Ao Yaoxin, Xiao Fangjun, Qiu Junpeng, Lyu Jiangfeng, Luo Wenli, Liufu Yifei, Yang Junxing
Department of Orthopedics, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, 518000, China.
Lipids Health Dis. 2025 May 26;24(1):191. doi: 10.1186/s12944-025-02618-2.
The uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is an established biomarker for metabolic and inflammatory disorders but has received little attention in relation to osteoarthritis (OA). This investigation examines the UHR‒OA risk correlates.
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2016. Descriptive analyses, univariate and multivariate logistic regression models, as well as generalized additive and segmented regression models were used to investigate the nonlinear correlation and threshold effect of UHR-OA.
A total of 20,727 U.S. adults were included, 2,900 of whom (13.99%) were diagnosed with osteoarthritis (OA). A nonlinear relationship with a significant threshold effect was observed between the UHR and OA. When the UHR was less than 0.109, it was strongly inversely related to OA (OR = 0.028, 95% CI: 0.002-0.345, P < 0.01). The odds ratio increased when the UHR surpassed 0.109 but was not statistically significant (OR = 0.625, 95% CI: 0.162-2.421, P > 0.05). According to the unadjusted logistic regression model, the UHR was not significantly correlated with OA (P > 0.05). Following adjustment for confounders, including sex, age, ethnicity, education, marriage, BMI, income, hypertension, diabetes, coronary heart disease, and hypercholesterolemia, a notable inverse relationship emerged (OR = 0.259, 95% CI: 0.093-0.718, P < 0.01). Univariate linear regression studies revealed an intense inverse relationship between UA and HDL-C (OR = -3.2, 95% CI: -3.3 to -3.0, P < 0.001). In addition, stratified studies revealed that the negative relationships between the UHR and OA were more pronounced in elderly individuals (≥ 50 years old), women, drinkers, non-Hispanic whites, individuals with higher education levels and individuals without metabolic disorders (those with no hypertension, diabetes, coronary heart disease, or hypercholesterolemia) and did not show obvious heterogeneity in smoking status, BMI, marriage, or income level.
This study revealed a nonlinear relationship between the UHR and OA, with a threshold at UHR = 0.109. Below this level, the UHR was significantly negatively associated with OA, especially in older adults (≥ 50 years old), females, drinkers, non-Hispanic Whites, and those with an education level above high school, or no metabolic diseases.
尿酸与高密度脂蛋白胆固醇比值（UHR）是一种公认的代谢和炎症性疾病生物标志物，但在骨关节炎（OA）方面鲜受关注。本研究旨在探讨UHR与OA风险的相关性。
本横断面研究利用了1999 - 2016年美国国家健康与营养检查调查（NHANES）的数据。运用描述性分析、单因素和多因素逻辑回归模型，以及广义相加回归模型和分段回归模型来研究UHR与OA的非线性相关性和阈值效应。
共纳入20727名美国成年人，其中2900人（13.99%）被诊断为骨关节炎（OA）。观察到UHR与OA之间存在非线性关系且具有显著的阈值效应。当UHR小于0.109时，它与OA呈强烈负相关（OR = 0.028，95%可信区间：0.002 - 0.345，P < 0.01）。当UHR超过0.109时优势比增加，但无统计学意义（OR = 0.625，95%可信区间：0.162 - 2.421，P > 0.05）。根据未调整的逻辑回归模型，UHR与OA无显著相关性（P > 0.05）。在对包括性别、年龄、种族、教育程度、婚姻状况、体重指数、收入、高血压、糖尿病、冠心病和高胆固醇血症等混杂因素进行调整后，出现了显著的负相关关系（OR = 0.259，95%可信区间：0.093 - 0.718，P < 0.01）。单因素线性回归研究显示尿酸与高密度脂蛋白胆固醇之间存在强烈的负相关（OR = -3.2，95%可信区间：-3.3至-3.0，P < 0.001）。此外，分层研究显示UHR与OA之间的负相关关系在老年人（≥50岁）、女性、饮酒者、非西班牙裔白人、教育程度较高者以及无代谢紊乱者（无高血压、糖尿病、冠心病或高胆固醇血症者）中更为明显，且在吸烟状况、体重指数、婚姻状况或收入水平方面未显示出明显的异质性。
本研究揭示了UHR与OA之间存在非线性关系，阈值为UHR = 0.109。低于该水平时，UHR与OA显著负相关，尤其在老年人（≥50岁）、女性、饮酒者、非西班牙裔白人以及高中以上学历或无代谢疾病者中。
