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To explore whether dyslipidemia, hyperglycemia or hypertension has mediating effect on the association between serum uric acid (SUA) and the development of chronic kidney disease (CKD).    Methods  We conducted a mediation analysis to explore the potential mediating effects of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) on the association between SUA and estimated glomerular filtration rate (eGFR). The data were obtained from China Health and Retirement Longitudinal Study (CHARLS), covering 5,762 individuals.    Results  SUA had a negative dose-response total effect on eGFR ( β  -3.11, 95% CI -3.40 to -2.82,  P -value<0.001). The linear regression between SUA and seven potential mediators indicated that blood glucose ( β  0.80, 95% CI 0.18 to 1.42,  P -value=0.012), TG ( β  10.01, 95% CI 8.22 to 11.79,  P- value<0.001), TC ( β  2.64, 95% CI 1.83 to 3.45,  P -value<0.001), HDL-C ( β  -0.27, 95% CI -0.52 to -0.02,  P- value=0.034) and LDL-C ( β  1.15, 95% CI 0.49 to 1.80,  P -value=0.001) all had significant dose-response association with SUA, but SBP and DBP showed no significant association with SUA. In terms of the association between potential mediators and eGFR, only TG ( β  0.003, 95% CI -0.001 to 0.01,  P -value=0.117) and HDL-C ( β  0.01, 95% CI -0.02 to 0.04,  P -value=0.444) did not have significant linear association with eGFR. The linear regression showed that SUA was directly associated with eGFR ( P- value<0.001).    Conclusions  This study supported that the association between SUA and the risk of CKD was not mediated by hypertension, hyperglycemia or dyslipidemia.

frontiers in endocrinology

The Effects of Cardiometabolic Factors on the Association Between Serum Uric Acid and Chronic Kidney Disease in Chinese Middle-Aged and Older Population: A Mediation Analysis