摘要： Coronary artery disease in young adults is rare, but it is in an increasing trend. However, the risk factors are largely unknown. Previous studies have shown that hyperuricemia is associated with coronary artery disease, but the relationship in young adults is unknown. In this article, we hope to explore the effect of hyperuricemia on coronary artery disease in young adults less than 35 years old. In this retrospective study,we consecutively included young adults (aged 18–35 years old) undergoing coronary angiography in our institution from January 2005 to December 2015. Patients with coronary angiography showed that luminal diameter stenosis≥50% in any of the major epicardial coronary arteries were considered as CAD. The severity of CAD was assessed by gensini score. We tested for interactions between uric acid (hyperuricemia or normouricemia) and other traditional risk factors on the coronary artery disease. The interaction effect on the presence of CAD in young adults was analyzed with multi-variate logistic regression analyses. The relationship between hyperuricemia and CAD in young adults was analyzed with multi-variate regression. 1203 patients (1129 male and 74 female) were included in this study. 790 of young adults were confirmed as having coronary artery disease. The hyperuricemia was present in 35.41% of patients. The multivariate analysis identified hyperuricemia was not independent for the presence of CAD. We furtherly found that the interaction between hyperuricemia and smoking achieved statistical significance for the present of CAD (p=0.0109).In non-smokers, hyperuricemia was an independent risk factor for the presence of CAD (odds ratio [OR]=1.85, 95% confidence interval [CI]=1.06–3.21, P=0.0293). Multivariate analysis identified hyperuricemia was an independent risk factor for the severity of CAD in young adults (odds ratio [OR]=8.45, 95% confidence interval [CI]=1.18–15.71, p=0.0231). In young adults (≤35 years old), hyperuricemia is significantly associated with the presence of CAD in non-smokers. Hyperuricemia has strong correlation with the severity of coronary artery disease in young adults (≤35 years old).