Serum uric acid-to-HDL-C ratio as an independent predictor of metabolic syndrome in the elderly: diagnostic model optimization and inflammatory mechanism insights

作者：Runfeng Sun, Bin Hu, Zhaodong Sun, Na Wang, Jiaping Wang, Zhigang Wu, Jin Yang, Yuan Jin · 发表于：BMC Geriatrics · 年份：2026 · DOI：10.1186/s12877-026-07315-y · 被引用次数：1 · 研究领域：Gout, Hyperuricemia, Uric Acid、Exercise and Physiological Responses、Diabetes, Cardiovascular Risks, and Lipoproteins

OBJECTIVE: This study aimed to investigate the independent predictive value of the uric acid-to-HDL-C ratio (UHR) for metabolic syndrome (MS) in the elderly, develop an optimized diagnostic model, and assess whether UHR dynamics reflect inflammatory improvements. METHODS: A prospective cohort study was conducted including elderly individuals (n = 1064) undergoing health examinations at two hospitals in 2023. MS was diagnosed according to the International Diabetes Federation (IDF, 2005) criteria (central obesity: waist circumference ≥ 90 cm in men, ≥ 80 cm in women). The association between UHR and MS was evaluated using multivariable logistic regression. Predictive performance was assessed by receiver operating characteristic (ROC) analysis, with the optimal cut-off determined by the Youden index. Model robustness was tested by 1000 bootstrap resamplings and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analyses. Additional analyses included age- and sex-stratified inflammatory profiling (NLRP3, GDF15, SOD) and a quasi-experimental intervention study in participants with UHR ≥ 14.9% (n = 102), who received a 12-week low-purine diet plus daily exercise. RESULTS: UHR was identified as an independent risk factor for MS (OR = 1.96, 95% CI: 1.52–2.53, P < 0.001). It also showed significant correlations with key MS components, including waist circumference (r = 0.394) and triglycerides (r = 0.212; both P < 0.001). The AUC of UHR for predicting ...