Systematic investigation of population-wide elevation in serum uric acid among military conscripts: development of a traceable laboratory quality control framework

INTRODUCTION: A collective elevation in serum uric acid levels was detected among 98 military conscripts during routine physical examinations. This study aimed to determine the underlying causes and establish a traceable laboratory quality control framework for abnormal biochemical results. METHODS: A systematic investigation encompassing analytical performance, preanalytical variables, and possible exogenous interferences was conducted. Population characteristics, including dietary habits and physical activity, were examined and experimentally validated. Ten participants were retested after controlling high-purine intake and exercise intensity. RESULTS: No deviations were identified in analytical systems or preanalytical procedures. No interference from exogenous substances was observed. Controlled validation experiments demonstrated that consumption of chicken liver and high-intensity exercise increased serum uric acid levels by 21.22% and 20.85%, respectively (P < .001). After intervention, serum uric acid levels decreased by 32.40% on average, with levels in 70% of participants returning to the reference range. DISCUSSION: The generalized serum uric acid elevation in conscripts was primarily attributed to combined effects of a high-purine diet and strenuous exercise. Establishing a traceable, standardized quality management model enables laboratories to accurately identify, verify, and resolve abnormal test results, enhancing analytical reliability and clinical data integrity.