Objective: The role of different body composition phenotypes in hyperuricemia (HUA) among adolescents remains unclear. Therefore, this study aimed to investigate the association between distinct body composition phenotypes and HUA in this population. Design and method: In this cross-sectional study, 1055 adolescents aged 12–18 years were recruited from six schools in Yinchuan City between 2020 and 2023 using stratified cluster random sampling. Participants were categorized into four body composition phenotypes based on fat mass index (FMI) and skeletal muscle index (SMI): low FMI–low SMI (LFMI-LSMI), low FMI–high SMI (LFMI-HSMI), high FMI–low SMI (HFMI-LSMI), and high FMI–high SMI (HFMI-HSMI). Results: After adjusting for covariates, SMI exhibited a linear dose-response relationship with HUA risk (P for trend 0.50), whereas FMI showed a nonlinear association (P for trend < 0.05; P for nonlinearity < 0.50). Bivariate response models revealed that among individuals with low SMI, serum uric acid (SUA) levels initially increased and then declined with rising FMI, while among those with high SMI, SUA levels increased monotonically with higher FMI. Compared with the LFMI-HSMI, the LFMI-LSMI phenotype was associated with a significantly lower risk of HUA (OR = 0.47, 95% CI: 0.30–0.71), whereas both HFMI-HSMI (OR = 4.18, 95% CI: 1.93–9.08) and HFMI-LSMI (OR = 2.21, 95% CI: 1.19–4.11) were linked to elevated risks. Among all phenotypes, HFMI-HSMI demonstrated the highest predictive accuracy for HUA, with the largest area under the ROC curve (AUC = 0.748, P < 0.05). Conclusions: Adolescents with the HFMI-HSMI body composition phenotype face a substantially increased risk of HUA and exhibit the strongest predictive performance. These findings highlight the importance of targeting this high-risk group in early screening and preventive strategies.
Xu et al. (2026) studied this question.