Abstract

Background and Objectives: Diet is a modifiable factor influencing serum uric acid levels, but evidence on the associations between dietary fat composition and hyperuricemia (HUA) remains limited. This study examined the relationships between the proportion of energy from total fat and specific dietary fatty acids and the risk of HUA among Chinese adults. Methods and Study Design: Data were obtained from adults who participated in at least two follow‑up waves of the China Health and Nutrition Survey (CHNS) in 2009, 2015, and 2018. Associations and dose–response relationships were assessed using multivariate Cox proportional hazards and restricted cubic spline (RCS) models. Results: During a mean follow‑up of 6.05 years among 2,722 participants, the prevalence of HUA was 10.2% (men: 14.1%; women: 7.76%). In women, energy from saturated fatty acids (SFAs) in the fourth quintile (7.88%) and from monounsaturated fatty acids (MUFAs) in the third quintile (9.97%) was positively associated with HUA (HR = 2.19, 95% CI 1.19-4.05; HR = 2.14, 95% CI 1.21-3.79), whereas polyunsaturated fatty acids (PUFAs) in the third quintile (6.88%) were negatively associated (HR = 0.41, 95% CI 0.22-0.78). RCS analyses showed J‑shaped and U‑shaped associations in men between total fat (37.9%, 95% CI 11.0-40.3) and PUFAs energy ratio (9.60%, 95% CI 2.25-10.7) with HUA, respectively, and an L‑shaped association in women for PUFAs energy ratio (6.25%, 95% CI 5.54-9.42). Conclusions: These findings suggest sex‑specific, non‑linear relationships between total fat and different fatty acid intakes and HUA risk. Men should consider moderating total fat intake, while women should limit SFAs and moderately increase PUFAs to help reduce HUA risk.

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