Association between sedentary behavior, hyperuricemia, and gout in American adults: a nationally representative...

The prevalence of sedentary behavior, hyperuricemia, and gout is increasing worldwide. However, the relationships between sedentary behavior and the risk of hyperuricemia and gout in American adults remain unclear. Therefore, we aim to investigate the association between sedentary behavior and the risk of hyperuricemia and gout.

Adults aged ≥ 20 years from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed, with sedentary time assessed via questionnaires and serum uric acid levels measured through laboratory tests. Gout was confirmed by a physician or health professional. Hyperuricemia was defined as a serum uric acid level of ≥ 7.0 mg/dL in men and ≥ 5.7 mg/dL in women. Weighted logistic regression models and restricted cubic spline analyses were used to examine the associations between sedentary time and hyperuricemia and gout. Mediation analysis was used to explore the potential mediating role of hyperuricemia.

A total of 17,634 participants were included in the analysis. The prevalence of hyperuricemia was 20.24% (3569/17,634), and gout was 4.11% (725/17,634). After adjusting for multiple covariates, weighted logistic regression indicated that higher sedentary time (> 8 h/day) was associated with increased risk of hyperuricemia and gout, with adjusted odds ratios (OR) of 1.18 (95% CI: 1.01, 1.39) and 1.41 (95% CI: 1.04, 1.93), respectively. Restricted cubic spline analysis revealed a nonlinear association between sedentary time and the risks of hyperuricemia and gout. Subgroup analyses showed that chronic kidney disease (CKD) stage (P = 0.012) and sex (P = 0.04) modified the association between sedentary time and hyperuricemia, while sex alone modified the association with gout (P = 0.04). The results of the sensitivity analyses remained robust. The results of the mediation analysis showed that hyperuricemia played a mediating role between sedentary time and gout, with a mediation proportion of 15.93%.

Sedentary time increases the risk of hyperuricemia and gout in US adults, especially in men and those with advanced CKD, with hyperuricemia acting as a key mediator. Key Points • Sedentary time of more than 8 h per day is significantly associated with an 18% increased risk of hyperuricemia and a 41% increased risk of gout, compared to less than 4 h per day among US adults. • The association between sedentary time and hyperuricemia is more pronounced among males and individuals with advanced stages of chronic kidney disease, while the association with gout is significantly modified by sex, with a stronger effect observed in males. • Hyperuricemia plays a mediating role between sedentary time and gout, with a mediation proportion of 15.93%.