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Objective <p>This study aimed to investigate the role of serum uric acid (SUA) in disease progression from baseline to first cardiometabolic disease (FCMD), subsequent cardiometabolic multimorbidity (CMM), and mortality.</p> Methods <p>We conducted a prospective analysis using UK Biobank data (<i>n</i> = 418,765). CMM was defined as the coexistence of at least at least two cardiometabolic conditions out of type 2 diabetes (T2D), ischemic heart disease (IHD), and stroke. Multi-state models were employed to analyze the associations between SUA levels and disease transitions across different stages, including disease-specific analyses for individual cardiometabolic diseases.</p> Results <p>During follow-up, 54,946 participants developed FCMD, of whom 6,260 progressed to CMM. Each 1&#xa0;mg/dL increase in SUA was associated with higher risks of FCMD [HR: 1.08 (1.07, 1.09)], transition from FCMD to CMM [HR: 1.07 (1.05, 1.10)], and all-cause mortality from all states [HR 1.04 (1.03, 1.05) from baseline to death; HR 1.03 (1.01, 1.05) from FCMD to death; HR 1.08 (1.03, 1.12) from CMM to death]. When FCMD was further divided into IHD, stroke, and T2D, we found that SUA played different roles in disease-specific transitions even within the same stage, with the strongest associations observed for incident T2D [HR: 1.15 (1.14, 1.17)] and stroke-to-CMM progression [HR: 1.11 (1.04, 1.18)]. These associations remained robust across sensitivity analyses and were stronger in younger participants (&lt; 60 years).</p> Conclusions <p>Elevated SUA levels serve as a potential marker across the entire trajectory of cardiometabolic disease progression. These findings suggest the importance of SUA monitoring and management in preventing cardiometabolic disease progression.</p>

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Serum uric acid and the trajectory of cardiometabolic multimorbidity: a prospective study conducted with data from the UK Biobank

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月30日

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  • Juan Wu,
  • Yingdong Han,
  • Menghui Yao,
  • Zhikai Li,
  • Tiange Xie,
  • Yun Zhang,
  • Xuejun Zeng

摘要

Objective

This study aimed to investigate the role of serum uric acid (SUA) in disease progression from baseline to first cardiometabolic disease (FCMD), subsequent cardiometabolic multimorbidity (CMM), and mortality.

Methods

We conducted a prospective analysis using UK Biobank data (n = 418,765). CMM was defined as the coexistence of at least at least two cardiometabolic conditions out of type 2 diabetes (T2D), ischemic heart disease (IHD), and stroke. Multi-state models were employed to analyze the associations between SUA levels and disease transitions across different stages, including disease-specific analyses for individual cardiometabolic diseases.

Results

During follow-up, 54,946 participants developed FCMD, of whom 6,260 progressed to CMM. Each 1 mg/dL increase in SUA was associated with higher risks of FCMD [HR: 1.08 (1.07, 1.09)], transition from FCMD to CMM [HR: 1.07 (1.05, 1.10)], and all-cause mortality from all states [HR 1.04 (1.03, 1.05) from baseline to death; HR 1.03 (1.01, 1.05) from FCMD to death; HR 1.08 (1.03, 1.12) from CMM to death]. When FCMD was further divided into IHD, stroke, and T2D, we found that SUA played different roles in disease-specific transitions even within the same stage, with the strongest associations observed for incident T2D [HR: 1.15 (1.14, 1.17)] and stroke-to-CMM progression [HR: 1.11 (1.04, 1.18)]. These associations remained robust across sensitivity analyses and were stronger in younger participants (< 60 years).

Conclusions

Elevated SUA levels serve as a potential marker across the entire trajectory of cardiometabolic disease progression. These findings suggest the importance of SUA monitoring and management in preventing cardiometabolic disease progression.