Serum uric acid and TG/HDL-C ratio in non-obese working women: an exploratory cross-sectional study

Serum uric acid has been suggested to be associated with metabolic abnormalities; however, its independent role remains unclear, particularly among non-obese individuals.

We conducted a cross-sectional analysis of 630 non-obese women (body mass index < 25 kg/m²) selected from an initial cohort of 892 participants. Individuals receiving lipid-lowering therapy and those with missing data on serum uric acid, triglycerides, or HDL-C were excluded. Blood samples included in this analysis were limited to fasting samples obtained as part of routine occupational health examinations. The TG/HDL-C ratio was used as a surrogate marker related to insulin resistance and cardiometabolic risk, rather than as a direct measure of insulin resistance or clinical cardiovascular outcomes. Associations between serum uric acid and the TG/HDL-C ratio were examined using quartile analysis and multivariable linear regression adjusting for age, BMI, systolic blood pressure, medication use, smoking, alcohol consumption, and weight gain since early adulthood.

The TG/HDL-C ratio increased across quartiles of serum uric acid, particularly in the upper quartiles. In the crude model, serum uric acid was positively associated with the TG/HDL-C ratio (β = 0.060, p = 0.010), but this association was attenuated after multivariable adjustment and was no longer statistically significant (β = 0.025, p = 0.289). In contrast, BMI (β = 0.063, p < 0.001) and weight gain since early adulthood (β = 0.261, p < 0.001) showed stronger adjusted associations with the TG/HDL-C ratio. Exploratory subgroup analyses were interpreted cautiously because of limited sample size.

In this exploratory cross-sectional study, serum uric acid was not independently associated with the TG/HDL-C ratio after adjustment for confounding factors. These findings suggest that serum uric acid may reflect underlying metabolic status in non-obese working women; however, this interpretation should be considered hypothesis-generating because of the cross-sectional design and the use of the TG/HDL-C ratio as a surrogate marker.

Not applicable.