High-altitude hyperuricemia: a double-edged sword of adaptation and maladaptation

Hyperuricemia is characterized by elevated serum uric acid levels and is associated with multiple diseases. Studies have consistently demonstrated that the prevalence of hyperuricemia in high-altitude areas is significantly higher than that in low-altitude areas. For high-altitude hyperuricemia, some environmental and genetic factors exhibit distinct characteristics among patients. Hyperuricemia also contributes to the onset and progression of a range of high-altitude-related disorders. Although studies have identified the characteristics of high-altitude hyperuricemia, the associations between elevated uric acid levels and influencing factors remain to be fully elucidated. This perspective compiles data from global epidemiological studies and clinical practices, and provides an exploration of the factors contributing to elevated uric acid levels at high altitudes. Additionally, we uncover the metabolic processes in patients with hyperuricemia and the correlation between hyperuricemia and high-altitude-related diseases, providing a foundation for developing more targeted therapeutic approaches and advanced pharmaceutical strategies.