Association between the ratio of serum uric acid to high-density lipoprotein cholesterol and liver fat content: evidence from a Chinese health examination dataset

Despite numerous studies investigating the correlation between the serum uric acid and high-density lipoprotein cholesterol ratio (UHR) and fatty liver disease, the evidence for the dose-response relationship between UHR and liver fat content (LFC) remains uncertain. This study employs quantitative computed tomography (CT) to quantify LFC and aims to investigate the correlation and dose-response relationship between UHR levels and LFC in Chinese adults. Based on the health check-up data from 2021 at Henan Provincial People's Hospital, China, the objective of this cross-sectional study was to investigate the association between UHR levels and LFC among individuals of different genders. The analytical approach encompassed one-way ANOVA, multiple regression analysis, subgroup analysis, smooth curve fitting, and the evaluation of threshold and saturation effects. Upon adjusting for potential influencing factors, the multiple regression analysis indicated a positive correlation between UHR and LFC in both male and female subjects. This positive correlation was more significant in the highest UHR quartile (Male Q4 in model II: β = 2.119, 95% CI: 1.353-2.886, P < 0.05; Female Q4 in model II: β = 1.312, 95% CI: 0.499-2.124, P < 0.05). Subgroup and threshold saturation effect analyses demonstrated a positive correlation between UHR and LFC in the male population, independent of age, although the linear correlation trend was influenced by different body mass index (BMI) groups. In the female population, age also affected the association between UHR and LFC, with a negative association observed when age ≥ 45 years and UHR > 30.63. A positive association exists between UHR levels and LFC in both genders among Chinese adults, albeit exhibiting variations across different age and BMI groups. Consequently, early monitoring of UHR levels may be crucial for the early detection and intervention in high-risk groups exhibiting increased LFC.