The Uric Acid/HDL-Cholesterol Ratio as a Potential Marker of Obstruction in Hypertrophic Cardiomyopathy

Authors : Ayşegül Ülgen Kunak, Tolga Kunak

Pages : 172-178

Doi:10.30565/medalanya.1802324

View : 111 | Download : 171

Publication Date : 2025-12-31

Article Type : Research Paper

Abstract :Aim: The uric acid to high-density lipoprotein cholesterol ratio (UHR) has recently emerged as a composite metabolic–inflammatory marker linked to cardiovascular risk. However, its relevance in hypertrophic cardiomyopathy (HCM), particularly in distinguishing obstructive (HOCM) from non-obstructive (HNCM) forms, remains unknown. We aimed to investigate whether UHR differs between HOCM, HNCM, and healthy controls, and to determine its association with echocardiographic and inflammatory markers, as well as its diagnostic performance for identifying obstructive HCM. Methods: This retrospective study included 200 participants (60 HOCM, 80 HNCM, 60 controls). Clinical, biochemical, and echocardiographic data were analyzed. UHR was calculated as serum uric acid (mg/dL) divided by HDL-C (mg/dL). Correlation and receiver operating characteristic (ROC) analyses were performed. Results: UHR was significantly higher in HOCM than in HNCM and controls (p<0.001). It strongly correlated with resting (r=0.741) and provoked (r=0.729) LVOT gradients, and moderately with CRP, septal thickness, and left atrial diameter. ROC analysis showed high diagnostic accuracy for detecting obstruction (AUC = 0.916, cut-off = 0.145, sensitivity 83.3%, specificity 85.0%). Conclusions: UHR, reflecting the balance between oxidative stress and antioxidant capacity, is significantly elevated in obstructive HCM and correlates with disease severity. This easily obtainable marker may assist in phenotypic differentiation, risk stratification, and potentially in monitoring disease progression.
Keywords : hipertrofik kardiyomiyopati, obstrüksiyon, ürik asit, HDL kolesterol, oksidatif stres, biyobelirteç

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