Cholesterol Ratio Research Articles

Assessing the predictive value of elevated triglycerides, triglyceride-glucose index (TyG), and TG/HDL ratios for cardiovascular disease and mortality during 20 years of follow-up: Tehran lipid and glucose study.

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality globally, influenced by a complex interplay of risk factors including lipid disorders and insulin resistance (IR). The triglyceride-glucose (TyG) index and the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio have emerged as potential indicators for assessing cardiovascular risk. This study aimed to evaluate the predictive value of hypertriglyceridemia, the TyG index, and the TG/HDL ratio for mortality and CVD occurrence within an Iranian population. Conducted within the Tehran Lipid and Glucose Study over 20 years, this research analyzed 7,117 participants to assess the association between these lipid biomarkers and CVD risk and mortality. Participants were stratified by their TyG and TG/HDL indices, with Cox proportional hazards models determining risk ratios across three adjusted models considering various demographic and clinical variables. The study found significant associations between elevated triglycerides, TyG, and TG/HDL levels with increased risks of mortality and CVD during the 20-year follow-up. Specifically, the hazard ratios for CVD events were notably significant in the second triglyceride group (150-250 mg/dL), with a hazard ratio of 1.36 (1.19-1.55) in both Model 1 and Model 2, and in the third group (250-400 mg/dL), with ratios of 1.88 (1.63-2.17) in Model 1, 1.90 (1.65-2.19) in Model 2, and 1.44 (1.24-1.67) in Model 3. Hypertriglyceridemia, the TyG index, and the TG/HDL ratio are easily calculable and clinically relevant markers for cardiovascular risk assessment. Their integration into routine health evaluations could facilitate early detection and management of at-risk individuals, potentially reducing the incidence and impact of CVD within the community.

The potential of the serum uric acid to high-density lipoprotein cholesterol ratio as a predictive biomarker of diabetes risk: a study based on NHANES 2005–2018

The potential of the serum uric acid to high-density lipoprotein cholesterol ratio as a predictive biomarker of diabetes risk: a study based on NHANES 2005–2018

Association between non-insulin-based insulin resistance surrogate makers and Helicobacter pylori infection: a population-based study

BackgroundCurrent evidence on the associations between insulin resistance (IR) and Helicobacter pylori (H. pylori) infection remains limited. This study aimed to investigate the association between non-insulin-based surrogate markers of IR, including the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (METS-IR), and H. pylori infection in U.S. populations.MethodsThis cross-sectional study involving 939 U.S. participants from the National Health and Nutrition Examination Survey (NHANES) 1999–2000. The associations between three IR surrogate markers and H. pylori infection were respectively investigated using logistic regression model, restricted cubic spline (RCS) curve and subgroup analysis.ResultsThree IR surrogate markers levels were significantly elevated in H. pylori infection participants. There was a positive association between three IR surrogate markers and H. pylori infection, even after adjusting for potential confounding variables by three different models. In subgroup analysis, the adjusted association between three IR surrogate markers and H. pylori infection were more likely to be observed in female and Non-Hispanic White. Additionally, the RCS curve revealed a positive linear correlation between TyG index and H. pylori infection across all three models, and between METS-IR and H. pylori infection in Model 3. However, a positive nonlinear correlation was observed between TG/HDL-C ratio and H. pylori infection in all three models.ConclusionsThese findings suggest that non-insulin-based IR surrogate markers including TyG index, TG/HDL-C ratio, and METS-IR were all positively associated with H. pylori infection. These markers may serve as the potential indicators for identifying the risk of H. pylori infection in U.S. populations.Clinical trial numberNot applicable.

Association of non-highdensity lipoprotein cholesterol to highdensity lipoprotein cholesterol ratio (NHHR) and subsequent hypertension and heart diseases: findings from the CHARLS cohort

PurposeNHHR, the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, is a novel lipid marker associated with the risk of heart diseases and various health conditions. However, there is limited evidence regarding the relationship between NHHR and the onset of hypertension and heart diseases. The aim of this study was to investigate the association between NHHR and the new-onset hypertension and heart diseases among the Chinese middle-aged and older general population.MethodsThis prospective cohort study utilized data from a nationally representative sample of Chinese residents aged 45 and older, sourced from the China Health and Retirement Longitudinal Study (CHARLS). The primary outcomes of the study were new-onset hypertension and heart diseases. To investigate the relationship between the NHHR and the risk of new-onset hypertension and heart diseases, multivariate logistic regression models and the restricted cubic spline (RCS) method were employed. Additionally, the mediating effects of hypertension on the association between NHHR and heart diseases were assessed using the bootstrap method.ResultsA total of 5349 participants were included in the final analysis and three groups of NHHR were identified, including low-stable, medium-stable, and high-stable NHHR. By 2020, 1,631 participants (30.5%) had been newly diagnosed with hypertension, while 1233 (23.1%) developed heart diseases. Compared to those with a low-stable NHHR, individuals in the other two groups showed a significantly increased risk of developing hypertension and heart diseases. The findings remained consistent across various sensitivity analyses. According to the RCS analysis, a partial U-shaped relationship existed between the NHHR and the risk of developing hypertension and heart diseases (P for nonlinear < 0.001). Furthermore, hypertension was found to partially mediate the association between NHHR and heart diseases.ConclusionThe NHHR was closely associated with an increased risk of developing hypertension and heart diseases. In addition, the NHHR partially mediated the development of heart diseases by promoting hypertension progression. In the prevention and treatment of heart diseases, managing both lipid levels and blood pressure is crucial.

Nomogram model for decompressing craniectomy after mechanical thrombectomy in patients with acute ischemic stroke

The most common treatment method for patients with acute ischemic stroke with large vessel occlusion is mechanical thrombectomy. However, complications such as cerebral edema and hemorrhage transformation after MT can affect patient prognoses, while decompression craniectomy considerably improves patient prognoses. The aim of this study was to identify clinical indicators, such as the neutrophil/high-density lipoprotein cholesterol ratio, to predict DC. A retrospective analysis was conducted in AIS-LVO patients who received MT at Huizhou Central People’s Hospital and the Affiliated Hospital of Guilin Medical University. The patients were randomly divided into training, internal validation group and external validation group sets to generate and validate a nomogram model. Multivariate binary logistic analyses indicated that SBP > 178.5 mmHg, WBC > 12.05*109/L, PT > 14.54 s, and NHR > 8.874*109/mmol were independent risk factors for DC after MT in patients with AIS-LVO. In the training set, the area under the curve indicated good accuracy. Calibration curve results showed the average error in the training set was 0.038, and 0.036 in the validation set, showing good model fit. NHR was an independent risk factor for DC treatment after MT in AIS-LVO patients. A nomogram based on NHR accurately predicted if DC treatment was required after MT in patients with AIS-LVO.

Association between triglyceride/high density lipoprotein ratio and incidence risk of Parkinson’s disease: a population-based cohort study

The association between insulin resistance and increased risk of Parkinson’s disease (PD) has rarely been investigated. Our study aimed to investigate the association between the triglyceride/high-density lipoprotein (TG/HDL) ratio (which represents insulin resistance), and the incidence risk of PD in the general population. This study was conducted using data from the National Health Insurance Service-Health Screening Cohort Database of South Korea (2002–2019). We enrolled 310,023 participants who had no previous PD history and who had undergone more than three repeated measurements for the TG/HDL cholesterol ratio. The diagnosis of PD was determined using the International Classification of Diseases, 10th Revision code G20, specific reimbursement codes for Rare Intractable Diseases of V124, and a history of anti-PD drug prescription. During a median of 9.64 years (interquartile range 8.72–10.53), 4,587 individuals (1.47%) had an incidence of PD. Considering the multivariable time-dependent Cox proportional hazard model with repeated measures of average TG/HDL cholesterol ratio, a per unit increase in TG/HDL cholesterol ratio significantly increased the risk of PD in the entire cohort (hazard ratio (HR), 1.010; 95% confidence interval (CI), 1.001–1.020). These repeated measures of the average TG/HDL cholesterol ratio were associated with the incidence risk of PD in a J-shaped pattern for the entire diabetes mellitus (DM) and non-DM cohorts in restricted cubic spline analysis. Compared to the lowest tertiles (T1), the highest tertiles (T3) were positively associated with the incidence risk of PD (HR: 1.149, 95% CI 1.065–1.239 in the entire cohort, p for trend < 0.001; HR: 1.175, 95% CI 1.075–1.285 in the non-DM cohort, p for trend < 0.001). In contrast, the lowest (T1) and highest tertiles (T3) were not associated with the incidence risk of PD in the DM cohort (HR: 1.128, 95% CI 0.909–1.348) in fully adjusted multivariable analysis. Our study provides information that TG/HDL ratio may be positively associated with PD incidence risk in a non-DM population in longitudinal setting of the general population.

Association between neutrophil-to-high-density lipoprotein cholesterol ratio and non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease: evidence from NHANES 2017–2020

BackgroundNon-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with chronic inflammation and lipid metabolism disorders. The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is an integrative marker reflecting inflammatory responses and lipid metabolism disorders and is associated with various diseases. This cross-sectional study aimed to determine the association between NHR and NAFLD, MASLD, and liver fibrosis.MethodsData for this study were obtained from the 2017–2020 National Health and Nutrition Examination Survey (NHANES), we employed weighted multiple regression and restricted cubic spline (RCS) analysis to assess the relationship between NHR and NAFLD, MASLD, and liver fibrosis. Additionally, we performed stratified analyses based on gender, age, body mass index, diabetes, hypertension, smoking status, and history of cardiovascular disease to evaluate the consistency of these associations across different subgroups.ResultsA total of 6,526 participants were included in the study. 2,839 (weighted 44.1%) participants were diagnosed with NAFLD and 2,813 (weighted 43.7%) participants were diagnosed with MASLD. After adjusting for confounders, NHR was positively associated with the risk of NAFLD/MASLD, and the correlation was particularly significant in the subgroups of females, those without hypertension, and those without diabetes (p &amp;lt; 0.05). By the NHR quartile, the risk of NAFLD/MASLD increased progressively with higher NHR levels (P for trend &amp;lt;0.001). In addition, RCS analysis showed a nonlinear association between NHR and NAFLD/MASLD and liver fibrosis (P-non-linear &amp;lt;0.05).ConclusionNHR may serve as a potential marker for NAFLD/MASLD and liver fibrosis, and lowering NHR levels could help reduce the incidence of these conditions.

Cotinine, trans-3'-hydroxycotinine, and nicotine metabolite ratio indicate association between smoking and tooth loss.

Previous research has indicated a potential connection between smoking and tooth loss, but it remains unclear how the metabolites of nicotine, cotinine (COT) and trans-3'-hydroxycotinine (HC), and the nicotine metabolite ratio (NMR) affect the occurrence and progress of tooth loss. In this study, we aimed to investigate the relationship between tooth loss and smoking metabolites, then verify how the systemic immunoinflammatory index (SII) or monocyte to high-density lipoprotein cholesterol ratio (MHR) levels mediate this process. The cross-sectional study data were collected from the National Health and Nutrition Examination Survey (NHANES). After screening and comparing the baseline data, regression models were utilized to evaluate the relationship between serum COT+HC level and tooth loss, as well as COT+HC and SII/MHR and tooth loss. Furthermore, bootstrapping was applied to test the mediation effect of SII and MHR in the association between COT+HC and tooth loss. A total of 9036 subjects were included in the study, with 2795 individuals in the COT/HC- group and 6241 in the COT/HC+ group. In the models with covariates adjusted, COT+HC level was found to be positively correlated with tooth loss (Model 3: odds ratio [OR]=1.001, 95% CI=1.001-1.001), especially in the fourth quartile (Q4) of COT+HC level (Model 3: OR=2.647, 95% CI=2.645-2.649) as compared to Q1. Furthermore, NMR was found to be negatively associated with tooth loss after adjustments (Model 3: OR=0.803, 95% CI=0.802-0.803). For mediation analysis, COT+HC level was significantly correlated with SII score, and SII was proved to be positively associated with tooth loss; meanwhile, COT+HC level was significantly correlated with MHR, and MHR was positively associated with tooth loss. SII and MHR played a partial mediating role in the association between COT+HC and tooth loss, and the indirect effect was 0.0001 (SII; 95% CI=0.0000-0.0002) and 0.0002 (MHR; 95% CI=0.0001-0.0004), respectively. The mediating effect of both SII and MHR was 0.0003 (95% CI=0.0001-0.0004). This study revealed that the level of nicotine metabolites (COT+HC) was a risk factor, while higher NMR was a protective factor for tooth loss, and further demonstrated the partial mediating role of SII and MHR in the association between COT+HC and tooth loss. Prior studies have suggested a possible link between smoking and tooth loss, but how certain nicotine byproducts and their ratios impact tooth loss is unclear. This research aimed to explore how these smoking metabolites influence tooth loss. Data from national health surveys were used for a cross-sectional study to assess the connection between cotinine levels in the blood and tooth loss, as well as to understand if immune and cholesterol markers mediate the link between smoking metabolites and tooth loss. The results showed a positive relationship between cotinine levels and tooth loss. The immune and cholesterol markers were found to partially mediate the relationship between smoking metabolites and tooth loss. Higher levels of nicotine byproducts were linked to an increased risk of tooth loss.

The association between neutrophil to high-density lipoprotein cholesterol ratio and gallstones: a cross-sectional study

ObjectiveSeveral studies have discussed the relationship between cholesterol and gallstones, and high-density lipoprotein cholesterol (HDL-C) as a representative of this has been addressed in various diseases. The metric neutrophil to high-density lipoprotein cholesterol ratio (NHR) derived from HDL-C has attracted much attention. The purpose of this article is to examine the relationship between NHR and gallstones in a population of American adults.MethodsThis study investigated the correlation between NHR and gallstone prevalence among US adults using population-based data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). NHR was derived by dividing the neutrophil count by HDL-C. Data were analyzed using a variety of statistical techniques, such as univariate analysis, multivariate analysis, and subgroup analysis. In addition, a receiver operating characteristic curve (ROC) was used to determine the predictive power of the index for the risk of gallstone prevalence.ResultsThe trial enrolled 6,954 subjects, among whom 746 patients were diagnosed with gallstones. By fully adjusted multivariate logistic regression analysis in the Model 3 section observed a significant positive association between NHR and gallstones with an odds ratio (OR) of 1.05 and a 95% confidence interval (CI) of (1.01, 1.10). The restricted cubic curve (RCS) had a P-Nonlinear = 0.481, suggesting that the relationship was a near-linear one. The area under the curve (AUC) of the ROC curve was 0.550, indicating that NHR has a predictive value for the development of gallstones.ConclusionThis study demonstrated a near-linear correlation between NHR and increased susceptibility to gallstones, and the ROC curve is evidence that NHR has some predictive value for the risk of gallstones, albeit with weak predictive power relative to NPAR (Neutrophil percentage/albumin) and NAR (Neutrophils/albumin). Of course, to confirm these findings, more extensive prospective studies are needed to thoroughly validate the role of NHR in the development of gallstones.

Monocyte to high-density lipoprotein cholesterol ratio as a marker of the presence and progression of diabetic kidney disease

Background Monocyte to high-density lipoprotein cholesterol ratio (MHR) is considered a novel marker of inflammation. However, whether MHR can predict the risk of diabetic kidney disease (DKD) remains uncertain. Our research aimed to investigate the relationship between MHR and DKD. Methods This was a cross-sectional retrospective study of 159 participants with type 2 diabetes mellitus. MHR, urinary albumin-to-creatinine ratio (UACR) and other indexes were measured. According to UACR, participants were divided into normal group (UACR < 30 mg/g), moderately increased group (UACR 30-300 mg/g) and severely increased group (UACR > 300 mg/g). The association between MHR and DKD was analyzed. Results MHR was significantly elevated in severely increased albuminuria group (p = 0.029). The prevalence of DKD increased in parallel with the elevation in MHR (p = 0.009). MHR was positively related with DKD in univariate logistic regression analysis (ORs = 11.27, 95%CI 1.26-101.24, p = 0.031). Multivariable logistic regression analysis showed MHR significantly correlated with DKD (ORs = 6.20, 95%CI 1.49-25.84, p = 0.012). Each quartile elevation in MHR was associated with an increased risk of DKD (ORs = 1.90, 95%CI 1.19-3.01, p = 0.007). In subgroup analyses MHR was a risk factor for DKD, particularly in patients with HbA1c <8.0%. Conclusions Our findings suggest that MHR can be used as a marker for the presence and progression of DKD.

Association between lymphocyte to high-density lipoprotein cholesterol ratio and insulin resistance and metabolic syndrome in US adults: results from NHANES 2007–2018

BackgroundInsulin resistance (IR) and metabolic syndrome (MetS) are significant global health challenges that increase the risk of various chronic diseases. The lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) has emerged as a novel inflammatory metabolic marker. The present study focused on evaluating the association between the LHR and both IR and MetS.MethodsWe analyzed data from 14,779 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (2007–2018). To investigate the relationship between LHR and both IR and MetS, we conducted multivariable logistic regression analyses. The reliability of the results was validated through both stratified and sensitivity analyses. Furthermore, we thoroughly examined possible nonlinear associations by implementing a restricted cubic spline in conjunction with a threshold effect analysis.ResultsCompared to the lowest LHR quartile, individuals in the highest quartile indicated significantly increased prevalence of IR (odds ratio = 3.72, 95% confidence intervals: 3.01–4.59) and MetS (odds ratio = 11.38, 95% confidence intervals: 8.85–14.63) in fully adjusted models. Subgroup analyses demonstrated that the association between the LHR and IR remained consistent across all subgroups, with no significant interaction effect observed. However, the association between LHR and MetS was more pronounced in female participants. Restricted cubic spline analyses revealed nonlinear associations between LHR and both IR and MetS. The threshold effect analyses identified inflection points at 0.055 for these non-linear relationships.ConclusionsAn elevated LHR was positively associated with the prevalence of IR and MetS, indicating its promising role in early screening and disease prevention through biological monitoring.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and sarcopenia: A cross-sectional study.

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a newly developed lipid parameter that's used to evaluate cardiovascular disease risk. However, its association with sarcopenia risk has not been explored before. Data on NHHR and sarcopenia were based on the secondary analysis of the years 2011-2018 of National Health and Nutrition Examination Survey (NHANES) dataset. NHHR was nature log-transformed (LnNHHR) to achieve a normal distribution. A multivariate logistic regression and a restricted cubic spline (RCS) model adjusted for associated factors were utilized to evaluate the correlation between NHHR and sarcopenia. Subgroup and sensitivity analyses were conducted to verify the robustness of the findings. The study cohort comprised 7069 participants, of whom 6497 (91.91%) were sarcopenia-free, and 572 (8.09%) exhibited sarcopenia. A significant increase in NHHR was observed in the sarcopenia group compared to the non-sarcopenic group (P<0.001). Multivariate logistic regression analysis revealed that sarcopenia was independently linked to NHHR [odds ratio (OR): 1.394, P=0.007]. A linear relationship was identified between NHHR and sarcopenia risk (Pnon-linear=0.108). Interaction analysis indicated that the relationship between NHHR and sarcopenia risk was not significantly modified by gender, sex, poverty income ratio, education, smoking status, or race. NHHR was significantly associated with an elevated risk of sarcopenia among U.S. adults. Further research is warranted to elucidate the underlying physiological mechanisms through which NHHR influences sarcopenia development.

U-shaped association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality risk in obese adults: evidence from NHANES 1999–2018

U-shaped association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality risk in obese adults: evidence from NHANES 1999–2018

The relationship between non-HDL-C/HDL-C ratio and bone mineral density: an NHANES study.

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a newly developed lipid parameter. However, the current research has only explored the relationship with lumbar spine bone mineral density, lacking studies on bone mineral density at other sites, total body bone mineral density, and an analysis of risk factors. This study aims to determine the potential association between NHHR and lumbar BMD, increase awareness of the impact of lipid levels on bone health. By utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, we conducted univariate and generalized linear models (GLMs) analysis, stratified analysis, threshold effect analysis, smooth curve fitting and stratified analysis to investigate the association between NHHR and BMD. NHHR levels were categorized into tertiles (low, medium, and high) based on their distribution among the study population. The study included 8,671participants, studies have shown, the ratio of non-high-density lipoprotein to high-density lipoprotein (NHHR) exhibits a stratified correlation with bone mineral density (BMD). In the BMI subgroup, NHHR is significantly negatively correlated with BMD at multiple sites in the low-to-middle BMI group (BMI <25 kg/m2), while no significant correlation is found in the high BMI group (BMI ≥30 kg/m2). In the gender subgroup, NHHR has a more pronounced effect on male BMD, mainly reflected in the reduction of lumbar spine and total body BMD. In the age subgroup, the negative correlation between NHHR and BMD is strongest in the younger group (18-30 years), gradually weakening in the middle-aged (31-44 years) and older groups (45-59 years). Further analysis suggests that dyslipidemia may influence bone metabolism through pathways such as inflammation and oxidative stress. The effect of NHHR on bone mineral density (BMD) varies by BMI, gender, and age. This study suggests that controlling NHHR levels may be a potential intervention target for bone health management, particularly for individuals with low-to-middle BMI, males, and younger populations. These findings offer a new perspective on the relationship between lipid metabolism and bone metabolism and provide scientific evidence for the development of personalized osteoporosis prevention and treatment strategies.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and telomere length: the NHANES 1999-2002.

The relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and telomere length (TL) remains unclear. This study aims to investigate their association in a nationally representative US population. Data from 6,342 adults aged ≥20 were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. The NHHR was calculated and categorized into tertiles. TL was measured as the telomere-to-standard reference DNA ratio. Multivariate linear regression and smooth curve fitting were employed to assess the association between NHHR and TL. The study population (mean age 45.1 ± 0.4 years, 48.9% male) was stratified into NHHR tertiles. Compared with the lowest NHHR tertile, the highest NHHR tertile was associated with adverse inflammatory and cardiometabolic profiles, including elevated white blood cell counts (6.88 ± 0.07-7.54 ± 0.08 × 109/L) and increased prevalence of hypertension (18.81%-25.71%) and diabetes (3.38%-7.17%). An elevated NHHR was significantly associated with a shorter TL (T/S ratio: 1.09 ± 0.02-1.03 ± 0.02; P = 0.0005). This association remained significant in partially adjusted models but was attenuated in a fully adjusted model. Significant interactions were observed for age and hypertension status. This study revealed a linear inverse association between NHHR and TL, suggesting the utility of the NHHR as a novel biomarker for biological aging. Further prospective studies are warranted to validate these findings.

Associations of neutrophil/high-density lipoprotein cholesterol ratio with frailty and its mortality.

Frailty is an increasingly important determinant in the field of health, and its identification has important clinical significance in the field of critical care medicine. However, there are still a large number of challenges in quick and accurate identification of frailty. This study aims to evaluate the value of the neutrophil/high-density lipoprotein cholesterol ratio (NHR) in frailty and its long-term survival. Adult participants from seven study cycles of the National Health and Nutrition Examination Survey (NHANES) database were included. Frailty was assessed with a 49-item Frailty Index (FI). Weighted logistic regression, restricted cubic spline (RCS), and Cox regression were used to analyze the association of NHR with frailty and its long-term survival. In addition, subgroup and interaction analyses were also performed. A total of 34,382 adult participants aged 47.6 on average were included, and 16,950 (48.8%) of them were males. After the adjustment of potential confounding variables, an increase of one standard deviation (SD) in NHR resulted in the increase of the incidence of frailty by 11% (OR: 1.11, 95% CI: 1.04-1.18, P = 0.002). RCS showed a J-shaped association between NHR and frailty, which was robust in all subgroups according to the subgroup analysis. In addition, the survival analysis revealed that NHR was significantly positively associated with all-cause (HR: 1.12, 95% CI: 1.07-1.17, P < 0.0001), cardiocerebrovascular disease (CCD)-specific (HR: 1.21, 95% CI: 1.11-1.33, P < 0.0001), and cancer-specific mortality risks (HR: 1.13, 95% CI: 1.07-1.19, P < 0.0001) in frail individuals. In the American adult population, NHR maintains a J-shaped relationship with frailty. In addition, NHR can help predict long-term mortality in frail individuals. This study demonstrates that NHR may become an effective predictor of frailty and its mortality.

The predictive value of estimated glucose disposal rate and its association with myocardial infarction, heart failure, atrial fibrillation and ischemic stroke.

The relationship between the incidence of major cardiovascular diseases (CVDs) and estimated glucose disposal rate (eGDR), a proxy measurement for insulin resistance (IR), is not well understood in the general population. The predictive value of eGDR and other proxies of IR for CVD incidents have not been examined in previous studies. This study aimed to investigate the association between eGDR and various CVD events, including myocardial infarction (MI), heart failure (HF), atrial fibrillation (AF) and ischemic stroke. Additionally, the predictive values of eGDR, triglyceride-glucose (TyG) index, TyG-waist circumference (WC), TyG-body mass index (BMI), TyG-waist-to-height ratio (WHtR), triglyceride (TG)-to-high density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) and the metabolic score for insulin resistance (METS-IR) for CVD events were compared. The study population was extracted from the UK Biobank, and the CVD events were documented by linking to hospital records. Cox proportional hazards model and the restricted cubic spline model were used to assess the association between eGDR and the risk of CVDs with adjustment for potential confounders. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive values of eGDR, TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR. A total of 360 953 participants were included in this study. During a median follow-up of 13.8 years, 12 698 MI, 10 360 HF, 23 638 AF and 6512 ischemic stroke events were documented. Compared with participants in the lowest quartile category of eGDR, those in the highest quartile category had the adjusted hazard ratio (HR) and 95% confidence interval (CI) of 0.59 (0.51-0.67) for MI, 0.66 (0.56-0.76) for HF, 0.88 (0.80-0.98) for AF and 0.73 (0.61-0.89) for ischemic stroke. eGDR outperformed TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR in terms of predicting MI (AUC: 0.661), HF (AUC: 0.690), AF (AUC: 0.653) and ischemic stroke (AUC: 0.646). eGDR was inversely associated with the incidence of MI, HF, AF and ischemic stroke in the general population. eGDR could serve as a more valuable predictive indicator than TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR for CVD events in clinical practice.

Estimated Glucose Disposal Rate predicts the risk of incident Metabolic dysfunction-associated steatotic liver disease.

There is a relationship between insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD) and the estimated glucose disposal rate (eGDR) has been reported as a surrogate marker of insulin resistance. This study aimed to investigate the association between eGDR and the incident MASLD, and compare the ability to predict incident MASLD with other insulin resistance markers. Retrospective cohort data from a health check-up program were analyzed. Participants were categorized into four subgroups according to eGDR quartiles. To assess the association between eGDR quartiles and incident MASLD, logistic regression analyses were used. Additionally, to compare the predictive ability of eGDR, triglyceride/HDL cholesterol (TG/HDL) ratio, and triglyceride glucose (TyG) index with respect to incident MASLD, receiver operating characteristics (ROC) analysis was used. Of 16,689 participants were included, and 3,654 developed MASLD. After multivariate adjustment, compared with the lowest eGDR quartile, odds ratios (95% confidence interval [CI]) for incident MASLD in the second, third, and highest GDR quartiles, were 0.775 (0.692-0.868), 0.478 (0.408-0.560) and 0.147 (0.110-0194), respectively. The association between lower eGDR levels and MASLD risk remained consistent across stratification by sex and obesity status. Moreover, the area under the ROC curve (95% CI) for eGDR (0.8 [0.79-0.81]) was higher than for TG/HDL ratio 0.76 [0.79-0.81]) and TyG index (0.75 [0.74-0.76]). Lower eGDR levels were associated with an increased risk of incident MASLD. Our findings suggest that eGDR may be a more effective tool for predicting MASLD risk.

Association Between Four Non-Insulin-Based Insulin Resistance Indices and the Risk of Post-Stroke Depression.

Research suggests that insulin resistance (IR) is associated with acute ischemic stroke (AIS) and depression. The use of insulin-based IR assessments is complicated. Therefore, we explored the relationship between four non-insulin-based IR indices and post-stroke depression (PSD). A total of 638 consecutive AIS patients were enrolled in this prospective cohort study. Clinical data were collected to compute indices such as the triglyceride glucose (TyG) index, triglyceride glucose-body mass index (TyG-BMI), insulin resistance metabolic score (METS-IR), and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C). One month post-stroke, neuropsychological assessments were conducted using the 17-item Hamilton Depression Scale. Binary logistic regression analysis was performed to explore the relationship between the four non-insulin-based IR indices and PSD. Ultimately, 381 patients completed the 1-month follow-up, including 112 (29.4%) with PSD. The PSD group exhibited significantly higher levels of the four IR indices compared to the non-PSD group. Logistic regression analysis demonstrated that these indicators were independently associated with PSD occurrence, both before and after adjusting for potential confounders (all P < 0.001). Tertile analyses indicated that the highest tertile group had a greater risk of PSD occurrence than the lowest tertile group for four IR indicators, even after adjusting for potential confounders (all P < 0.05). Restricted cubic spline analysis revealed a linear dose-response relationship between the four IR indices and PSD. In the subgroup analysis, only the TyG index showed a significant interaction with diabetes (P for interaction = 0.014). The area under curve values for the TyG index, TyG-BMI, METS-IR, and TG/HDL-C were 0.700, 0.721, 0.711, and 0.690, respectively. High TyG index, TyG-BMI, METS-IR, and TG/HDL-C at baseline were independent risk factors for PSD in AIS. Each of these indicators exhibits predictive value for PSD occurrence, aiding in the early identification of high-risk groups.

Correlation between serum uric acid to high-density lipoprotein cholesterol ratio and cardiometabolic multimorbidity in China: a nationwide longitudinal cohort study

Correlation between serum uric acid to high-density lipoprotein cholesterol ratio and cardiometabolic multimorbidity in China: a nationwide longitudinal cohort study