RHEUMATOLOGY / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The muscle quality index (MQI) is an increasingly recognized indicator of muscle status. The objective of this research was to analyze the association between MQI and hyperuricemia.

Material and methods:
We performed a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2011 to 2014. Participants in this study were adults aged 20–59 years. The muscle quality index (MQI) was calculated as the ratio of handgrip strength (HGS) to appendicular skeletal muscle mass (ASM). Hyperuricemia was defined by serum uric acid concentrations exceeding 420 µmol/l (7 mg/dl) in males and 360 µmol/l (6 mg/dl) in females. Assessment of the MQI-hyperuricemia relationship involved logistic regression, analysis of subgroups, and the application of smooth curve fitting.

Results:
This research included 5,283 participants, of whom 716 had hyperuricemia. The prevalence of hyperuricemia decreased with higher quartiles of MQI (p < 0.001). After correcting for confounders, MQI was closely associated with hyperuricemia (OR = 0.59, 95% CI: 0.46–0.77, p < 0.001). Smooth curve fitting indicated a nonlinear association between the variables, with a threshold identified at 2.92. Subgroup analyses demonstrated that this association was particularly evident in participants with diabetes.

Conclusions:
Our findings revealed an inverse correlation between MQI and hyperuricemia, suggesting that preserving adequate muscle quality may be advantageous in reducing the risk of hyperuricemia. Further prospective research is needed.
REFERENCES (43)
1.
El Ridi R, Tallima H. Physiological functions and pathogenic potential of uric acid: a review. J Adv Res 2017; 8: 487-93.
 
2.
Kuwabara M, Kodama T, Ae R, et al. Update in uric acid, hypertension, and cardiovascular diseases. Hypertens Res 2023; 46: 1714-26.
 
3.
Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Uric acid and oxidative stress-relationship with cardiovascular, metabolic, and renal impairment. Int J Mol Sci 2022; 23: 3188.
 
4.
Crawley WT, Jungels CG, Stenmark KR, Fini MA. U-shaped association of uric acid to overall-cause mortality and its impact on clinical management of hyperuricemia. Redox Biol 2022; 51: 102271.
 
5.
Zeng F, Huang R, Lu Y, Wu Z, Wang L. Association of anti-hyperuricemia treatment and prevalent cardiovascular disease in hypertensive patients. Arch Med Sci 2020; 16: 545-50.
 
6.
Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol 2020; 16: 380-90.
 
7.
Celis-Morales C, Welsh P, Lyall DM, et al. Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants. BMJ 2018; 361: k1651.
 
8.
Llopez-Bueno R, Andersen LL, Koyanagi A, et al. Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: a systematic review with dose-response meta-analysis. Ageing Res Rev 2022; 82: 10177.
 
9.
Veronese N, Stubbs B, Trevisdan C, et al. Results of an observational cohort study of hyperuricemia as a predictor of poor physical performance in the elderly. Arthritis Care Res 2016; 69: 1238-44.
 
10.
Xu ZR, Zhang Q, Chen LF, et al. Characteristics of hyperuricemia in older adults in China and possible associations with sarcopenia. Aging Med 2018; 1: 23-34.
 
11.
Lopes LCC, Vas-Goncalves L, Schincaglia RM, et al. Sex and population-specific cutoff values of muscle quality index: results from NHANES 2011-2014. Clin Nutr 2022; 41: 1328-34.
 
12.
Weng L, Xu Z, Chen Y, Chen C. Associations between the muscle quality index and adult lung functions from NHANES 2011-2012. Front Public Health 2023; 11: 1146456.
 
13.
Chen Y, Lin W, Fu L, et al. Muscle quality index and cardiovascular disease among US population-findings from NHANES 2011-2014. BMC Public Health 2023; 23: 2388.
 
14.
You Y, Chen Y, Zhang Q, et al Muscle quality index is associated with trouble sleeping: a cross-sectional population based study. BMC Public Health 2023; 23: 489.
 
15.
Song J, Wu Y, Ma H, Zhang J. Association between muscle quality index and periodontal disease among American adults aged ≥ 30 years: a cross-sectional study and mediation analysis. BMC Oral Health 2023; 23: 918.
 
16.
Wang Z, Zhao G, Cao Y, Gu T, Yang Q. Association between monocyte to high-density lipoprotein cholesterol ratio and kidney stone: insights from NHANES. Front Endocrinol 2024; 15: 151374376.
 
17.
Gonzales-Islas D, Robles-Hernandez R, Flores-Cisneros L, et al. Association between muscle quality index and pulmonary function in post-COVID-19 subjects. BMC Pulm Med 2023; 23: 442.
 
18.
Mohammed AQ, Abdu FA, liu L, et al. Hyperuricemia predicts adverse outcomes after myocardial infarction with non-obstructive coronary arteries. Front Med 2021; 8: 716840.
 
19.
Han Y, Cao Y, Han X, et al. Hyperuricemia and gout increased the risk of long-term mortality in patients with heart failure: insights from the National Health and Nutrition Examination Survey. J Transl Med 2023; 21: 463.
 
20.
Wang Z, Tang F, Zhao B, Yan H, Shao X, Yang Q. Composite dietary antioxidant index and abdominal aortic calcification: a national cross-sectional study. Nutr J 2024; 23: 130.
 
21.
Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-12.
 
22.
Lee J, Hong YS, Park SH, Kang KY. High serum uric acid level is associated with greater handgrip strength in the aged population. Arthritis Res Ther 2019; 21: 73.
 
23.
Floriano JP, Nahas PC, de Branco FMS, et al. Serum uric acid is positively associated with muscle mass and strength, but not with functional capacity, in kidney transplant patients. Nutrients 2020; 12: 2390.
 
24.
Xie L, Mo PKH, Tang Q, et al. Skeletal muscle mass has stronger association with the risk of hyperuricemia than body fat mass in obese children and adolescents. Front Nutr 2022; 9: 792234.
 
25.
Scott D, Hayes A, Sanders KM, Aitken D, Ebeling PR, Jones G. Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults. Osteoporos Int 2014; 25: 187-93.
 
26.
Jerez-Mayorga D, Delgado-Floody P, Intelangelo L, et al. Behavior of the muscle quality index and isometric strength in elderly women. Physiol Behav 2020; 227: 113145.
 
27.
Nishikawa H, Asai A, Fukunishi S, et al. Metabolic syndrome and sarcopenia. Nutrients 2021; 13: 3519.
 
28.
Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes 2019; 12: 1057-72.
 
29.
Sakalli AA, Küçükerdem HS, Aygün O What is the relationship between serum uric acid level and insulin resistance? A case-control study. Medicine (Baltimore) 2023; 102: e36732.
 
30.
Toyoki D, Shibata S, Kuribayashi-Okuma E, et al. Insulin stimulates uric acid reabsorption via regulating urate transporter 1 and ATP-binding cassette subfamily G member 2. Am J Physiol Renal Physiol 2017; 313: F826-34.
 
31.
Oh SK, Son DH, Kwon YJ, Lee HS, Lee JW. Association between basal metabolic rate and handgrip strength in older Koreans. Int J Environ Res Public Health 2019; 16: 4377.
 
32.
Stanhope KL. Sugar consumption, metabolic disease and obesity: the state of the controversy. Crit Rev Clin Lab Sci 2016; 53: 52-67.
 
33.
Maciak S, Sawicka D, Sadowska A, et al. Low basal metabolic rate as a risk factor for development of insulin resistance and type 2 diabetes. BMJ Open Diabetes Res Care 2020; 8: e001381.
 
34.
Petrie JL, Patman GL, Sinha I, Alexander TD, Reeves HL, Agius L. The rate of production of uric acid by hepatocytes is a sensitive index of compromised cell ATP homeostasis. Am J Physiol Endocrinol Metab 2013; 305: E1255-65.
 
35.
Tuttle CSL, Thang LAN, Maier AB. Markers of inflammation and their association with muscle strength and mass: a systematic review and meta-analysis. Ageing Res Rev 2020; 64: 101185.
 
36.
Ertek S, Cicero A. Impact of physical activity on inflammation: effects on cardiovascular disease risk and other inflammatory conditions. Arch Med Sci 2012; 8: 794-804.
 
37.
Du L, Zong Y, Li H, et al. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduct Target Ther 2024; 9: 212.
 
38.
Yoruk EO, Dost FS, Ontan MS, Bulut EA, Aydin AE, Isik AT. Hyperuricemia may be associated with muscle wellness in older adults. Int Urol Nephrol 2023; 55: 2981-8.
 
39.
Chen L, Wu L, Li Q, et al. Hyperuricemia associated with low skeletal muscle in the middle-aged and elderly population in China. Exp Clin Endocrinol Diabetes 2022; 130: 546-53.
 
40.
Shao Y, Wang Y, Jiang X, et al. Muscle quality index and hyperuricemia: adipose tissue as a mediator. Front Endocrinol 2025; 16: 1562837.
 
41.
Wang F, Wen L, Guo X, et al. Association of serum uric acid with relative muscle loss: a US population-based cross-sectional study. J Cachexia Sarcopenia Muscle 2025; 16: e13867.
 
42.
Chao HH, Liu JC, Lin JW, Chen CH, Wu CH, Cheng TH. Uric acid stimulates endothelin-1 gene expression associated with NADPH oxidase in human aortic smooth muscle cells. Acta Pharmacol Sin 2008; 29: 1301-12.
 
43.
Roumeliotis S, Roumeliotis A, Dounousi E, Eleftheriadis T, Liakopoulos V. Dietary antioxidant supplements and uric acid in chronic kidney disease: a review. Nutrients 2019; 11: 1911.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top