ArticleFrontiers in neurology
Serum uric acid-to-HDL cholesterol ratio and stroke prevalence: NHANES 1999-2018 with external support from an imaging-confirmed hemorrhagic stroke dataset.
Article in Frontiers in neurology. 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
Metabolic-inflammatory dysregulation contributes to cerebrovascular vulnerability, yet accessible composite indices for population-level stratification remain under active investigation. Using nationally representative data from U. S. adults in NHANES 1999-2018, we investigated the association between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and prevalent stroke. Survey-weighted multivariable logistic regression and restricted cubic spline models were applied with comprehensive adjustment for demographic, metabolic, and socioeconomic factors. Higher UHR levels were independently associated with increased odds of prevalent stroke [1.02 (1.01-1.03)]. Individuals within the top UHR quartile exhibited roughly a 37% higher stroke prevalence compared with those in the lowest quartile [1.37 (1.17-1.61)]. Restricted Cubic Spline analyses demonstrated an approximately linear association between UHR and stroke prevalence (P for nonlinearity = 0.62). Cross-sectional discrimination assessed by survey-weighted ROC analysis yielded an AUC of 0.825, which should be interpreted as differentiation of prevalent stroke rather than prognostic prediction. Diabetes status significantly modified the association (P for interaction < 0.05), with a stronger relationship observed among non-diabetic individuals. To assess robustness across settings and phenotype definitions, we further evaluated UHR in an independent Chinese hospital-based cohort with imaging-confirmed hemorrhagic stroke, which showed directionally consistent associations. Collectively, these findings support UHR as a clinically accessible, hypothesis-generating marker capturing metabolic-inflammatory imbalance relevant to cerebrovascular pathology and motivate future longitudinal and mechanistic studies.
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