ACCELERATED biological aging may be a missing link between hyperuricemia, rising serum uric acid, gout, and diet-driven prevention.
In this large prospective analysis of 412,493 UK Biobank participants, investigators examined how biological aging relates to serum uric acid, hyperuricemia, and gout risk. Using multiple regression models, they found that each step of biological aging acceleration was associated with an average increase of 8.1 μmol/L in serum uric acid, with tight confidence intervals and strong statistical support.
Compared with peers whose biological aging was delayed, individuals with accelerated aging showed a 40% increase in the odds of developing hyperuricemia and a 39% increase in the odds of gout. Among participants who already had hyperuricemia, accelerated biological aging conferred a further 14% increase in the odds of progressing to gout, underscoring biological aging as a potential modifier of disease trajectory rather than simply a background characteristic.
Large Cohort and Genetic Evidence
To explore causality beyond observational associations, the authors performed Mendelian randomization analyses. Genetically determined traits linked to delayed biological aging were significantly associated with a lower risk of gout. These genetic findings support a causal pathway in which slower biological aging reduces gout risk, complementing the cohort-level associations between biological aging and gout risk in hyperuricemia.
Anti-Aging Diet Signals and Gout Prevention
The study also evaluated the composite dietary antioxidant index as a marker of an anti-aging diet. Among participants with hyperuricemia, those with a positive dietary antioxidant index had a marginally significant 68% reduction in the odds of developing gout compared with those with a negative index. Although the p value was borderline, this signal suggests that antioxidant-rich dietary patterns may contribute to healthy aging and gout prevention in hyperuricemia.
Clinical Implications for Gout Prevention
For clinicians managing hyperuricemia and gout, these findings position biological aging as an emerging risk dimension alongside traditional metabolic factors. Assessing markers of biological aging may help stratify gout risk in patients with elevated uric acid. The data also highlight healthy aging strategies, including attention to antioxidant-rich dietary patterns, as a potential adjunct to pharmacologic urate lowering when aiming to prevent the 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.
