Background To investigate and analyze the relationship between hyperuricemia and various metabolic diseases and complications in people over 60 years old in Shijing Town, Nan'an City, Fujian Province, as well as the genetic analysis of familial gout attacks. Methods A cross-sectional study was conducted on the health examination data of people over 60 years old in Shijing Town, Nan'an City, Fujian Province (total population of 78,500) in 2019 and 2020. The differences between groups of metabolic indicators and complications and the correlation between uric acid and various metabolic indicators were analyzed. And 2 gout attack families were selected and used clinical whole-exome sequencing (including mitochondria) to conduct genome-wide association analysis. Results The total prevalence rate of hyperuricemia was 29.04%; albumin, triglyceride, alanine aminotransferase, aspartate aminotransferase, potassium ion, blood urea nitrogen, blood glucose, creatinine, body mass index, hypertension, and fatty liver were higher than those in the non-hyperuricemia group, and the difference was statistically significant (P < 0.05); the high-density lipoprotein in the hyperuricemia group was lower than that in the non-hyperuricemia group blood group, the difference was statistically significant (P < 0.05). There was no significant difference in serum total cholesterol, low-density lipoprotein, total bilirubin, direct bilirubin, sodium ion, diabetes, coronary heart disease, and abnormal electrocardiogram (P > 0.05); serum uric acid level in people over 60 years old It was positively correlated with albumin, triglyceride, low-density lipoprotein, potassium ion, alanine aminotransferase, aspartate aminotransferase, and body mass index levels (P < 0.05), and negatively correlated with HDL level (P < 0.05). P < 0.05); each of SLC4A1 gene, ABCB4 gene, and LRBA gene mutation was detected in the two tested families, and no mutation of SLC2A9 and ABCG2 gene was found. Conclusions The prevalence of hyperuricemia in the elderly population in Nan'an City, Fujian Province (29.04%) is significantly higher than the average level of the elderly in my country (13.1%). Compared with the normal population, patients have significantly abnormal metabolism. There is a significant correlation with the abnormal degree of familial hyperuricemia. Hypertension and fatty liver are risk factors for hyperuricemia; the SLC4A1 gene, ABCB4 gene, and LRBA gene may be closely related to the occurrence of familial hyperuricemia.