- 1Department of Neurology, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China
- 2Department of Neurology, Liuyang Jili Hospital, Changsha, China
- 3Department of Neurology, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
Background: The Uric Acid-to-HDL Ratio (UHR), a
novel index derived from serum uric acid and high-density lipoprotein,
has been linked to hypertension and poor diabetes control. It has also
been shown to predict ischemic heart disease and is strongly associated
with collateral circulation and coronary artery flow reserve. However,
fewer studies have focused on the relationship between UHR and stroke,
highlighting the need for further research in this area.
Methods: The study included 33,192 individuals
from the NHANES 1999–2023, of whom 1,363 had a history of stroke. The
nonlinear relationship between UHR and stroke risk was assessed using
restricted cubic spline (RCS) analysis, and the robustness of the
findings was further tested through stratified analysis. Logistic
regression was employed to analyze the relationship between UHR and
stroke risk, considering both UHR as a continuous variable and its
categorization into quartiles (Q1–Q4).
Results: UHR was not nonlinearly associated with stroke (p for overall <0.01; p
for nonlinearity = 0.65), and the RCS graph approximated a straight
line with a positive slope. UHR was significantly associated with an
increased risk of stroke, both when analyzed as a continuous variable
(Model 4: OR = 1.02, 95% CI 1.01–1.03, p < 0.01) and when categorized into quartiles (Q4, OR = 1.31, 95% CI 1.11–1.55, p < 0.01).
Conclusion: There was a significant positive correlation between UHR and stroke risk.
Introduction
Stroke remains a leading cause of mortality and
disability worldwide, placing a substantial burden on individuals,
families, and healthcare systems (1, 2).
Given its unfavorable prognosis and the long-term functional
impairments experienced by many survivors, a comprehensive understanding
and identification of risk factors are essential for effective
prevention strategies (3–5).
Traditional risk factors for stroke include hypertension, diabetes mellitus, dyslipidemia, smoking, and alcohol consumption (6–10).
Beyond these established factors, elevated serum uric acid (UA) and
reduced high-density lipoprotein (HDL) levels have also been implicated
in stroke pathogenesis (11, 12).
The Uric Acid-to-HDL Ratio (UHR) is a novel and easily accessible index
that integrates these two parameters, providing a potential marker for
systemic inflammatory and metabolic conditions (13, 14).
Studies have demonstrated that UHR outperforms serum uric acid and HDL
alone in predicting coronary artery disease and the severity of coronary
stenosis (15).
Furthermore, UHR has been associated with an increased risk of type 2
diabetes mellitus, metabolic syndrome, myocardial infarction, and
all-cause mortality in individuals with diabetes (16–19).
However, its relationship with stroke remains inadequately explored.
Therefore, this study aims to investigate the association between UHR
and stroke using data from the National Health and Nutrition Examination
Survey (NHANES) 1999–2023, providing a foundation for future
prospective research.
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