Sex difference in the risk of coronary artery calcification progression related to hyperuricemia among asymptomatic 12,316 Korean adults

Data on hyperuricemia-related changes in coronary atherosclerosis are limited, especially in sex difference. This study evaluated the association between hyperuricemia and coronary artery calcification (CAC) progression in asymptomatic Korean men and women. We analysed the data of 12,316 asymptomatic adults (51.7 ± 8.5 years; 84.2% men) with a mean follow-up of 3.3 years. Participants were divided into two groups: those with and without hyperuricemia (serum uric acid levels > 7.0 mg/dL for men and > 6.0 mg/dL for women). CAC progression was defined as a difference of ≥ 2.5 between the square roots of the baseline and follow-up coronary artery calcium score (CACS) (Δ√transformed CACS). The incidence of CAC progression was higher in men with hyperuricemia than in those without the condition (37.9% vs. 32.3%, P < 0.001); however, no significant difference in the incidence of CAC progression was observed in women with and without hyperuricemia (20.2% vs. 15.8%, P = 0.243). After adjusting for age, hypertension, diabetes, dyslipidaemia, obesity, current smoking status, serum creatinine, baseline CACS, and inter-scan periods, hyperuricemia was associated with increased risk of CAC progression in men (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.06 − 1.36, P = 0.004); however, hyperuricemia was not significantly associated with the risk of CAC progression in women (OR: 0.73, 95% CI: 0.36 − 1.49, P = 0.385). In conclusion, hyperuricemia is more closely associated with CAC progression in men than in women among asymptomatic Korean adults.