Zhou Wei, Wang Tao, Zhu Lingjuan, Shi Yumeng, Yu Chao, Bao Huihui, Cheng Xiaoshu
Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1 Minde Road, Nanchang, 330006, China.
Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi M edical College, Nanchang University, Nanchang, China.
BMC Endocr Disord. 2025 Mar 18;25(1):73. doi: 10.1186/s12902-025-01902-7.
There is a paucity of prior research on residual cholesterol (RC) and hyperuricemia, and it remains unclear whether body mass index (BMI) functions as a mediating factor between them or intensifies lipid metabolic dysregulation, thereby elevating the risk of hyperuricemia. This study aims to investigate whether BMI mediates the association between RC and hyperuricemia, as well as the interaction or joint effect of BMI and RC on hyperuricemia.
This is a cross-sectional study, involving a total of 14,218 hypertensive patients. Exposure factors include RC and BMI. The outcome was Hyperuricemia, defined as serum uric acid (SUA) ≥ 420 µmol/L. Multivariable logistic regression models and causal mediation analysis were used to examine the association between RC and BMI and the prevalence of hyperuricemia.
A total of 14,218 hypertensive patients were enrolled in this cross-sectional study, comprising 6,713 (47.2%) males, with a mean age of 63.8 (9.36) years. The prevalence of diabetes mellitus was found to be 10.4% (1,473), while hyperuricemia accounted for approximately 44.4% (6,319). The results show that there is a linear positive correlation between RC and hyperuricemia (P for trend < 0.01). RC and BMI only had significant additive interaction on hyperuricemia, but there was no multiplicative interaction (Additive: RERI = 0.45, 95%CI: 0.13-0.78; Multiplicative, OR = 1.09, 95% CI 0.92-1.3, P = 0.308). There are direct and indirect effects between RC and hyperuricemia [estimate (95% CI): DE = 0.063 (0.048, 0.070), IE = 0.005 (0.003, 0.001)]. In the aforementioned causal mediation analysis, among the hyperuricemia caused by RC, BMI mediates 7.1%.
The intermediary role of BMI and its interaction with RC play a pivotal role in augmenting the prevalence of hyperuricemia.
Registered prospectively in the Chinese Clinical Trial Registry (ChiCTR1800017274) on July 20, 2018. Access at https://www.chictr.org.cn/showproj.html?proj=28262 .
既往关于残余胆固醇（RC）与高尿酸血症的研究较少，体重指数（BMI）在二者之间是否起中介作用，或是否会加剧脂质代谢紊乱从而增加高尿酸血症风险尚不清楚。本研究旨在探讨BMI是否介导RC与高尿酸血症之间的关联，以及BMI与RC对高尿酸血症的交互作用或联合效应。
这是一项横断面研究，共纳入14218例高血压患者。暴露因素包括RC和BMI。结局为高尿酸血症，定义为血清尿酸（SUA）≥420µmol/L。采用多变量logistic回归模型和因果中介分析来检验RC、BMI与高尿酸血症患病率之间的关联。
本横断面研究共纳入14218例高血压患者，其中男性6713例（47.2%），平均年龄63.8（9.36）岁。糖尿病患病率为10.4%（1473例），高尿酸血症约占44.4%（6319例）。结果显示，RC与高尿酸血症之间存在线性正相关（趋势P<0.01）。RC与BMI仅对高尿酸血症有显著的相加交互作用，但无相乘交互作用（相加：RERI=0.45，95%CI：0.13-0.78；相乘，OR=1.09，95%CI 0.92-1.3，P=0.308）。RC与高尿酸血症之间存在直接和间接效应[估计值（95%CI）：直接效应（DE）=0.063（0.048，0.070），间接效应（IE）=0.005（0.003，0.001）]。在上述因果中介分析中，在由RC引起的高尿酸血症中，BMI介导了7.1%。
BMI的中介作用及其与RC的交互作用在增加高尿酸血症患病率方面起关键作用。
于2018年7月20日在中国临床试验注册中心（ChiCTR1800017274）前瞻性注册。可在https://www.chictr.org.cn/showproj.html?proj=28262查询。
