Utility of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in evaluating incident hyperuricemia risk.

BACKGROUND AND AIMS: The predictive value of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for hyperuricemia risk remains inadequately explored. This study aims to elucidate the relationship between NHHR and the incidence of hyperuricemia in a cohort of Chinese adults.

METHODS

We conducted a prospective, longitudinal analysis using data from the China Health and Retirement Longitudinal Study (CHARLS). The study included 7102 participants free from hyperuricemia at baseline. NHHR was computed as the ratio of non-HDL-C to HDL-C. The primary outcome was new-onset hyperuricemia, defined by serum uric acid (SUA) levels ≥417μmol/L (7mg/dL) in males or ≥357μmol/L (6mg/dL) in females during follow-up.

RESULTS

Over a follow-up period of 4 years, 626 participants developed new-onset hyperuricemia. An elevated NHHR was significantly associated with an increased risk of hyperuricemia, with an adjusted-odds ratio (OR) of 1.21 (95% confidence interval [CI]: 1.15-1.27) per 1-unit increase in NHHR. The risk was markedly higher in the highest NHHR quartile compared to the lowest (OR: 2.64, 95% CI: 2.01-3.47). The area under the receiver operating characteristic curve for NHHR in predicting hyperuricemia was 0.61, reflecting superior predictive accuracy compared to other lipid parameters.

CONCLUSION

NHHR serves as an independent predictor of new-onset hyperuricemia in Chinese adults, with higher ratios correlating with a significantly increased risk. These results propose NHHR as a potential clinical marker for identifying individuals at elevated risk for hyperuricemia.