IntroductionPrevious studies have demonstrated a correlation between the serum uric acid‐to‐high‐density lipoprotein cholesterol ratio (UHR) and insulin resistance (IR) in individuals with type 2 diabetes mellitus. However, no existing studies have investigated the relationship between IR and UHR in the general population. Therefore, the primary objective of this study was to investigate the correlation between UHR and IR in the general American population.MethodsA sample of 8,817 participants was selected from the 2013 to 2020 National Health and Nutrition Examination Survey (NHANES). Homeostatic model assessment of insulin resistance (HOMA‐IR) was used to assess insulin resistance. Multiple logistic regression, generalized smooth curve fitting, and subgroup analysis were used to assess the association between IR and UHR.ResultsMultiple logistic regression analysis indicated a significant correlation between insulin resistance and UHR, with odds ratios (OR) of 1.07 (95% CI = 1.03–1.11) in males and 1.18 (95% CI = 1.13–1.25) in females. A non‐linear relationship and saturation effect between IR risk and UHR were observed, characterized by an inverted L‐shaped curve and a critical inflection point at 8.82. It was found that the area under the ROC curve (AUC) of UHR was significantly larger (AUC = 0.703 for males and 0.747 for females, all P < 0.01) compared with the use of UA or HDL‐C alone. Subgroup analysis showed that this independent association remain consistent regardless of race, age, BMI, diabetes, moderate activities, education level, alcohol drinking, and gender.ConclusionElevated UHR demonstrates a significant correlation with insulin resistance, so it can be used as a potential indicator of insulin resistance within the American population.

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美国人群血清尿酸与高密度脂蛋白胆固醇比值与胰岛素抵抗之间的关联：基于人群的分析

简介之前的研究表明，2 型糖尿病患者的血清尿酸与高密度脂蛋白胆固醇比值 (UHR) 与胰岛素抵抗 (IR) 之间存在相关性。然而，现有研究还没有调查一般人群中 IR 和 UHR 之间的关系。因此，本研究的主要目的是调查美国普通人群中 UHR 和 IR 之间的相关性。方法从 2013 年至 2020 年国家健康和营养检查调查 (NHANES) 中选取了 8,817 名参与者作为样本。胰岛素抵抗稳态模型评估（HOMA-IR）用于评估胰岛素抵抗。采用多元logistic回归、广义平滑曲线拟合和亚组分析来评估IR和UHR之间的关联。结果多元logistic回归分析表明胰岛素抵抗和UHR之间存在显着相关性，优势比（OR）为1.07（95% CI =男性为 1.03–1.11)，女性为 1.18 (95% CI = 1.13–1.25)。IR 风险与 UHR 之间存在非线性关系和饱和效应，其特征是倒 L 形曲线，临界拐点为 8.82。结果发现，UHR的ROC曲线下面积（AUC）明显更大（男性AUC = 0.703，女性AUC = 0.747，所有磷< 0.01) 与单独使用 UA 或 HDL-C 相比。亚组分析表明，无论种族、年龄、BMI、糖尿病、适度活动、教育水平、饮酒和性别如何，这种独立关联都保持一致。结论 UHR 升高与胰岛素抵抗显着相关，因此可以作为一个潜在指标美国人口中的胰岛素抵抗。