Association between serum uric acid and frailty: Evidence from NHANES database and perioperative geriatric frailty cohort

Exp Gerontol. 2025 Nov 15;212:112969. doi: 10.1016/j.exger.2025.112969. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty is a common syndrome among older adults, increasing vulnerability to adverse outcomes. Serum uric acid (SUA) has been associated with several aging-related diseases, but its relationship with frailty remains inconclusive.

METHODS: We performed an analysis using data from the NHANES (2003-2016) and a cohort study of perioperative geriatric frailty. Multivariable logistic regression and restricted cubic spline analysis were used to examine the association between SUA and frailty. Subgroup analyses and interaction were also conducted. Sensitivity analysis was conducted to evaluate the robustness of the results.

RESULTS: Among 24,183 NHANES participants, 16.2 % were frail. The cohort study included 149 participants, with 57.0 % developed frailty post-surgery. Higher SUA levels were significantly associated with frailty in both populations [NHANES: adjusted OR (aOR): 1.14, 95 % CI: 1.09-1.20; p < 0.001; Cohort: aOR: 1.49, 95 % CI: 1.04-1.91; p = 0.025]. Restricted cubic spline regression revealed a U-shaped relationship between SUA and frailty, with OR lowest at 4.3 mg/dL. The association between SUA and frailty was significantly stronger in females than in males (adjusted OR: 1.24; 95 % CI: 1.16-1.32). Sensitivity analysis confirmed the robustness of the association between SUA and frailty (aOR: 1.17; 95 % CI: 1.11-1.23).

CONCLUSIONS: SUA is significantly associated with frailty in both community and surgical populations. In community population, a U-shaped relationship was observed, whereas only high SUA levels predict frailty perioperatively. Females are more susceptible to SUA-related frailty.

PMID:41248838 | DOI:10.1016/j.exger.2025.112969