The predictive performance of the uric acid-to-high-density lipoprotein cholesterol ratio (UHR) for cardiovascular diseases in cancer patients: A cross-sectional study from NHANES

Cancer survivors are at an elevated risk of cardiovascular disease (CVD), imposing a significant burden on healthcare systems. The uric acid-to-high-density lipoprotein cholesterol ratio (UHR), a novel biomarker, has demonstrated predictive ability for cardiovascular events. However, whether UHR can effectively predict the incidence of CVD in cancer patients remains unclear. This study was based on National Health and Nutrition Examination Survey data (1999-2020), from which we constructed a nationally representative cross-sectional cohort of cancer patients. After rigorous screening, 4690 cancer patients were included in the final analysis. Weighted logistic regression models were employed to assess the association between UHR and CVD risk, with additional analyses using restricted cubic spline regression model to evaluate potential non-linear relationships. Subgroup analyses were conducted to explore interaction effects of various covariates on the relationship between UHR and CVD risk. Finally, Receiver Operating Characteristic (ROC) curve was applied to evaluate the predictive efficacy of UHR. The risk of CVD increased progressively with higher UHR levels. In fully adjusted models, each 1% increase in UHR was associated with a 3% higher risk of CVD (OR: 1.03, 95% CI: 1.01-1.05, = =0.003). The restricted cubic spline regression model demonstrated a linear positive correlation between UHR and CVD risk. Subgroup analyses indicated that the impact of UHR on CVD risk was more pronounced in cancer patients who were former smokers or had no history of diabetes. Receiver Operating Characteristic (ROC) curve analysis showed that UHR had a modest discriminative ability in identifying CVD occurrence in cancer patients. This study offers novel evidence that UHR exhibited modest discriminative capacity and may function as a supplementary marker of CVD occurrence in cancer populations. The conduction of additional prospective cohort studies is indicated to further substantiate these findings.