Independent and synergistic effects of sedentary lifestyle and obstructive sleep apnea on hyperuricemia: a nationwide cross-sectional study in Korea

초록

Introduction: Hyperuricemia, a precursor to gout and a risk factor for various cardiometabolic and renal disorders, is influenced by a complex interplay of lifestyle, physiological, and environmental factors. This study aimed to investigate the independent and combined effects of a sedentary lifestyle and obstructive sleep apnea (OSA) on hyperuricemia. Methods: We analyzed data from 14,808 participants aged 40-80 years in the Korea National Health and Nutrition Examination Survey (2019-2022). Sedentary lifestyle was defined based on daily sedentary time, categorized as <= 6 or >6 h/day. OSA risk was assessed using the STOP-Bang questionnaire (Snoring, Tiredness, Observed apnea, blood Pressure, Body mass index, Age, Neck circumference, Gender), classifying participants into high- and low-risk groups. Hyperuricemia was defined as serum uric acid levels >= 7.0 mg/dL in males and >= 6.0 mg/dL in females. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression, and interaction effects were evaluated through relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Results: Sedentary time [AOR = 1.16 (95% CI: 1.04-1.29)] was independently associated with increased hyperuricemia risk. High OSA risk was associated with hyperuricemia in the partially adjusted model [AOR = 1.94 (95% CI: 1.71-2.19)], although this association was attenuated and no longer statistically significant after further adjustment for variables incorporated into the STOP-Bang questionnaire [AOR = 1.12 (95% CI: 0.98-1.28)]. A significant synergistic interaction was evident when both coexisted [RERI = 0.14 (95% CI: 0.08-0.19), AP = 0.17 (95% CI: 0.09-0.25), SI = 1.17 (95% CI: 1.01-1.37)]. Discussion: These findings highlight the need for integrated screening and management strategies targeting sedentary lifestyles and OSA to mitigate hyperuricemia and its associated health burdens in at-risk populations.

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