Association between serum uric acid level and cataract Arisk: A cross-sectional study based on two databases (CHARLS...

ObjectiveCataracts represent the predominant cause of global blindness. Although previous research has implicated aqueous humor uric acid in cataract pathogenesis, its invasive measurement method limits clinical utility. Consequently, the association between readily accessible serum uric acid levels and cataract risk remains poorly defined. This study aimed to elucidate this relationship in two large, independent populations.MethodsThis cross-sectional analysis utilized data from 11,473 participants in the China Health and Retirement Longitudinal Study (CHARLS, 2011) and 9754 participants from the National Health and Nutrition Examination Survey (NHANES, 1999-2008). Cataract status was defined by self-reported history of cataract surgery. Multivariable logistic regression analysis was employed to calculate odds ratios, using restricted cubic splines and subgroup analyses used to assess dose-response relationships and the robustness of associations.ResultsIn both cohorts, significant crude associations between higher serum uric acid and cataract prevalence were observed (CHARLS, odds ratio: 1.14, 95% confidence interval: 1.03-1.25; NHANES, odds ratio per SD: 1.23, 95% confidence interval: 1.16-1.30). However, these associations were no longer statistically significant after full adjustment for demographic, socioeconomic, and cardiometabolic covariates (CHARLS, odds ratio: 1.09, 95% confidence interval: 0.98-1.22; NHANES, odds ratio per SD: 1.05, 95% confidence interval: 0.98-1.12). Restricted cubic spline analyses confirmed no significant linear or nonlinear dose-response relationship (all p > 0.05). Subgroup analyses consistently demonstrated a null association across key demographic and clinical strata.ConclusionsThis large-scale, two-country study suggests that the apparent association between serum uric acid and cataracts is not independent; it may be largely explained by confounding factors such as age, cardiometabolic diseases, and socioeconomic factors. Serum uric acid levels may not be independently associated with self-reported cataract surgery status and may have limited utility as a marker for risk assessment in population-based settings.