Association between serum uric acid levels and left ventricular hypertrophy based on electrocardiographic findings: a sex-specific analysis across cardiometabolic diseases

The association between serum uric acid (UA) levels and left ventricular hypertrophy (LVH) remains unclear. We aimed to investigate this association using electrocardiographic findings. Health examination data from Kagoshima Kouseiren Hospital included 79,200 participants without cardiovascular diseases. Hypertension was defined as a blood pressure ≥ 140/90 mmHg. A Sokolow-Lyon criterion of ≥ 3.5 mm was used to define LVH. Sex-specific associations between UA and LVH were adjusted for age, body mass index, systolic blood pressure, serum triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, estimated glomerular filtration rate, and lifestyle factors. The mean UA levels were 4.5 ± 1.1 and 6.1 ± 1.4 mg/dL in women and men, respectively (LVH prevalences, 4.0%, and 11.8%, respectively). Individuals without and with hypertension had mean UA levels of 5.2 ± 1.4 and 5.7 ± 1.5 mg/dL, respectively (LVH prevalences, 5.5%, and 14.4%, respectively). UA levels were significantly associated with LVH in women aged 40-49 and 50-59 years and in men aged 50-59 years. Compared with the first UA quartile, the fourth quartile showed a more significant association with LVH in individuals without hypertension. Furthermore, UA was associated with LVH in individuals without obesity, dyslipidemia, reduced kidney function, and diabetes in both sexes. Serum UA levels are associated with LVH in middle-aged women and men without cardiovascular disease risk, suggesting the potential role of UA as an LVH marker. Anwar Ahmed Salim and Shin Kawasoe contributed equally to this work.