The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey

BackgroundPrevious studies on the relationship between serum uric acid to serum creatinine ratio (SUA/SCr) and stroke have shown inconsistent results. This study investigates the association between SUA/SCr and stroke risk using data from the National Health and Nutrition Examination Survey (NHANES)...

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Main Authors: Xinmin Deng, Kunlin Kuang, Yumei Zhong, Rui Lai, Xiaofeng Lv, Shanshan Liu, Meijun Liu, Jingtao Liang, Dongdong Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1542298/full
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author Xinmin Deng
Kunlin Kuang
Yumei Zhong
Rui Lai
Xiaofeng Lv
Shanshan Liu
Meijun Liu
Jingtao Liang
Dongdong Yang
author_facet Xinmin Deng
Kunlin Kuang
Yumei Zhong
Rui Lai
Xiaofeng Lv
Shanshan Liu
Meijun Liu
Jingtao Liang
Dongdong Yang
author_sort Xinmin Deng
collection DOAJ
description BackgroundPrevious studies on the relationship between serum uric acid to serum creatinine ratio (SUA/SCr) and stroke have shown inconsistent results. This study investigates the association between SUA/SCr and stroke risk using data from the National Health and Nutrition Examination Survey (NHANES).Materials and methodsA cross-sectional analysis was conducted using NHANES data from 1999 to 2018. Weighted univariate and multivariate logistic regression models were used to evaluate the association between SUA/SCr and stroke. The restricted cubic spline (RCS) curve was used to explore the nonlinear relationship between SUA/SCr and stroke risk.ResultsIn the regression model adjusted for all covariates, the OR (95% CI) for the association between SUA/SCr and stroke was 0.84 (0.78, 0.92), indicating a significant association between SUA/SCr and stroke risk. When SUA/SCr was analyzed as a categorical variable by quartiles, participants in the highest SUA/SCr quartile (Q4) had a 53% lower risk of stroke compared to those in the lowest quartile (Q1), with an OR (95% CI) of 0.47 (0.31, 0.71). RCS analysis revealed a nonlinear relationship between SUA/SCr and stroke risk (nonlinearity p = 0.048). Before the nonlinear inflection point (6.33), stroke risk significantly decreased as SUA/SCr increased. After this point, the decrease in stroke risk with increasing SUA/SCr slowed down markedly.ConclusionOur study indicates that higher SUA/SCr levels are associated with a lower risk of stroke. However, further prospective longitudinal studies are required to establish the causal relationship and explore the potential role of SUA/SCr in stroke risk assessment and prevention strategies.
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spelling doaj-art-3074152a03b24472a5f672e0ea9492cb2025-08-20T02:29:27ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-04-011710.3389/fnagi.2025.15422981542298The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination SurveyXinmin Deng0Kunlin Kuang1Yumei Zhong2Rui Lai3Xiaofeng Lv4Shanshan Liu5Meijun Liu6Jingtao Liang7Dongdong Yang8School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Pain, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, ChinaSchool of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaBackgroundPrevious studies on the relationship between serum uric acid to serum creatinine ratio (SUA/SCr) and stroke have shown inconsistent results. This study investigates the association between SUA/SCr and stroke risk using data from the National Health and Nutrition Examination Survey (NHANES).Materials and methodsA cross-sectional analysis was conducted using NHANES data from 1999 to 2018. Weighted univariate and multivariate logistic regression models were used to evaluate the association between SUA/SCr and stroke. The restricted cubic spline (RCS) curve was used to explore the nonlinear relationship between SUA/SCr and stroke risk.ResultsIn the regression model adjusted for all covariates, the OR (95% CI) for the association between SUA/SCr and stroke was 0.84 (0.78, 0.92), indicating a significant association between SUA/SCr and stroke risk. When SUA/SCr was analyzed as a categorical variable by quartiles, participants in the highest SUA/SCr quartile (Q4) had a 53% lower risk of stroke compared to those in the lowest quartile (Q1), with an OR (95% CI) of 0.47 (0.31, 0.71). RCS analysis revealed a nonlinear relationship between SUA/SCr and stroke risk (nonlinearity p = 0.048). Before the nonlinear inflection point (6.33), stroke risk significantly decreased as SUA/SCr increased. After this point, the decrease in stroke risk with increasing SUA/SCr slowed down markedly.ConclusionOur study indicates that higher SUA/SCr levels are associated with a lower risk of stroke. However, further prospective longitudinal studies are required to establish the causal relationship and explore the potential role of SUA/SCr in stroke risk assessment and prevention strategies.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1542298/fullserum uric acidserum creatininestrokeNHANEScross-sectional study
spellingShingle Xinmin Deng
Kunlin Kuang
Yumei Zhong
Rui Lai
Xiaofeng Lv
Shanshan Liu
Meijun Liu
Jingtao Liang
Dongdong Yang
The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
Frontiers in Aging Neuroscience
serum uric acid
serum creatinine
stroke
NHANES
cross-sectional study
title The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
title_full The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
title_fullStr The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
title_full_unstemmed The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
title_short The association between kidney function-standardized serum uric acid levels and stroke risk: insights from the National Health and Nutrition Examination Survey
title_sort association between kidney function standardized serum uric acid levels and stroke risk insights from the national health and nutrition examination survey
topic serum uric acid
serum creatinine
stroke
NHANES
cross-sectional study
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1542298/full
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