Gender differences in the association between metabolic syndrome components and 5-year risk of hyperuricemia: a retrospective cohort study

Hyperuricemia is a recognized risk factor for cardiovascular disease and is closely linked to metabolic syndrome (MetS). This study aimed to assess the impact of MetS and its components on the 5-year risk of developing hyperuricemia, specifically focusing on gender differences. This retrospective cohort study included participants who underwent health check-ups at Nanjing Drum Tower Hospital in 2018 and 2023. Individuals with pre-existing hyperuricemia or gout were excluded. The influence of MetS, its components, and MetS scores on hyperuricemia risk was analyzed using multivariable logistic regression stratified by gender. LASSO regression was used to identify critical predictors and develop a nomogram for estimating the 5-year risk. Of the 10,487 participants, 1,455 (13.8%) developed hyperuricemia over 5 years, with a higher incidence in males (17.6%) compared to females (9.8%). After adjusting for confounding factors, MetS was found to increase the risk of hyperuricemia in both genders significantly (males: OR = 1.22, 95% CI: 1.02, 1.45; females: OR = 1.42, 95% CI: 1.04, 1.95; both p < 0.05). Abdominal obesity, hypertriglyceridemia, and low high-density lipoprotein cholesterol (HDL-C) were significant risk factors, with a stronger effect observed in females. In contrast, hyperglycemia and high blood pressure were not significantly associated with hyperuricemia. A MetS score of 2 or higher markedly increased the risk, regardless of gender. LASSO regression identified gender, waist circumference, triglycerides, and serum uric acid as key predictors, with the nomogram achieving an area under the curve (AUC) of 0.774. MetS significantly increases the risk of hyperuricemia, with abdominal obesity, hypertriglyceridemia, and low HDL-C being critical risk factors, especially in females.