The association between the uric acid to high-density lipoprotein cholesterol ratio with gestational diabetes mellitus: a cross-sectional study based on NHANES 1999–2020

Gestational diabetes mellitus (GDM) affects approximately one in six pregnant women worldwide, imposing a significant health and economic burden. The uric acid to high-density lipoprotein cholesterol ratio (UHR), as a biomarker reflecting metabolic dysfunction, may be utilized to assess the prevalence of developing GDM. We calculated the UHR index using data from pregnant women who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020. Subsequently, we conducted in-depth validation through analytical methods including multivariate logistic regression, smooth curve fitting, and subgroup analysis. The logistic regression model demonstrated a positive correlation between the UHR index and GDM, which remained significant even after adjusting for all confounding variables (Odds Ratio [OR] = 1.16, 95% Confidence Interval [CI]: 1.07–1.26, p Although UHR demonstrated limited independent diagnostic accuracy (AUC = 0.611), its dual role in correlating inflammation and lipid metabolism may confer complementary value within multiparametric models, a hypothesis that warrants future research validation.