Hormone replacement therapy and serum uric acid in postmenopausal women: A cardiometabolic insight

Background and aims: Elevated serum uric acid (SUA) is an independent marker of cardiometabolic risk in postmenopausal women. Hormone replacement therapy (HRT) may influence SUA levels, though mechanisms and clinical implications remain underexplored. This study compares SUA and cardiometabolic indicators in HRT users and nonusers within a cardiovascular prevention cohort. Methods and results: We conducted a cross-sectional analysis of 440 postmenopausal women attending a cardiovascular prevention clinic. Participants were stratified by HRT use (n = 109 users vs. n = 331 nonusers). Clinical, biochemical, and lifestyle data were collected. SUA and lipid profiles were compared using t-tests with significance set at p < 0.05. HRT users had significantly lower SUA (5.4 ± 0.27 mg/dL) versus nonusers (6.6 ± 0.24 mg/dL, p < 0.001), along with reduced LDL cholesterol, BMI, and waist circumference. No renal function differences were observed. Conclusions: HRT use is associated with lower SUA and more favorable cardiometabolic profiles in postmenopausal women. HRT may play a protective metabolic role and could support tailored cardiometabolic prevention in postmenopausal women.