Association between serum uric acid to high-density lipoprotein cholesterol ratio and all-cause and cardiovascular disease mortality after stroke: A cross-sectional study from 2005 to 2018.

BACKGROUND AND AIMS: The uric acid to high-density lipoprotein cholesterol ratio (UHR) has been shown to be associated with multiple metabolic diseases and inflammation. Stroke is the second leading cause of death and the third leading cause of disability worldwide. This study investigated the relationship between serum UHR and mortality in adults with stroke.

METHODS AND

RESULTS

This study recruited 1,382 participants with stroke from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Mortality outcome data were determined by the National Death Index (NDI). Multivariate hazard ratio (HR) and 95 % confidence interval (CI) were assessed using Cox proportional risk modeling and threshold effects analysis. Stratified analyses identified high-risk mortality groups. Among the participants, 508 all-cause mortality occurred, including 135 cardiovascular disease (CVD) mortality. After multivariate adjustment, UHR was significantly and linearly associated with all-cause mortality (HR 1.05, 95 % CI 1.01-1.08). An inverted U-shaped relationship was observed between UHR and CVD mortality, plateauing at 14.42 %. Below this threshold, a 1-unit increase in UHR was linked to a 27 % higher risk of CVD mortality (HR 1.27, 95 % CI 1.07-1.51). However, above the threshold, a 1-unit increase in UHR corresponded to a 11 % reduction in CVD mortality (HR 0.89, 95 % CI 0.79-1.00).

CONCLUSIONS

A linear relationship between UHR and all-cause mortality, as well as an inverted U-shaped association between UHR and CVD mortality, were observed in adults with stroke in the United States. The threshold for CVD mortality was identified at a UHR of 14.42 %.