Abstract
PURPOSE: Hyperuricemia is a precursor to gout and is linked to various metabolic disorders. This study investigated the associations of hyperuricemia with concordant/discordant lipid phenotypes based on low-density lipoprotein cholesterol (LDL-C) and remnant cholesterol (RC). METHODS: We analyzed 8,971 participants from a cluster-stratified random sample across six provinces in Northwest China. They were categorized into four groups by LDL-C and RC levels: NRC+NLDL, NRC+HLDL, HRC+NLDL, and HRC+HLDL. Multivariable logistic regression was used to assess the odds of hyperuricemia across these groups. RESULTS: Participants in Group NRC+HLDL, Group HRC+NLDL, and Group HRC+HLDL exhibited an increased risk for hyperuricemia by 37%, 96%, and 120%, respectively (OR: 1.37, 95% CI: 1.13-1.66 for NRC+HLDL; OR: 1.96, 95% CI: 1.57-2.45 for HRC+NLDL; OR: 2.20, 95% CI: 1.82-2.65 for HRC+HLDL), relative to Group NRC+NLDL. Subgroup analyses highlighted significant interaction effects based on gender and hypertriglyceridemia, with a more pronounced association observed in female participants. Sensitivity analyses revealed Group HRC+NLDL was most closely related to HUA when stricter LDL-C cut-offs were applied. Body mass index (BMI) and waist circumference (WC) mediated 20.27% and 6.67% of this association, respectively. CONCLUSION: RC demonstrated a stronger association with hyperuricemia than LDL-C, partially mediated by BMI and WC. Women exhibited greater susceptibility to RC-related hyperuricemia.