BACKGROUND

The connection between non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and gout has been documented among American adults; however, the specific mechanisms underlying this relationship remain to be elucidated. This cross-sectional study aimed to explore the mediating role of Body mass index (BMI) in the relationship between NHHR and gout prevalence among US adults, using the National Health and Nutrition Examination Survey (NHANES) data.

METHODS

Participants were drawn from the NHANES across four cycles for this cross-sectional analysis. NHHR is characterized by the proportion of cholesterol that is non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol. We employed bootstrapping-based mediation analysis to assess the impact of NHHR on gout risk mediated by BMI.

RESULTS

The prevalence of gout in our study was found to be 5.07%. Multivariate logistic regression analysis identified a significant correlation between NHHR and the likelihood of developing gout (OR = 1.13, 95%CI 1.06-1.20, p = 0.001). Mediation analysis indicated that the relationship between NHHR and gout risk was partially mediated by BMI, accounting for 26.27% (95% CI 10.96-57.95%; p < 0.0001; total effect = 0.0076, direct effect = 0.0056) of the association.

CONCLUSION

BMI significantly mediates part of the relationship between NHHR and gout among American adults, underscoring the need to factor in body weight when comprehending gout risk elements.