ArticleBMJ nutrition, prevention & health2025
Mortality risk prediction of uric acid to high-density lipoprotein cholesterol ratio in community residents: a cohort study.
Article in BMJ nutrition, prevention & health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The serum uric acid to high-density lipoprotein cholesterol ratio (UHR) is a marker reflecting systemic inflammation and metabolic dysregulation. This study aimed to explore the association of UHR with all-cause and cause-specific mortality in a community-based Chinese cohort. Methods: This study included 9448 participants from the community-based prospective cohort study conducted in Pudong New Area, Shanghai, China. We employed Cox proportional hazards regression to assess the associations between UHR quartiles and mortality risks. Nonlinear trends were examined through restricted cubic spline Cox regression, while bivariate exposure-response surface plots showed the joint effects of UHR and age. Model performance improvements were evaluated using C-index changes, integrated discrimination improvement and net reclassification improvement. Results: During a median follow-up of 10.77 years, 987 deaths occurred. Compared with the lowest quartile (Q1), the highest UHR quartile (Q4) exhibited a 37% increased risk for all-cause mortality (HR=1.37, 95% CI: 1.14 to 1.65, p=0.001) and a 49% increased risk for cardiovascular mortality (HR=1.49, 95% CI: 1.10 to 2.00, p<0.01). The correlation between UHR and all-cause mortality risk exhibited an inverted L-shaped curve, whereas no significant nonlinear pattern was observed for cardiovascular mortality. Bivariate response analysis revealed a significant synergistic effect between UHR and age on all-cause mortality (p<0.05). The addition of UHR significantly improved the prediction performance of conventional models for all-cause and cardiovascular mortality. Conclusions: Our findings establish UHR as an independent risk factor for all-cause and cardiovascular mortality, and the impact of UHR on all-cause mortality varies with age.
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