The urate deposition index as a classification tool for identifying subclinical monosodium urate deposition in patients with hyperuricemia

Abstract Background The incidence of asymptomatic hyperuricemia is rising, and there are no simple and effective indicators for identifying patients at high risk of subclinical crystal deposition. Our study explores the value of the urate deposition index (UDI) as a classification tool for risk stratification in asymptomatic hyperuricemia (AH). Methods Male participants with AH who visited from June 2021 to December 2025 were enrolled. After applying inclusion and exclusion criteria, 654 participants were included. Clinical data, including age, serum urate, AH duration, homocysteine levels, 24-h urinary serum urate excretion, and hypertension history, were collected. Participants were divided into positive and negative groups based on dual-energy CT (DECT) scans indicating the presence or absence of urate crystals in the joints of both feet. Statistical analyses were performed to identify independent clinical factors associated with monosodium urate (MSU) deposition and to evaluate the diagnostic efficacy of the UDI. Results Among the 654 participants, 342 (52.29%) tested positive for joint urate crystals. Compared to the negative group, the positive group had a longer duration of hyperuricemia and higher UDI ( P < 0.05). Logistic regression analysis revealed that UDI is a significant marker associated with the risk of joint urate crystal formation ( P < 0.05). ROC curve analysis showed an area under the curve (AUC) of 0.814 for the UDI. Conclusion The UDI can be used as a risk stratification tool for patients with AH, as it is a statistical indicator that reflects MSU deposition in joints. Therefore, this index has high value in identifying high-risk patients who may benefit from closer monitoring or earlier therapeutic evaluation.