Association between ZJU index and concurrent hypertension and hyperuricemia among adults undergoing health examinations in Wuhu, China: a cross-sectional study

Background The Zhejiang University (ZJU) Index, integrating BMI, fasting plasma glucose, triglycerides, and liver enzymes, has been established as a predictor for non-alcoholic fatty liver disease (NAFLD). Given the strong interconnections among NAFLD, hypertension (HTN), and hyperuricemia (HUA), we hypothesized that the ZJU index might be associated with their comorbid state (HTN-HUA). However, no comprehensive study has yet fully elucidated this association. Methods This cross-sectional investigation analyzed data from individuals undergoing health examinations at the First Affiliated Hospital of Wannan Medical College in Wuhu, China, from 2017 to 2023, enrolling 468,558 participants. The association between the ZJU index and HTN-HUA was assessed using restricted cubic spline (RCS) analysis. Logistic regression models explored associations of the ZJU index with HTN-HUA, HTN, and HUA. Receiver operating characteristic (ROC) analyses compared the discrimination of ZJU alone, clinical covariates without ZJU, and clinical covariates plus ZJU. Results Among 468,558 participants, 44,225 (9.4%) had HTN-HUA, 162,858 (34.8%) had HTN, and 90,521 (19.3%) had HUA. RCS analysis demonstrated a non-linear relationship between the ZJU index and HTN-HUA. After adjustment for covariates, the ZJU index showed significant positive associations with HTN-HUA, HTN, and HUA. Compared to the lowest quartile, the highest ZJU quartile had increased odds of 7.01 (95% CI: 6.72–7.31) for HTN-HUA, 5.66 (95% CI: 5.53–5.79) for HTN, and 4.01 (95% CI: 3.90–4.11) for HUA. For HTN-HUA, the AUC was 0.725 (95% CI: 0.723–0.727) for ZJU alone, 0.785 (95% CI: 0.783–0.787) for the clinical covariate model, and 0.827 (95% CI: 0.825–0.828) for the clinical covariate model with ZJU. Conclusion Elevated ZJU index values were significantly associated with higher odds of prevalent HTN-HUA, suggesting its potential value as a marker of the metabolic profile associated with concurrent hypertension and hyperuricemia among adults undergoing health examinations.