Associations between blood lead, cadmium, and mercury levels with hyperuricemia in the Korean general population: A retrospective analysis of population-based nationally representative data

Aim An elevated serum uric acid level is associated with various diseases, such as gout, hypertension, renal impairment, and diabetes. Heavy metals, including lead and cadmium, are suspected to increase serum uric acid levels, but evidence regarding this is not sufficient, particularly in the Asian population. Therefore, this study aimed to evaluate the association between lead, cadmium and mercury exposure and hyperuricemia in the Korean general population. Methods We enrolled 2682 participants (1124 men and 1528 women) aged >= 19 years from The Korean National Health and Nutrition Examination Survey. Sex- and hyperuricemic state-stratified general characteristics of study participants were compared using the Chi-square test, Student's t test, and Mann-Whitney U test for categorical, continuous, and non-normally distributed continuous variables, respectively. Multivariate logistic regression analysis was performed to evaluate the association between blood lead and cadmium levels and hyperuricemia. Results Subjects with hyperuricemia had higher blood lead and cadmium levels than those without hyperuricemia. Lead and cadmium exposure had a positive association with serum uric acid levels in a dose-response manner in the nationally representative Korean population. In logistic analysis, blood cadmium levels had a positive association with increasing risk for hyperuricemia only in men, and this association was more evident in cotinine-verified non-smokers. Although an incremental trend of hyperuricemia in relation to lead exposure was observed, it was not statistically significant. Conclusion Further studies are necessary to clarify the observed association, and public health strategies to reduce heavy metal exposure may be necessary for decreasing the potential harmful effects of hyperuricemia.