Association between the Zhejiang University index and hyperuricemia among adults with type 2 diabetes in China.

PURPOSE: The Zhejiang University (ZJU) index is an established surrogate marker for metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to investigate the association between ZJU index and hyperuricemia in patients with type 2 diabetes mellitus (T2DM).

METHODS

We performed a retrospective cross-sectional analysis of 1772 adults with T2DM at the Affiliated Hospital of Jiangsu University. The ZJU index was derived from clinical metabolic variables, and participants were classified by hyperuricemia status. Associations between the ZJU index and hyperuricemia were examined using multivariable regression, restricted cubic spline modeling, and subgroup analyses.

RESULTS

Patients with hyperuricemia exhibited significantly worse metabolic profiles, including higher ZJU index levels (P<0.001). The ZJU index demonstrated a significant positive association with the prevalence of hyperuricemia (OR = 1.036, 95%CI: 1.017-1.056, P<0.001) and serum uric acid levels (β=1.187, 95%CI: 0.595-1.780, P<0.001), with a graded increase observed across quantiles (P for trend<0.001). Restricted cubic spline analysis further indicated a linear relationship. The association showed overall consistency across subgroups, while a stronger effect was evident in participants with coronary heart disease.

CONCLUSIONS

The ZJU index is associated with hyperuricemia in T2DM and may reflect interlinked hepato-metabolic pathways that drive hyperuricemia.