Abstract: Objective:To explore the impact of exposure to high-altitude hypoxic environments on serum uric acid (SUA) levels in migrant youth and to analyze the risk factors of hyperuricemia (HUA). Methods:A prospective cohort study was conducted, dividing the 3090 youth included in the study into a high-altitude exposure group (n=1590) and a plain group (n=1500). Demographic data and SUA levels were collected on the 7th day post-exposure. The results from the high-altitude exposure group on the 7th day were used as the baseline,and the dynamic changes in SUA and other indicators in this group were tracked after 3 and 6 months of physical training in the high-altitude environment.Univariate and multivariate Logistic regression analyses were conducted to identify the risk factors for hyperuricemia in the high-altitude exposure group. Results:Baseline data were comparable between the two groups.The baseline SUA level in the high altitude group was significantly higher than that in the plain group [428.00 (380.00,485.00) vs 372.00 (329.00,418.00),P<0.001]. The risk of HUA in the high-altitude exposure goup was 2.322 times that of the plain group (RR=2.322, 95% CI 2.103-2.565,P<0.001). Dynamic observation in the high altitude group showed that red blood cell count (RBC) and hemoglobin (Hb) increased progressively,while SUA levels peaked at baseline and decreased significantly after 3 and 6 months of physical training (all P<0.001). Univariate and multivariate Logistic regression analysis showed that a history of long-term exposure to high altitude was an independent protective factor against high-altitude exercise-induced HUA (OR=0.311,95% CI 0.158-0.614,P<0.001), while elevated white blood cell count (OR=1.112,95% CI 1.016-1.217,P=0.021) and elevated blood urea nitrogen (OR=1.164,95% CI 1.029-1.316,P=0.016) were independent risk factors. Conclusion:High-altitude hypoxie exposure significantly raises the risk of HUA in young migrants.Combined effect of high-altitude acclimatization and exercise training effectively reduces SUA levels.