Relationship between uric acid to high-density cholesterol ratio (UHR) and circulating α-klotho: evidence from NHANES 2007-2016

Lipids Health Dis. 2024 Aug 9;23(1):244. doi: 10.1186/s12944-024-02234-6.

Abstract

Objective: To investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) and circulating α-klotho levels in U.S. adults.

Methods: A cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Circulating α-klotho was defined as the dependent variable and UHR was defined as the independent variable. Multivariable linear regression was performed to assess the relationship between the independent and dependent variables. The nonlinear relationship and effect size between UHR and α-klotho were evaluated using smooth curve fitting and threshold effect analysis. Subgroup analysis and sensitivity analysis were conducted to determine the stability of the results. The diagnostic performance of UHR and α-klotho in common elderly diseases was compared using ROC (Receiver Operating Characteristic) analysis.

Results: Among 12,849 participants, there was a negative relationship between the UHR and circulating α-klotho. In the fully adjusted overall model, each unit increase in UHR was associated with a decrease of 4.1 pg/mL in α-klotho. The threshold effect analysis showed that before the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 15.0 pg/mL in α-klotho; beyond the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 2.8 pg/mL in α-klotho. Subgroup analyses and sensitivity analysis indicated that the relationship between UHR and α-klotho remained stable across most populations. The ROC diagnostic test indicated that the evaluative efficacy of UHR in diagnosing age-related diseases was comparable to that of α-klotho.

Conclusion: This study revealed that the UHR was associated with the circulating α-klotho concentration, with a negative association observed in most cases. This finding suggested that the UHR might be a promising indicator for evaluating circulating α-klotho levels.

Keywords: Cross-sectional study; HDL cholesterol; NHANES database; UHR index; Uric acid; α-klotho.

MeSH terms

  • Adult
  • Aged
  • Cholesterol, HDL* / blood
  • Cross-Sectional Studies
  • Female
  • Glucuronidase* / blood
  • Humans
  • Klotho Proteins*
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • ROC Curve
  • Uric Acid* / blood

Substances

  • Klotho Proteins
  • Uric Acid
  • Glucuronidase
  • Cholesterol, HDL
  • KL protein, human