Association between obstructive sleep apnea and hyperuricemia/gout in the general population: a cross-sectional study

Background: Obstructive sleep apnea (OSA) is linked to various health conditions, including cardiovascular diseases and metabolic disorders. Hyperuricemia and gout may be associated with OSA, but large-scale studies on this are limited. This study aimed to investigate the association between hyperuricemia/gout and OSA using data from the Korea National Health and Nutrition Survey (KNHANES).

Methods: Using the 2019-2021 KNHANES data, 11,728 participants were selected. OSA risk was assessed using the STOP-BANG questionnaire score, which is as follows: (1) high-risk (5-8), (2) intermediate-risk (3-4), and (3) low-risk (0-2). Anthropometric, socioeconomic, health-related variables, and biochemical measurements, including serum uric acid (SUA) levels, were included in the analysis. Multiple regression analyses examined the association between the STOP-BANG score and hyperuricemia/gout.

Results: After assigning weights, among 25,354,276 individuals, 3,114,119 (12.2%) had a high OSA risk. The high OSA risk group exhibited higher SUA levels (5.9 mg/dL) than those of the intermediate (5.6 mg/dL) and low OSA risk groups (4.7 mg/dL) (P < 0.001). Additionally, it had a higher incidence of physician-diagnosed gout than the other groups (6.6% vs. 3.8% vs. 0.8%, respectively, P < 0.001). The STOP-BANG questionnaire scores and SUA levels were positively correlated (r = 0.383; P < 0.001). When adjusted for confounding factors, the high OSA risk group demonstrated an association with hyperuricemia (SUA ≥ 6.8 mg/d) (adjusted Odds Ratio [OR]: 1.462, 95% Confidence interval [CI]: 1.108-1.929). High and intermediate OSA risk was associated with severe hyperuricemia (SUA ≥ 9.0 mg/dL) and gout; however, the significant association between OSA and severe hyperuricemia and gout attenuated to null after adjusting for confounding factors.

Conclusions: High OSA risk was independently associated with hyperuricemia but not severe hyperuricemia or gout. Screening and management of OSA may help prevent hyperuricemia.