ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1594080
Serum uric acid to high-density lipoprotein cholesterol ratio is associated with stroke in the elderly: a population-based study
Provisionally accepted
Qingsong Jiang1Guoyong Zhan1Yi Liu1Cai Jiang1
Kang Wang1Guofu Zheng1Weixian Liu2
Jiangchun Ma2
Ming Wang2
Zhuxiao Tang2*- 1Quzhou Kecheng People's Hospital, Quzhou, China
- 2Zhejiang Hospital, Hangzhou, China
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The ratio of serum uric acid (UA) to high-density lipoprotein cholesterol (HDL-c), known as UHR, has been identified as a novel marker for oxidative stress and metabolic disorders. This study focused on exploring the association between UHR and stroke risk among older adults in the United States.This cross-sectional study utilized data from individuals aged 60 years and older, collected through the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Stroke assessment was based on participants' self-reported history. The association between UHR and stroke risk was analyzed using logistic regression, restricted cubic splines (RCS), subgroup analysis, and receiver operating characteristic (ROC) curves.This study included a total of 16,562 older adults, and the proportion of stroke cases increased with higher UHR levels. After adjusting for confounders, multivariable logistic regression analysis revealed that individuals in the highest UHR quartile had an odds ratio of 1.48 (1.23-1.80) for stroke risk compared to those in the lowest quartile. Subgroup analyses further demonstrated a stronger association in non-diabetic populations. RCS analysis suggested a linear relationship. Based on ROC results, UHR outperformed UA and HDL-c.Higher UHR levels are strongly associated with an increased risk of stroke in older adults. Additional large-scale prospective studies are required.
Keywords: Serum uric acid, High-density lipoprotein cholesterol, ratio, Stroke, NHANES
Received: 27 Jun 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Jiang, Zhan, Liu, Jiang, Wang, Zheng, Liu, Ma, Wang and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhuxiao Tang, Zhejiang Hospital, Hangzhou, China
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