ABSTRACT
Purpose: Visceral fat accumulation can negatively affect uric acid metabolism in healthy adults. The hypertriglyceridemic-waist (HTGW) phenotype is a predictor of diabetes and cardiometabolic risk. This study aimed to investigate the association between the HTGW phenotype and asymptomatic hyperuricemia in Korean adults. Patients and Methods: The study included 23,240 adults, aged 20-80 years who underwent comprehensive health examinations at a general hospital in Gyeonggi Province, Korea, from January 2020 to December 2022. The HTGW phenotype was defined as the simultaneous presence of elevated serum triglyceride (TG) levels and increased waist circumference (WC). The diagnostic capability of the HTGW phenotype for hyperuricemia and its association with the condition were assessed using the receiver operating characteristic (ROC) curve and logistic regression analysis. Results: The prevalence of hyperuricemia in the HTGW phenotype was 3.44 times higher than that in the normal TG normal waist (NTNW) phenotype. Compared with those in the NTNW group, the hazard ratios for developing hyperuricemia in the HTGW group were 2.887 (2.566-3.249, P <0.001) for men and 7.341 (5.139-10.487, P <0.001) for women, and these values remained significant after adjusting for potential confounders. The stratified analysis revealed that the HTGW phenotype, coupled with diabetes, had the highest probability of developing asymptomatic hyperuricemia (2.55 times). ROC curve analysis revealed that the area under the curve values of the WC*TG index for hyperuricemia diagnosis were 0.702, 0.627, and 0.685 for all participants, men, and women, respectively. Conclusion: Among Korean adults, the HTGW phenotype was closely related to hyperuricemia in both men and women and showed a particularly strong association in patients with diabetes. It may be used in combination with an indicator that can complement its accuracy for identifying individuals at high risk of hyperuricemia.
ABSTRACT
Purpose: The visceral adiposity index (VAI) and lipid accumulation product (LAP) are useful for assessing visceral obesity. However, these indices were developed for Caucasians, and it is necessary to confirm whether the VAI and LAP are appropriate indicators for identifying obesity phenotypes in Asians. This study investigated whether the VAI and LAP are effective indicators for diagnosing four obesity phenotypes in South Korean adults. Patients and Methods: This cross-sectional study enrolled 23,310 adult participants (age ≥20 years) who had undergone a health checkup at a general hospital in Gyeonggi-do, South Korea from January 2017 to December 2020. VAI and LAP were calculated based on the presented mathematical model according to sex. According to the metabolic health status and presence or absence of obesity, the obesity phenotypes were classified into 4 groups: metabolically healthy non-obese (N=14,240, 61.1%), metabolically unhealthy non-obese (N=477, 2.0%), metabolically healthy obese (MHO; N=6796, 29.2%), and metabolically unhealthy obesity (MUO; N=1797, 7.7%). Results: The receiver operating characteristics curve analysis showed VAI best predicted MUO among the four obesity phenotypes, whereas the LAP showed excellent discriminating ability for the MUO group (area under the curve 0.877, 0.849, and 0.921 and 0.923, 0.907, and 0.954 for all participants, men, and women, respectively). The optimal VAI cutoff values for identifying the MUO group were 1.83 in men and 1.58 in women, and the optimal cutoff values for the LAP were 41.45 in men and 23.83 in women, with a higher value for men. After adjusting for potential confounding factors, the VAI and LAP were associated with an increased risk in the MHO and MUO groups among the obesity phenotypes in both sexes. Conclusion: In South Korean adults, the VAI and LAP are closely related to the MUO phenotype in both sexes and are effective indices for predicting the MUO phenotype.