Association Between Uric Acid to High-Density Lipoprotein Cholesterol Ratio and Gallstones: A NHANES Cross-Sectional...

Gallstones are a common digestive disorder linked to a bile composition imbalance. Uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) are key metabolic markers associated with gallstone risk.

To investigate the association between the uric acid to HDL-C ratio (UHR) and gallstone risk.

Using 2017-2020 NHANES data, we included participants with complete UHR and gallstone information. Analyses included weighted multivariate logistic regression, restricted cubic splines (RCS) for nonlinearity, subgroup/interaction tests, and sensitivity analysis using multiple imputation.

Among 6354 participants, UHR was positively associated with gallstones. The fully adjusted model revealed that for every 1-unit increase in UHR, the incidence of gallstones increased by 4% (OR = 1.04, 95% CI: 1.00-1.08, p = 0.045). RCS indicated a nonlinear relationship (P_nonlinear < 0.001) with an inflection at 14.6: risk increased significantly below 14.6 but weakened above it. Subgroup analysis revealed a remarkable interaction within the asthma subgroup (P_{forinteraction} = 0.017). Sensitivity analysis corroborated the robustness of these findings.

UHR, a novel inflammatory and metabolic marker, is closely related to gallstone risk. Its predictive value is particularly high in the lower range (< 14.6), offering a new reference for screening high-risk populations for gallstones.