Abstract
BACKGROUND: The relationship between Helicobacter pylori (H. pylori) infection and serum uric acid levels remains debated. This study investigates the association between H. pylori infection and serum uric acid levels in a Chinese community, exploring renal function as a potential modifier. METHODS: We conducted a cross-sectional study involving 8,439 adults who underwent health examinations at a hospital in Wuhan from January 2022 to January 2024. H. pylori infection was assessed via the 14C-urea breath test, and serum uric acid levels were measured by the uricase method. Multivariable linear regression models evaluated the associations, and interaction analysis identified potential effect modifiers. Subgroup analyses were stratified by estimated glomerular filtration rate (eGFR). RESULTS: The prevalence of H. pylori infection was 21.5% (1,816/8,439). Initial analysis showed higher serum uric acid levels in individuals with H. pylori infection compared to those without (403.76 ± 102.89 vs. 395.87 ± 102.13 μmol/L, p = 0.004). However, after adjusting for age, sex, body mass index, lipid profiles, and hepatorenal function, this association was no longer significant in the overall cohort (β = 1.92, 95% CI: -2.38 to 6.23, p = 0.381). Interaction analysis revealed a significant modification by eGFR (p for interaction = 0.007). Stratified analysis showed an inverse association between H. pylori infection and serum uric acid in individuals with mild renal impairment (eGFR 60-80 mL/min/1.73m(2), n = 824; adjusted β = -17.86, 95% CI: -31.28 to -4.44, p = 0.009), while no such association was observed in those with normal renal function (eGFR ≥80 mL/min/1.73m(2), n = 7,531; β = 3.92, 95% CI: -0.66 to 8.50, p = 0.094). Sensitivity analyses confirmed the robustness of these findings. CONCLUSION: Renal function modulates the association between H. pylori infection and serum uric acid levels, with an inverse correlation observed in individuals with mild renal impairment. These findings suggest that renal function may influence the impact of H. pylori infection on uric acid metabolism.