Xu JJ, Ma J, Wei S, Hu D, Dang YQ. Letter to the Editor: How serum uric acid-to-high-density lipoprotein cholesterol ratio predicts cardiovascular risk in metabolic dysfunction-associated steatotic liver disease: Addressing challenges. World J Gastroenterol 2026; 32(26): 117368 [DOI: 10.3748/wjg.117368]
Corresponding Author of This Article
Yan-Qi Dang, Institute of Digestive Diseases, China-Canada Center of Research for Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Fenglin Road Sub-district, Shanghai 200032, China. yq_dang@shutcm.edu.cn
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Gastroenterology & Hepatology
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letter
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Xu JJ, Ma J, Wei S, Hu D, Dang YQ. Letter to the Editor: How serum uric acid-to-high-density lipoprotein cholesterol ratio predicts cardiovascular risk in metabolic dysfunction-associated steatotic liver disease: Addressing challenges. World J Gastroenterol 2026; 32(26): 117368 [DOI: 10.3748/wjg.117368]
World J Gastroenterol. Jul 14, 2026; 32(26): 117368 Published online Jul 14, 2026. doi: 10.3748/wjg.117368
Letter to the Editor: How serum uric acid-to-high-density lipoprotein cholesterol ratio predicts cardiovascular risk in metabolic dysfunction-associated steatotic liver disease: Addressing challenges
Jing-Juan Xu, Jing Ma, Shang Wei, Dan Hu, Yan-Qi Dang
Jing-Juan Xu, Shang Wei, Department of Traditional Chinese Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, Jiangsu Province, China
Jing Ma, Dan Hu, Department of Clinical Research Management, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
Yan-Qi Dang, Department of Institute of Digestive Diseases, China-Canada Center of Research for Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Co-corresponding authors: Dan Hu and Yan-Qi Dang.
Author contributions: Hu D and Dang YQ contribute equally to this study as co-corresponding authors; Xu JJ wrote the letter; Wei S, Ma J, and Hu D contributed to reviewing; Dang YQ participated in revising the letter; all authors have read and approved the final version of the manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools for language refinement. All authors were responsible and agree to accountability for all scientific content.
Supported by the Digestive Diseases Committee of the Chinese Association of Traditional Chinese Medicine-The Youth Empowerment Program, No. 202557-006; State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, No. LSLSKL20240127; Science and Technology Development Fund of Shanghai Pudong New Area, No. PKJ2024-Y19; and the Investigator-Initiated Trial Program of Shanghai Pudong New Area Health Commission (the Cohort Study Program), No. 2025-PWDL-03.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
Corresponding author: Yan-Qi Dang, Institute of Digestive Diseases, China-Canada Center of Research for Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Fenglin Road Sub-district, Shanghai 200032, China. yq_dang@shutcm.edu.cn
Received: December 8, 2025 Revised: January 11, 2026 Accepted: February 3, 2026 Published online: July 14, 2026 Processing time: 204 Days and 13.1 Hours
Abstract
Chronic diseases frequently interact, forming complex comorbidity networks. Recent research published in the World Journal of Gastroenterology by Wang et al has identified that the ratio of serum uric acid to high-density lipoprotein cholesterol (UHR) independently predicts the 10-year risk of cardiovascular disease (CVD), particularly in younger individuals, males, and those with central obesity. Individuals with metabolic dysfunction-associated steatotic liver disease represent at high-risk cohort for CVD. In these patients, the risk associated with cardiovascular events significantly surpasses that of liver disease, rendering CVD the primary cause of disability and mortality. The UHR is an emerging composite biomarker that effectively synthesizes indices of inflammation and metabolism, facilitating an assessment of a person’s metabolic and inflammatory status. This biomarker exhibits considerable clinical potential.
Core Tip: This correspondence aims to contribute to the ongoing discourse on the utility of the uric acid to high-density lipoprotein cholesterol (UHR) as a predictive marker for cardiovascular disease risk in patients with metabolic dysfunction-associated steatotic liver disease, emphasizing critical considerations for its broader applicability. The primary focus of this letter is to underscore the potential of UHR as a cost-effective and integrative biomarker, while also addressing significant limitations such as single-center bias, medication-related confounders, and the necessity for more comprehensive demographic representation. Additionally, it seeks to actively promote future multicenter studies to validate these findings across diverse populations and settings.
