Triglycerides and HDL Cholesterol Mediate the Association Between Waist Circumference and Hyperuricemia in Normal-Weight Men

Wen-Xia Cui; Shi-Wen Wang; Lei Gao; Ding-Huang Mu; Nan Li; Feng-Hui Pan; Wei-Hong Zhou; Yun Hu

doi:10.2147/DMSO.S493327

Triglycerides and HDL Cholesterol Mediate the Association Between Waist Circumference and Hyperuricemia in Normal-Weight Men

Diabetes Metab Syndr Obes. 2024 Dec 1:17:4599-4610. doi: 10.2147/DMSO.S493327. eCollection 2024.

Authors

Wen-Xia Cui^#¹, Shi-Wen Wang^#¹, Lei Gao¹, Ding-Huang Mu², Nan Li¹, Feng-Hui Pan¹, Wei-Hong Zhou³, Yun Hu^{1

4}

Affiliations

¹ Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People's Republic of China.
² Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.
³ Department of Medical Examination Center, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People's Republic of China.
⁴ Department of Chemistry, State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Hyperuricemia has traditionally been associated with obesity and dyslipidemia. However, the relationship between waist circumference (WC) and hyperuricemia in normal-weight men is still unclear, particularly regarding the roles of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). The aim of this research was to explore the mediating roles of TG and HDL-C in the association between WC and hyperuricemia in normal-weight men.

Methods: A retrospective observational study was conducted among normal-weight men (18.5 ≤ BMI < 24 kg/m²) aged ≥ 18 years who underwent health checkups in Nanjing from 2021-2023. Relationships between WC, blood lipids, and hyperuricemia were investigated by multivariable regression models and mediation analysis.

Results: We enrolled 35,984 participants, with an overall hyperuricemia prevalence of 24.2%. The research found a significant positive association between WC and hyperuricemia in normal-weight men (P < 0.001). For hyperuricemia across rising WC quartiles, with WC divided as follows: Q1 (59 ≤ WC < 77 cm), Q2 (77 ≤ WC < 81 cm), Q3 (81 ≤ WC < 85 cm), and Q4 (85 ≤ WC ≤ 107 cm), the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 1.00 (reference), 1.09 (1.01, 1.18), 1.26 (1.15, 1.37), and 1.34 (1.22, 1.46), respectively (all P < 0.001). The mediation analysis indicated that WC had a significant total effect on hyperuricemia (Coefficient = 0.0046, 95% CI: 0.0028, 0.0070, P < 0.001), with significant indirect effects mediated through TG and HDL-C, contributing mediation proportions of 22.3% and 18.3%, respectively (both P < 0.05).

Conclusion: Elevated WC is associated with an increased likelihood of hyperuricemia in normal-weight men. TG and HDL-C play substantial mediating roles in this association. These findings suggest that monitoring WC and lipid profiles in normal-weight men could help identify those at higher risk of hyperuricemia, even in the absence of general obesity.

Keywords: central obesity; high-density lipoprotein cholesterol; hyperuricemia; mediation analysis; triglycerides; waist circumference.

Grants and funding

This study was supported by the Nanjing Health Science and Technology Development Major Project (No. ZDX21001).