{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:28:12Z","timestamp":1770812892899,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteoporosis has emerged as a growing public health concern due to its high prevalence and substantial economic burden on both individuals and society. Recent studies have identified the serum uric acid to high-density lipoprotein cholesterol ratio (UHR) as a novel predictive biomarker for various diseases. However, its association with bone mineral density (BMD) remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated the association of the UHR and forearm BMD (FR-BMD) in a middle-aged and elderly cohort. We also assessed the interaction effects of age, sex, and body mass index (BMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 4,958 adults aged \u226550 years were enrolled from health examinees at Heze Municipal Hospital (2022\u20132025). We collected demographic data, serum lipids, and uric acid levels. Measurements of FR-BMD were performed on the left distal radius (1\/3 site) utilizing dual-energy X-ray absorptiometry. Multivariate linear regression analyses evaluated the UHR-BMD relationship, supplemented by subgroup analyses and interaction tests. Nonlinear associations were assessed using generalized additive models with smoothing curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for age, sex, BMI, Alb, ALP, ALT, BUN, TP, Scr, Lp(a), TC, GGT and hypertension, a higher UHR was significantly associated with lower FR-BMD [\u03b2=-0.076, 95%CI(-0.138~-0.015), P = 0.015]. Significant interaction effects were observed for age and sex (\n                      <jats:italic>P for interaction<\/jats:italic>\n                      &amp;lt; 0.05). Subgroup analysis revealed that this inverse association was significant in males and overweight individuals (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). In contrast, a positive association was observed in females aged \u2265 60 years [\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.278,\n                      <jats:italic>95%CI<\/jats:italic>\n                      (0.126~0.430),\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt;0.001]. Nonlinear analyses demonstrated a U-shaped relationship in those with BMI &amp;lt; 24 kg\/m\u00b2 (inflection point: 0. 102), an inverted U-shaped association in females \u226560 years (inflection point: 0. 156) and a significant but nonspecific nonlinear association was observed in males aged &amp;lt;60 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The association of UHR with FR-BMD is significantly modified by age and sex in middle-aged and elderly populations. Nonlinear relationships exist in males &amp;lt;60 years, females \u226560 years and non-overweight individuals. The potential of UHR as a novel indicator for bone health assessment in select populations is highlighted by our results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1710027","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:26:46Z","timestamp":1770787606000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the serum uric acid to HDL cholesterol ratio and forearm bone mineral density in middle-aged and older 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