@article {Kang380, author = {Eunjeong Kang and Seung-sik Hwang and Dong Ki Kim and Kook-Hwan Oh and Kwon Wook Joo and Yon Su Kim and Hajeong Lee}, title = {Sex-specific Relationship of Serum Uric Acid with All-cause Mortality in Adults with Normal Kidney Function: An Observational Study}, volume = {44}, number = {3}, pages = {380--387}, year = {2017}, doi = {10.3899/jrheum.160792}, publisher = {The Journal of Rheumatology}, abstract = {Objective. To explain the clinical effect of serum uric acid (SUA) levels as a risk factor for mortality, considering exclusion of kidney function.Methods. Participants aged over 40 years who underwent health checkups were recruited. Individuals with estimated glomerular filtrations rates \< 60 ml/min/1.73 m2 and who received laboratory study and colonoscopy on the same day were excluded.Results. SUA levels were higher in men than in women (5.7 {\textpm} 1.2 mg/dl for men and 4.2 {\textpm} 0.9 mg/dl for women, p \< 0.001). During 12.3 {\textpm} 3.6 years of followup, 1402 deaths occurred among 27,490 participants. About 6.9\% of men and 3.1\% of women died. The overall mortality rate had a U-shaped association with SUA levels, a U-shaped association in men, and no association in women. There was a significant interaction of sex for the SUA-mortality association (p for interaction = 0.049); therefore, survival analysis was conducted by sex. In men, the lower SUA group had a higher mortality rate after adjustment (SUA <= 4.0 mg/dl, adjusted HR 1.413, 95\% CI 1.158{\textendash}1.724, p = 0.001) compared with the reference group (SUA 4.1{\textendash}6.0 mg/dl). A higher SUA contributed to an insignificant increased mortality in men (\> 8.0 mg/dl, adjusted HR 1.140, 95\% CI 0.794{\textendash}1.636, p = 0.479). Women failed to show any significant association between SUA and mortality.Conclusion. This study provided novel evidence that SUA-mortality association differed by sex. We demonstrated that a lower SUA was an independent risk factor for all-cause mortality in men with normal kidney function.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/44/3/380}, eprint = {https://www.jrheum.org/content/44/3/380.full.pdf}, journal = {The Journal of Rheumatology} }