To investigate the prevalence of hyperuricemia and its associated risk factors among residents aged 35-74 years in Hainan Province, and to provide scientific evidence for the development of prevention and control strategies for hyperuricemia.

A total of 3 950 eligible participants were selected from the prospective chronic disease cohort of the general population in Hainan from 2017 to 2021. Binary logistic regression models were used to identify risk factors associated with hyperuricemia.

A total of 3 950 participants were included in this study, and the prevalence of hyperuricemia (HUA) was 17.2% (679/3 950). Results from the multivariable logistic regression model showed that overweight/obesity (compared with underweight, OR=14.496, 95% CI:7.566-27.773), retirement (compared with manual labor, OR=2.184, 95% CI:1.166-4.091), smoking (OR=2.300, 95% CI:1.820-2.906), alcohol consumption (OR=11.073, 95% CI:8.713-14.073), eating late-night snacks (OR=7.628, 95% CI:5.135-11.333), fair sleep quality (compared with good sleep quality, OR=4.928, 95% CI:3.588-6.768), poor sleep quality (OR=14.194, 95% CI:10.145-19.859), and living in urban areas (compared with rural areas, OR=2.526, 95% CI:1.971-3.237) were major risk factors for HUA. In contrast, having completed junior high school (compared with no formal education, OR=0.278, 95% CI:0.130-0.595) or high school and above (OR=0.366, 95% CI:0.174-0.767), engaging in mental labor (compared with manual labor, OR=0.270, 95% CI:0.169-0.432) or other types of labor (OR=0.381, 95% CI:0.208-0.699), and eating breakfast (OR=0.446, 95% CI:0.344-0.577) were protective factors against HUA.

The prevalence of hyperuricemia (HUA) among middle-aged and older adults aged 35-74 years in Hainan Province is relatively high. Targeted health education and interventions should be prioritized for key populations, including those who are overweight/obese, retired, havingpoor sleep quality, or engagingin unhealthy behaviors such as smoking, alcohol consumption, and late-night eating, in order to reduce the risk of HUA.