Journal of Capital Medical University ›› 2025, Vol. 46 ›› Issue (2): 348-355.doi: 10.3969/j.issn.1006-7795.2025.02.022

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The relationship between the serum uric acid to high density lipoprotein-cholesterol ratio and female infertility

Jian Huanling1，2 , Dai Zi1，Cen Xiaoli3，Chen Huiling4，Liu Zhiwen5，Zhao Ying6*   

  1. 1.First Department of Gynecology,The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China；2. Department of Education and Scientific Research, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, China；3. First Department of Gynecology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, China；4. Department of Reproductive Health，Shenzhen Bao’an Chinese Medicine Hospital，Shenzhen 518133, Guangdong Province, China; 5. Trauma Orthopedics,The Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510378, China; 6. Women and Children's Center，The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
  • Received:2024-09-30 Online:2025-04-21 Published:2025-04-14
  • Supported by:
    This study was supported by Guangdong Basic and Applied Basic Research Foundation Natural Science Foundation Project (2024A1515012161), Guangdong Basic and Applied Basic Research Foundation Provincial-Enterprise Joint Fund (2023A1515220247), Guangdong Provincial Administration of Traditional Chinese Medicine Fund Project (20231170).

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Abstract: Objective  To conduct a cross-sectional study on the relationship between the serum uric acid (sUA) to high density lipoprotein-cholesterol (HDL-C) ratio (UHR) and female infertility. Methods  We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013—2018 cycle, examining 2,963 women aged 18 to 45 years.A multivariable Logistic regression model was used to assess the association between UHR and infertility, adjusting for various confounding factors. The study also explored interactions and dose-response relationships through subgroup analyses and restricted cubic spline (RCS) models, and evaluated the predictive value of UHR for infertility by using receiver operating characteristic (ROC) curve analysis. Results  The results showed that the prevalence of infertility was significantly higher among women with elevated UHR. Baseline characteristics revealed that the mean UHR in women with infertility (9.68±4.23) was significantly higher than in those without infertility (8.7±3.81, P<0.001). Multivariable Logistic regression analysis indicated that women in the highest quartile (Q4) of UHR had a significantly increased likelihood of infertility compared to those in the lowest quartile (Q1), with adjusted odds ratios (ORs) ranging from 1.61 (95% CI: 1.14－2.28) to 1.98 (95% CI: 1.42－2.78) across different models (P for trend<0.001). Subgroup analyses demonstrated that these associations were consistent across different age groups, body mass index (BMI) categories, and racial groups. The RCS model showed a significant linear dose-response relationship between UHR and infertility risk (nonlinear P=0.03, overall association P<0.001). Additionally, ROC analysis indicated that UHR had a moderate ability to discriminate infertility status, with an area under the curve (AUC) of 0.570. Conclusion  A higher UHR is significantly associated with an increased risk of female infertility，and UHR has the potential to serve as a predictive biomarker for the risk of female infertility.

Key words: serum uric acid, high density lipoprotein-cholesterol, uric acid to high density lipoprotein-cholesterol ratio, infertility, NHANES, forecast, biomarker

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