Of the 4922 patients enrolled, 856 (17.4%) were placed into the Dyslipidemia group (Table 1). The SUA concentration ranged from 1.80 to 9.19 mg/dL, increased gradually between 3 and 10 years of age, and then increased markedly between 11 and 12 years of age (Fig. 1; Supplementary Table 1). There were no sex differences, other than in 11- and 12-year-olds, among whom the SUAs of boys were significantly higher than those of girls (Fig. 1). For the entire cohort, the mean SUA was 4.27 ± 1.01 mg/dL, the mean TC was 3.85 ± 0.67 mmol/L, the mean TG was 0.87 ± 0.52 mmol/L, the mean HDL-C was 1.40 ± 0.30 mmol/L, the mean LDL-C was 2.16 ± 0.57 mmol/L, the mean non-HDL-C was 2.45 ± 0.62 mmol/L and the mean FPG was 4.44 ± 0.47 mmol/L (Table 1). Pearson correlation analysis showed a significant negative correlation between the SUA and HDL-C concentrations and a positive correlation of SUA with the TG and non-HDL-C concentrations (Supplementary Table 2).

Change in the mean and SD of SUA with age by sex. Sex differences in SUA concentrations at the same age: *P < 0.05, **P < 0.001

For the participants with dyslipidemia, the mean SUA was 4.51 ± 1.15 mg/dL, the mean TC was 4.04 ± 1.02 mmol/L, the mean TG was 1.46 ± 0.91 mmol/L, the mean HDL-C was 1.14 ± 0.33 mmol/L, the mean LDL-C was 2.44 ± 0.83 mmol/L, the mean non-HDL-C was 2.90 ± 0.85 mmol/L and the mean FPG was 4.47 ± 0.48 mmol/L (Table 1). Compared with participants in the Ortholiposis group, those with dyslipidemia were older; had a significantly higher prevalence of hyperuricemia; and had higher BMI z score, SUA, TC, TG, LDL-C, non-HDL-C, ALT, GGT and ALP. HDL-C and AST were significantly lower in the Dyslipidemia group (Table 1).

As shown in Table 1, the mean and SD of SUA in participants with ortholiposis were 4.22 and 0.97 mg/dL, respectively. The spread in the SUA data for all 4922 enrolled participants ranged from -2.5 SD to + 5.3 SD. Accordingly, the participants were placed into five groups: Group 1, defined as SUA < 1 SD below the mean value for the Ortholiposis group (from -2.5 SD to -1 SD); Group 2, with SUAs between 1 SD below the mean value for the Ortholiposis group and the mean (from -1 SD to 0 SD); Group 3, with SUAs between the mean value for the Ortholiposis group and 1 SD above the mean (from 0 SD to + 1 SD); Group 4, with SUAs between 1 and 2 SDs above the mean for the Ortholiposis group (from + 1 SD to + 2 SD); and Group 5, with SUAs > 2 SD above the mean for the Ortholiposis group ( from + 2 SD to + 5.3 SD). In Group 1, the SUA concentrations ranged from 1.80 to 3.28 mg/dL, with a mean value of 2.92 ± 0.30 mg/dL; in Group 2, the SUA ranged from 3.29 to 4.22 mg/dL, with a mean value of 3.78 ± 0.27 mg/dL; in Group 3, the SUA ranged from 4.23 to 5.16 mg/dL, with a mean value of 4.65 ± 0.26 mg/dL; in Group 4, the SUA ranged from 5.17 to 6.10 mg/dL, with a mean value of 5.54 ± 0.26 mg/dL; and in Group 5, the SUA ranged from 6.12 to 9.19 mg/dL, with a mean value of 6.84 ± 0.70 mg/dL.

Among SUA deviation groups, significant differences were observed in terms of age, sex, BMI z score, FPG, IFG, TG, HDL-C, non-HDL-C, ALT, AST, GGT, ALP, urea and Cr (Table 2). The prevalence of dyslipidemia increased with group number, particularly the prevalence of hypertriglyceridemia and low HDL-C (Fig. 2). Groups 1 and 2 were younger; had significantly higher HDL-C; lower BMI z score, TG, urea and Cr; and a lower prevalence of hypertriglyceridemia than Groups 3, 4, and 5. In addition, Group 1 was younger; had significantly lower BMI z scores, ALT, GGT, ALP, Cr, FPG, TC, LDL-C and non-HDL-C; and a lower prevalence of dyslipidemia than Group 2. Therefore, Group 1 (SUA deviations between -2.5 and -1 SD) was defined as the most suitable reference group, and the other groups were compared with this group in further analyzes.

Percentage of dyslipidemia and abnormal lipid profiles among groups with SUA deviations

Univariate logistic regression analysis showed that the following variables were risk factors for dyslipidemia: age, sex, BMI z score, SUA, ALT, AST, GGT and ALP (Supplementary Table 3). Unadjusted binary logistic regression analysis showed that each additional 1-SD increase in SUA was associated with a 27% increase in the risk of dyslipidemia (Table 3, Model 1: OR = 1.270, 95% CI, 1.185–1.361). As shown in Table 3, compared with the SUA deviations in Group 1, those in Groups 2, 3, 4 and 5 were significantly associated with higher risks of dyslipidemia (Group 2: OR, 1.285, 95% CI, 1.004–1.645; Group 3: OR, 1.363, 95% CI, 1.056–1.759; Group 4: OR, 2.040, 95% CI, 1.534–2.714; Group 5: OR, 2.924, 95% CI, 2.064–4.143). Adjustment of the data for age and sex did not alter the association between the deviation from the mean SUA of the Ortholiposis group and the risk of dyslipidemia (Table 3, Model 2: OR = 1.259, 95% CI, 1.171–1.353). After further adjustment for BMI z score, a significantly higher risk remained for Groups 4 and 5 (Table 3, Model 3: Group 4, OR = 1.841, 95% CI, 1.373–2.470; Group 5, OR = 2.541, 95% CI, 1.762–3.665) but disappeared for Groups 2 and 3. Finally, after further adjustment for ALT, AST, GGT and ALP, the strength of this association was weakened, but it remained statistically significant (Table 3, Model 4: OR = 1.125, 95% CI, 1.042–1.215; Group 4, OR = 1.475, 95% CI, 1.090–1.996; Group 5, OR = 1.870, 95% CI, 1.276–2.740).