Sleep quality is associated with gut microbiome signatures of hyperuricemia in Chinese elderly adults: a community-based case–control study

Hyperuricemia (HUA) has become a global health issue due to its rapidly increasing prevalence. Growing evidence from population and animal studies suggests that gut microbial dysbiosis and lifestyle changes are involved in serum uric acid metabolism. However, most existing studies are limited by small sample sizes or have yielded inconsistent findings. This study aimed to jointly investigate the associations of the gut microbiome, lifestyles, and dietary habits with HUA in Chinese elderly adults. A community-based case–control study was conducted across nine provincial-level regions in China, involving 617 participants. Data collection included lifestyle and dietary habit questionnaires, chronic disease history, serum uric acid (sUA) measurement, and 16S rRNA sequencing of fecal samples. Taxonomic composition and diversity analyses revealed significant difference between the HUA and controls in gut microbiota structure and diversity. Through differential abundance and co-occurrence network analyses, 42 microbial signatures associated with HUA or sUA were identified. Notably, the prevalence of g_Stenotrophomonas was positively associated with short sleep duration. A microbial risk score (MRS) model constructed using these signatures demonstrated an area under curve (AUC) of 0.761 in the discovery cohort and 0.675 in the validation cohort. Furthermore, a significant positive association was observed between sleep quality (sleep duration, number of awakenings, and short sleep duration) and the MRS model. These results add to the accumulating evidence implicating the role of gut microbiota and sleep in HUA, such as g_Stenotrophomonas , and inform the potential effect of the microbiome-based association between sleep duration and HUA. However, due to the cross-sectional design, we cannot infer causality from these associations, and the observed findings should be confirmed in prospective studies.