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

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.