertensive adults.