A nonlinear correlation between the serum uric acid to creatinine ratio and the prevalence of hypertension: a large cross-sectional population-based study

Figures & data

Figure 1. Flow chart of the study population. CHNS, China Health and Nutrition Survey.

Table 1. Baseline characteristics of participants stratified by the hypertension.

	Total population	Non-hypertension	Hypertension	P value
Age, years	50.44 ± 15.03	46.96 ± 14.42	59.16 ± 12.82	< 0.001
Sex, male, n (%)	4033 (47.10%)	2817 (46.00%)	1216 (49.80%)	0.001
Smoking status, n (%)				< 0.001
Now	2378 (27.80%)	1702 (27.80%)	676 (27.70%)
Ever	282 (3.30%)	155 (2.50%)	127 (5.20%)
Never	5908 (69.00%)	4270 (69.70%)	1638 (67.10%)
Diabetes, n (%)	927 (10.80%)	458 (7.50%)	469 (19.20%)	< 0.001
Hypoglycemic drugs, n (%)	217 (2.50%)	75 (1.20%)	142 (5.80%)	< 0.001
Body mass index, kg/m^2	23.38 ± 3.48	22.86 ± 3.24	24.68 ± 3.71	< 0.001
Systolic blood pressure, mmHg	125.01 ± 19.06	116.10 ± 11.19	144.77 ± 18.01	< 0.001
Diastolic blood pressure, mmHg	80.30 ± 11.17	75.59 ± 7.51	90.72 ± 10.88	< 0.001
Triglyceride, mmol/L	1.26 (0.86, 1.96)	1.17 (0.80, 1.80)	1.51 (1.01, 2.33)	< 0.001
Total cholesterol, mmol/L	4.86 ± 1.01	4.77 ± 0.98	5.11 ± 1.02	< 0.001
LDL‑C, mmol/L	2.98 ± 0.98	2.91 ± 0.96	3.16 ± 1.02	< 0.001
HDL‑C, mmol/L	1.44 ± 0.49	1.45 ± 0.44	1.41 ± 0.60	0.004
Apolipoprotein A1, g/L	1.16 ± 0.38	1.15 ± 0.35	1.17 ± 0.45	0.055
Apolipoprotein B, g/L	0.91 ± 0.27	0.88 ± 0.26	0.99 ± 0.28	< 0.001
CR, µmol/L	87.60 ± 23.14	86.00 ± 21.33	91.62 ± 26.73	< 0.001
UA, µmol/L	308.77 ± 105.63	299.08 ± 104.00	333.07 ± 105.78	< 0.001
Fasting plasma glucose, mmol/L	5.41 ± 1.47	5.26 ± 1.29	5.78 ± 1.79	< 0.001
Hemoglobin A1c, %	5.63 ± 0.92	5.53 ± 0.79	5.89 ± 1.14	< 0.001
Hs-CRP, mg/L	1.00 (0, 2.00)	1.00 (0, 2.00)	2.00 (1.00, 3.00)	< 0.001
eGFR, ml/min/1.73 m^2	81.89 ± 17.84	84.16 ± 17.92	76.21 ± 16.32	< 0.001
UA/Cr	3.56 ± 1.41	3.51 ± 1.50	3.70 ± 1.14	< 0.001

Data were expressed as mean ± SD, median (interquartile range), or n (%). LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; CR, creatinine; UA, uric acid; Hs-CRP, high-sensitivity C-reactive protein; eGFR, estimated glomerular filtration rate.

Table 2. Multivariate logistic regression analysis of association between the UA/Cr ratio with hypertension.

	Model 1		Model 2		Model 3
	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value
Q1	Ref	–	Ref	–	Ref	–
Q2	1.151 (1.002, 1.323)	0.047	1.160 (0.998, 1.348)	0.052	1.085 (0.927, 1.268)	0.309
Q3	1.415 (1.235, 1.622)	< 0.001	1.485 (1.281, 1.722)	< 0.001	1.183 (1.011, 1.384)	0.035
Q4	1.736 (1.518, 1.984)	< 0.001	1.964 (1.697, 2.273)	< 0.001	1.347 (1.146, 1.582)	< 0.001
P for trend	–	< 0.001	–	< 0.001	–	0.002
UA/Cr^a	1.123 (1.077, 1.171)	< 0.001	1.161 (1.109, 1.217)	< 0.001	1.054 (1.014, 1.095)	0.007

^a The OR was examined by per 1-unit increase of UA/Cr. Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for variables included in Model 2 and smoking, diabetes, hypoglycemic drugs, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein B, fasting plasma glucose, hemoglobin A1c, high-sensitivity C-reactive protein and eGFR. UA, uric acid; CR, creatinine; eGFR, estimated glomerular filtration rate; OR, odd ratio; CI, confidence interval.

Table 3. Subgroups analyses for the association between the UA/Cr ratio and the hypertension.

	Q1	Q2	Q3	Q4
	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	P for trend	P for interaction
Age						0.136
< 60 years	Ref	1.092 (0.888, 1.344)	1.253 (1.020, 1.538)*	1.257 (1.010, 1.563)*	0.105
≥ 60 years	Ref	1.079 (0.849, 1.371)	1.060 (0.832, 1.352)	1.474 (1.136, 1.913)**	0.016
Sex						0.506
Male	Ref	1.211 (0.957, 1.533)	1.229 (0.973, 1.553)	1.349 (1.056, 1.723)*	0.119
Female	Ref	0.985 (0.796, 1.218)	1.111 (0.894, 1.381)	1.314 (1.042, 1.658)*	0.064
Diabetes						0.798
Yes	Ref	1.211 (0.770, 1.904)	1.329 (0.864, 2.044)	1.322 (0.840, 2.081)	0.581
No	Ref	1.050 (0.888, 1.242)	1.133 (0.956, 1.342)	1.295 (1.087, 1.544)**	0.022
CKD						0.061
Yes	Ref	1.616 (1.041, 2.507)*	1.929 (1.200, 3.100)**	2.127 (1.218, 3.716)**	0.014
No	Ref	1.046 (0.884, 1.238)	1.136 (0.961, 1.343)	1.288 (1.088, 1.524)**	0.015
BMI						0.329
< 28 kg/m^2	Ref	1.123 (0.952, 1.324)	1.166 (0.987, 1.378)	1.385 (1.165, 1.647)***	0.003
≥ 28 kg/m^2	Ref	0.920 (0.528, 1.601)	1.454 (0.864, 2.446)	1.245 (0.738, 2.101)	0.211

The multivariate adjusted model used in the subgroups analysis consisted of all covariates used in model 3 in Table 2 except for the variable (as a categorical variable) that was used for stratification. The interaction of the UA/Cr ratio and variables used for stratification was examined by likelihood ratio tests.

*p < 0.05, **p < 0.01, ***p < 0.001. UA, uric acid; CR, creatinine; CKD, chronic kidney disease; BMI, body mass index; OR, odd ratio; CI, confidence interval.

Table 4. Association between the UA/Cr ratio with hypertension after excluding participants with eGFR < 30 mL/min/1.73 m².

	Model 1		Model 2		Model 3
	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value
Q1	Ref	–	Ref	–	Ref	–
Q2	1.171 (1.018, 1.346)	0.027	1.170 (1.006, 1.360)	0.042	1.090 (0.931, 1.275)	0.284
Q3	1.437 (1.253, 1.648)	< 0.001	1.495 (1.289, 1.735)	< 0.001	1.184 (1.012, 1.386)	0.035
Q4	1.765 (1.543, 2.018)	< 0.001	1.981 (1.711, 2.294)	< 0.001	1.347 (1.146, 1.583)	< 0.001
P for trend	–	< 0.001	–	< 0.001	–	0.003
UA/Cr^a	1.130 (1.083, 1.179)	< 0.001	1.165 (1.112, 1.221)	< 0.001	1.053 (1.013, 1.094)	0.008

^a The OR was examined by per 1-unit increase of UA/Cr. Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for variables included in Model 2 and smoking, diabetes, hypoglycemic drugs, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein B, fasting plasma glucose, hemoglobin A1c, high-sensitivity C-reactive protein and eGFR. UA, uric acid; CR, creatinine; eGFR, estimated glomerular filtration rate; OR, odd ratio; CI, confidence interval.

Figure 2. OR (95% CI) for the hypertension by the UA/Cr ratio. The association was adjusted for variables included in model 3 in Table 2. UA, uric acid; CR, creatinine; or, odd ratio; CI, confidence interval.

Data availability statement

All raw data and materials included in this study are publicly available on the CHNS website.