Study Reveals Link Between Obesity and Hyperuricemia

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The strongest predictors of hyperuricemia were body mass index, lipid accumulation product, and visceral adiposity index.

Hyperuricemia was associated with 10 obesity-related indices, which was more strongly linked to women than men, according to a study published in Environmental Research and Public Health.1

Approximately 2 billion adults were classified as overweight or obese in 2015, which represents approximately 39% of the global population. Obesity is linked to a variety of metabolic syndromes, including hyperuricemia, dyslipidemia, insulin resistance, and increased rates of cardiovascular morbidity and morbidity. Evaluating obesity using indices such as body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), body shape index (ABSI), body adiposity index (BAI), lipid accumulation product (LAP), abdominal volume index (AVI), visceral adiposity index (VAI), and conicity index (CI), can help to determine their association with other health problems. These include lung function, hypertension, osteoporosis, fatty liver, advanced kidney disease, and dementia.2

“Of the known risk factors for hyperuricemia, including older age and obesity/overweight, obesity has been independently associated with its development,” wrote a team of Taiwanese investigators. “Even though relationships between obesity-related indices and hyperuricemia are well documented, the effects of sex differences on this relationship remain unclear. Therefore, we conducted this study to investigate sex differences in the associations among obesity-related indices with hyperuricemia in a large Taiwanese population.”

The sex differences among various indices of obesity with hyperuricemia, a condition which has previously been linked to the development of gout, diabetes, kidney, and cardiovascular diseases, was evaluated in community-dwelling Taiwanese patients enrolled in the Taiwan Biobank in the cross-sectional study. Data included genetic information, lifestyle habits, and health records. Hyperuricemia was defined as serum uric acid >7.0 mg/dL in men and >6.0 mg/dL in women.

In total, 121,888 patients were included in the study (male patients: 43,790; female patients: 78,098) with a mean age of 49.9 years. The prevalence rates of hyperuricemia were 29.8% in men and 13.6% in women (P <.0001).

In both male and female patients, ABSI, WHtR, WHR, LAP, CI, VAI, BAI, AVI, BRI, and BMI were significantly linked to hyperuricemia in the multivariable analysis (P <.001).

The relationship between sex and all 10 indices were significant for hyperuricemia (P <.001). In male patients, LAP had the highest area under the curve (.669), followed by BMI (.655), VAI (.645), AVI (.642), BRI (.640), WHtR (.633), BAI (.605), WHR (.599), CI (.574), and ABSI (.510). In female patients, LAP similarly had the highest area under the curve .754), followed by BMI (.728), VAI (.724), WHtR (.721), BRI (.720), AVI (.713), WHR (.676), BAI (.673), CI (.626), and ABSI (.544).

Investigators noted the strengths of the study included detailed assessments of 10 obesity indices and their relationship to hyperuricemia in a large cohort of men and women. However, limitations were a lack of urate- and lipid-lowering prescription data, as well as drugs used to treat hypertension and diabetes. Additionally, they did not assess the duration of hyperuricemia, which hindered the analysis of causal relationships. Future studies should be conducted to confirm results. Generalizability may have been hindered due to only recruiting patients of Chinese ethnicity. Further, physical activity and dietary habits were not analyzed and may have affected serum urate.

“Stronger associations were found between each obesity index and hyperuricemia in the women in this study,” investigators concluded. “Further research into the sexual physiology associated with hyperuricemia and obesity is needed.”


  1. Su SY, Lin TH, Liu YH, et al. Sex Difference in the Associations among Obesity-Related Indices with Hyperuricemia in a Large Taiwanese Population Study. Nutrients. 2023;15(15):3419. Published 2023 Aug 1. doi:10.3390/nu15153419
  2. Keller, K.B.; Lemberg, L. Obesity and the metabolic syndrome. Am. J. Crit. Care 2003, 12, 167–170