Association of Cumulative Average Uric Acid to HDL Cholesterol Ratio with the Risk of Rapidly Declining Renal Function: A Retrospective Community-Based Cohort Study in Shanghai Undertaken on Elderly Subjects with Hypertension and Type 2 Diabetes Mellitus Patients.

BACKGROUND

In patients ≥60 years with hypertension and type 2 diabetes mellitus, triglyceride-glucose index (TyG), TyG-BMI, uric acid to high-density lipoprotein cholesterol ratio (UHR), atherogenic index of plasma (AIP), single point insulin sensitivity estimator (SPISE Index) and their cumulative averages are linked to rapid kidney function decline (RD). This study aimed to identify the parameter most strongly independently associated with RD.

METHODS

A retrospective cohort study used electronic records from Shanghai Chuansha Huaxia Community Health Service Center. Consecutive patients ≥60 years with both diseases (January 2020-December 2023) were enrolled and divided into RD (n=151) and Non-RD (n=499) groups based on 4-year eGFR trajectory.

RESULTS

RD group had higher age, cum TyG, UHR, cum UHR, and cum AIP (all P<0.05). Multivariable logistic regression showed UHR, cum UHR, and cum AIP were independently associated with RD (P<0.001, P<0.001, P=0.015). Cum UHR had the strongest association (AUC=0.724, 95% CI 0.675-0.773) and non-linear relations with incident RD and absolute eGFR decline.

CONCLUSION

Elevated cum UHR is significantly associated with RD in these patients and may serve as a valuable biomarker for high-risk individual identification.