Huang Xuanchun, Hu Lanshuo, Li Jun, Wang Xuejiao
Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
BMC Cardiovasc Disord. 2024 Dec 27;24(1):744. doi: 10.1186/s12872-024-04436-3.
To investigate the relationship between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and ALL-cause and cardiovascular mortality among diabetic patients.
This study utilized health data from diabetic patients included in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The Kaplan-Meier curves was employed to preliminarily explore the association between UHR, its components, and all-cause and cardiovascular mortality in diabetic patients, as well as to analyze UHR levels and mortality across different genders. Subsequently, the Cox proportional hazards model was used to further investigate the relationship between UHR, its components, and mortality in diabetic patients. Restricted cubic spline (RCS) curves were applied to examine the nonlinear relationship between UHR, its components, and mortality, with a particular focus on the association between UHR and mortality across different genders.
This longitudinal cohort study included a total of 6,370 participants, comprising 3,268 males and 3,102 females. Kaplan-Meier analysis revealed a positive correlation between UHR, UA, and mortality in diabetic patients, while the association between HDL and mortality was negligible. The Cox proportional hazards model demonstrated a positive association between UHR and mortality in the diabetic population, while the statistical effects of UA and HDL on mortality were less pronounced compared to UHR. When analyzed by gender, no significant linear relationship was observed between UHR and mortality in either males or females. Subsequently, RCS analysis indicated a U-shaped nonlinear relationship between UHR and mortality in the overall diabetic population and among female patients, with a similar trend observed in males. Furthermore, stratified RCS analysis confirmed the persistence of the U-shaped relationship between UHR and prognosis across most subgroups.
This study found a U-shaped relationship between UHR and both ALL-cause and cardiovascular mortality in diabetic population. This suggests that clinicians should control UHR around 9-10 to improve the long-term prognosis of diabetic patients.
探讨糖尿病患者尿酸与高密度脂蛋白胆固醇比值（UHR）与全因死亡率和心血管死亡率之间的关系。
本研究利用了1999年至2018年美国国家健康与营养检查调查（NHANES）中糖尿病患者的健康数据。采用Kaplan-Meier曲线初步探讨UHR及其组成成分与糖尿病患者全因死亡率和心血管死亡率之间的关联，并分析不同性别的UHR水平和死亡率。随后，使用Cox比例风险模型进一步研究UHR及其组成成分与糖尿病患者死亡率之间的关系。应用受限立方样条（RCS）曲线检验UHR及其组成成分与死亡率之间的非线性关系，特别关注不同性别中UHR与死亡率之间的关联。
这项纵向队列研究共纳入6370名参与者，其中男性3268名，女性3102名。Kaplan-Meier分析显示，糖尿病患者中UHR、尿酸与死亡率呈正相关，而高密度脂蛋白与死亡率之间的关联可忽略不计。Cox比例风险模型表明，糖尿病患者中UHR与死亡率呈正相关，而尿酸和高密度脂蛋白对死亡率的统计学影响与UHR相比不太明显。按性别分析时，男性或女性中UHR与死亡率之间均未观察到显著的线性关系。随后，RCS分析表明，总体糖尿病患者和女性患者中UHR与死亡率之间呈U形非线性关系，男性中也观察到类似趋势。此外，分层RCS分析证实了UHR与大多数亚组预后之间U形关系的持续性。
本研究发现糖尿病患者中UHR与全因死亡率和心血管死亡率之间均呈U形关系。这表明临床医生应将UHR控制在9至10左右，以改善糖尿病患者的长期预后。
