Uric acid, vitamin D, and left ventricular hypertrophy: Unveiling cardiovascular risks – a retrospective cross-sectional study

Abstract

Hyperuricemia is increasingly recognized as being associated with adverse cardiovascular outcomes. The connection between serum uric acid (SUA) levels, vitamin D levels, and cardiovascular risk factors, particularly in the Middle Eastern population, is a subject that requires further exploration. This study aimed to explore the association between high uric acid levels and low vitamin D levels in adults to identify independent predictors of left ventricular hypertrophy (LVH). A retrospective cross-sectional study was conducted using medical records from the rheumatology and cardiology departments at King Faisal University Polyclinics in Al Ahsa, Saudi Arabia, between May 2024 and June 2025. According to the National Health and Nutrition Examination Survey criteria, hyperuricemia was defined. Demographic, biochemical, and echocardiographic factors were examined. Multivariate logistic regression was performed to identify independent predictors of LVH. A total of 803 participants, including 207 individuals with hyperuricemia, were analyzed. Patients with hyperuricemia had significantly higher fasting blood glucose, glycated hemoglobin, total cholesterol, low-density lipoprotein, triglycerides, body mass index (BMI), and left ventricular mass index (all P < .001). The prevalence of LVH was markedly higher in the hyperuricemic group (43.5% vs 1.2%, P < .001). A strong negative correlation was found between SUA and vitamin D levels (r = -0.466, P < .001). SUA and BMI were independently associated with LVH (P < .05). The study found that hyperuricemia was significantly associated with LVH and lower vitamin D levels. However, only SUA and BMI showed independent associations with LVH. This highlights the substantial impact on cardiac and metabolic health linked to high levels of uric acid in the Saudi population.