Abstract
BACKGROUND AND AIMS: This study examines the association between the serum uric acid high-density lipoprotein cholesterol ratio (UHR) biomarker and the risk of prediabetes and diabetes, a relationship that remains under-researched, to provide insights for diabetes prevention. METHODS AND RESULTS: This study utilized data from 13,975 American participants in the National Health and Nutrition Examination Survey (2011-2018). Logistic regression models, restricted cubic splines (RCS) analysis and subgroup analyses were employed to examine the association between UHR and prediabetes/diabetes. The median UHR was 10.4%, with 6,382 (45.7%) cases of prediabetes and diabetes detected. A higher UHR was associated with an increased risk of prediabetes and diabetes, showing a 39% increased risk per standard deviation increment (OR: 1.39; 95% CI: 1.33,1.46). Consistent results were observed when UHR was categorized. Participants in the highest UHR quartile exhibited a significantly higher risk of prediabetes/diabetes than those in the lowest quartile (OR: 2.63, 95% CI: 2.30,3.01). The RCS analysis revealed a nonlinear association, with a threshold value of 12.50%. Below this threshold, higher UHR was significantly associated with prediabetes/diabetes (OR: 1.17, 95% CI: 1.15,1.19), while above this threshold, the association was not significant. Subgroup analyses highlighted a marked gender disparity, with women exhibiting a stronger association. CONCLUSION: This research found a positive link between UHR and prediabetes and diabetes prevalence, with a nonlinear relationship noted. A significant association was observed below a UHR threshold of 12.50%, especially in females.