Abstract: Objective To investigate whether baseline neck circumference （NC） is associated with development of hyperuricemia （HUA） in future and its ability to predict HUA,so as to provide evidences for prevention and early treatment of HUA. Methods Atotal of 4 383 subjects （1 445 males and 2 938 females） without HUA at baseline from REACTION study were included in this study,and the data collected in 2015 were used as baseline data.After 3 years of follow-up,the incidence of HUA was collected.Cox regression analysis was used to assess the correlation between baseline NC and the risk of developing HUA at follow-up. Results Thecumulative incidence of male subjects for HUA was significantly higher than that of female subjects （15.4% vs 13.1% P=0.033） during the 3-year follow-up.The sample was divided into Q1,Q2,Q3,Q4 groups according to quatiles of NC.The prevalence of HUA during the follow-up in the Q2-Q4 groups was obviously higher than that in the Q1 group （for male subjects,the prevalence was 10.5% in Q1 versus 15.5% in Q2,19.1% in Q3 and 18.0% in Q4;while for female subjects,it was 7.7% in Q1 versus 12.6% in Q2,14.8% in Q3 and 19.6 in Q4;all P<0.05）.For female subjects,after adjusting for confounding factors,the higher baseline NC was positively associated with the higher risk of HUA (P_{for trend}<0.001).And compared to the Q1 group of baseline NC,the risk of hyperuricemia in the Q3 and the Q4 groups significantly increased （HR was 1.43 for Q3 and 1.76 for Q4;P<0.05）.For male subjects,after adjusting for confounding factors,there was no significant correlation between baseline NC and risk of HUA the following. Conclusion For female subjects,higher neck circumference is positively associated with an increased risk of HUA in following 3 years.For male subjects,higher baseline NC cannot predict HUA risk within 3 years.