Uric acid to HDL cholesterol ratio as a novel predictor of carotid intima-media thickness: a cross-sectional study in rural China.

PURPOSE

Carotid intima-media thickness (cIMT) is a widely recognized marker for assessing carotid atherosclerosis, which is a significant predictor of cardiovascular diseases such as ischemic stroke. The serum uric acid to high-density lipoprotein cholesterol ratio (UHR) has recently emerged as a potential combined marker for metabolic and inflammatory processes related to cardiovascular risk. This study aims to investigate the association between UHR and cIMT in a rural Chinese population, with a particular focus on differences across age and sex groups.

PATIENTS AND METHODS

A cross-sectional study was conducted using data from the 2019 general physical examination of residents in Jizhou District, Tianjin, China. A total of 3,280 participants aged 45 years and older were included after excluding those with incomplete data or specific health conditions. Demographic and clinical data were collected through face-to-face interviews and physical examinations. Serum levels of uric acid (SUA) and high-density lipoprotein cholesterol (HDL-C) were measured, and UHR was calculated. Carotid intima-media thickness was assessed using ultrasound. Multivariate linear and logistic regression analyses were performed to evaluate the association between UHR and cIMT, adjusting for potential confounders. Subgroup analyses were conducted to explore variations in this association by age and sex. Receiver operating characteristic (ROC) analysis was used to compare the predictive value of UHR, SUA, and HDL-C for cIMT thickening.

RESULTS

The study population had a mean age of 64.10 ± 8.02 years, with 45.2% males and 54.8% females. The prevalence rates of hypertension, diabetes, smoking, and alcohol consumption were 77.2%, 19.7%, 41.4%, and 36.3%, respectively. Univariate analysis showed significant associations between UHR, age, hypertension, diabetes, smoking, alcohol consumption, systolic blood pressure (SBP), pulse pressure (PP) difference, glucose (GLU), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and cIMT. Multivariate analysis revealed that UHR was an independent risk factor for increased cIMT (β = 0.06, 95% CI [0.01-0.10], = 0.017) and carotid intima-media thickening, particularly in older men. Subgroup analysis indicated that the association between UHR and cIMT was more pronounced in participants aged 60 years or older and in males. ROC analysis demonstrated that UHR had a higher predictive value for cIMT thickening in older men (AUC = 0.577, 95% CI [0.510-0.644], < 0.05) compared to SUA or HDL-C alone.

CONCLUSION

This study identifies UHR as a significant predictor of cIMT and carotid intima-media thickening, with a particularly strong association observed in older men. These findings suggest that UHR could serve as a valuable marker for early detection and intervention of carotid atherosclerosis.