Asymptomatic Hyperuricemia and Metabolically Unhealthy Obesity: A Cross-Sectional Analysis in the Tianning Cohort

Jia Yu,1,* Hongyan Sun,2,* Jinhua Zhu,3,* Xintong Wei,1 Hongfei Shi,2 Bin Shen,3 Liyun Ren,1 Yan He,1 Rongyan Zhang,3 Mingzhi Zhang,1 Hao Peng1,4 1Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People’s Republic of China; 2Center for Disease Prevention and Control of Tianning District, Changzhou, People’s Republic of China; 3Center for Disease Prevention and Control of Wujiang District, Suzhou, People’s Republic of China; 4Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hao PengDepartment of Epidemiology, School of Public Health, Medical College of Soochow University, 199 Renai Road, Industrial Park, Suzhou, 215123, People’s Republic of ChinaTel +86 512 6588 0078Fax +86 512 6588 0052Email penghao@suda.edu.cnObjective: The relationship between obesity and hyperuricemia has been demonstrated by many studies. However, whether or to what extent metabolic condition influents the association between obesity and hyperuricemia was not clear. Here, we aimed to examine the association between obese-metabolic phenotype and hyperuricemia in a large sample of Chinese adults.Methods: According to BMI and metabolic syndrome, obese-metabolic phenotype was defined as metabolically unhealthy obesity (MUO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically healthy non-obesity (MHNO)in the Tianning cohort (N=5072). We conducted a cross-sectional analysis between obese-metabolic phenotype and hyperuricemia, followed by a Mendelian Randomization analysis using GWAS summary data to confirm the causality between uric acid and BMI.Results: The average level of serum UA showed 41.87-higher μmol/L in participants with MHO (β=41.87, P< 0.001) and 63.18-higher μmol/L in participants with MUO (β=63.18, P< 0.001), compared to those with MHNO. Compared to participants with MHNO, those with MUO had the highest likelihood to have hyperuricemia (OR=4.56, P< 0.001), followed by those with MHO (OR=3.32, P< 0.001). Mendelian randomization analysis indicated that uric acid was more likely to be a consequence of BMI (β=0.059, P=6.54× 10− 154).Conclusion: MUO, in comparison with MHO, was significantly associated with hyperuricemia in Chinese adults.Keywords: metabolic syndrome, obesity, serum uric acid, hyperuricemia