Association of platelet-to-HDL cholesterol ratio with hyperuricemia among Qatari adults: a national primary care study

Hyperuricemia is increasingly recognized as a metabolic condition associated with obesity and cardiometabolic risk, yet data from Middle Eastern populations remain limited. We conducted a retrospective cross-sectional study using electronic health records from Primary Health Care Corporation centers in Qatar between 1 January 2020 and 1 January 2025. Adult Qatari patients (≥ 18 years) with available same-day platelet count, high-density lipoprotein cholesterol (HDL-C) (mmol/L), and serum uric acid measurements were included. Among 60,841 participants, 7771 (12.8%) had hyperuricemia. In multivariable logistic regression analyses adjusting for major cardiometabolic factors, higher platelet-to-HDL cholesterol ratio (PHR) was independently associated with hyperuricemia. When categorized into tertiles, participants in the highest PHR tertile had significantly greater odds of hyperuricemia compared with the lowest tertile (adjusted odds ratio 1.55, 95% confidence interval 1.44-1.66, p < 0.001), demonstrating a clear dose-response relationship. Associations remained consistent across body mass index strata and after additional adjustment for estimated glomerular filtration rate. Although the per-unit effect size was modest, the graded association across tertiles supports the relevance of PHR as a marker of inflammatory-metabolic risk. Further prospective studies are warranted to clarify its role in risk stratification and cardiometabolic assessment.