Nutrition Journal · Published 2026-04-30 · DOI 10.1186/s12937-026-01324-8
Abstract 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.
Abstract from DOAJ. Public domain (CC0 1.0).
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