-
Original Article
-
Korean J Intern Med. 2026;41(4):748-762. Published online July 1, 2026.
DOI: https://doi.org/10.3904/kjim.2025.269
- Association of hyperuricemia with valvular heart disease and the modifying effect of obesity
-
Seung Min Jung1, Sang-Hyuk Jung2,3, Su-Nam Lee4, Jin A Choi5, Dokyoon Kim3,6, Hong-Hee Won7,8, Jae-Seung Yun9
-
1Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Medical Informatics, Kangwon National University College of Medicine, Chuncheon, Korea, Korea
3Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA, Korea
4Division of Cardiology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
5Department of Ophthalmology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Korea
6Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, USA, Korea
7Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Korea
8Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
9Division of Endocrinology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding author: Jae-Seung Yun ,Tel: +82-31-881-8932, Fax: +82-31-253-8898, Email: dryun@catholic.ac.kr
- Received: August 5, 2025; Revised: February 19, 2026 Accepted: March 9, 2026.
- Abstract
- Background/Aims
Hyperuricemia has been widely associated with cardiovascular health, but its relationship with incident valvular heart disease (VHD) remains uncertain. This study investigated the association between hyperuricemia and VHD, and further explored the role of weight management within this context.
Methods
Participants from the UK Biobank cohort were categorized into three groups based on serum uric acid (SUA) level: normal (< 6.0 mg/dL), high (6.0–8.9 mg/dL), and very high (≥ 9.0 mg/dL). The risk of VHD associated with SUA level was assessed in the overall population and across subgroups with differing metabolic profiles. To examine the impact of obesity on VHD development, the relative risk of VHD was analyzed based on body mass index and waist circumference.
Results
Among 462,705 participants, 340,793 (73.7%) had normal SUA levels, 118,861 (25.7%) had high levels, and 3,051 (0.7%) had very high levels. Over an average follow-up period of 12.3 years, the adjusted risk of VHD was significantly higher in individuals with very high SUA, followed by those with high and normal SUA (2.31 vs. 1.25 vs. reference, respectively). Stratifying VHD risk by metabolic disorders revealed a dose-response relationship between SUA level and VHD risk. The impact of obesity on VHD development was notable among individuals with SUA below 9.0 mg/dL, but less pronounced in those with SUA exceeding 9.0 mg/dL.
Conclusions
This finding suggests a significant association between hyperuricemia and VHD, highlighting the potential relevance of elevated SUA levels in VHD risk stratification.
Keywords :Uric acid; Valvular heart disease; Metabolic disorder; Obesity
