Association of circadian syndrome with risk of hyperuricemia among middle-aged and older adults in China: The first nationwide cohort study

Objectives: No studies have been conducted to explore the association of circadian syndrome (CircS) and hyperuricemia. We addressed the gap by investigating the association of CircS and the risk of hyperuricemia among middle-aged and older adults in China. Study design: Prospective cohort study. Methods: We utilized a nationwide cohort from the China Health and Retirement Longitudinal Study, 7009 adults aged at least 45 years were enrolled at baseline in 2011, and 4415 participants followed up to 2015. CircS was assessed using seven components including five components used to define metabolic syndrome and two components of lack of sleep and depression. Multivariable logistic regression analysis was applied to examine the association of CircS and hyperuricemia. Stratified analyses were used to identify the vulnerable subgroup. Results: Among the 7009 participants (mean age: 60.6 [SD: 9.8] years), 52.8 % were women. Compared to participants without CircS, those with CircS had a higher risk of hyperuricemia (adjusted odds ratio, aOR 2.246, 95 % CI:1.819-2.773). After 4-year follow-up, 457 (10.4 %) cases developed as hyperuricemia. The longitudinal analyses showed that CircS had a higher risk of incident hyperuricemia (aOR 2.136, 1.740-2.620). The association was stronger in women and those with kidney disease. Sensitivity analysis showed that individuals with >= six CircS components had the highest risk of hyperuricemia. Conclusions: This nationwide cohort first revealed that CircS was related to an increased risk of hyperuricemia among Chinese adults. Our findings provide epidemiological evidence regarding the importance of CircS management as a preventative strategy for hyperuricemia.