Sex-specific differences in associations between diet quality and hyperuricemia in Korean adults

초록

Objective: We aimed to evaluate the sex-specific associations between overall diet quality and hyperuricemia in Korean adults. Methods: We analyzed the data of 14,305 adults (6,131 men and 8,174 women) aged ≥20 years from the Korea National Health and Nutrition Examination Survey (2019~2021). We categorized dietary quality into quartiles: Q1 (lowest, reference), Q2, Q3, and Q4 (highest) using the Korean Healthy Eating Index (HEI). We used restricted cubic spline (RCS) models and multivariate logistic regression to assess non-linear associations and examine dose-response and quartile associations with hyperuricemia, respectively. Results: The weighted prevalence of hyperuricemia was 35.6% in men and 12.6% in women. In men, RCS analyses showed a monotonic inverse association, with risk decreasing steadily at higher HEI scores; in women, the curve followed a U-shaped pattern. Logistic regression confirmed that in men, adjusted odds ratios (ORs) across quartiles (vs. Q1) were 0.92 (95% confidence interval [CI], 0.77~1.11) in Q2, 0.84 (95% CI, 0.70~1.01) in Q3, and 0.76 (95% CI, 0.61~0.94) in Q4 (p for trend<0.01). In women, crude inverse associations were attenuated after adjustment, with adjusted ORs of 0.83 (95% CI, 0.65~1.05) in Q2, 0.81 (95% CI, 0.64~1.01) in Q3, and 0.94 (95% CI, 0.73~1.20) in Q4, and no significant trend (p for trend=0.55). Conclusion: Higher diet quality was independently associated with a lower risk of hyperuricemia in men; no significant protective effect was evident in women. These results underscore the need for sex-specific dietary strategies in hyperuricemia prevention.

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