糖尿病患者血清尿酸与高密度脂蛋白胆固醇比值（UHR）与心肌梗死风险的关联：一项使用2005 - 2020年美国国家健康与营养检查调查（NHANES）数据的横断面分析

Association of serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) with risk of myocardial infarction among individuals with diabetes: a cross-sectional analysis using data from NHANES 2005-2020.

作者信息

Sun Shibo, Xu Hongtao, Liu Li, Luan Zhongqiu, Liu Chunyan, Zhi Fumin

机构信息

Heilongjiang University of Chinese Medicine, Harbin, 150040, China.

First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.

出版信息

Eur J Med Res. 2025 Jul 2;30(1):554. doi: 10.1186/s40001-025-02845-4.

DOI:10.1186/s40001-025-02845-4

PMID:40605038

Abstract

BACKGROUND

The serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is a novel indicator of cardiometabolic health that has demonstrated strong predictive potential in various studies. However, the association between UHR and the occurrence of myocardial infarction (MI) among individuals with diabetes has not been well-established. This study aimed to assess the relationship between UHR and the presence of MI in diabetic individuals and to provide evidence for early identification of high-risk groups.

METHODS

This cross-sectional study included 7039 adult participants from the NHANES 2005-2020 data set. The association between UHR and MI risk was examined using UHR quartile grouping, multivariable logistic regression, and restricted cubic spline (RCS) analyses. Subgroup analyses were performed to evaluate whether the predictive value of UHR differed among population subgroups. All statistical procedures incorporated appropriate sample weights to ensure nationally representative estimates.

RESULTS

UHR was significantly elevated among participants with diabetes who had MI (p < 0.001). MI prevalence rose progressively across UHR quartiles (8.20% vs. 8.55% vs. 9.01% vs. 14.87%; p < 0.001). In the unadjusted model, each 1-unit increase in UHR was associated with a 4.5% higher odds of MI (OR = 1.045, 95% CI 1.021-1.071, p < 0.001). Participants in the highest quartile (Q4) had 1.957 times higher odds of MI compared to those in the lowest quartile (Q1) (95% CI 1.399-2.735, p < 0.001). RCS analysis revealed no significant non-linear association, suggesting a potentially linear relationship between UHR and the odds of MI. No significant interaction was observed across subgroups, such as sex, race, and education level (P for interaction > 0.05).

CONCLUSIONS

Elevated UHR was significantly associated with higher odds of MI in individuals with diabetes, demonstrating potential predictive value. As a simple and cost-effective indicator, UHR may assist in the early identification and stratification of individuals at higher likelihood of cardiovascular disease among people with diabetes; however, prospective studies are warranted to confirm its clinical utility.

摘要

背景

血清尿酸与高密度脂蛋白胆固醇比值（UHR）是一种新的心脏代谢健康指标，在各项研究中已显示出强大的预测潜力。然而，UHR与糖尿病患者心肌梗死（MI）发生之间的关联尚未完全明确。本研究旨在评估UHR与糖尿病患者MI发生之间的关系，并为早期识别高危人群提供证据。

方法

这项横断面研究纳入了来自2005 - 2020年美国国家健康与营养检查调查（NHANES）数据集的7039名成年参与者。使用UHR四分位数分组、多变量逻辑回归和受限立方样条（RCS）分析来检验UHR与MI风险之间的关联。进行亚组分析以评估UHR的预测价值在不同人群亚组中是否存在差异。所有统计程序均纳入了适当的样本权重，以确保获得具有全国代表性的估计值。

结果

患有MI的糖尿病参与者的UHR显著升高（p < 0.001）。MI患病率在UHR四分位数中逐渐上升（8.20%对8.55%对9.01%对14.87%；p < 0.001）。在未调整模型中，UHR每增加1个单位，MI的发生几率就会增加4.5%（OR = 1.045，95% CI 1.021 - 1.071，p < 0.001）。最高四分位数（Q4）的参与者发生MI的几率是最低四分位数（Q1）参与者的1.957倍（95% CI 1.399 - 2.735，p < 0.001）。RCS分析显示无显著的非线性关联，表明UHR与MI发生几率之间可能存在线性关系。在性别、种族和教育水平等亚组中未观察到显著的交互作用（交互作用p > 0.05）。