Background: Atherosclerotic cardiovascular disease (ASCVD) has long been recognized as a significant contributor to mortality rates, holding a prominent position in the hierarchy of causes of death. Nevertheless, the presence of a causal relationship between serum uric acid (SUA) and the risk of ASCVD, as well as mortality rates, remains unclear.
Methods: We initially conducted a comprehensive cohort study utilizing data sourced from National Health and Nutrition Examination Survey (NHANES) 1999-2018 to investigate the specific correlation between SUA levels and ASCVD. Then, we subsequently examined the link between SUA levels and all-cause and cardio-cerebrovascular mortality among ASCVD individuals.
Results: We identified a U-shaped relationship between SUA levels and the risk of ASCVD in all participants (inflection point at 5.399, p value = 0.014). Similarly, SUA levels showed U-shaped trends with all-cause mortality (inflection point at 5.748, p value < 0.0001) and cardio-cerebrovascular mortality (inflection point at 5.936, p value < 0.0001), respectively.
Conclusions: Our findings demonstrate a U-shaped association between SUA levels and the risks of ASCVD, all-cause mortality, and cardio-cerebrovascular mortality. However, further research is needed to better understand how SUA affects ASCVD and its underlying mechanisms.
Keywords: Atherosclerotic cardiovascular disease; Mortality; NHANES; Serum uric acid.
© 2025. The Author(s).