Sutdy On The Dynamic Interrelationship Between Serum Uric Acid And Lipid Levels In A Cohort-base Elderly Population

ObjectivesHyperuricemia(HUA)and dyslipidemia often go hand in hand,and the effect of lipids on hyperuricemia and the effect of serum uric acid(SUA)on dyslipidemia are both controversial.The aim of this study was to investigate the bidirectional association between hyperuricemia and dyslipidemia in order to provide a scientific basis for improving intervention effects and further research.MethodsThis study was based on the established Weitang cohort,which conducted a baseline survey of 5496 adults aged 60 years and older in Weitang Town,Xiangcheng District,Suzhou,China,in 2014,with annual follow-up surveys from January 2015 to December 2021.Latent growth curve model(LGCM)was constructed to explore SUA and each component of lipids,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C)during the 7-year follow-up period,and a parallel LGCM model was constructed to assess cross-sectional,prospective,and parallel correlations between simultaneous changes in lipid components and SUA during the study period.Two cohorts were established according to inclusion and exclusion criteria(Cohort A:SUA as exposure,dyslipidemia as outcome,3675 participants;Cohort B:lipid levels as exposure,hyperuricemia as outcome,4061 participants).The risks of dyslipidemia and hyperuricemia were analyzed separately in two for Ms of Cox proportional hazards regression models,stratified by normal abnormalities and by quintiles.The strength of association was estimated using the hazard ratio(HR)and 95%confidence interval(CI).Restricted cubic spline(RCS)was used to investigate the dose-response relationship between SUA and blood lipid levels.Stratification analysis and sensitivity analysis were used to further evaluate the robustness of the association results.Results1.The LGCM results indicated that the trend of increasing TG over time was more pronounced in women,and that SUA levels tended to increase more significantly over the years in men.Parallel LGCM results indicated that baseline SUA was positively correlated with baseline TG(β=0.242,P<0.05),TC(β=0.073,P<0.05),and LDL-C(β=0.079,P<0.05)and negatively correlated with baseline HDL-C(β=-0.147,P<0.05)in older men.In older women,baseline SUA was positively correlated with baseline TG only(β=0.323,P<0.05)and negatively correlated with baseline HDL-C(β=-0.237,P<0.05).In men,the rate of change in TG was positively correlated with the rate of change in SUA,suggesting that the trends in TG and SUA were synchronous(P=1.082,P=0.017).2.In the cohort with normal lipids at baseline,a total of 1309 participants developed dyslipidemia(35.62%)after 7 years of follow-up investigation.Using the baseline normal uric acid group as a reference and adjusting for covariates,the HR(95%CI)for the occurrence of dyslipidemia,high TC,high TG,high LDL-C,and low HDLC in the hyperuricemia group were 1.30(1.11-1.51),1.58(1.16-2.16),1.36(1.08-1.72),3.30(2.07-5.27),and 1.23(0.96-1.57).Using the lowest quintile of baseline SUA levels as a reference,the HR(95%CI)for the risk of dyslipidemia,high TC,high TG,high LDL-C,and low HDL-C in the fifth quintile were 1.44(1.17-1.76),1.14(0.77-1.70),1.14(0.77-1.70).3.In the cohort with normal SUA at baseline,a total of 1162 participants had hyperuricemia(28.61%)after 7 years of follow-up investigation.After multivariableadjusted analysis,the risk of hyperuricemia in the dyslipidemic group was 1.28 times higher(95%CI:1.12-1.47)than in the group with normal lipid levels.The HR(95%CI)for the development of hyperuricemia was 0.99(0.72-1.37),1.30(1.07-1.57),1.02(0.70-1.50),and 1.20(1.00-1.44)for high TC,high TG,high LDL-C,and low HDL-C respectively.RCS showed a positive U-shaped non-linear dose-response relationship between TG levels and hyperuricemia(P non-linear=0.010)and a negative linear doseresponse relationship between HDL-C levels and hyperuricemia(P non-linear=0.010).ConclusionStudies have shown that there is a dynamic correlation between hyperuricemia and dyslipidemia,with elevated SUA levels increasing the risk of developing dyslipidemia,particularly high LDL-C.Conversely,elevated lipid levels,particularly TG and HDLC,will also increase the risk of developing hyperuricemia.Therefore,blood uric acid and lipid levels should be tested simultaneously in older people in the region.