Abstract
Background
The relationship between the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR), serum uric acid levels, and hyperuricemia risk remains unclear. This study evaluated the association between NHHR with serum uric acid levels, and hyperuricemia risk in US adults.
Methods
The data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018 were analyzed cross-sectionally using weighted linear regression, weighted logistic regression, restricted cubic splines, and threshold effects analysis. Additionally, subgroup analyses were performed to investigate the relationships between NHHR, serum uric acid levels, and the risk of hyperuricemia.
Results
Among 9439 individuals (mean age: 48 ± 14 years), the mean NHHR was 2.56 ± 0.71, and the mean uric acid level was 5.40 ± 0.90. The overall prevalence of hyperuricemia was 21%, increasing significantly with NHHR quartiles (Q1: 13%, Q2: 17%, Q3: 24%, Q4: 31%, P < 0.01). Each unit increase in NHHR was associated with a 20% higher risk of hyperuricemia (95% confidence interval [CI]: 1.09–1.33, P < 0.01) and a 0.13 increase in uric acid levels (95% CI: 0.09–0.18, P < 0.001). Subgroup analyses confirmed these findings across various demographics. A non-linear relationship was found between NHHR and uric acid levels/hyperuricemia risk, with breakpoints at 4.33 and 3.91, respectively (P for nonlinear < 0.001).
Conclusions
Elevated NHHR is significantly correlated with higher uric acid levels and hyperuricemia risk in US adults. Early intervention and management of NHHR may help mitigate hyperuricemia.