Association between serum uric acid to high-density lipoprotein ratio and all-cause in hypertensive patients: Mediating role of neutrophils

• DOI: 10.1371/journal.pone.0325620
• Publication Date: 2025-06-05T17:38:37Z
• Authors: Chunyu Yan; Yabin Zhou; He Wang; Jiamei Fu; Qian Xu
• Keywords: Quartile

Background The aim of this study was mainly to investigate the association between Serum uric acid (SUA) high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and all-cause mortality in hypertensive patients,and further mediating role neutrophils. Methods Our cohort included 4533 patients drawn from 2005–2018 National Health Nutrition Examination Survey (NHANES) database combined with Death Index (NDI) obtain data for subjects. Kaplan-Meier survival curves, multifactorial Cox risk-proportional modeling, restricted cubic spline (RCS)-based smoothed curve fitting, threshold effects analysis, subgroup analyses were performed evaluate associations UHR mortality, and, finally,causal analyze Results Over a mean duration 90.32 months, follow-up occurred 1003 individuals, age all subjects (61.69 ± 14.28) years, curves demonstrated that high levels notably connected lower survival. In multivariate regression quartile positively (HR: 1.36, 95% CI: 1.03,1.80, P = 0.031), fitting effect analysis showed nonlinear relationship inflection point 0.14, i.e., when < an increase did not affect 0.84, 0.06, 11.51, 0.8968), > increased UHR. We stratify by gender find male is 0.13, suggesting increasing HR (95% CI): 0.01 (0.00, 0.22), 0.41 (0.04, 1.36), 0.01. However there significant linear correlation females 1.31 0.15, 11.55, 0.0001). Analysis causal elucidated proportion neutrophils 18.63%. Conclusion There positive elevated patients, may be mediated