Greater Levels of Physical Activity Linked to Reduced Risk of Hyperuricemia

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The analysis of NHANES data revealed a dose-response association between weekly moderate-to-vigorous physical activity levels and hyperuricemia risk.

Findings from a recent study suggest moderate-to-vigorous physical activity may have a protective effect against hyperuricemia.1

The analysis of US National Health and Nutrition Examination Survey (NHANES) 2007 - 2018 data found a U-shaped dose-response relationship between moderate-to-vigorous physical activity level and hyperuricemia, with the lowest risk observed at an activity level of 1556 metabolic equivalent (MET)-minutes per week.1

“As far as we know, few studies had explored the dose-response relationship between physical activity and hyperuricemia at present and there is no specific study like our research to investigate their dose-response association,” Xia Zeng, PhD, of the School of Public Health at Guangdong Pharmaceutical University in China, and colleagues wrote.1 “It is meaningful and necessary to explore appropriate recommended physical activity level to prevent hyperuricemia.”

Caused by an excess of uric acid in the blood, hyperuricemia has been linked to several chronic conditions, including kidney disease, heart disease, diabetes, and metabolic syndrome. Treatment and prevention efforts both typically include lifestyle modifications like following a low-purine diet, although the specific impact of physical activity on hyperuricemia risk is not as well understood.2

To investigate the dose-response association between moderate-to-vigorous physical activity and hyperuricemia and to determine an appropriate range of physical activity for preventing hyperuricemia, investigators collected NHANES 2007 - 2018 data for participants ≥ 20 years of age who did not have gout and had self-reported data on moderate-to-vigorous physical activity levels as well as hyperuricemia available. In total, 28,740 people were included in the present analysis.1

Moderate-to-vigorous physical activity levels were self-reported using the Global Physical Activity Questionnaire, where patients recorded the number of days they took part in different types of physical activity in a representative week, classified as vigorous work activity, vigorous leisure activity, moderate work activity, moderate leisure activity, and activity for transportation. Serum acid was measured using a timed endpoint method, with hyperuricemia defined as serum acid levels >7mg/dL in males and >6mg/dL in females in 2 fasting tests on different days under the condition of normal purine diet.1

Among the cohort (n = 28,740), the weighted mean age was 47.3 years and most participants were female (53.5%) and non-Hispanic White (66.6%). The weighted mean serum uric acid level was 5.36 mg/dL and 17.6% of participants had hyperuricemia. Self-reported moderate-to-vigorous physical activity levels were <600 MET-minutes per week in 36.2% of participants, between 600 and 2999 MET-minutes per week in 33.1%, and >3000 MET-minutes per week in 30.7%.1

Investigators called attention to significant differences between the groups regarding sex, age, race, ratio of family income to poverty, education, smoking and alcohol status, and BMI (P <.05). They also pointed out that participants with greater weekly levels of moderate-to-vigorous physical activity were more likely to be male and significantly younger with lower BMI.1

Upon analysis, investigators found a nonlinear dose-response association between moderate-to-vigorous physical activity levels and hyperuricemia, noting that as physical activity levels increased, the risk of hyperuricemia gradually decreased and reached the lowest value at about 1556 MET-min/wk. However, with the continuous increase of moderate-to-vigorous physical activity levels, hyperuricemia risk increased slowly and gradually leveled off at a cut-off of 933–3423 MET-minutes per week.1

Investigators noted that compared with participants in the moderate physical activity group (600–2999 MET-minutes/week), there was a significantly positive association of hyperuricemia for participants in the low physical activity level group (< 600 MET-minutes/week) after adjustment for all covariates (Odds ratio [OR], 1.13; 95% CI, 1.02–1.26), but not in the high physical activity group (P >.05).1

Investigators called attention to several potential limitations to these findings, including the inability to infer any causal relationships due to the cross-sectional study design; possible recall and reporting bias due to the use of self-reported physical activity levels; and residual confounding as a result of unmeasured or unidentified factors.1

“This study based on a nationally representative population of American adults found that compared with the moderate moderate-to-vigorous physical activity level, the low moderate-to-vigorous physical activity level was associated with the higher risk of hyperuricemia,” investigators concluded.1 “The association we investigated in this study is plausible, but further large-scale prospective studies are required to confirm the causal relationship between moderate-to-vigorous physical activity level and hyperuricemia.”


  1. Zeng X, Huang J, Xu Y, et al. Nonlinear dose-response association of moderate-to-vigorous physical activity with hyperuricemia in US adults: NHANES 2007–2018. Plos One.
  2. Cleveland Clinic. Hyperuricemia (High Uric Acid Level). Diseases & Conditions. July 17, 2023. Accessed May 30, 2024.