Background/Purpose: Serum uric acid (SUA) has been shown to be a powerful endogenous antioxidant in the body. The double-edged characteristics of serum uric acid (SUA) and mixed results from previous studies have complicated determination of whether SUA plays a pulmonary-protective or pulmonary-destructive role. We hypothesized that SUA could have an important role in protecting the lung from oxidant damage and preventing a decline in pulmonary function. Therefore, we performed this study to investigate the association between SUA and spirometric values in a large sample drawn from a healthy population without overt clinical disease.

Methods: The Kangbuk Samsung Health Study was a cohort study of subjects who underwent a comprehensive annual or biennial examination at Kangbuk Samsung Hospital in Seoul, South Korea. We performed a cross-sectional study on 69,928 Koreans (30,572 men) without overt medical conditions who underwent a health examination in 2010.

Results:  : The overall prevalence of hyperuricemia among Korean health screening examinees was 25.5% in males and 8.5% in females. Overall serum urate level was 5.1 ± 1.4 mg/dL in men and 5.0 ± 1.4 mg/dL in women. In sex-stratified analyses of SUA level, mean SUA level was positively associated with a quartile increase in Percent predicted forced vital capacity (FVC%) and forced expiratory volume in 1 s (FEV1%) in both genders (P < 0.001). FVC% and FEV1% were positively correlated with SUA in both genders (FVC %: r = 0.361; FEV1 %: r = 0.314 in males and FVC%: r = 0.413; FEV1%: r = 0.382 in females, all P < 0.001). Increasing levels of FEV1% and FVC% were associated with an increasing incidence of hyperuricemia in both genders, indicating that FVC% and FEV1% are predictive of hyperuricemia independently of other confounding factors. The adjusted ORs for hyperuricemia comparing quartiles 2, 3, and 4 to quartile 1 of FVC% in men were 0.876 (95% CI, 0.809-0.949), 0.631 (0.574-0.695), and 0.311 (0.278-0.349), respectively. The adjusted ORs for hyperuricemia comparing quartiles 2, 3, and 4 to quartile 1 of FEV1% in men were 0.791 (95% CI, 0.729-0.859), 0.565 (0.513-0.623), and 0.302 (0.270-0.337), respectively (P for trend <0.001). Similarly, the adjusted ORs of hyperuricemia in women decreased significantly across quartiles 2 to 4 of FEV1% and FVC % compared with the highest quartile as the reference group (Pfor trend <0.001).

Conclusion: To the best of our knowledge, this is the first cohort study to show a significant positive association between hyperuricemia and good pulmonary function in a healthy Korean population, supporting the hypothesis that hyperuricemia might have a favorable effect on lung function. Longitudinal follow-up studies are required to confirm this positive association between SUA and lung function.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-uric-acid-is-positively-associated-with-pulmonary-function-in-korean-health-screening-examinees-a-cross-sectional-study/