The global prevalence of hyperuricemia (HUA) is increasing year on year, raising urgent public health concerns. This study aimed to investigate the relationship between the remnant cholesterol to high-density lipoprotein cholesterol (RC/HDL-C) ratio and HUA. Data from 2795 participants in the 2017 to 2018 National Health and Nutrition Examination Survey were used for this cross-sectional study. Subgroup analyses were performed, stratified by age, sex, race, and body mass index (BMI), to evaluate the association between the RC/HDL-C ratio and the risk of HUA and serum uric acid levels, using adjusted multivariate logistic and linear regression analyses. The nonlinear relationship between the RC/HDL-C ratio and HUA risk was also tested using generalized additive models. Of the 2795 participants, 583 were diagnosed with HUA. A higher RC/HDL-C ratio is associated with an increased risk of HUA, model 1 (odds ratio OR = 3.677, 95% confidence interval CI: 2.841, 4.760), model 2 (OR = 3.609, 95% CI: 2.739, 4.755), and model 3 (OR = 2.551, 95% CI: 1.834, 3.548). Stratified analysis revealed that this association was particularly evident among women, individuals over 60 years of age, Other Hispanic individuals, and individuals with a BMI below 25 kg/m 2 . Furthermore, nonlinear correlation analysis revealed a threshold saturation effect between the RC/HDL-C ratio and HUA, with an inflection point at 0.400. In the American population, an increase in the RC/HDL-C ratio is independently related to an increased risk of HUA and higher serum uric acid levels. This correlation remains stable when further stratified by gender, age, and BMI.
Xuan et al. (Fri,) studied this question.