Hyperuricemia as a Biomarker for Circadian Syndrome: A Cross-Sectional Study

Circadian Syndrome (CircS) links metabolic, behavioral, and mental health challenges to disrupted circadian rhythm. Hyperuricemia (HUA) is associated with cardiometabolic disorders; however, its connection to CircS remains incompletely understood. This study aims to determine if HUA can serve as a biomarker for CircS. We analyzed the National Health and Nutrition Examination Survey (NHANES) data (2005-2020) from 27,410 adults. CircS was defined as the presence of at least five out of eight components, encompassing the traditional metabolic syndrome criteria plus three additional factors: short sleep duration, depression, and non-alcoholic fatty liver disease (NAFLD). HUA was set at serum uric acid levels >6 mg/dL (357 µmol/L) for females and >7 mg/dL (416 µmol/L) for males. Multivariable logistic regression identified predictors of CircS, and dose-response relationships were explored. Of 27,410 participants, 2076 (7.57%) had CircS. HUA was found to be the strongest independent predictor of CircS, with an odds ratio (OR) of 3.26 (95% uncertainty interval (UI) 2.80-3.80, p < 0.001). Other important risk factors included chronic kidney disease (CKD) (OR 2.80), female sex (OR 1.44), and smoking (OR 1.29). In addition, older age, lower educational level, and lower income were also linked with higher risk. Higher uric acid levels were consistently linked to metabolic components of CircS more strongly than to depression and short sleep. In conclusion, HUA is linked with a greater risk of CircS. Although testing is simple and widely available, it could be used for early risk detection. Future studies should determine if lowering uric acid improves circadian health.