Association between serum uric acid and abdominal fat distribution quantified by computed tomography in Korean men: a single center study of 5144 cases

BACKGROUND: Serum uric acid (UA), the end product of purine metabolism, has been implicated in metabolic and cardiovascular diseases. While obesity, particularly visceral fat accumulation, is related with hyperuricemia, limited studies have explored the association between serum UA levels and the visceral-to-subcutaneous fat ratio as a novel marker of cardiometabolic risk. This study investigates the relationship between serum UA levels and abdominal fat distribution, focusing on the visceral-to-subcutaneous fat ratio in Korean men. METHODS: This retrospective, cross-sectional study analyzed 5114 male participants who underwent serum UA measurement and abdominopelvic computed tomography (CT) as part of health examinations from 2014 to 2019. Visceral and subcutaneous fat areas were quantified using CT imaging, and the visceral-to-subcutaneous fat ratio was calculated. Participants were stratified into quartiles based on serum UA levels. Univariate and multivariate analyses were performed to assess the association between serum UA levels and abdominal fat area and visceral fat/subcutaneous fat ratio were evaluated using univariate and multivariate analyses. RESULTS: Higher serum UA levels were significantly associated with increased visceral fat area, subcutaneous fat area, and visceral-to-subcutaneous fat ratio in both univariate and multivariate analyses. Participants in the highest UA quartile demonstrated the greatest visceral fat accumulation and the highest visceral-to-subcutaneous fat ratios. Multivariate analyses revealed that the association between serum UA and the visceral-to-subcutaneous fat ratio remained significant after adjusting for covariates. CONCLUSIONS: This study demonstrated a positive correlation between serum UA levels and both visceral fat area and subcutaneous fat areas in Korean men. Furthermore, higher serum UA levels were positively correlated with the visceral-to-subcutaneous fat ratio, offering insights into its potential contribution to elevated cardiometabolic and cardiovascular risk.