Sex-specific differences in associations between diet quality and hyperuricemia in Korean adults
1Department of Home Economics Education, Korea University, Seoul, Korea.
Objective:
We aimed to evaluate the sex-specific associations between overall diet quality and hyperuricemia in Korean adults.
Methods:
We analyzed the data of 14,305 adults (6,131 men and 8,174 women) aged ≥20 years from the Korea National Health and Nutrition Examination Survey (2019~2021). We categorized dietary quality into quartiles Q1 (lowest, reference), Q2, Q3, and Q4 (highest) using the Korean Healthy Eating Index (HEI). We used restricted cubic spline (RCS) models and multivariate logistic regression to assess non-linear associations and examine dose-response and quartile associations with hyperuricemia, respectively.
Results:
The weighted prevalence of hyperuricemia was 35.6% in men and 12.6% in women. In men, RCS analyses showed a monotonic inverse association, with risk decreasing steadily at higher HEI scores; in women, the curve followed a U-shaped pattern. Logistic regression confirmed that in men, adjusted odds ratios (ORs) across quartiles (vs. Q1) were 0.92 (95% confidence interval [CI], 0.77~1.11) in Q2, 0.84 (95% CI, 0.70~1.01) in Q3, and 0.76 (95% CI, 0.61~0.94) in Q4 (p for trend<0.01). In women, crude inverse associations were attenuated after adjustment, with adjusted ORs of 0.83 (95% CI, 0.65~1.05) in Q2, 0.81 (95% CI, 0.64~1.01) in Q3, and 0.94 (95% CI, 0.73~1.20) in Q4, and no significant trend (p for trend=0.55).
Conclusion:
Higher diet quality was independently associated with a lower risk of hyperuricemia in men; no significant protective effect was evident in women. These results underscore the need for sex-specific dietary strategies in hyperuricemia prevention.
