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It is unclear whether uric acid (UA) has a negative or positive effect on anemia, and this may vary depending on the presence or absence of chronic disease such as hypertension (HTN). The present study was conducted to assess the relationship between anemia and hyperuricemia in Korean adults with or without hypertension. Data from 16,740 adults (age ≥20 years) in the Korean National Health and Nutrition Examination Survey (2016 − 2018) were analyzed. Several key findings were identified. First, after adjusting for the related variables in the non-HTN group, the odds ratio (OR) of anemia (hemoglobin [Hb] ≥ 13.0 mg/dL in men and ≥12.0 mg/dL in women), using the normouricemia (UA &lt; 7.0 mg/dL in men and UA &lt; 6.0 mg/dL in women) as a reference, was inversely significant for the hyperuricemia (UA ≥ 7.0 mg/dL in men and ≥6.0 mg/dL in women) in the overall population (OR, 0.589; 95% confidence interval [CI], 0.409–0.848) and women (OR, 0.575; 95% CI, 0.363–0.909) but not in men (OR, 0.836; 95% CI, 0.441–1.586). Second, after adjusting for the related variables in the HTN group, the OR of anemia, using the normouricemia as a reference, was positively significant for the hyperuricemia in the overall population (OR, 1.501; 95% CI, 1.167–1.930), men (OR, 1.706; 95% CI, 1.154–2.523), and women (OR, 1.512; 95% CI, 1.079–2.210). Hyperuricemia was positively associated with anemia in men and women with HTN. Hyperuricemia was inversely associated with anemia in women without HTN but not in men without HTN.

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The relationship between anemia and hyperuricemia and hypertension in Korean adults: the Korea National Health and Nutrition Examination Survey 2016–2018