{"id":"https://openalex.org/W7223919981","doi":"https://doi.org/10.3390/jcm15218264","title":"Cumulative and Persistently Elevated Serum Uric Acid-to-HDL Cholesterol Ratio and Incident Stroke Risk Among Middle-Aged Chinese Adults: A Landmark Analysis from CHARLS","display_name":"Cumulative and Persistently Elevated Serum Uric Acid-to-HDL Cholesterol Ratio and Incident Stroke Risk Among Middle-Aged Chinese Adults: A Landmark Analysis from CHARLS","publication_year":2026,"publication_date":"2026-10-23","ids":{"openalex":"https://openalex.org/W7223919981","doi":"https://doi.org/10.3390/jcm15218264"},"language":"en","primary_location":{"id":"doi:10.3390/jcm15218264","doi":"https://doi.org/10.3390/jcm15218264","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218264","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/jcm15218264","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5042840173","display_name":"Chongxia Zhong","orcid":"https://orcid.org/0000-0002-2327-5977","observed_orcids":["https://orcid.org/0000-0002-2327-5977"]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Chongxia Zhong","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020048815","display_name":"Min Wu","orcid":"https://orcid.org/0000-0002-5434-5544","observed_orcids":["https://orcid.org/0000-0002-5434-5544"]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Mingyue Wu","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109707651","display_name":"Kefan Mao","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Kefan Mao","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037885387","display_name":"Yihai Liu","orcid":"https://orcid.org/0000-0001-5404-5931","observed_orcids":["https://orcid.org/0000-0001-5404-5931"]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Yihai Liu","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159973654","display_name":"Biao Xu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Biao Xu","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5100738166","display_name":"Lina Kang","orcid":"https://orcid.org/0000-0003-3265-5944","observed_orcids":["https://orcid.org/0000-0003-3265-5944","https://orcid.org/0000-0003-2550-8778","https://orcid.org/0009-0001-3371-8321"]},"institutions":[{"id":"https://openalex.org/I4210111013","display_name":"Nanjing Drum Tower Hospital","ror":"https://ror.org/026axqv54","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210111013"]},{"id":"https://openalex.org/I881766915","display_name":"Nanjing University","ror":"https://ror.org/01rxvg760","country_code":"CN","type":"education","lineage":["https://openalex.org/I881766915"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Lina Kang","raw_affiliation_strings":["Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China"],"raw_orcid":"https://orcid.org/0009-0001-3371-8321","affiliations":[{"raw_affiliation_string":"Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing 210008, China","institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5037885387","https://openalex.org/A5100738166","https://openalex.org/A5159973654"],"corresponding_institution_ids":["https://openalex.org/I4210111013","https://openalex.org/I881766915"],"apc_list":{"value":2600,"currency":"CHF","value_usd":3137},"apc_paid":{"value":2600,"currency":"CHF","value_usd":3137},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.83109251,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"21","first_page":"8264","last_page":"8264"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11139","display_name":"Gout, Hyperuricemia, Uric Acid","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11139","display_name":"Gout, Hyperuricemia, Uric Acid","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10227","display_name":"Acute Ischemic Stroke Management","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10394","display_name":"Lipoproteins and Cardiovascular Health","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/serum-uric-acid","display_name":"serum uric acid","score":0.8500000238418579},{"id":"https://openalex.org/keywords/uric-acid-to-hdl-cholesterol-ratio","display_name":"uric acid to HDL cholesterol ratio","score":0.9169999957084656},{"id":"https://openalex.org/keywords/incident-stroke","display_name":"incident stroke","score":0.7450000047683716},{"id":"https://openalex.org/keywords/stroke-risk","display_name":"stroke risk","score":0.6909999847412109},{"id":"https://openalex.org/keywords/middle-aged-adults","display_name":"middle-aged adults","score":0.8289999961853027},{"id":"https://openalex.org/keywords/chinese-adults","display_name":"Chinese adults","score":0.6669999957084656},{"id":"https://openalex.org/keywords/cumulative-exposure","display_name":"cumulative exposure","score":0.4909999966621399},{"id":"https://openalex.org/keywords/biomarkers","display_name":"biomarkers","score":0.33399999141693115}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9351999759674072},{"id":"https://openalex.org/C68443243","wikidata":"https://www.wikidata.org/wiki/Q2786686","display_name":"Quartile","level":3,"score":0.8105000257492065},{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.7667999863624573},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.6834999918937683},{"id":"https://openalex.org/C2780645631","wikidata":"https://www.wikidata.org/wiki/Q671554","display_name":"Stroke (engine)","level":2,"score":0.6459000110626221},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5823000073432922},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.5493999719619751},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.5182999968528748},{"id":"https://openalex.org/C2777895361","wikidata":"https://www.wikidata.org/wiki/Q1758614","display_name":"Longitudinal study","level":2,"score":0.5059999823570251},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.49570000171661377},{"id":"https://openalex.org/C88879693","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative incidence","level":3,"score":0.45879998803138733},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.39559999108314514},{"id":"https://openalex.org/C2779668873","wikidata":"https://www.wikidata.org/wiki/Q6693756","display_name":"Lower risk","level":3,"score":0.35359999537467957},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.3481999933719635},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.32679998874664307},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.3122999966144562},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.2989000082015991},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.29829999804496765},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.2879999876022339},{"id":"https://openalex.org/C120195587","wikidata":"https://www.wikidata.org/wiki/Q2138790","display_name":"Absolute risk reduction","level":3,"score":0.2754000127315521},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.25600001215934753}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/jcm15218264","doi":"https://doi.org/10.3390/jcm15218264","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218264","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/jcm15218264","doi":"https://doi.org/10.3390/jcm15218264","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218264","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320322769","display_name":"Natural Science Foundation of Jiangsu Province","ror":"https://ror.org/01h0zpd94"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":23,"referenced_works":["https://openalex.org/W1982963662","https://openalex.org/W2029229243","https://openalex.org/W2094124359","https://openalex.org/W2151834039","https://openalex.org/W2163485744","https://openalex.org/W2463406035","https://openalex.org/W2599206788","https://openalex.org/W2946053432","https://openalex.org/W2965157629","https://openalex.org/W2965217605","https://openalex.org/W3158539538","https://openalex.org/W4224249510","https://openalex.org/W4385609572","https://openalex.org/W4386046865","https://openalex.org/W4386945218","https://openalex.org/W4387033845","https://openalex.org/W4388498821","https://openalex.org/W4398242185","https://openalex.org/W4410972568","https://openalex.org/W4413340471","https://openalex.org/W7133234722","https://openalex.org/W7166126052","https://openalex.org/W7203490428"],"related_works":["https://openalex.org/W7203490428","https://openalex.org/W7133234722","https://openalex.org/W7127589971","https://openalex.org/W7123350771","https://openalex.org/W4413340471","https://openalex.org/W4410972568","https://openalex.org/W4413147994","https://openalex.org/W3206049976","https://openalex.org/W7166126052","https://openalex.org/W7213367586"],"abstract_inverted_index":{"Objective:":[0],"To":[1],"examine":[2],"the":[3,31,80,114,130,162,172,181,190],"associations":[4],"of":[5,77,151,222,254],"baseline,":[6],"cumulative":[7,117,241],"average,":[8],"and":[9,34,56,72,94,110,120,159,244],"persistently":[10,210,215,245],"elevated":[11,216,246],"serum":[12],"uric":[13],"acid-to-high-density":[14],"lipoprotein":[15],"cholesterol":[16],"ratio":[17],"(UHR)":[18],"with":[19,53,66,147,198,207,209,214,250],"incident":[20,100,135,152,186,199,223,255],"stroke":[21,78,153,200,224],"among":[22],"middle-aged":[23],"Chinese":[24,232],"adults.":[25],"Methods:":[26],"We":[27],"used":[28,88],"data":[29],"from":[30],"China":[32],"Health":[33],"Retirement":[35],"Longitudinal":[36],"Study":[37],"(CHARLS).":[38],"A":[39,59],"dynamic-entry":[40],"baseline":[41,131,143,238],"cohort":[42,51,62],"included":[43,63],"7113":[44],"stroke-free":[45],"participants":[46,65,160,208],"aged":[47,234],"45\u201360":[48,235],"years":[49],"at":[50],"entry":[52],"available":[54],"UHR":[55,67,103,119,132,144,195,217,247],"follow-up":[57],"data.":[58],"repeated-UHR":[60,182],"landmark":[61,115,183],"3438":[64],"measurements":[68,125],"in":[69,111,161,171],"both":[70],"2011":[71],"2015":[73,81,191],"who":[74],"remained":[75],"free":[76],"through":[79],"assessment.":[82,192],"Cox":[83],"proportional":[84],"hazards":[85],"models":[86],"were":[87,126,248],"to":[89],"estimate":[90],"hazard":[91],"ratios":[92],"(HRs)":[93],"95%":[95,156,177,203,227],"confidence":[96],"intervals":[97],"(CIs)":[98],"for":[99],"stroke.":[101,256],"Baseline":[102],"was":[104,145,196],"analyzed":[105],"as":[106],"a":[107,148,166,219,251],"continuous":[108],"variable":[109],"quartiles.":[112],"In":[113,129,180],"cohort,":[116,133,184],"average":[118,194,242],"transition":[121],"patterns":[122],"across":[123],"repeated":[124],"assessed.":[127],"Results:":[128],"477":[134],"strokes":[136,187],"occurred":[137,188],"during":[138],"follow-up.":[139],"After":[140],"full":[141],"adjustment,":[142],"associated":[146,197,249],"higher":[149,167,220,237,240,252],"risk":[150,168,221,253],"(HR":[154,175,201,225],"1.082,":[155],"CI":[157,178,204,228],"1.013\u20131.155),":[158],"highest":[163],"quartile":[164,174],"had":[165,218],"than":[169],"those":[170,213],"lowest":[173],"1.458,":[176],"1.115\u20131.905).":[179],"250":[185],"after":[189],"Cumulative":[193],"1.176,":[202],"1.060\u20131.306).":[205],"Compared":[206],"low":[211],"UHR,":[212,239,243],"1.461,":[226],"1.063\u20132.009).":[229],"Conclusions:":[230],"Among":[231],"adults":[233],"years,":[236]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-28T00:00:00"}