Objective To observe the characteristics of tongue image in patients with hyperuricemia and to explore its influencing factors. Methods The study included 229 patients with hyperuricemia（hyperuricemia group）and 250 healthy subjects who received physical examination（healthy group）. General data of both groups were collected including gender

age

body mass index（BMI）

systolic blood pressure（SBP）

and diastolic blood pressure（DBP）. The serum uric acid（UA）

urea nitrogen（BUN）

creatinine（SCr）

fasting plasma glucose（FPG）

total cholesterol（TC）

triglyceride（TG）

low density lipoprotein cholesterol（LDL-C）

high density lipoprotein cholesterol（HDL-C）

glycated hemoglobin（HbA1 c） were determined. Image acquisition was performed using a TDA-1 small tongue imager. The characteristics of the tongue image such as the color of the tongue body（TB） including TBR

TB-G

TB-B

TB-H

TB-I

TB-S

TB-L

TB-a

TB-b

tongue coating（TC） color indicators including TC-R

TC-G

TC-B

TC-H

TC-I

TC-S

TC-L

TC-a

TC-b

and the thickness index of the tongue coating which included the area of the tongue coating/the area of the whole tongue（perAll）

the area of the tongue coating/the area of the tongue without the tongue（perPart） were observed. The correlation between uric acid and tongue image features was analyzed. Spearman correlation analysis was used to explore the relationship between tongue image features and uric acid. Multiple linear regression and logistic regression were used to analyze the risk factors of hyperuricemia.Results In the hyperuricemia group

the BMI

SBP

BUN

SCr

UA

FPG

TC

TG

LDL-C and Hb A1 c were higher than those in the healthy group

and the age and HDL-C were lower than those of the healthy group（P <0. 01）. The levels of TB-R

TB-G

TC-R

TB-H

TB-I

TC-H

TB-L

TB-b

TC-a

TC-b

and perPart were lower than those in the healthy group

while levels of TC-B

TB-S

TB-a

and perAll were higher than those in the healthy group（P < 0. 05 or P < 0. 01）. Uric acid was positively correlated with perAll

TB-S

TB-a

TC-B（P < 0. 05）

and TB-R

TB-G

TB-H

TB-I

TB-L

TB-b

TC-R

TC-H and TC-b were negatively correlated（P < 0. 05）. Multiple linear regression results suggested that gender

age

BMI

SCr

FPG

TG

TB-b were independently associated with uric acid. Logistic regression results showed that gender

BMI

BUN

TG

TB-a

TC-L

TC-b were the risk factors of hyperuricemia

and their corresponding OR values were 0. 085

1. 305

2. 370

16. 468

0. 704

0. 851

0. 714

respectively. Conclusion In patients with hyperuricemia

the color of the tongue becomes purple and the color of the tongue becomes white and thick with the increase of uric acid

and the onset may be related to phlegm

dampness and blood stasis.