Jiang Qingsong, Zhan Guoyong, Liu Yi, Jiang Cai, Wang Kang, Zheng Guofu, Liu Weixian, Ma Jiangchun, Wang Ming, Tang Zhuxiao
Department of Neurosurgery, QuZhou KeCheng People's Hospital, Quzhou, China.
Department of Neurology, QuZhou KeCheng People's Hospital, Quzhou, China.
Front Neurol. 2025 Aug 20;16:1594080. doi: 10.3389/fneur.2025.1594080. eCollection 2025.
The ratio of serum uric acid (UA) to high-density lipoprotein cholesterol (HDL-c), known as UHR, has been identified as a novel marker for oxidative stress and metabolic disorders. This study focused on exploring the association between UHR and stroke risk among older adults in the United States.
This cross-sectional study utilized data from individuals aged 60 years and older, collected through the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Stroke assessment was based on participants' self-reported history. The association between UHR and stroke risk was analyzed using logistic regression, restricted cubic splines (RCS), subgroup analysis, and receiver operating characteristic (ROC) curves.
This study included a total of 16,562 older adults, and the proportion of stroke cases increased with higher UHR levels. After adjusting for confounders, multivariable logistic regression analysis revealed that individuals in the highest UHR quartile had an odds ratio of 1.48 (1.23-1.80) for stroke risk compared to those in the lowest quartile. Subgroup analyses further demonstrated a stronger association in non-diabetic populations. RCS analysis suggested a linear relationship. Based on ROC results, UHR outperformed UA and HDL-c.
Higher UHR levels are strongly associated with an increased risk of stroke in older adults. Additional large-scale prospective studies are required.
血清尿酸（UA）与高密度脂蛋白胆固醇（HDL-c）的比值，即尿酸与高密度脂蛋白胆固醇比值（UHR），已被确定为氧化应激和代谢紊乱的一种新型标志物。本研究聚焦于探究美国老年人中UHR与中风风险之间的关联。
这项横断面研究利用了1999 - 2018年国家健康与营养检查调查（NHANES）收集的60岁及以上个体的数据。中风评估基于参与者自我报告的病史。使用逻辑回归、受限立方样条（RCS）、亚组分析和受试者工作特征（ROC）曲线分析UHR与中风风险之间的关联。
本研究共纳入16,562名老年人，中风病例的比例随UHR水平升高而增加。在调整混杂因素后，多变量逻辑回归分析显示，与最低四分位数组相比，UHR最高四分位数组个体发生中风风险的比值比为1.48（1.23 - 1.80）。亚组分析进一步表明在非糖尿病人群中关联更强。RCS分析提示存在线性关系。基于ROC结果，UHR优于UA和HDL-c。
较高的UHR水平与老年人中风风险增加密切相关。需要进一步开展大规模前瞻性研究。
