A u-shape association of serum uric acid with gout in US adults

Background Serum uric acid (SUA) level is the strongest determinant of gout, and the relationship between hyperuricemia and gout has been found. However, the association between the across-full range of SUA level and gout also remains uncertain. We aimed to investigate the trend across an across-full range of SUA level and gout in the general population. Materials and Methods This study included 4,738 US adults from The National Health and Nutrition Examination Survey (NHANES). A generalized additive model was used to fit the non-linear trend between SUA level and gout. Results 2,209 males and 2,469 females were included in our study, with the age range of 20∼80 years. The range of SUA level was from 0.8 to 15.1 mg/dL. About 5.9% of participants had gout. There was a U-shape association between SUA level and gout in univariable GAM (EDF = 3.881, p <0.001) and multivariable GAM (EDF = 3.795, p <0.001). The lowest risk of gout was observed in participants with SUA level of 5-6mg/dL. We evaluated the trend of SUA level with gout by gender. Both males and females with high SUA level have a high prevalence of gout. Male have a high prevalence of gout with low SUA level. The SUA level and prevalence of gout support a U-shape in males, while females show a linear shape. Conclusion This study showed that low as well as high SUA are associated with gout. Hypouricemia is a candidate predictor of gout in US adults.