The association between serum uric acid and hypertriglyceridemia: evidence from the national health and nutrition examination survey (2007-2018)

Background: Accumulating evidence suggests that elevated serum uric acid (SUA) may be a risk factor for hypertriglyceridemia (HTG). However, the epidemiological evidence for the association between SUA and HTG is limited. This article aimed to use the data from National Health and Nutrition Examination Survey (NHANES) (2007-2018) database to bridge the research gap.

Methods: This cross-sectional study used data from 10027 adults involved in NHANES from 2007-2018. We designed the exposure variable as SUA and the outcome variable as HTG. The covariates included demographics, questionnaires, laboratory, and examination information. Weighted logistic regression and subgroup analysis were used to explore the independent association between SUA and HTG. Furthermore, interaction tests were also carried out to evaluate the strata differences. Generalized additive models (GAM), smooth curve fittings, and threshold effect analysis were applied to examine the non-linear relationship.

Results: A total of 10027 participants were included, of which 3864 were HTG participants and 6163 were non-HTG participants. After fully adjusting for confounders, weighted multiple logistic regression models revealed a 77% increase in the risk of HTG when each unit of log2-SUA increased. There was also a positive association between elevated log2-SUA and developed risk of HTG in the quartile (Q) groups (Q1 OR: 1.00; Q2 OR: 1.17 [95%CI: 0.95,1.45]; Q3 OR: 1.43 [95%CI: 1.16,1.78]; Q4 OR: 1.68 [95%CI: 1.36,2.08]. The subgroup analysis results remained consistent across strata, with a strong positive correlation between SUA and HTG. Interaction tests showed no dependence on physical activity (PA), gender, BMI, smoking status, alcohol intake, hypertension, and diabetes for this positive association between log2-SUA and HTG (all p for interaction >0.05). The participants' age may impact the strength of the association between SUA and HTG (p for interaction <0.05).

Conclusion: There is a positive association between SUA and HTG in US adults. Considering that SUA may be a risk factor for HTG, individuals diagnosed with HTG should prioritize the daily management of SUA as part of their comprehensive care.