Frontiers in public health · 2026
Exploring the nonlinear association between serum uric acid and the TG/HDL-C Ratio: insights from school-aged children with adenoid or tonsillar hypertrophy.
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Liu Liming, Yang Yiqing, Liu Ying, Chen Yingyi, Zhang Ziyin, Wang Zhimin, Liu Xin
Аннотация
BACKGROUND: Serum uric acid (SUA) plays a critical role in metabolic dysfunction, including insulin resistance (IR) and lipid dysregulation. This study investigates the association between SUA and the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio in school-aged children with adenoid or tonsillar hypertrophy.
METHODS: A single-center retrospective study of 3,026 school-aged children with adenoid or tonsillar hypertrophy was conducted. Baseline characteristics, metabolic markers, and the TG/HDL-C ratio were analyzed across SUA quartiles. Spearman's test was used to explore the associations between clinical parameters and the TG/HDL-C ratio. A restricted cubic splines (RCS) linear regression model was used to explore the nonlinear relationships between SUA and the TG/HDL-C ratio.
RESULTS: SUA levels were positively associated with the TG/HDL-C ratio (r = 0.232, p < 0.001). RCS analysis revealed a significant nonlinear relationship between SUA and the TG/HDL-C ratio (p for nonlinear = 0.019). When SUA exceeded 4.40 mg/dL, the positive relationship between SUA and the TG/HDL-C ratio became stronger compared to levels below this threshold. Moreover, children with SUA levels >4.40 mg/dL showed a significantly higher proportion of BMI z-scores >2.0 and a greater prevalence of dyslipidemia than those with lower SUA levels. The relationship between SUA and the TG/HDL-C ratio in males and females was consistent with that observed in the general population.
CONCLUSION: Our study identified a nonlinear relationship between SUA levels and the TG/HDL-C ratio in school-age children with adenoid or tonsillar hypertrophy. This nonlinear pattern persisted in sex-stratified analyses, with males exhibiting a higher SUA inflection point compared to females. These findings suggest that SUA could serve as a practical marker for early metabolic risk assessment.
METHODS: A single-center retrospective study of 3,026 school-aged children with adenoid or tonsillar hypertrophy was conducted. Baseline characteristics, metabolic markers, and the TG/HDL-C ratio were analyzed across SUA quartiles. Spearman's test was used to explore the associations between clinical parameters and the TG/HDL-C ratio. A restricted cubic splines (RCS) linear regression model was used to explore the nonlinear relationships between SUA and the TG/HDL-C ratio.
RESULTS: SUA levels were positively associated with the TG/HDL-C ratio (r = 0.232, p < 0.001). RCS analysis revealed a significant nonlinear relationship between SUA and the TG/HDL-C ratio (p for nonlinear = 0.019). When SUA exceeded 4.40 mg/dL, the positive relationship between SUA and the TG/HDL-C ratio became stronger compared to levels below this threshold. Moreover, children with SUA levels >4.40 mg/dL showed a significantly higher proportion of BMI z-scores >2.0 and a greater prevalence of dyslipidemia than those with lower SUA levels. The relationship between SUA and the TG/HDL-C ratio in males and females was consistent with that observed in the general population.
CONCLUSION: Our study identified a nonlinear relationship between SUA levels and the TG/HDL-C ratio in school-age children with adenoid or tonsillar hypertrophy. This nonlinear pattern persisted in sex-stratified analyses, with males exhibiting a higher SUA inflection point compared to females. These findings suggest that SUA could serve as a practical marker for early metabolic risk assessment.