EVALUATION OF SERUM URIC ACID TO HDL-CHOLESTEROL RATIO (UHR) AS A PREDICTOR OF TARGET ORGAN DAMAGE IN PRIMARY HYPERTENSION
DOI:
https://doi.org/10.53555/a9gr2z82Keywords:
Uric acid to HDL-cholesterol ratio, Hypertension, Target organ damage, Biomarker, Risk stratification, Left ventricular hypertrophyAbstract
Objective: To evaluate the Uric acid to HDL-Cholesterol Ratio (UHR) as a novel biomarker for predicting target organ damage (TOD) in patients with primary hypertension and without known metabolic disease.
Methods: A cross-sectional study was conducted involving 240 adults with primary hypertension. Participants were stratified into two groups based on the presence (n=102) or absence (n=138) of composite TOD, defined as left ventricular hypertrophy (LVH), renal impairment (reduced eGFR or albuminuria), or increased carotid intima-media thickness (CIMT). The UHR was calculated from fasting blood samples. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were used to determine the association and predictive performance of UHR for TOD.
Results: The UHR was significantly higher in the TOD-positive group compared to the TOD-negative group (0.17 vs. 0.12, p<0.001). In multivariate analysis, UHR was an independent predictor of composite TOD (adjusted Odds Ratio: 2.41 per 0.05-unit increase; 95% CI: 1.52-3.82, p<0.001). UHR also showed strong associations with cardiac, renal, and vascular TOD individually (all p<0.001). The area under the ROC curve for UHR in predicting TOD was 0.81, which was significantly larger than for serum uric acid (0.74) or HDL-C (0.73) alone (p<0.05). The optimal UHR cut-off value for predicting TOD was 0.145, with 78.4% sensitivity and 72.5% specificity.
Conclusion: The Uric acid to HDL-Cholesterol Ratio is a potent, independent, and superior biomarker for identifying hypertensive patients at high risk for target organ damage. Its integration into clinical practice could enhance risk stratification and guide more personalized management.
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