Density Lipoprotein Cholesterol Ratio Research Articles

A cross-sectional analysis of the relationship between the non-high density to high density lipoprotein cholesterol ratio (NHHR) and kidney stone risk in American adults

BackgroundRecent interest in the Non-High Density to High Density Lipoprotein Cholesterol ratio (NHHR) has emerged due to its potential role in metabolic disorders. However, the connection between NHHR and the development of kidney stones still lacks clarity. The primary goal of this research is to explore how NHHR correlates with kidney stone incidence.MethodsAn analysis was conducted on the data collected by the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, focusing on adults over 20 years diagnosed with kidney stones and those with available NHHR values. Employing weighted logistic regression and Restricted Cubic Spline (RCS) models, NHHR levels’ correlation with kidney stone risk was examined. Extensive subgroup analyses were conducted for enhanced reliability of the findings.ResultsThe findings indicate a heightened kidney stone risk for those at the highest NHHR levels relative to those at the lowest (reference group). A notable non-linear correlation of NHHR with kidney stone incidence has been observed, with a significant P-value (< 0.001), consistent across various subgroups.ConclusionA clear link exists between high NHHR levels and increased kidney stone risk in the American adult population. This study highlights NHHR’s significance as a potential indicator in kidney stone formation.

The assessment of serum uric acid-to-HDL cholesterol ratio as a new predictor of mortality in ST-elevation myocardial infarction: a cross-sectional study

Aims: The objective of this study was to evaluate the predictive efficacy of the Uric Acid-to-High Density Lipoprotein Cholesterol Ratio (UHR) as a novel inflammatory and metabolic marker for mortality in patients with ST-segment Elevation Myocardial Infarction (STEMI).&#x0D; Methods: This retrospective, single-center, cross-sectional, observational study enrolled 1361 patients diagnosed with STEMI undergoing primary percutaneous coronary intervention (PPCI) from March 2021, to January 2022. The participants were categorized into two groups: those experiencing in-hospital mortality (n=100) and those without in-hospital mortality (n=1265).&#x0D; Results: In-hospital mortality occurred in 100 patients (7.3%). UHR was notably higher in the mortality group compared to the non-mortality group (23.6±14.9% vs. 15.3±6.9%, p

Monocyte-to-Hdl-Cholesterol Ratio as a Prognostic Marker in Covid-19

Background: There is an urgent need for mortality predictors for COVID-19 so that clinicians can diagnose severe cases and triage them as soon as possible. Many studies have suggested using hematologic markers to predict mortality and severity of COVID-19 disease. This study investigates the use of monocyte-to-high density lipoprotein cholesterol ratio (MHR) as a predictive marker for COVID-19 severity and mortality. Methods: This retrospective cross-sectional study was performed on 81 PCR-confirmed COVID-19 patients between 25 March 2020 to 26 June 2020. Patients were classified into two presentation categories: the non-severe group (n=37) and the severe group (n=44). Patients in the severe group were also divided into two subgroups: severe survivors (n=14) and severe non-survivors (n=30). In the receiver operating characteristic (ROC) analysis, optimal cut-off values of the monocyte count, high-density lipoprotein cholesterol (HDL-C), and MHR were calculated for the differentiation of severe and non-severe COVID-19 patients, as well as survivors and non-survivors. Results: A total of 81 patients, 29 (35.8%) males and 52 (64.2) females, with a median age of 71 (IQR 63-81) years. Both HDL-C and MHR showed a reasonable ability to distinguish severe disease from non-severe disease, while MHR had a higher area under curve (AUC) than HDL-C (0.799, 95%CI 0.704-0.894, p 0.001 vs 0.734, 95% Cl 0.626-0.843, p 0.001). Only MHR could distinguish survivors from non-survivors with an ROC AUC of 0.735 (95%Cl 0.619-0.850). The optimal cut-off values of MHR for predicting severe disease were 0.0061 (sensitivity: 66% and specificity: 66%) and 0.0066 (sensitivity: 70% and specificity: 62%) for predicting mortality. The optimal cut-off value of MHR for predicting severe disease was 0.0061 (sensitivity: 66% and specificity: 66%), and it was 0.0066 for predicting mortality among patients with severe disease (sensitivity: 70% and specificity: 62%). Conclusion: Our results showed that MHR was observed to be able to distinguish severe COVID-19 patients from non-severe patients as well as survivors from non-survivors.

Association of inflammatory and hematological indices with left ventricular hypertrophy in hypertensive patients

Objective. To identify an associative relationship between inflammatory indicators, hematological indices and left ventricular hypertrophy (LVH) in patients with uncontrolled arterial hypertension (HTN). Design and methods. We examined 130 patients with uncomplicated essential HTN I–II with ineffective blood pressure (BP) control (≥ 140/90 mmHg). All patients underwent a clinical examination with determination of risk factors, indicators of inflammation — high-sensitivity C-reactive protein (hs-CRP), interleukin‑1β (IL‑1β), interleukin‑6 (IL‑6), interleukin‑8 (IL‑8), tumor necrosis factor α (TNF-α), hematological indices — systemic immune inflammation index (SII), the monocyte to high density lipoprotein cholesterol ratio (MHR), the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), and echocardiography. Results. The positive correlations were found between the indicators of nonspecific inflammation and signs of LVH — MHR and left ventricular myocardial mass index (LVMI) (r = 0,448; p &lt; 0,001), the posterior wall thickness (PWT) of left ventricle (LV) in the diastole (r = 0,256; p = 0,003), the interventricular septum (IVS) thickness in the diastole (r = 0,311; p ≤ 0,001); the level of hs-CRP and the relative wall thickness (RWT) (r = 0,283; p = 0,002), PWT of LV in the diastole (r = 0,202; p = 0,043), IVS thickness in the diastole (r = 0,231; p = 0,011); the level of IL‑6 and the PWT of LV in the diastole (r = 0,215; p = 0,018); SII and IVS thickness in the diastole (r = 0,230; p = 0,009), the RWT (r = 0,205; p = 0,016); NLR and IVS thickness in the diastole (r = 0,227; p = 0,009), PWT of LV in the diastole (r = 0,205; p = 0,029), RWT (r = 0,206; p = 0,016). Using multiple linear regression, independent factors associated with increased LVMI in HTN patients were male sex (β = 0,201), waist circumference (WC) (β = 0,258) and MHR (β = 0,236) (p = 0,029). Independent factors for increasing PWT of LV in the diastole in HTN patients were WC (β = 0,354) and male sex (β = 0,266) (p = 0,003); increase of IVS thickness in the diastole — SII (β = 0,254), WC (β = 0,392) and male sex (β = 0,219) (p = 0,021); and an increase of RWT — hs-CRP (β = 0,333) (p = 0,001). Conclusions. In patients with uncontrolled HTN increased levels of hs-CRP, IL‑6, SII, MHR and NLR were associated with echocardiographic LVH criteria—LVMI, PWT and IVS thickness in the diastole, RWT. Independent factors for increasing LVMI were WC, male sex and MHR; IVS thickness in the diastole — SII, WC and male; RWT — hs-CRP.

Predictive cut-off values for the triglyceride-to-high-density lipoprotein cholesterol ratio to predict metabolic syndrome in the middle-aged Korean population

Background and aimsThe triglyceride-to-high density lipoprotein cholesterol (TG/HDL) ratio is associated with insulin resistance related diseases, including metabolic syndrome (MetS). However, specific TG/HDL values that can predict MetS have not been well identified. In this study, we analyzed both cross-sectional and longitudinal data from two national Korean datasets to obtain TG/HDL cut-off values that can identify MetS and predict its occurrence. Methods and resultsTo distinguish the presence and occurrence of MetS, the cut-off values were determined using the maximum F-score calculated through a logistic regression analysis. To predict new-onset MetS within 10 years, Cox proportional hazard models were used to consider the time of occurrence. The TG/HDL cut-off values of 3.97, 3.24, and 3.24 were optimal for identifying current MetS and predicting new-onset MetS within 10 years and five years, respectively, in Korean men. In Korean women, the optimal values for each task were 3.18, 2.38, and 2.26, respectively. ConclusionsWe suggest the TG/HDL ratio as a potential candidate predictor for MetS. Therefore, we anticipate that future studies will apply individual lipid levels as well as their combinatory values to establish models that predict the prevalence and occurrence of MetS, diabetes, and cardiovascular disease.

Association of atherogenic indices with myocardial damage and mortality in COVID-19.

Lipoproteins in cell membranes are related to membrane stability and play a role against microorganisms. Patients with COVID-19 often experience myocyte membrane damage. This study aimed to search the relationship of atherogenic indices with myocardial damage and mortality in COVID-19. This was an observational, single-center, retrospective study. The study population was grouped according to in-hospital mortality. C-reactive protein (CRP), CRP to albumin ratio (CAR), monocyte to high density lipoprotein cholesterol ratio (MHR), levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc) and cardiac troponin I (cTnI) were recorded. Atherogenic indices (plasma atherogenic index [AIP], atherogenic coefficient [AC], Castelli's risk indices I and II [CRI I and II], triglyceride to HDLc ratio (THR) were calculated. A total of 783 patients were included. The mortality rate was 15.45% (n = 121). The median age of non-survivor group (NSG) was higher than survivor group (SG) [66.0 years (Q1 -Q3: 55.0-77.5) vs 54.0 years (Q1 -Q3: 43.0-63.0)] (p < 0.001). Study parameters which were measured significantly higher in the NSG were CRP, cTnI, triglyceride, CRI-I, CRI-II, AC, AIP, ferritin, CAR, MHR and THR. LDLc, HDLc, TC and albumin were significantly lower in NSG (p<0.001). THR is positively correlated with myocardial damage and strongly predicts in-hospital mortality in COVID-19.

Maternal fibrinogen/fibrin degradation products to high density lipoprotein cholesterol ratio for predicting delivery of small and large for gestational age infants: a pilot study

BackgroundThe purpose of this pilot study was to investigate associations between fibrinogen/fibrin degradation products (FDP) to high density lipoprotein-cholesterol (HDL-C) ratio (FHR) of mothers and the risk of delivering large/small for gestational age (LGA/SGA) infants and to evaluate the predictive power of FHR on LGA/SGA.MethodsThis study retrospectively reviewed 11,657 consecutive women whose lipid profiles and FDP levels were investigated at the time of admission for delivery at a specialized hospital. The FHR was calculated, and perinatal outcomes, including clinical parameters, were analyzed.ResultsThe prevalence of SGA was 9% (n = 1034), and that of LGA was 15% (n = 1806) in this cohort study. FHR was significantly lower in women who delivered SGA infants (4.0 ± 3.2 vs. 4.7 ± 3.3 mg/mmol, P < 0.01) and higher in women who delivered LGA infants (5.7 ± 3.8 vs. 4.7 ± 3.3 mg/mmol, P < 0.01) compared with those who delivered infants of normal size for their gestational age. Women in the top quartile for FHR (> 5.9 mg/mmol) had a 2.9-fold higher risk of delivering LGA infants [adjusted odds ratio (OR) = 2.9, P < 0.01] and a 47% lower risk of delivering SGA infants (adjusted OR = 0.47, P < 0.01) than those in the bottom quartile (< 2.7 mg/mmol). In addition, adding FHR to the conventional models significantly improved the area under the curve for the prediction of delivering LGA (0.725 vs. 0.739, P < 0.01) and SGA (0.717 vs. 0.727, P < 0.01) infants.ConclusionThese findings suggest that the FHR calculated in late pregnancy is an innovative predictor of delivering LGA and SGA infants. Combining FHR with perinatal parameters could thus enhance the predictive ability for predicting the delivery of LGA/SGA infants.

Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study.

Both alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDL-C) are closely related to glucose homeostasis in the body, and the main objective of this study was to investigate the association between ALT to HDL-C ratio (ALT/HDL-C ratio) and the risk of diabetes in a Chinese population. The current study included 116,251 participants who underwent a healthy physical examination, and the study endpoint was defined as a diagnosis of new-onset diabetes. Multivariate Cox regression models and receiver operator characteristic curves were used to assess the association of the ALT/HDL-C ratio with diabetes onset. During the average observation period of 3.10 years, a total of 2,674 (2.3%) participants were diagnosed with new-onset diabetes, including 1,883 (1.62%) males and 791 (0.68%) females. After fully adjusting for confounding factors, we found a significant positive association between the ALT/HDL-C ratio and the risk of diabetes [Hazard ratios 1.06, 95% confidence intervals: 1.05, 1.06], and this association was significantly higher in males, obese individuals [body mass index ≥ 28 kg/m2] and individuals aged < 60 years (All P interaction < 0.05). In addition, the ALT/HDL-C ratio was significantly better than its components ALT and HDL-C in predicting diabetes in the Chinese population. There was a positive relationship between ALT/HDL-C ratio and diabetes risk in the Chinese population, and this relationship was significantly stronger in males, obese individuals, and individuals younger than 60 years old.

Association of remnant cholesterol and newly diagnosed early-onset type 2 diabetes mellitus in Chinese population: A retrospective cross-sectional study.

With the increasing incidence of diabetes worldwide, patients diagnosed with diabetes has been getting younger. Previous studies have shown that high remnant cholesterol (RC) level leads to an increased risk of cardiovascular disease events. However, the relationship between RC levels and newly diagnosed early-onset type 2 diabetes mellitus (T2DM) is unknown. This study aimed to explore the association between RC and newly diagnosed early-onset T2DM. A total of 606 patients newly diagnosed with early-onset T2DM and 619 gender-matched subjects with normal blood glucose levels were retrospectively enrolled in this study. All T2DM patients showed onset age of 18-40 years. Binary logistic regression analysis was performed to analyze independent risk factors and receiver operating characteristic (ROC) analysis was used to explore the predictive value of RC and other unconventional lipids. Moreover, the correlation between RC and insulin resistance in patients with newly diagnosed early-onset T2DM was also examined with binary logistic regression analysis and Spearman correlation analysis. Increased RC level was an independent risk factor for early-onset T2DM (p < .05). The area under the curve on ROC analysis of RC was 0.805, 95% confidence interval (CI) was 0.781 ~ 0.826, sensitivity was 82.18% and specificity was 66.24%, which showed higher predictive value than those of triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and total cholesterol (TC)/HDL-C ratio. Cutoff value of RC was 0.32 mmol/L. Level of RC in early-onset T2DM patients with moderate or severe insulin resistance was significantly higher than that in patients with mild insulin resistance (p < .0001). No difference in RC levels was found between patients with moderate and severe insulin resistance (p > .05). RC was still correlated with insulin resistance after adjusting the conventional lipid parameters (TG, TC, HDL-C, and low-density lipoprotein cholesterol) using partial correlation analysis. RC level was higher in patients with early-onset T2DM and was correlated to the degree of insulin resistance as well. Patients aged 18-40 years with RC >0.32 mmol/L showed an increased risk of developing T2DM.

Women's heart clinics to prevent cardiovascular disease in women with pregnancy-related risk factors: a prospective study

Abstract Background A woman’s risk of cardiovascular disease (CVD) is substantially increased after a diagnosis of hypertensive disorders of pregnancy (HDP), gestational diabetes (GDM), or have had a small for gestational age (SGA) baby. However, evidence for models of care that mitigate CVD risk in women with these pregnancy-related conditions is lacking. Purpose To assess the effectiveness of a Women’s Heart Clinic (WHC) on blood pressure (BP) and lipid control in women with past pregnancy-related cardiovascular risk factors. Method A six-month prospective cohort study of women aged 30-55 years with a past pregnancy diagnosis of HDP, GDM or an SGA baby. All women attended a multidisciplinary WHC comprising a cardiologist, a cardiac nurse, and a dietician, located in three cardiovascular healthcare service centers in Australia. Women were assessed at their first attendance of the WHC and at 6 months. The co-primary endpoints were: 1) BP&amp;lt;140/90mmHg or &amp;lt;130/80mmHg if diabetes mellitus and 2) total cholesterol to high density lipoprotein-cholesterol ratio (TC:HDL-C)&amp;lt;4.5. Results 156 women were recruited with a mean age of 41.0±4.2 years, 68.6% Caucasian, 20.5% South/East Asian and 80.5% university educated. Women were a mean of 3.9±2.9 years from last delivery with 23.1% past HDP only, 60.3% GDM only, 13.5% both HDP and GDM and, 3.2% with an SGA baby. All women attended a WHC at least once, with 69.5% reviewed by a dietician. The proportion meeting BP target increased (69.2% to 80.5%, p=0.004); with no significant change in women meeting lipid targets (80.6% to 83.7%, p=0.182). Women had significant reductions in mean systolic BP (-6.9mmHg, 95% confidence interval (CI): -9.1,-4.7, p&amp;lt;0.001), body mass index (-0.6kg/m2, CI: -0.8,-0.3, p&amp;lt;0.001), LDL-cholesterol (-4.2mg/dL, CI: -8.2,-0.2, p=0.042) and total cholesterol (-4.6mg/dL, CI: -9.1,-0.2, p=0.042). Heart-healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%, p=0.012) and decreased fast food consumption (33.8% to 11.0%, P&amp;lt;0.001), with more women meeting exercise recommendations (84.0% to 92.9%, p=0.025). Conclusion Women at high risk for CVD due to past pregnancy-related conditions experienced significant improvements in multiple cardiovascular risk factors, after attending a Women’s Heart Clinic. This female-specific cardiovascular healthcare model has the potential to improve long-term CVD outcomes for women.Figure 1:Visual abstract

Abstract 187: Nontraditional Lipid Indices and Intracranial Atherosclerotic Stenosis Burden

Introduction Expert consensus guidelines recommend low‐density lipoprotein cholesterol (LDL‐C) as the primary serum lipid target for recurrent stroke risk reduction. Nontraditional lipid variables including triglycerides/high‐density lipoprotein cholesterol (HDL‐C) ratio and total cholesterol/HDL‐C ratio are linked to a vascular risk as a residual risk factor. Since intracranial atherosclerotic stenosis (ICAS)‐related stroke is prevalent in Asian population, we evaluated the relationship between lipid indices and ICAS burden. Methods We analyzed consecutively enrolled 1220 patients with acute ischemic stroke from March 2009 to May February 2013, who underwent brain MRI and MRA. ICAS was defined as &gt;/=50% stenosis and quantified by presence, &gt;/=2, and &gt;/=3. Study patients were divided into four groups according to level of nontraditional lipid variables: triglycerides/HDL‐C, total cholesterol/HDL‐C ratio, and low‐density lipoprotein cholesterol (LDL‐C)/HDL‐C ratio, and non‐HDL‐C. Independent associations of 4 lipid variables with ICAS were assessed. Results Table shows multivariable adjusted odds of ICAS by Increasing strata of each lipid indices. Compared with the lowest triglycerides/HDL‐C quartile, stepwise relationships were observed between increasing quartiles and the presence of ICAS (adjusted OR 1.04, 95% CI 0.68–1.58; 1.06, 0.69–1.62; and 1.80, 1.17–2.77), ICAS &gt;/=2 (1.32, 0.83–2.09; 1.32, 0.82–2.11; and 1.72, 1.07–2.74), and ICAS &gt;/=3 (2.49, 1.32–4.69; 2.98, 1.58–5.63; and 3.18, 1.67–6.04). Compared with the lowest total cholesterol/HDL‐C ratio, stepwise relationships were observed with ICAS &gt;/=2 (1.51, 0.90–2.54; 1.56, 0.90–2.68; and 2.03, 1.00–3.74), and ICAS &gt;/=3 (1.67, 0.84–3.33; 2.22, 1.10–4.51; and 2.63, 1.20–5.77). Relationships between LDL‐C/HDL‐C ratio and ICAS burden showed similar pattern to findings from total cholesterol/HDL‐C. Association between non‐HDL‐C and ICAS was not significant. Conclusion Among four lipid indices, elevated triglycerides/HDL‐C is more likely associated with ICAS burden. HDL‐C might exert as a crucial role for developing ICAS.

Effect of pregnancy and lactation on the serum lipid profiles: cholesterol and triacylglycerol ratios of apparently healthy large white sows

This study evaluated the effects of pregnancy and lactation on the serum lipid profiles of large white (LW) sows. Twenty (20) sexually matured LW sows and three (3) LW boars, of mean weight 45.38±1.29 kg, aged between 8 and 10 months were used for this study. The sows were randomly assigned to five groups (A to E) of four sows per group in a completely randomized design (CRD). Group A: Non pregnant (control), Group B: Early gestation (38 days), Group C: Mid gestation (78 days), Group D: Late gestation (112 days) and Group E: Post gestation (14 days postpartum). Blood samples were collected during five stages of gestation. The mean total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) concentrations of group A (non-mated or control group) were significantly (p &lt; 0.05) higher than groups B and C. The mean total cholesterol:high density lipoprotein cholesterol (TC/HDL-C) and low density lipoprotein cholesterol:high density lipoprotein cholesterol (LDL-C/HDL-C) ratios of the postpartum sows were significantly (p &lt; 0.05) lower than group C. There were however no significant (p &gt; 0.05) variations in the mean triacylglycerol (TAG), low density lipoprotein cholesterol (LDL-C), triacylglycerol:high density lipoprotein cholesterol (TAG/HDL-C) ratio and very low density lipoprotein cholesterol (VLDL-C) concentrations among all the groups. This present study has presented preliminary information on the changes of serum lipid profiles, cholesterol and triacylglycerol ratios during gestation in LW sows that can be sought by the scientific community

Effects of 12 Weeks of Continuous Exercise and Accumulation of Short-Duration Exercise on Body Composition, Physical Fitness, and Lifestyle Disease indices in Overweight Men in their 30s

PURPOSE This study aimed to investigate the effects of continuous exercise and the accumulation of short-duration exercise for 12 weeks on body composition, physical fitness, and lifestyle disease indices in overweight men in their 30s.METHODS Participants in the continuous exercise group (CE; &lt;i&gt;n&lt;/i&gt;=13) performed a circuit exercise program of 30 min/session, 3 sessions/week for 12 weeks. Participants in the accumulation of short duration exercise group (ASE; &lt;i&gt;n&lt;/i&gt;=12) performed the same exercise time of 30 min per day, divided into three sessions of 10 min. Body composition, physical fitness, and lifestyle disease indices were measured pre- and post-test and were compared by utilizing a repeated two-way ANOVA.RESULTS 1) Regarding body composition, body weight, body mass index, skeletal muscle mass, waist circumference, and fat mass decreased significantly, while hip circumference increased significantly in the CE group. Waist circumference and skeletal muscle mass decreased significantly, while hip circumference increased significantly in the ASE group. 2) Regarding physical fitness, right grip strength, sit and reach, sit up, and maximal oxygen uptake increased significantly in both groups. 3) Regarding hypertension indices, there were no significant differences in both groups, but they showed a tendency to improve. 4) Regarding hyperlipidemia indices, triglycerides (TG) decreased significantly in both groups, and total cholesterol (TC) decreased significantly in the CE group. 5) Regarding diabetes indices, there were no significant differences in both groups, but a tendency to improve was noticed. 6) Regarding arteriosclerosis indices: TG/high density lipoprotein-cholesterol ratio decreased significantly in both groups, and the TC/high density lipoprotein-cholesterol ratio decreased significantly in the CE group.CONCLUSIONS We concluded that both the accumulation of short duration exercise and continuous exercise can be effective in improving body composition, physical fitness, and lifestyle disease in overweight men.

Association between serum uric acid to high density lipoprotein-cholesterol ratio and arterial stiffness in a Japanese population.

Uric acid (UA) and HDL-cholesterol (HDL-C) level are closely associated to the cardiovascular disease (CVD) morbidity. The UA/HDL-C ratio (UHR), a new parameter combination of serum UA and HDL-C, attracts attention for its association with metabolic and inflammatory conditions. There may exists the association between UHR and arterial stiffness. This study aims to explore the association between the UHR and brachial-ankle PWV (baPWV) and to determine whether or not UHR has effect on arterial stiffness. The present study included a total of 912 Japanese (592 men and 320 women), aged from 24 to 84, received a health medical checkup programme with an automatic waveform analyzer to measure baPWV and various standardized questionnaires in a medical center of Japan. Non-linear regression and threshold effect analysis were conducted to explore the association between UHR and baPWV. It was found that UHR was positively correlated with baPWV after adjusting for multiple confounders. A non-linear relationship (with a inflection point was 14.25) was found between UHR and baPWV. Subgroup analyses showed that the significant association between UHR and baPWV only existed in females group, no fatty liver group and normal BMI groups. This study revealed the nonlinear relationship between UHR and baPWV. A significant correlation between UHR and baPWV existed in females but not in males. Fatty liver status, BMI, and menopausal status may affect the above association.

Monocyte-to-High Density Lipoprotein Cholesterol Ratio Positively Predicts Coronary Artery Disease and Multi-Vessel Lesions in Acute Coronary Syndrome.

We investigated the hypothesis that MHR (monocyte-to-high density lipoprotein cholesterol ratio) is related to the severity of coronary artery in ACS (acute coronary syndrome). In this case-control study, we recruited 15,853 participants undergoing the first time percutaneous coronary intervention (PCI) including 4093 normal controls, 10,518 chronic coronary artery disease (CAD), and 1242 ACS cases. Examination of demographic clinical data and biochemical profiles, as well as MHR values, were performed before PCI. The relationship between MHR and severity of coronary artery lesion in ACS was analyzed. We also used a flow cytometric assay to distinguish CD14+/CD16- classical monocyte subsets in peripheral blood mononucleated cells from CAD patients. MHR was higher in patients with ACS compared with MHR in normal control and chronic CAD (normal control vs chronic CAD vs ACS: 0.46 ± 0.27 × 109/mmol vs 0.53 ± 0.29 × 109/mmol vs 0.73 ± 0.47 × 109/mmol, P < 0.001). MHR showed a significantly progressive increase as the angiographic severity of coronary lesions increased (single vessel lesion vs multi-vessel lesions in ACS: 0.54 ± 0.31 × 109/mmol vs 0.58 ± 0.35 × 109/mmol, P < 0.001), and classical monocyte subset to HDL-C ratio (CMHR) was increased in with CAD patients compared with control [4.69 (IQR, 1.06, 2.97) × 103/mmol vs 1.92 (IQR, 0.92, 3.04) × 103/mmol, P = 0.02]. Using a multivariate analysis, after adjusting for age, gender, body mass index (BMI), diabetes, and dyslipidemia, MHR was positively associated with multi-vessel lesions in ACS [OR (odds ratio): 1.28 (95% CI: 1.03-1.59, P = 0.029)]. MHR level could be a potential predictor of coronary artery lesion severity in ACS.

Relationship between Uric Acid to High Density Lipoprotein Cholesterol Ratio and Nonalcoholic Fatty Liver Disease in Nonoverweight/Obese Patients with Type 2 Diabetes.

To investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) levels and nonalcoholic fatty liver disease (NAFLD) in nonoverweight/obese patients with type 2 diabetes. A retrospective study was designed including a total of 343 inpatients with type 2 diabetes whose BMI<24 kg/m2. The population was divided into three groups as the UHR tertiles. Logistic regression analysis was performed to estimate odds ratios (ORs) of UHR for NAFLD. ROC curve analysis was used to estimate the diagnostic value of UHR for NAFLD. The prevalence rat of NAFLD enhanced progressively from the tertile 1 to tertile 3 of UHR (30.70% vs. 56.52% vs. 73.68%). Logistic regression analysis showed that participants in the higher UHR groups, compared with those in the first tertile group, had higher occurrence risks for NAFLD. The positive association between UHR and NAFLD was independent of age, BMI, blood pressure, hepatic enzymes, and other components of metabolic disorders. ROC curve analysis showed that the area under curve (AUC), sensitivity, and specificity for UHR were 0.697, 0.761, and 0.553, respectively. In type 2 diabetic patients without overweight or obesity, UHR is significantly associated with NAFLD and can be used as a novel and useful predictor for NAFLD onset.

The Predictive Role of Hematological Parameters in Hypertension.

Hypertension (HT) is a common chronic disease that often causes target-organ damage and severe complications, contributing to cardiovascular morbidity and mortality worldwide. Accumulating evidence suggests that inflammation plays a prominent role in the initiation and progression of HT. Multiple inflammatory biomarkers have been proposed to predict HT. Several new hematological parameters can reflect the inflammatory response and platelet activation. The major advantage of hematological parameters over conventional inflammatory markers is that they are relatively inexpensive and easily obtained from routine blood tests. Numerous studies have investigated several hematological parameters for their utility as predictive biomarkers for the diagnosis and prognosis of HT. Among them, the neutrophil to lymphocyte ratio (NLR), monocyte to high density lipoprotein cholesterol ratio (MHR), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and systemic immune-inflammation index (SII) have recently received attention. We searched PubMed and Embase databases (up to September 18, 2022) to assess the relationships between hematological parameters and HT. This review discusses the diagnostic and prognostic value of these hematological parameters in HT, providing an important basis for early screening, risk stratification, and optimal management of hypertensive patients.

Application of systemic inflammation indices and lipid metabolism-related factors in coronary artery disease.

We aimed to investigate the relationship between coronary artery disease (CAD) and systemic inflammation indices and lipid metabolism-related factors and subsequently, discuss the clinical application of these factors in CAD. We enrolled 284 consecutive inpatients with suspected CAD and divided them into a CAD group and a non-CAD group according to coronary angiography results. Serum levels of angiopoietin-like protein 3 (ANGPTL3), angiopoietin-like protein 4 (ANGPTL4), fatty acid-binding protein 4 (FABP4), and tumor necrosis factor-α (TNF-α) levels were assessed using the ELISA and the systemic inflammation indices were calculated. Multivariate logistic regression was used to assess the risk factors of CAD. The receiver operating characteristic curve was used to determine the cutoff and diagnostic values. The neutrophil-to-high density lipoprotein cholesterol ratio (5.04 vs. 3.47), neutrophil-to-lymphocyte ratio (3.25 vs. 2.45), monocyte-to-high density lipoprotein cholesterol ratio (MHR) (0.46 vs. 0.36), monocyte-to-lymphocyte ratio (0.31 vs. 0.26), systemic immune-inflammation index (SII) (696.00 vs. 544.82), serum TNF-α (398.15 ng/l vs. 350.65 ng/l), FABP4 (1644.00 ng/l vs. 1553.00 ng/l), ANGPTL3 (57.60 ng/ml vs. 52.85 ng/ml), and ANGPTL4 (37.35 ng/ml vs. 35.20 ng/ml) values showed a significant difference between the CAD and non-CAD groups ( P < 0.05). After adjusting for confounding factors, the following values were obtained: ANGPTL3 > 67.53 ng/ml [odds ratio (OR) = 8.108, 95% confidence interval (CI) (1.022-65.620)]; ANGPTL4 > 29.95 ng/ml [OR = 5.599, 95% CI (1.809-17.334)]; MHR > 0.47 [OR = 4.872, 95% CI (1.715-13.835)]; SII > 589.12 [OR = 5.131, 95% CI (1.995-13.200)]. These factors were found to be independently associated with CAD ( P < 0.05). Diabetes combined with MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l had the highest diagnostic value for CAD [area under the curve: 0.921, 95% CI, (0.881-0.960), Sensitivity: 88.9%, Specificity: 82.2%, P < 0.001]. MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l were identified as independent CAD risk factors and have valuable clinical implications in the diagnosis and treatment of CAD.

Serum Uric Acid to High‑density Lipoprotein Cholesterol Ratio is Associated with Visceral Fat in Patients with Type 2 Diabetes.

To determine whether the uric acid/high‑density lipoprotein cholesterol ratio (UHR) is associated with visceral fat area (VFA) in patients with type 2 diabetes mellitus (T2DM). Participants aged 18-70 years with a diagnosis of T2DM were recruited from the National Metabolic Management Center from January 2020 to July 2022. Medical data collected for all participants included medical history, general measures, carotid intima-media thickness, abdominal VFA, and subcutaneous fat area (SFA). The participants were divided into groups according to VFA ≥100 cm2 (n=109) and VFA <100 cm2 (n=100). Compared with the VFA <100 cm2 group, the VFA ≥100 cm2 group had higher height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), SFA, fasting plasma glucose, fasting insulin, C peptide, homeostatic model assessment of insulin resistance (HOMA-IR), alanine transaminase (ALT), aspartate transaminase, γ-glutamine acyltransferase (γ-GGT), uric acid (UA), triglyceride (TG), and UHR measurements and lower high-density lipoprotein cholesterol (HDL-C) (P<0.05). No significant difference was observed between the groups for age, duration of T2DM, diastolic blood pressure, systolic blood pressure, IMT, glycosylated hemoglobin, total cholesterol, and low-density lipoprotein cholesterol. Positive correlations were found between the UHR and height, weight, BMI, WC, HC, C peptide, ALT, γ-GGT, TG, and UA, as well as between VFA and these variables (P<0.05). Both the UHR and VFA were negatively correlated with HDL-C (P<0.05). Positive correlations were observed between VFA and the UHR as well as UA (P<0.05), and a negative correlation was found between VFA and HDL-C (P<0.05). Multivariate linear stepwise regression identified BMI, WC, UHR, SFA, and HC as influencing factors for VFA (P<0.05). UHR was positively associated with VFA in T2DM patients and may be a useful and convenient additional tool for metabolic risks in these patients.

Association Between Serum Bicarbonate Levels and Prediabetes and Subclinical Inflammation in Young Healthy Adults: A Cross-sectional Study.

Low bicarbonate, a hallmark of metabolic acidosis is associated with various diseases. This study investigated associations between bicarbonate levels with prediabetes and subclinical inflammation among healthy young adults in Qatar. A cross-sectional study was carried out with 825 participants aged 18-40 years, devoid of any known comorbidities, using data from the Qatar Biobank. For each participant, blood samples were taken for measurements of bicarbonate, prediabetes, and subclinical inflammation biomarkers. Prediabetes was defined using HbA1c between 5.7 and 6.4% and subclinical inflammation was defined using monocyte to high density lipoprotein (HDL) cholesterol ratio (MHR). Associations between bicarbonate levels and the outcomes were analyzed using multivariable linear and logistic regression and then stratified by gender. A total of 825 participants with mean age 29.2 years (5.9) of which 365 (44.2%) were males. After multivariable logistic regression, each unit increase in serum bicarbonate was associated with a 17% decreased risk of prediabetes (OR: 0.83, 95%CI: 0.70-0.99, p=0.034), in males but no association was observed for females. Similarly, after multivariable linear regression, a unit increase in serum bicarbonate was associated with a 0.18 unit decrease in MHR (beta -0.18, 95%CI: -0.29, -0.07, p=0.002), again with no association observed in females. In a healthy young adult population, higher serum bicarbonate levels were inversely associated with both prediabetes and subclinical inflammation in males, but not in females.