This study aimed to investigate the relationship between visceral fat area (VFA) and hyperuricemia (HUA) among non-obese adults. We extracted data from 6224 US adults aged 20–59 years from the National Health and Nutrition Examination Survey (NHANES) from 2011–2018. The VFA was divided into four quartiles (Q1–Q4). We used multivariable logistic regression models to control for known confounders. A generalized additive model (GAM) and restricted cubic spines were used to examine the association between VFA and HUA stratified by sex, and a two-piecewise linear regression model was used to calculate the threshold effect among males. The results revealed that the prevalence of HUA was 11.8% (men 15.8%, women 7.2%). In the fully adjusted model, there was a positive association between VFA and HUA [as a quartile variable, Q4 vs. Q1, odds ratio (OR): 3.77 and 95% confidence interval (CI): (2.47~5.75), p < 0.001, p for trend < 0.001; as a continuous variable, per 10 cm2 increment, OR (95%CI):1.10(1.07,1.14), p < 0.001]. Besides, this positive association remained significantly stratified by sex. Interestingly, we observed a nonlinear dose-response relationship between VFA and HUA in males (inflection point: 107.46 cm2). In conclusion, our study confirmed a significant positive relationship between VFA and HUA among non-obese adults and remained statistically significant when stratified by sex.
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