Association Between the Uric Acid-to-Creatinine Ratio and Elevated Parathyroid Hormone Levels in Adults Without Known Parathyroid Disease.

Background

Parathyroid hormone (PTH) is mainly regulated by calcium, vitamin D, and renal function, but metabolic factors may also influence its levels. The uric acid/creatinine (UA/Cr) ratio reflects uric acid metabolism and renal handling. This study evaluated its association with elevated PTH in adults without known parathyroid disease.

Methods

This retrospective cross-sectional study included 244 adults undergoing routine biochemical evaluation. The uric acid-to-creatinine ratio (UA/Cr) was calculated. Participants were categorized according to PTH levels (≤65 pg/mL vs. >65 pg/mL). Logistic regression analyses were performed to identify factors associated with elevated PTH levels.

Results

A total of 244 individuals (mean age 40.6 ± 11.7 years; 70.9% female) were included in the analysis. Participants with elevated PTH levels had significantly higher UA/Cr ratios compared with those with normal PTH levels (8.93 ± 1.82 vs. 7.47 ± 1.79, p = 0.031). In univariate logistic regression analysis, UA/Cr was associated with elevated PTH (OR 1.15, 95% CI 1.01-1.32, p = 0.043). In multivariable logistic regression analysis adjusting for vitamin D, magnesium, phosphorus, corrected calcium, age, sex, body mass index, and the estimated glomerular filtration rate, the UA/Cr ratio remained significantly associated with elevated PTH levels (OR 1.41, 95% CI 1.036-1.66, p = 0.024).

Conclusions

The UA/Cr ratio was associated with elevated PTH levels in adults without known parathyroid disease, independently of vitamin D status, mineral metabolism parameters, and renal function. These findings suggest that the UA/Cr ratio may help characterize a broader metabolic context associated with elevated PTH levels, rather than serving as a diagnostic marker. Further prospective studies are needed to clarify the clinical relevance and direction of this association.