Background We aimed to investigate the association between serum uric acid (SUA) and all-cause or cardiovascular mortality among participants with obesity.
Method All participants were included from the 1999 to 2014 National Health and Nutrition Examination Survey with follow-up mortality assessment through 31 December 2015. Cox proportional hazards models were built to estimate adjusted HRs and 95% CIs for mortality according to baseline uric acid in quartiles. Obesity was defined as body mass index ≥30 (kg/m2). Generalised additive model (GAM) and two-piecewise linear regression models were performed to explore any non-linearity in associations.
Results There were 12 637 adults with obesity eligible for analysis. There were 999 (7.91%) all-cause and 147 (1.16%) cardiovascular mortality occurred during the mean follow-up of 98.11 months. Comparing with the lowest quartile of SUA, the highest SUA group did not have significant association with all-cause (HR 1.08, 95% CI 0.76 to 1.52) and cardiovascular mortality (HR 1.63, 95% CI 0.58 to 4.53) after adjusting for various confounding factors. GAM and two-piecewise linear regression model demonstrated a non-linearly relationship between SUA and all-cause mortality, and the corresponding cut-off point was 6.5 mg/dL. However, there is no significant relationship between uric acid and cardiovascular death on both sides of the cut-off value of 6.1 mg/dL.
Conclusions SUA showed a J-shaped relationship with all-cause mortality, but no significant with cardiovascular mortality in adults with obesity.
- all-cause mortality
- cardiovascular mortality
- uric acid
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Contributors JL and YQF designed the study. JL and Y-QH drafted the manuscript. J-YH, LL and KL analysed the data. J-YH, LL, SS, C-LC and BZ checked the collected data. KL and J-YH edited and revised the manuscript. The final manuscript was read and approved by all authors.
Funding During analysing data and submission of manuscript, this work was supported by the Science and Technology Program of Guangzhou (No.201604020143, No.201604020018, No.201604020186 and No.201803040012), and the National Key Research and Development Program of China (No.2017YFC1307603, No.2016YFC1301305 and No.2017YFC0909303) and the Key Area R&D Program of Guangdong Province (No.2019B020227005).
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval The survey protocol was approved by the Institutional Review Board of the CDC.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in: https://wwwn.cdc.gov/nchs/nhanes/Default.aspx.
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