Sex differences in the association of uric acid to HDL-cholesterol ratio (UHR) with subclinical cardiovascular damage.
5 affiliations
- 1Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy.
- 2Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy.
- 3AO Renato Dulbecco University Hospital of Catanzaro, Catanzaro, 88100, Italy.
- 4Department of Science of Health, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy. [email protected].
- 5Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy. [email protected].
Abstract
Background
Cardiovascular diseases remain the leading cause of global mortality, with risk increasing significantly in women post-menopause. Identifying accessible biomarkers for subclinical risk stratification is a clinical priority. The uric acid to HDL-cholesterol ratio (UHR) has emerged as a composite marker reflecting metabolic burden and reduced vascular protection. This study investigates the independent association between UHR and subclinical organ damage, exploring sex-specific differences.Methods
We analyzed 1,198 Caucasian subjects. Subclinical cardiovascular damage was evaluated via carotid intima-media thickness (c-IMT) and left ventricular mass index (LVMI). Multivariate linear regression and formal interaction analyses were employed to assess the independent association of UHR with organ damage, adjusting for traditional cardiometabolic risk factors.Results
UHR correlated significantly with adiposity, insulin resistance, blood pressure, and lipid profiles. In the total population, UHR was independently associated with both c-IMT (β = 0.093, p = 0.003) and LVMI (β = 0.194, p < 0.0001). A significant sex-UHR interaction was observed for LVMI (p = 0.024). Sex-stratified analyses revealed that UHR was linked to LVMI in women, particularly those postmenopausal, but not in males. In postmenopausal women, UHR remained an independent determinant of LVMI (β = 0.164, p = 0.033).Conclusions
UHR is independently associated with subclinical cardiovascular damage, displaying a sex-specific relationship with myocardial remodeling after menopause. As an inexpensive and easily accessible biomarker, UHR may represent a practical tool to combat clinical inertia and improve the early selection of postmenopausal women warranting targeted diagnostic workups.
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BibTeX
@article{rubino2026differences,
title = {{Sex differences in the association of uric acid to HDL-cholesterol ratio (UHR) with subclinical cardiovascular damage.}},
author = {Mariangela Rubino and Angela Palummo and Mattia Massimino and Carolina Averta and Stefania Belviso and Asia Servello and Francesco Maria Brisinda and Alberto Cosenza and Angela Sciacqua and Maria Perticone and Francesco Perticone and Elettra Mancuso and Gaia Chiara Mannino and Francesco Andreozzi},
journal = {Biology of sex differences},
year = {2026},
month = jul,
doi = {10.1186/s13293-026-00956-z},
url = {https://europepmc.org/article/MED/42894256},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sex differences in the association of uric acid to HDL-cholesterol ratio (UHR) with subclinical cardiovascular damage.
AU - Mariangela Rubino
AU - Angela Palummo
AU - Mattia Massimino
AU - Carolina Averta
AU - Stefania Belviso
AU - Asia Servello
AU - Francesco Maria Brisinda
AU - Alberto Cosenza
AU - Angela Sciacqua
AU - Maria Perticone
AU - Francesco Perticone
AU - Elettra Mancuso
AU - Gaia Chiara Mannino
AU - Francesco Andreozzi
PY - 2026
DA - 2026/07/01
JO - Biology of sex differences
DO - 10.1186/s13293-026-00956-z
UR - https://europepmc.org/article/MED/42894256
AB - Background Cardiovascular diseases remain the leading cause of global mortality, with risk increasing significantly in women post-menopause. Identifying accessible biomarkers for subclinical risk stratification is a clinical priority. The uric acid to HDL-cholesterol ratio (UHR) has emerged as a composite marker reflecting metabolic burden and reduced vascular protection. This study investigates the independent association between UHR and subclinical organ damage, exploring sex-specific differences.Methods We analyzed 1,198 Caucasian subjects. Subclinical cardiovascular damage was evaluated via carotid intima-media thickness (c-IMT) and left ventricular mass index (LVMI). Multivariate linear regression and formal interaction analyses were employed to assess the independent association of UHR with organ damage, adjusting for traditional cardiometabolic risk factors.Results UHR correlated significantly with adiposity, insulin resistance, blood pressure, and lipid profiles. In the total population, UHR was independently associated with both c-IMT (β = 0.093, p = 0.003) and LVMI (β = 0.194, p < 0.0001). A significant sex-UHR interaction was observed for LVMI (p = 0.024). Sex-stratified analyses revealed that UHR was linked to LVMI in women, particularly those postmenopausal, but not in males. In postmenopausal women, UHR remained an independent determinant of LVMI (β = 0.164, p = 0.033).Conclusions UHR is independently associated with subclinical cardiovascular damage, displaying a sex-specific relationship with myocardial remodeling after menopause. As an inexpensive and easily accessible biomarker, UHR may represent a practical tool to combat clinical inertia and improve the early selection of postmenopausal women warranting targeted diagnostic workups.
SN - 2042-6410
ER -