Objective  To analyze the complex relationships between individual or combined exposures to six aldehydes and hyperuricemia (HUA) and serum uric acid (SUA) levels in adults by Bayesian kernel machine regression (BKMR), and to explore the factors associated with aldehyde exposure leading to HUA.

Methods  Participants aged 20 years and older with available aldehyde data were selected from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. The study employed BKMR to explore the complex associations between individual or combined exposure to multiple aldehydes and both HUA and SUA. Multivariable Logistic regression analysis was performed to evaluate the association between aldehydes and HUA, while multiple linear regression models were used to examine the linear relationship between aldehydes and SUA. Stratified analysis was conducted to explore the association between aldehydes and HUA across populations with different characteristics.

Results  A total of 1,952 participants were included in the analysis, of whom 346 (17.73%) were diagnosed with HUA. Butyraldehyde [OR=1.59, 95%CI (1.23, 2.07)], heptaldehyde [OR=1.58, 95%CI (1.18, 2.13)], and hexaldehyde [OR=1.68, 95%CI (1.15, 2.45)] were significantly associated with HUA. For each one-unit increase in the concentration of butyraldehyde, heptaldehyde, or hexaldehyde, the risk of developing HUA increased by approximately 59%, 58%, and 68%, respectively. The results from the BKMR model indicated that the combined effect of aldehyde exposure was positively associated with both HUA and SUA. Among the individual aldehydes, hexaldehyde showed the highest posterior inclusion probability (PIP=0.324), suggesting the greatest contribution to the observed association. Six aldehydes were also significantly positively correlated with reduced glomerular filtration rate (GFR) and elevated levels of triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C).

Conclusion  Individual or combined exposure to aldehydes was positively associated with HUA. This association may be attributed to factors such as reduced GFR, as well as elevated levels of TG and LDL-C.

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