Ma Yan, Wang Junxiao, Zhang Mingqi, Li Fengzhen, Qin Zujie, Shu Jianlong
Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China.
The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
Eur J Med Res. 2025 Sep 3;30(1):839. doi: 10.1186/s40001-025-03106-0.
Neutrophil-to-HDL-C ratio (NHR) has recently emerged as a composite biomarker integrating lipid metabolism and inflammatory status. Nevertheless, its potential association with the risk of gout or hyperuricemia remains inadequately explored. The present study aimed to examine the possible link between NHR and both conditions.
This study included 31,117 eligible adults from the 2007-2018 NHANES database in the United States. Participants were categorized into NHR quartiles, and weighted multivariate logistic regression along with restricted cubic spline (RCS) analyses was performed to assess its association with gout and hyperuricemia risk. Subgroup analyses were performed to assess the robustness and heterogeneity of the association across different subpopulations. All analyses were weighted to guarantee the generalizability of the findings to the national population.
A positive correlation was observed between NHR and the risk of both gout and hyperuricemia. As NHR levels increased, the proportion of participants with gout or hyperuricemia rose significantly-specifically, the prevalence of gout was 2.46%, 3.69%, 4.24%, and 5.79% (p < 0.001), and for hyperuricemia, it was 13.63%, 17.38%, 20.65%, and 26.08% (p < 0.001), respectively. Multivariable logistic regression indicated that, in the unadjusted Model 1 analysis, each 1-unit increase in NHR was associated with a 5.1% higher risk of gout (OR = 1.051, 95% CI 1.036-1.069, p < 0.001) and a 5.8% higher risk of hyperuricemia (OR = 1.058, 95% CI 1.051-1.066, p < 0.001). The positive association remained stable and statistically significant after adjusting for potential confounding variables. Further RCS analysis revealed a nonlinear trend in the relationship between NHR and both conditions, with a potential risk threshold of approximately 16, beyond which the risk of disease increased substantially. Additionally, receiver operating characteristic (ROC) analysis showed that the NHR had better discriminatory performance than either HDL-C or NEU alone in predicting hyperuricemia (AUC = 0.682) and gout (AUC = 0.81).
NHR showed a significant association with the risk of gout and hyperuricemia, demonstrating a nonlinear dose-response pattern. NHR may serve as a promising inflammation-metabolism marker for the early identification of individuals at risk for uric acid-related disorders.
中性粒细胞与高密度脂蛋白胆固醇比值（NHR）最近作为一种整合脂质代谢和炎症状态的复合生物标志物出现。然而，其与痛风或高尿酸血症风险的潜在关联仍未得到充分研究。本研究旨在探讨NHR与这两种疾病之间的可能联系。
本研究纳入了来自美国2007 - 2018年国家健康与营养检查调查（NHANES）数据库的31117名符合条件的成年人。参与者被分为NHR四分位数组，并进行加权多变量逻辑回归以及受限立方样条（RCS）分析，以评估其与痛风和高尿酸血症风险的关联。进行亚组分析以评估不同亚人群中关联的稳健性和异质性。所有分析均进行加权，以确保研究结果对全国人群的可推广性。
观察到NHR与痛风和高尿酸血症风险之间呈正相关。随着NHR水平升高，痛风或高尿酸血症参与者的比例显著上升——具体而言，痛风的患病率分别为2.46%、3.69%、4.24%和5.79%（p < 0.001），高尿酸血症的患病率分别为13.63%、17.38%、20.65%和26.08%（p < 0.001）。多变量逻辑回归表明，在未调整的模型1分析中，NHR每增加1个单位，痛风风险增加5.1%（OR = 1.051，95% CI 1.036 - 1.069，p < 0.001），高尿酸血症风险增加5.8%（OR = 1.058，95% CI 1.051 - 1.066，p < 0.001）。在调整潜在混杂变量后，这种正相关关系仍然稳定且具有统计学意义。进一步的RCS分析揭示了NHR与这两种疾病之间关系的非线性趋势，潜在风险阈值约为16，超过该值疾病风险大幅增加。此外，受试者工作特征（ROC）分析表明，在预测高尿酸血症（AUC = 0.682）和痛风（AUC = 0.81）方面，NHR比单独的高密度脂蛋白胆固醇（HDL - C）或中性粒细胞（NEU）具有更好的数据区分能力。
NHR与痛风和高尿酸血症风险显著相关，呈现非线性剂量反应模式。NHR可能作为一种有前景的炎症 - 代谢标志物，用于早期识别尿酸相关疾病的高危个体。
