Correlation between uric acid/high-density lipoprotein cholesterol ratio and carotid plaque formation: A retrospective cross-sectional study in Anhui's health check-up population

BACKGROUND: This study examines the uric acid to high-density lipoprotein cholesterol ratio (UHR) and carotid plaque formation in a health examination cohort to explore its association with early atherosclerosis and its discriminative ability for carotid plaque screening. METHODS: This retrospective cross-sectional study included 31,146 health examinees at Anhui Medical University's First Affiliated Hospital (2021-2024). Participants were grouped by ultrasound into carotid plaque (n = 6693) and non-plaque (n = 24,453) groups. General and hematological parameters were assessed; serum uric acid (SUA) was measured to calculate UHR, categorized into quartiles (Q1-Q4). Multivariate logistic regression analyzed UHR, age, sex, and other factors with carotid plaque; Receiver Operating Characteristic (ROC) curve analysis evaluated UHR's discriminative ability. RESULTS: 24.9% of males and 16.5% of females had carotid plaques. Plaque and non-plaque groups showed significant differences in High Density Lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides, and other indicators (P < 0.001). Among UHR quartiles, Q3 had the highest plaque rate (23.4%), and Q4 had metabolic anomalies like elevated triglycerides and uric acid (P < 0.001). After adjusting for age, sex, etc., UHR, Low Density Lipoprotein (LDL)-cholesterol, and others were independent risk factors for carotid plaques (P < 0.05). ApoB and HbA1c correlated positively; Q3's plaque risk was 1.4486 times Q1's. ROC curve analysis demonstrated that the UHR had a discriminative ability for carotid atherosclerosis in the overall population and across sexes, with a higher discriminative ability in females (Area Under the Curve, AUC = 0.844) than in males (AUC = 0.824, P < 0.05). CONCLUSIONS: Increased UHR is an independent risk factor for carotid plaques and has a good discriminative ability for plaque formation, with higher discriminative ability accuracy in females than in males.