Sex differences in the associations between prior weight loss and all-cause or cardiovascular mortality in non-elderly individuals with hyperuricemia: a mortality follow-up study

Abstract

Background: Hyperuricemia, a common metabolic condition, is strongly associated with obesity and represents as an independent risk factor for elevated risk of mortality. This observational study aimed to examine the sex-specific associations of prior long-term weight loss (LTWL), defined as a sustained reduction in body weight maintained for at least 12 months, with all-cause and cardiovascular disease (CVD) mortality in non-elderly individuals with hyperuricemia. Methods: Non-elderly individuals with hyperuricemia and a historical maximum body mass index ≥ 25 kg/m2 from the 1999–2018 US National Health and Nutrition Examination Survey were included. Sex-specific associations between prior LTWL (< 5%, 5-9.9%, 10-14.9%, and ≥ 15%) with all-cause and CVD mortality were investigated by weighted multivariable Cox proportional hazard regression analysis and stratified analysis. Results: Among 5,130 participants included, 505 all-cause (147 from CVD) deaths occurred during a median follow-up of 113 months. Compared with the LTWL < 5% reference group, the hazard ratios and 95% confidence intervals for the LTWL 5-9.9%, 10-14.9% and ≥ 15% groups were 1.11 (0.72–1.71), 1.34 (0.79–2.26) and 1.85 (1.14–2.92), respectively, for all-cause mortality (P for trend = 0.02) and 1.83 (0.76–4.43), 2.15 (0.76–6.10), and 3.76 (1.51–9.36), respectively, for CVD mortality (P for trend = 0.003). Significant associations between LTWL with all-cause and CVD mortality were observed exclusively in female, not male participants. Conclusions: Prior LTWL ≥ 5% was associated with increased all-cause and CVD mortality in US non-elderly female participants with hyperuricemia. Additional prospective and longitudinal randomized clinical trials are necessary to further examine the current findings.