Association between uric acid to high-density lipoprotein cholesterol ratio (UHR) and female infertility: insights from a cross-sectional study.

BACKGROUND

Infertility in women of reproductive age is a major worldwide health problem. Oxidative stress, inflammatory responses, and dysregulation of lipid metabolism are among the factors that contribute to female infertility. The ratio of serum uric acid to high-density lipoprotein cholesterol (UHR), a novel composite biomarker that reflects oxidative stress and lipid metabolism, has not been extensively studied in relation to female infertility. This study aims to explore the associations between UHR levels and female infertility.

METHODS

This cross-sectional study focused on females aged 18-44 years in the National Health and Nutrition Examination Survey from 2013 to 2018. The association between UHR and infertility was assessed by weighted multivariable logistic regression. Restricted cubic spline (RCS) analysis was employed to analyze the presence of nonlinear relationships between UHR and infertility. Stratified analyses were conducted to investigate the interactions between UHR and infertility in subgroups.

RESULTS

Of the included 3087 women, 357 (11.56%) were recognized with infertility. When UHR was continuous, elevated UHR levels showed a positive association with infertility risk after comprehensive adjustment for confounding factors [odds ratio (OR) = 1.07, 95% confidence interval (CI): 1.02-1.12]. Compared with the lowest UHR level (UHR ≤ 6.14), women with the highest UHR level (UHR > 10.49) had higher odds of infertility (OR = 1.80, 95% CI: 1.03-3.14). A linear relationship was found between UHR and infertility in the RCS analysis. Stratified analyses did not discover any interactions between UHR and infertility in selected subgroups, including age group, educational level, body mass index category, marital status, diabetes, hypertension, hyperlipidemia, and menstrual cycle regularity (all p values for interaction were > 0.05).

CONCLUSIONS

The findings demonstrated significant linear associations between elevated UHR levels and increased odds of female infertility. UHR may serve as a potential biomarker for infertility that requires validation. Future studies should remedy the cross-sectional limitations of this study.