Serum uric acid to HDL-cholesterol ratio: a novel ındicator for metabolic syndrome risk in children

The aim of this cross-sectional study was to examine the association between the serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and metabolic syndrome (MetS) in pediatric populations, as well as its potential role in predicting the diagnosis of MetS in children and adolescents. This is a cross-sectional study included 323 overweight and obese children and adolescents (116 males, 207 females) aged 8 to 17 years who were referred to the Pediatric Endocrinology Clinic. Participants were grouped based on the presence or absence of MetS. Demographic data, anthropometric measurements, blood pressure readings, and blood biochemical parameters, including serum uric acid and UHR, were recorded and analyzed. Significantly higher levels of fasting blood glucose, triglycerides, systolic and diastolic blood pressure, hypertension, serum uric acid (SUA), and UHR were observed in participants with MetS compared to those without MetS. In contrast, high-density lipoprotein cholesterol(HDL-C) levels were significantly lower in children with MetS. Furthermore, each one-unit increase in the UHR was associated with a 6.19-fold higher likelihood of MetS diagnosis. It also showed high diagnostic accuracy for metabolic syndrome (AUC = 0.883). These findings suggest that the UHR is a simple, reliable, and innovative marker for early detection and risk stratification of MetS in children. It may serve as an effective screening tool for identifying at-risk children, thereby facilitating early intervention and management of MetS.