Bold statement first: Biological aging might be the missing link linking high uric acid, gout risk, and the diet-driven path to prevention. And this is the part most people miss: aging processes could shape how hyperuricemia turns into gout, beyond the usual metabolic factors.
A large prospective study with 412,493 UK Biobank participants examined how accelerated biological aging relates to serum uric acid levels, hyperuricemia, and gout risk. Using multiple regression analyses, researchers found that for each step of accelerated aging, serum uric acid rose on average by 8.1 μmol/L, with tight confidence intervals and robust statistics supporting the finding.
Compared with peers whose biological aging progressed more slowly, individuals with faster aging had about 40% higher odds of developing hyperuricemia and roughly 39% higher odds of experiencing gout. Among people who already had hyperuricemia, accelerated aging added about 14% more risk of progressing to gout. This suggests that biological aging acts as a modifier of disease trajectory, not just a background trait.
To probe causality beyond observational links, the study employed Mendelian randomization analyses. Genetic variants associated with delayed biological aging were significantly linked to a lower gout risk. These genetic results support a causal pathway in which slower aging reduces gout risk, reinforcing the cohort findings that aging processes influence gout development in hyperuricemia.
The research also explored anti-aging dietary signals. The composite dietary antioxidant index served as a marker of an anti-aging diet. Among hyperuricemic participants, those with a positive antioxidant index showed a marginally significant 68% reduction in the odds of developing gout compared with those with a negative index. Although the p-value hovered near the conventional threshold, the pattern hints that antioxidant-rich dietary patterns may contribute to healthy aging and gout prevention in the context of elevated uric acid.
Clinical implications for gout prevention are notable. For clinicians, biological aging emerges as a new risk dimension alongside traditional metabolic factors in hyperuricemia and gout. Measuring aging-related markers could help stratify gout risk in patients with high uric acid. Moreover, promoting antioxidant-rich dietary patterns may complement pharmacologic urate-lowering strategies to curb progression from hyperuricemia to gout.
Reference: Li N et al. Biological aging and gout risk in hyperuricemia: a UK biobank cohort study. Int J Surg. 2025;doi:10.1097/JS9.0000000000003948.
Author: This article is shared under the Creative Commons Attribution-Non Commercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/).
