The association between calcium-phosphorus product and hyperuricemia varied in BMI groups: a mediation analysis study

The relationship between the calcium-phosphorus product (Ca × P) and hyperuricemia (HUA) has not been thoroughly explored. This study sought to investigate this association across BMI groups in US adults.

A cross-sectional analysis was conducted using the 2017-2018 National Health and Nutrition Examination Survey (NHANES) dataset (N = 5068). The association was evaluated through restricted cubic splines, logistic regression, and mediation analysis.

Participants in the highest quartile of Ca × P had a 1.31-fold higher odds of HUA (OR 1.31; 95% CI 1.04-1.65) compared to those in the lowest quartile. A positive linear association between Ca × P and HUA was observed among overweight or obese individuals (OR 1.04; 95% CI 1.01-1.08 and OR 1.04; 95% CI 1.01-1.06, respectively). In the obese subgroup, those in the highest Ca × P quartile had a 1.50-fold increased odds of HUA (OR 1.50; 95% CI 1.11-2.03). Moreover, serum triglycerides mediated 23.12% of the association between Ca × P and HUA in obese adults, showing differential effect patterns.

Ca × P levels were positively associated with a greater prevalence of HUA, especially in the overweight or obesity population. Serum triglycerides play a crucial mediating role in the relationship between Ca × P and HUA among obese people. Key Points • Elevated per Ca × P level is significantly associated with a 3% increased risk of hyperuricemia among US adults, with individuals in the highest quartile exhibiting 1.31-fold higher odds compared to those in the lowest quartile. • The association between Ca × P and hyperuricemia is notably stronger in overweight and obese populations, with obese adults in the highest Ca × P quartile showing a 1.5-fold increased risk of hyperuricemia. • Serum triglycerides mediate 23.12% of the relationship between Ca × P and hyperuricemia in obese individuals, indicating a substantial metabolic pathway influencing hyperuricemia development in this high-risk group.