Association of serum uric acid with cardiovascular risk and exploratory profiling of circulating tsRNAs in gout patients

To investigate the associations between serum uric acid (SUA) levels and cardiovascular disease (CVD)-related clinical factors in gout patients, and to descriptively characterize serum tRNA-derived small RNA (tsRNA) expression profiles in an exploratory sequencing subset. A retrospective cross-sectional study was performed on 315 gout patients hospitalized between October 2021 and October 2023. Participants were categorized into low (≤ 408 μmol/L), moderate (408–660 μmol/L), and high (≥ 660 μmol/L) SUA groups. Associations between SUA and CVD-related clinical parameters were assessed using group comparisons, Spearman correlation analyses, sensitivity analyses, and age- and sex-adjusted regression models. In addition, tRF and tiRNA sequencing was performed on serum samples from 10 gout patients and 10 matched healthy controls to describe exploratory tsRNA expression patterns. SUA levels showed weak positive correlations with creatinine (CREA), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) (all r = 0.150, P < 0.05), and a weak negative correlation with female ( r = −0.131, P < 0.05). The exploratory tRF and tiRNA sequencing analysis revealed exploratory variation in serum tsRNA expression profiles between gout patients and healthy controls, as well as between gout patients stratified by cardiovascular risk status. SUA elevation was weakly associated with adverse lipid profiles and impaired renal function in gout patients, suggesting that SUA may be considered as one component of broader clinical and metabolic assessment rather than as an isolated cardiovascular indicator. The serum tsRNA sequencing findings should be interpreted as descriptive and hypothesis-generating only. Further validation in larger independent cohorts is required before any biological or clinical relevance can be inferred.