# Association of smoking with serum uric acid levels, hyperuricemia, and gout based on the 7th to 9th Korea National Health and Nutrition Examination Survey: A secondary dataset analysis based on a cross-sectional study

## TL;DR

The study found that smoking is linked to higher uric acid levels and a greater risk of gout in women, but not in men, based on health survey data from Korea.

## Contribution

The study reveals a gender-specific association between smoking and gout-related outcomes using a large national health survey dataset.

## Key findings

- Current smoking in females was associated with higher serum uric acid levels compared to never smokers.
- Female smokers had increased odds of hyperuricemia and gout compared to non-smokers.
- No significant associations were found between smoking and gout or uric acid levels in males.

## Abstract

Previous studies have reported conflicting results on the relationship of smoking with gout and hyperuricemia. This study aimed to investigate the associations of smoking with serum uric acid levels, hyperuricemia, and gout.

This study was a pooled analysis of secondary data from the 7th to 9th Korea National Health and Nutrition Examination Survey (2016–2022). We analyzed 29516 participants (12626 for gout analysis) aged ≥19 years. Smoking status (exposure) and doctor-diagnosed gout (primary outcome) were assessed through self-reported questionnaires, while serum uric acid levels (secondary outcome) were measured from blood samples. Multiple linear and logistic regression analyses were performed to assess the associations, adjusting for potential confounders.

In females, current smokers had significantly higher serum uric acid levels than never smokers (adjusted mean difference=0.16 mg/dL; 95% CI: 0.08–0.24; p<0.001). Current smoking in females was also significantly associated with increased odds of both hyperuricemia (adjusted odds ratio, AOR=1.49; 95% CI: 1.11–2.00; p=0.008) and self-reported doctor-diagnosed gout (AOR=22.07; 95% CI: 6.66–73.09; p<0.001) compared with never smoking. In contrast, no significant associations were observed in males; the adjusted mean difference in serum uric acid levels between current and never smokers was -0.01 mg/dL (95% CI: -0.08–0.05; p=0.668), and the AOR for gout was 1.00 (95% CI: 0.62–1.59; p=0.984).

The results suggest that smoking is associated with elevated serum uric acid levels and an increased prevalence of hyperuricemia and gout in women but not in men.