[Study on the association between serum uric acid/high density lipoprotein cholesterol ratio and chronic kidney...

Objective: To investigate the association between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and chronic kidney disease (CKD). Methods: This cross-sectional study enrolled participants who underwent comprehensive health evaluations in the Health Management Center of Sichuan Provincial People's Hospital between January 2020 and December 2024. Data were collected through standardized questionnaire survey, physical examinations, and biochemical assessments. Multivariate logistic regression model was used to evaluate the independent association between UHR and CKD. Restricted cubic spline (RCS) analysis with four knots was conducted to evaluate potential nonlinear dose-response relationships. Results: A total of 54 040 participants with age (51.79±13.35) years were included in this study, including 5 708 CKD cases (prevalence 10.56%) and 48 332 controls. Multivariable-adjusted logistic regression analysis revealed a progressive increase in CKD risk across increased UHR quartiles (Q₁ as reference). Adjusted OR for Q₃ and Q₄ were 1.24 (95%CI: 1.13-1.37) and 1.83 (95%CI: 1.64-2.03), respectively (all P<0.001). RCS analysis demonstrated a nonlinear association between UHR and CKD risk (nonlinear P=0.001), with significantly increased risk observed when UHR ≥247.59 (inflection point). Subgroup analyses stratified by sex, age, BMI categories, and alcohol consumption status consistently showed increased CKD risk across UHR quartiles. Conclusion: The level of UHR is significantly associated with an increased risk for CKD, and this association exhibits a nonlinear increasing trend.