Background

Hyperuricemia is widely considered as a key risk factor for metabolic syndrome, including dyslipidemia, in which hypertriglyceridemia is the most common lipid abnormality [1,2,3,4,5,6]. High uric acid (UA) levels were associated with increased triglyceridemia, independently of metabolic syndrome [7]. A survey of the prevalence of obesity in China during 2004 to 2008 showed that all rural areas had a low prevalence of obesity except in Henan, probably because of differences in diet [17]. A Kuwait study further supported the close relation in dyslipidemic patients, a group already at high coronary artery disease risk [18]. Nevertheless, whether age and gender differences mediate the association between serum UA levels and TG is still controversial. In present study, we demonstrated that after adjustment with age (Model 2) and other confounding factors (Model 3), the OR still increased with the increase in TG. These results suggest that TG levels independently affect the incidence of hyperuricemia. However, in multivariate logistic regression analysis, the positive association between hyperuricemia and TG showed a gender and age differences and the positive association was the lowest in the 50~ age group. Whether decreasing level of estrogen after menopause is responsible for the differences needs further studies.

Stelmach et al. investigated 607 Polish adults with hyperuricemia and demonstrated that the upper tertile of serum uric acid levels had higher TG values in males but not in females [19]. In contrast, Lippi et al. retrospectively enrolled a large cohort of unselected adult outpatients and showed that triglycerides were independently associated with serum UA in women but not in men [20]. Notably, in this study our data showed that high TG level was positively associated with the incidence of hyperuricemia in both men and women. This is consistent with a prospective study which demonstrated that hypertriglyceridemia in men might strengthen the effect of serum UA on the development of gout [21]. Chinese diet is characterized with a high-fat diet, particularly the overconsumption of cooking oil may be a significant risk factor for obesity [22, 23].

To investigate lipid abnormalities in acute myocardial infarction (AMI) patients, Wei et al. retrospectively analyzed 1213 AMI patients in East China and showed a significant difference in triglycerides for male but not for female AMI patients [24]. Xu et al. found that older Chinese people had moderate and high levels of unbalanced diets [25]. Significant differences were influenced by many factors, such as gender, marital status, work status, education levels. These findings highlight complex interaction between hyperuricemia and TG. Differences in dietary patterns such as the proportion of carbohydrate or fat may be responsible for the variability in the relationship between serum uric acid and triglyceridemia.

TyG index is proposed as a marker of moderate insulin resistance. Therefore, we analyzed the association of TyG with hyperuricemia. We found that TyG could be a better index of hyperuricemia in females than in males. However, a recent study indicated that TyG index presented the significant risks for chronic kidney disease in both men and women [26]. The reason for the disparities is unclear and need additional investigations.

Our study has two main limitations. First, our study was conducted in a special group, so the generalizability of our findings to other population needs confirmation in future studies. Second, confounding factors such as diet patterns and health concerns among people of different ages were not included in our analysis, which may have an impact on the results. Further studies are required to elucidate the association between triglyceride and hyperuricemia in different gender and age groups.

Conclusions

Our study demonstrated that high triglyceride was positively associated with hyperuricemia in both men and women, and this association was age-related, especially in women.