Background
Waist circumference (WC) and uric acid (UA) are significantly related. Still, their temporal sequence and how the sequence works on future risk of insulin resistance (IR) are unknown, especially in the Chinese population.
Methods
Cross-lagged panel model was used to analyze the reciprocal, longitudinal relationships between a set of inter-related variables. The mediation model was constructed to test the impact of the relationship between WC and UA on IR.
Results
A total of 5,727 subjects in our study population were enrolled, of which 53.5% were women, and the mean age was 59.0 (SD, 8.62) years. After adjusting for traditional confounding factors, we found that a higher level of baseline WC was significantly associated with a higher level of follow-up UA (β = 0.003, P = 0.031) and follow-up triglycerides glucose index (TyG) (β = 0.003, P < 0.001);. Simultaneously, there was no statistical association between the level of baseline UA and the level of follow-up WC (β = -0.009, P = 0.951). Besides, the cross-lagged panel model showed that the baseline WC had influenced the level of follow-up UA. The mediation effects of UA on WC-IR were estimated to be 18.1% in general adults, and 36.2% in women.
Conclusions
The current study demonstrated that the higher WC levels probably preceded UA in general population, and UA mediated the relationship of WC to TyG, especially among females. However, the mediation effect was different between men and women, and the possible mechanism would require further clarification.