Association between dampness syndrome severity and hyperuricemia after accounting for adiposity

Dampness syndrome is a symptom-based traditional Chinese medicine pattern frequently observed in individuals with metabolic disorders. However, whether dampness syndrome severity provides information on hyperuricemia (HUA) beyond conventional adiposity indicators remains unclear. This study examined the association between dampness syndrome severity and HUA and evaluated whether this association persisted after accounting for adiposity. This cross-sectional study used retrospective health-examination data from adults in 2024. Dampness syndrome severity was assessed using the Dampness Syndrome Scale of Chinese Medicine (DSSCM). Multivariable logistic regression and restricted cubic spline analyses were used to examine the association between DSSCM score and HUA. Body mass index (BMI) was included in the fully adjusted model, with waist circumference and waist-to-height ratio examined in sensitivity analyses. Because the DSSCM includes an explicit body obesity item, an additional sensitivity analysis recalculated the DSSCM score after excluding this item. Robust Poisson regression was performed to estimate prevalence ratios because HUA was common in the study population. Exploratory BMI-decomposition analysis was interpreted as statistical decomposition rather than causal mediation. Among 5973 participants, 3173 (53.1%) had HUA. In the model adjusted for demographic, renal, metabolic, and lifestyle covariates but not BMI, each 10-point increase in DSSCM score was weakly associated with higher odds of HUA (odds ratio = 1.041; 95% confidence interval: 1.004–1.079; P  = .028). After additional adjustment for BMI, the association was attenuated and was no longer statistically significant (odds ratio = 1.011; 95% confidence interval: 0.975–1.048; P  = .558). Sensitivity analyses using waist circumference and waist-to-height ratio as alternative adiposity indicators yielded consistent nonsignificant results. After excluding the body obesity item from the DSSCM score, the association was further weakened in multivariable models. BMI-stratified analyses showed no significant association across BMI strata. The association between dampness syndrome severity and HUA was substantially attenuated after accounting for adiposity. The DSSCM may help characterize symptom burden in integrative health assessment, but it was not independently associated with prevalent HUA after adjustment for adiposity indicators.