Yang Simin, Zhou Yan, Pan Baoying, Su Xinwei
Department of Anesthesiology, The Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, China.
Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, China.
J Gynecol Obstet Hum Reprod. 2025 Jun;54(6):102965. doi: 10.1016/j.jogoh.2025.102965. Epub 2025 Apr 30.
The elevated levels of serum uric acid (SUA) may be closely associated with female infertility. Serum uric acid to serum creatinine ratio (SUA/SCr) is a standardized indicator for assessing kidney function, providing a more accurate reflection of endogenous SUA levels within the body. Up to now, there have been no reports on the relationship between SUA/SCr and infertility. Therefore, we conducted a study on the relationship between SUA/SCr and infertility.
The analysis was based on data from the 2013-2016 National Health and Nutrition Examination Survey (NHANES), a cross-sectional study of 1918 female participants between the ages of 20 and 45. The levels of SUA (mg/dL) and serum creatinine (mg/dL) were measured, and the reproductive status of each subject was evaluated with reproductive health questionnaire. In the analysis of the whole sample and each group, the Logistic regression model was used to evaluate the relationship between SUA/SCr and infertility. The level of SUA/SCr was analyzed by stratified multivariate Logistic regression model.
Infertility was found in 277 (14.4 %) of the 1,918 female adults in this study, with greater mean SUA/SCr (6.79 ± 1.85 vs. 6.99 ± 1.90). SUA/SCr were associated with infertility in both the initial and adjusted models. According to multivariate logistic regression, the odds of female infertility were found to be significantly higher with rising SUA levels (Q4 [SUA/SCr ≥ 7.78] vs. Q1 [SUA/SCr ≤ 5.37]), fully adjusted odds ratio [OR] = 1.80 p = 0.004]. The data suggests that there is a dose-response relationship between the two.
The results from this nationally representative sample from the United States indicates that the increase of SUA/SCr promotes the occurrence of female infertility events. Infertile women may benefit from improving their lifestyle and modifying dietary habits to reduce the SUA/SCr, which could potentially be advantageous for increasing the probability of pregnancy.
血清尿酸（SUA）水平升高可能与女性不孕症密切相关。血清尿酸与血清肌酐比值（SUA/SCr）是评估肾功能的标准化指标，能更准确地反映体内内源性SUA水平。截至目前，尚无关于SUA/SCr与不孕症之间关系的报道。因此，我们开展了一项关于SUA/SCr与不孕症关系的研究。
该分析基于2013 - 2016年美国国家健康与营养检查调查（NHANES）的数据，这是一项对1918名年龄在20至45岁之间的女性参与者进行的横断面研究。测量了SUA（mg/dL）和血清肌酐（mg/dL）水平，并通过生殖健康问卷评估了每个受试者的生殖状况。在全样本和各亚组分析中，使用逻辑回归模型评估SUA/SCr与不孕症之间的关系。通过分层多变量逻辑回归模型分析SUA/SCr水平。
在本研究的1918名成年女性中，发现277人（14.4%）存在不孕症，其平均SUA/SCr更高（6.79±1.85对6.99±1.90）。在初始模型和校正模型中，SUA/SCr均与不孕症相关。根据多变量逻辑回归分析，随着SUA水平升高，女性不孕症的几率显著更高（四分位数4 [SUA/SCr≥7.78]对四分位数1 [SUA/SCr≤5.37]），完全校正后的优势比[OR]=1.80，p = 0.004]。数据表明两者之间存在剂量反应关系。
来自美国的这个具有全国代表性样本的结果表明，SUA/SCr升高会促进女性不孕症事件的发生。不孕女性可能通过改善生活方式和调整饮食习惯来降低SUA/SCr而获益，这可能有利于提高怀孕几率。
