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To explore the relationship between serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and metabolic syndrome (MetS) in nondiabetic individuals. A total of 15,760 nondiabetic participants were screened from the China National Diabetes and Metabolic Disorders Study. Pearson correlation was used to determine the correlation between the components of MetS and UHR, HDL-C, and UA. Receiver operating characteristic curves were used to evaluate the ability of UHR, HDL-C, and UA to identify MetS in the nondiabetic population. A total of 6,386 men and 9,374 women were enrolled in this study. There were 1,480 (23.2%) men and 1,828 (19.5%) women with MetS. UHR significantly correlated with the components of MetS in men and women, especially with waist circumference  and triglyceride. In men, although HDL-C showed a higher specificity index, UHR presented higher sensitivity index and area under the curve (AUC) than HDL-C ( P  = 0.0001) and UA ( P  &lt; 0.0001), with AUC (95% CI) of 0.762 (0.752–0.773). Higher AUCs of UHR relative to HDL-C and UA were also observed in the age groups &lt;40 and 40–59 years. There was no significant difference in AUC between UHR and HDL-C in the age group ≥60 years ( P  = 0.370). However, similar results were not observed in women. UHR significantly correlated with the components of MetS and could serve as a novel and reliable marker for identifying the population at a high risk of MetS in nondiabetic men, especially in younger adults.

Serum uric acid to high-density lipoprotein cholesterol ratio is a promising marker for identifying metabolic syndrome in nondiabetic Chinese men