Abstract
This study explores the relationship between serum uric acid to high-density lipoprotein-cholesterol ratio (UHR) and all-cause mortality among US cancer patients. Data from the 2005 to 2018 National Health and Nutrition Examination Survey, linked to National Death Index records until December 31, 2019, are analyzed. To investigate the relationship between UHR and mortality, multivariate Cox proportional hazards models are utilized. Kaplan-Meier curves compare survival across UHR quartiles, while the restricted cubic spline approach evaluates dose-response relationships. Subgroup analyses consider age, gender, diabetes, hypertension, body mass index, and income-to-poverty ratio, with stratified analyses by cancer type. Two sensitivity analyses exclude participants under 65 and those with multiple cancers. During the 81.0-month follow-up period, the all-cause mortality rate is 15.6%. Cancer patients in the top quartile group have a significantly increased mortality risk (hazard ratio: 1.43, 95% confidence interval: 1.07-1.93). Kaplan-Meier survival analysis links higher UHR to reduced survival. This association is nonlinear and more pronounced in those aged ≥ 65, males, and individuals with diabetes or hypertension. Stratified analyses reveal a significant link in breast, colorectal, and prostate cancers. UHR may serve as a valuable predictor of all-cause mortality among individuals with cancer.