Serum uric acid to serum creatinine ratio and gallstones risk: Analysis from the National Health and Nutrition Examination Survey (2017–2020)

Background Insulin resistance and metabolic syndrome had a significant impact on the development of gallstones. This study investigated the relationship between gallstone patients in the United States and the serum uric acid to serum creatinine ratio (SUA/SCR). Methods In this study, a cross-sectional analysis was conducted with data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. The ratio of SUA/SCR functioned as a standalone predictor, and gallstones prevalence was deemed the outcome variable of significance. We utilized a multivariate logistic regression model to assess the relationship between these independent and dependent variables. A restricted cubic spline (RCS) was executed to evaluate potential non-linear relationships. In cases where non-linear relationships were observed, recursive algorithms were employed to identify significant inflection points. Likelihood ratios were used to evaluate the threshold effect. In the end, stratified analyses were executed to determine particular demographics showing enhanced proneness to gallstones prevalence. Results The 7,335 participants were analyzed in this research, including 777 patients who self-reported gallstones. A substantial difference in the SUA/SCR was noted when participants were divided into those with and without gallstones. The fully adjusted multivariable logistic regression results demonstrated an apparent positive association between SUA/SCR and the likelihood of gallstones (OR = 1.10, 95% CI: 1.04, 1.16; P = 0.007). In addition, a non-linear connection between the SUA/SCR and gallstones prevalence was detected (log-likelihood ratio p < 0.01), with the ideal inflection point for SUA/SCR calculated at 5.78. In the subgroup analysis, the positive relationship between SUA/SCR and gallstones prevalence was notably pronounced among white Americans under the age of 60, with diabetes, hypertension, and female participants. Conclusion SUA/SCR was positively correlated with a higher probability of gallstones occurrence among Americans. It could function as a practical and budget-friendly tool for initially detecting individuals predisposed to gallstones. This study provided valuable insights for developing preventive strategies and interventions for gallstones.