Wen-xia Cui,1,* Shi-wen Wang,1,* Lei Gao,1 Ding-huang Mu,2 Nan Li,1 Feng-hui Pan,1 Wei-hong Zhou,3 Yun Hu1,4 

1Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 3Department of Medical Examination Center, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People’s Republic of China; 4Department of Chemistry, State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wei-hong Zhou, Department of Medical Examination Center, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People’s Republic of China, Email njzhouwh@126.com Yun Hu, Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University; Department of Chemistry, State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, 210008, People’s Republic of China, Tel +86-25-6818-30402, Email huyun304@njglyy.com

Purpose: Hyperuricemia has traditionally been associated with obesity and dyslipidemia. However, the relationship between waist circumference (WC) and hyperuricemia in normal-weight men is still unclear, particularly regarding the roles of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). The aim of this research was to explore the mediating roles of TG and HDL-C in the association between WC and hyperuricemia in normal-weight men.
Methods: A retrospective observational study was conducted among normal-weight men (18.5 ≤ BMI < 24 kg/m2) aged ≥ 18 years who underwent health checkups in Nanjing from 2021– 2023. Relationships between WC, blood lipids, and hyperuricemia were investigated by multivariable regression models and mediation analysis.
Results: We enrolled 35,984 participants, with an overall hyperuricemia prevalence of 24.2%. The research found a significant positive association between WC and hyperuricemia in normal-weight men (P < 0.001). For hyperuricemia across rising WC quartiles, with WC divided as follows: Q1 (59 ≤ WC < 77 cm), Q2 (77 ≤ WC < 81 cm), Q3 (81 ≤ WC < 85 cm), and Q4 (85 ≤ WC ≤ 107 cm), the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 1.00 (reference), 1.09 (1.01, 1.18), 1.26 (1.15, 1.37), and 1.34 (1.22, 1.46), respectively (all P < 0.001). The mediation analysis indicated that WC had a significant total effect on hyperuricemia (Coefficient = 0.0046, 95% CI: 0.0028, 0.0070, P < 0.001), with significant indirect effects mediated through TG and HDL-C, contributing mediation proportions of 22.3% and 18.3%, respectively (both P < 0.05).
Conclusion: Elevated WC is associated with an increased likelihood of hyperuricemia in normal-weight men. TG and HDL-C play substantial mediating roles in this association. These findings suggest that monitoring WC and lipid profiles in normal-weight men could help identify those at higher risk of hyperuricemia, even in the absence of general obesity.

Keywords: waist circumference, triglycerides, high-density lipoprotein cholesterol, central obesity, hyperuricemia, mediation analysis