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Metabolic Dysfunction Outweighs Inflammatory Burden in Association with Hyperuricemia: A Cross-Sectional Study in a
Xinxin Fan1, Yiqing Shen1, Wentao Zhu1
1Department of Clinical Laboratory, Civil Aviation Shanghai Hospital, Shanghai, People's Republic of China.
Background:
Hyperuricemia is a common metabolic abnormality frequently identified during routine health examinations, but the relative contributions of metabolic dysfunction and systemic inflammation remain incompletely understood.
Methods:
In this cross-sectional study, data from individuals undergoing routine health examinations were analyzed. Inflammatory burden was assessed using the neutrophil-to-high-density lipoprotein cholesterol ratio (NHR), and metabolic dysfunction was assessed using the triglyceride-glucose (TyG) index. Associations with hyperuricemia were evaluated using multivariable logistic regression, restricted cubic spline analyses, joint effect models, interaction testing, and subgroup analyses by sex and age.
Results:
Among 7959 participants included in the NHR analysis, 1398 (17.6%) had hyperuricemia. A metabolic subcohort of 4193 participants with complete triglyceride, fasting glucose, and covariate data was included in TyG-related analyses, among whom 781 (18.6%) had hyperuricemia. Each 1-SD increase in NHR was associated with hyperuricemia after multivariable adjustment (OR 1.16, 95% CI 1.09-1.25), whereas neutrophil percentage alone was not independently associated (OR 0.97, 95% CI 0.91-1.04). The TyG index showed a stronger association with hyperuricemia (OR 1.60, 95% CI 1.46-1.77). In models including both indices, the association between NHR and hyperuricemia was attenuated (OR 1.00, 95% CI 0.91-1.10), whereas TyG remained robust. Joint analyses showed that the high NHR/high TyG group had the highest risk of hyperuricemia (OR 2.61, 95% CI 2.01-3.39). Associations were generally consistent across sex and age strata.
Conclusion:
Metabolic dysfunction appears to have a stronger association with hyperuricemia than inflammatory burden in routine health examination populations. The apparent association between inflammatory burden and hyperuricemia may depend largely on underlying metabolic abnormalities. However, the cross-sectional design precludes causal inference.
