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Independent and synergistic effects of sedentary lifestyle and obstructive sleep apnea on hyperuricemia

A nationwide cross-sectional study in Korea

Bibliographic Data

ID22433432
AuthorsHyewon Lee (0000-0002-5960-535X, Chung-Ang University), Wanhyung Lee (0000-0001-6408-7668, Chung-Ang University), Seung-Yeon Lee (0000-0002-2505-895X, Seoul National University Bundang Hospital)
Year2026
Volume14
Publication date2026-07-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1854396
OpenAlexW7168345526
LanguageEN
References cited46

Introduction Hyperuricemia, a precursor to gout and a risk factor for various cardiometabolic and renal disorders, is influenced by a complex interplay of lifestyle, physiological, and environmental factors. This study aimed to investigate the independent and combined effects of a sedentary lifestyle and obstructive sleep apnea (OSA) on hyperuricemia. Methods We analyzed data from 14,808 participants aged 40–80 years in the Korea National Health and Nutrition Examination Survey (2019–2022). Sedentary lifestyle was defined based on daily sedentary time, categorized as ≤6 or >6 h/day. OSA risk was assessed using the STOP-Bang questionnaire (Snoring, Tiredness, Observed apnea, blood Pressure, Body mass index, Age, Neck circumference, Gender), classifying participants into high- and low-risk groups. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in males and ≥6.0 mg/dL in females. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression, and interaction effects were evaluated through relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Results Sedentary time [AOR = 1.16 (95% CI: 1.04–1.29)] was independently associated with increased hyperuricemia risk. High OSA risk was associated with hyperuricemia in the partially adjusted model [AOR = 1.94 (95% CI: 1.71–2.19)], although this association was attenuated and no longer statistically significant after further adjustment for variables incorporated into the STOP-Bang questionnaire [AOR = 1.12 (95% CI: 0.98–1.28)]. A significant synergistic interaction was evident when both coexisted [RERI = 0.14 (95% CI: 0.08–0.19), AP = 0.17 (95% CI: 0.09–0.25), SI = 1.17 (95% CI: 1.01–1.37)]. Discussion These findings highlight the need for integrated screening and management strategies targeting sedentary lifestyles and OSA to mitigate hyperuricemia and its associated health burdens in at-risk populations.

Body mass index · Confidence interval · Gout · Hyperuricemia · Logistic regression · Obstructive sleep apnea · Odds ratio · Risk factor · Exercise and Physiological Responses · Gout, Hyperuricemia, Uric Acid · Obstructive Sleep Apnea Research

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