Abstract
BACKGROUND: Research on the relationship between visceral adipose tissue (VAT) and serum uric acid (SUA) in the general population remains limited. This study aims to comprehensively examine the association between VAT area and SUA concentrations in a representative sample of U.S. adults. METHODS: Data were drawn from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2018. A total of 10,514 participants aged 18 to 59 years were included in the analysis. VAT area was measured using dual-energy X-ray absorptiometry (DXA) scans, and SUA levels were collected at mobile examination centers. Multivariable linear regression models were employed to assess the association between VAT and SUA. Restricted cubic splines (RCS) were used to detect potential non-linear relationships. Subgroup analyses were conducted based on age, sex, drinking status, and renal function to test the robustness of the findings. RESULTS: The median VAT area and SUA concentration were 91.24 cm² and 5.2 mg/dL, respectively. In the unadjusted model, each standard deviation (SD) increase in VAT was positively associated with SUA (β = 0.43; 95% CI: 0.39-0.47). After adjusting for covariates, this positive association remained consistent across all models. RCS analysis revealed a non-linear relationship (P for non-linearity < 0.001), with a stronger association observed when VAT was below 3.3 SDs. Significant interactions were identified in age and sex subgroups (P for interaction < 0.05). CONCLUSION: This study demonstrates a positive, non-linear association between VAT area and SUA concentrations in young and middle-aged U.S. adults. The observed threshold effect provides valuable insight for clinicians in stratifying risks for hyperuricemia and related comorbidities, particularly among individuals with elevated VAT levels.