Nonlinear Association Between the Liver Fat Content and the Risk of Hyperuricemia in Prediabetic Individuals: Evidence from Cross-Sectional Health Screening Data in China

Purpose: The impact of hepatic lipid accumulation on hyperuricemia presents an intriguing research avenue, particularly in light of existing studies linking obesity with hyperuricemia. Nevertheless, there remains a scarcity of quantitative investigations into the correlation between liver fat content (LFC) and hyperuricemia among prediabetic cohorts, notably within the Chinese demographic. Patients and Methods: This cross-sectional study was conducted at the Health Management Center of Henan Provincial People's Hospital between January 2019 and December 2023, involving 2,950 pre-diabetic participants. Participants were categorized into groups based on diagnostic criteria for hyperuricemia. LFC was assessed using computed tomography. Statistical analyses included multivariate logistic regression, limited cubic spline regression models, and subgroup analyses to explore the association between LFC and hyperuricemia among individuals with pre-diabetes. Results: The prevalence of hyperuricemia among the 2,950 prediabetic individuals was observed to be 22.20%. Prediabetic individuals with hyperuricemia exhibited higher levels of LFC compared to those without hyperuricemia. This association persisted even after adjusting for other variables, indicating a heightened risk of hyperuricemia among prediabetic individuals with elevated LFC [Q4 vs Q1: odds ratio (OR 2.70), 95% confidence interval (CI) 1.93– 3.79, P < 0.001; P for trend < 0.001]. Importantly, a nonlinear relationship between LFC and hyperuricemia risk was identified in the prediabetic individuals, showing a significant increase in hyperuricemia risk when LFC exceeded 8.4% (OR per standard deviation = 1.05, 95% CI: 1.02– 1.08, P < 0.001). Conclusion: In individuals with prediabetes, a higher LFC is associated with an elevated risk of hyperuricemia, especially when LFC exceeds 8.4%. Keywords: hyperuricemia, LFC, prediabetes, Chinese adults