{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:45:48Z","timestamp":1771922748646,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Serum uric acid (SUA) plays a critical role in metabolic dysfunction, including insulin resistance (IR) and lipid dysregulation. This study investigates the association between SUA and the triglyceride-to-high-density lipoprotein cholesterol (TG\/HDL-C) ratio in school-aged children with adenoid or tonsillar hypertrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center retrospective study of 3,026 school-aged children with adenoid or tonsillar hypertrophy was conducted. Baseline characteristics, metabolic markers, and the TG\/HDL-C ratio were analyzed across SUA quartiles. Spearman\u2019s test was used to explore the associations between clinical parameters and the TG\/HDL-C ratio. A restricted cubic splines (RCS) linear regression model was used to explore the nonlinear relationships between SUA and the TG\/HDL-C ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SUA levels were positively associated with the TG\/HDL-C ratio (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.232,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). RCS analysis revealed a significant nonlinear relationship between SUA and the TG\/HDL-C ratio (\n                      <jats:italic>p<\/jats:italic>\n                      for nonlinear\u202f=\u202f0.019). When SUA exceeded 4.40\u202fmg\/dL, the positive relationship between SUA and the TG\/HDL-C ratio became stronger compared to levels below this threshold. Moreover, children with SUA levels &amp;gt;4.40\u202fmg\/dL showed a significantly higher proportion of BMI\n                      <jats:italic>z<\/jats:italic>\n                      -scores &amp;gt;2.0 and a greater prevalence of dyslipidemia than those with lower SUA levels. The relationship between SUA and the TG\/HDL-C ratio in males and females was consistent with that observed in the general population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study identified a nonlinear relationship between SUA levels and the TG\/HDL-C ratio in school-age children with adenoid or tonsillar hypertrophy. This nonlinear pattern persisted in sex-stratified analyses, with males exhibiting a higher SUA inflection point compared to females. These findings suggest that SUA could serve as a practical marker for early metabolic risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1613538","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:42:14Z","timestamp":1768977734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the nonlinear association between serum uric acid and the TG\/HDL-C Ratio: insights from school-aged children with adenoid or tonsillar hypertrophy"],"prefix":"10.3389","volume":"14","author":[{"given":"Liming","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiqing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, College of Laboratory Medicine, Hebei North University","place":["Zhangjiakou, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Central Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Information, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhimin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.ejim.2022.04.022","article-title":"Uric acid in metabolic syndrome: does uric acid have a definitive role?","volume":"103","author":"Copur","year":"2022","journal-title":"Eur J Intern 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