High-density Lipoprotein Cholesterol Ratio Research Articles

Gender differences in the association between the uric acid to high-density lipoprotein cholesterol ratio and diabetes risk: a mediation analysis of c-reactive protein, triglycerides, and insulin resistance

BackgroundThe uric acid to high-density lipoprotein cholesterol ratio (UHR) has emerged as a novel metabolic marker and is proven to be associated with diabetes risk. However, there is still a lack of systematic research regarding its role in gender differences and underlying mechanisms. This study aims to assess the association of UHR with diabetes risk in the context of gender differences and to investigate its mediation effects through metabolic and inflammatory pathways.MethodsThis study utilized data from NHANES 2005–2010 and included 6,843 adult participants. Multivariate logistic regression was employed to assess the association between UHR and diabetes risk, and restricted cubic spline (RCS) along with correlation analysis was applied to explore its relationship with metabolic risk factors. Multiple mediation analysis was conducted to evaluate the mediating effects of homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and C-reactive protein (CRP) on the association between UHR and diabetes risk.ResultsIn the overall population, UHR was significantly positively associated with diabetes risk, but gender-stratified analysis revealed a stronger predictive effect in women. In the unadjusted model, every unit increase in UHR was linked to an 18.6% increase in diabetes risk in women (p < 0.001). In the quartile analysis, women in the highest quartile showed an 8.49-fold increased risk of diabetes (OR = 8.494, 95% CI: 5.542–13.019, p < 0.001), whereas no significant association was observed in men (p > 0.05). Mediation analysis revealed that HOMA-IR was the main mediator of the relationship between UHR and diabetes risk, with mediation effects of 64.55%, 118.38%, and 39.09% in the overall population, men, and women, respectively. Additionally, the mediation effect of TG was stronger in men (36.78%) and weaker in women (17.31%). The mediation effect of CRP was relatively minimal across all groups, accounting for 7.62% in men and 2.67% in women.ConclusionThis study demonstrates that the association between UHR and diabetes risk exhibits gender differences, with higher diabetes risk observed in women, while men show stronger mediation effects in insulin resistance, lipid metabolism, and inflammatory response.

Monocyte to high-density lipoprotein cholesterol ratio as a predictor of the activity of thyroid-associated ophthalmopathy.

To evaluate the relationship between monocyte to high-density lipoprotein cholesterol ratio (MHR) and the disease activity of thyroid-associated ophthalmopathy (TAO). A total of 87 patients were classified into two groups based on clinical activity score (CAS) scoring criteria: high CAS group (n=62, the CAS score was ≥3); low CAS group (n=25, the CAS score was <3). In addition, a group of healthy people (n=114) were included to compared the MHR. Proptosis, MHR, average signal intensity ratio (SIR), average lacrimal gland (LG)-SIR, average extraocular muscles (EOM) area from 87 patients with TAO were calculated in magnetic resonance imaging (MRI), and compared between these two groups. Correlation testing was utilized to evaluate the association of parameters among the clinical variables. Patients in high CAS group had a higher proptosis (P=0.041) and MHR (P=0.048). Compared to the healthy group, the MHR in the TAO group was higher (P=0.001). Correlation testing declared that CAS score was strongly associated with proptosis and average SIR, and MHR was positively associated with CAS score, average SIR, and average LG-SIR. The area under the receiver operating characteristic curve (AUC) of MHR was 0.6755. MHR, a novel inflammatory biomarker, has a significant association with CAS score and MRI imaging (average SIR and LG-SIR) and it can be a new promising predictor during the active phase of TAO.

Effect of LDL-C/HDL-C ratio on severity of coronary artery disease and 2-year long-term prognosis in elderly patients with coronary heart disease

Objective: To explore the effect of low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio on the severity of coronary artery disease and 2-year adverse events in elderly patients with coronary heart disease. Methods: This prospective, multicenter, observational cohort study was from the prospective observational multicenter cohort for ischemic and hemorrhage risk in coronary artery disease patients (PROMISE) study, in which 18 701 patients with coronary heart disease (CHD) were included from January 2015 to May 2019. Among them, 6 770 elderly patients with CHD were enrolled in the current study. According to the median of LDL-C/HDL-C ratio (2.1), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.1, n=3 346) and high LDL-C/HDL-C group (LDL-C/HDL-C2.1, n=3 424). Baseline data and 2-year outcomes (including death, myocardial infarction, revascularization, stroke) were collected and analyzed in order to found the differences of elderly CHD patients with different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and prognosis using Cox multivariate regression analysis. Results: Patients in the low LDL-C/HDL-C group were older [(71.9±5.5) vs (71.5±5.4) years old, P=0.003], and there was no statistically significant difference in the proportion of males between the two groups (61.9% vs 63.4%,P=0.208). The indicators reflecting the severity of coronary artery lesions, including the number of target lesions, the number of coronary artery disease, preoperative SNYTAX score, and the proportion of triple-vessel disease (1.01±0.81 vs 0.88±0.78, 2.28±0.81 vs 2.14±0.83, 16.05±10.67 vs 13.59±9.49, 49.0% vs 41.0%, respectively, all P0.05) were higher in the high LDL-C/HDL-C group. The 2-year follow-up showed that there was no statistically significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause mortality, cardiac death, myocardial infarction, and revascularization between the high LDL-C/HDL-C ratio group and the low LDL-C/HDL-C ratio group. Compared by gender, the incidence of all-cause death and cardiac death in the high LDL-C/HDL-C group of female patients were higher than the low LDL-C/HDL-C group (6.9% vs 4.8%, 5.3% vs 3.7%, both P0.05, respectively); There was no statistically difference in the incidence of adverse events between the two groups of male patients. Cox multivariate regression analysis showed that, regardless of gender, the LDL-C/HDL-C ratio was not a risk factor for 2-year MACCE in elderly patients with CHD (male: HR=1.21, 95%CI: 0.87-1.69; female: HR=0.96, 95%CI: 0.65-1.43;total: HR=1.09, 95%CI: 0.85-1.39,all P0.05). Conclusions: The severity of coronary artery disease is higher in elderly patients with high LDL-C/HDL-C ratio than in those with low LDL-C/HDL-C ratio. The LDL-C/HDL-C ratio is not a risk factor for 2-year adverse cardiovascular and cerebrovascular events in elderly patients with coronary heart disease. However, the incidences of 2-year adverse cardiovascular events of female patients with high LDL-C/HDL-C ratio are higher than patients with low LDL-C/HDL-C ratio.

Monocyte to high-density lipoprotein ratio as biomarker for cardiovascular health and cognitive function in the elderly diabetic and nondiabetic population: a case–control study

BackgroundAtherosclerosis plays a crucial role in the progression of cardiovascular disease, which is still a major global health concern. Its onset and advancement are significantly influenced by inflammation, especially when it comes to the immune system’s relationship with hypercholesterolemia. Effective serum biomarkers for atherosclerosis are still elusive, despite continuous research into anti-inflammatory therapies. Both monocytes and high-density lipoprotein play important roles in inflammatory and antioxidant processes, while high-density lipoprotein cholesterol (HDL-C) provides protective benefits, and monocytes are involved in the development of atherosclerotic plaque. The monocyte to high-density lipoprotein ratio (MHR) has emerged as a promising predictor of cardiovascular events, potentially more sensitive than each one’s individual levels. Studies have investigated the relationship between MHR and cardiovascular events in a number of diseases, such as acute coronary syndrome and chronic kidney disease. This study investigates the associations between MHR, atherosclerosis, arteriosclerosis, and cognitive impairment in elderly Egyptian populations, exploring its potential as a diagnostic marker and its role in predicting cognitive decline in diabetic individuals.Comprehending this intricate correlation is essential for developing preventive measures and targeted interventions for preventing cardiovascular disease and cognitive deterioration in the geriatrics.ResultsThe study included 100 participants, 50 with type 2 diabetes and 50 nondiabetic, with a mean age of 67 years. Significant negative correlations were found between MHR and the 3MS test (r: − 0.353, p = 0.012) and (r: − 0.170, p = 0.238) and between carotid femoral PWV and the 3MS test in diabetics and in nondiabetics (r: − 0.453, p = 0.001) in both groups, suggesting a potential link between MHR and cognitive impairment.ConclusionThis study highlights the complex relationship between monocyte to HDL-C ratio (MHR), atherosclerosis, and cognitive function in the elderly. Positive correlations were found between MHR and carotid intima-media thickness and carotid femoral PWV, suggesting a role for MHR in atherosclerosis. Notably, a negative correlation between MHR and cognitive function in diabetic individuals suggests a potential link between MHR and cognitive decline.

The impact of metabolic health on fibromyalgia: insights from insulin resistance and related indexes

ABSTRACT Objectives To assess the association between fibromyalgia (FM) and insulin resistance (IR) using multiple IR indices in FM patients and to investigate how these indices vary with the severity of FM. Methods This cross-sectional study included 70 female patients diagnosed with FM and 70 age-matched female healthy controls. The data collected included demographics, clinical characteristics, and laboratory parameters. FM severity was evaluated using the Fibromyalgia Impact Questionnaire-Revised (FIQR). The metabolic indices calculated were the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), triglyceride – glucose index (TyG), triglyceride to HDL cholesterol ratio (TG/HDL-C), and Metabolic Score for Insulin Resistance (METS-IR). Results FM patients exhibited significantly higher HOMA-IR values (p = 0.002), and lower QUICKI values (p = 0.000) than controls. METS-IR also showed significant differences between FM patients and controls (p = 0.026). HOMA-IR and METS-IR values increased with FM severity, whereas QUICKI values decreased (p < 0.05). Duration of FM showed a moderately positive correlation with HOMA-IR (r = 0.249, p = 0.027). For TG/HDL-C and METS-IR, the correlations were weaker, but still positive (r = 0.094, p = 0.378, and r = 0.184, p = 0.056, respectively). Conclusion This study observed a significant association between FM and IR, as evidenced by metabolic indices in FM patients compared to controls. IR levels tended to increase with FM severity and duration. These findings suggest that IR could play a role in FM pathogenesis. Non-invasive and practical methods, such as METS-IR, may provide advantages for metabolic screening in FM patients; however, further studies are needed to establish their clinical utility.

Obesity indices may affect and reflect the blood glucose and lipid profile values

The aim of the present study was to observe the association between obesity indices, blood glucose, and lipid profiles as indicators for its levels. In a cross-sectional study, 491 Jordanian adults were included. Socio-demographic and anthropometric data were measured. Blood samples were collected and tested for fasting plasma glucose (FPG), insulin, and lipid profile. Obesity indices [Conicity Index (CI), Body adiposity index (BAI), Abdominal volume index (AVI), A Body Shape Index (ABSI), Body Roundness Index (BRI), and Weight-adjusted-waist index (WWI)] were calculated using standard formulas. AVI, BRI, and WWI had a higher impact on FPG and lipid profile. They explain 6.2%, 6.6%, and 4.1% of changes observed in FPG and explained 3.1%, 4.1%, and 3.5% of changes observed in total cholesterol (TC), respectively. In addition, they explain 9.9%, 9.7%, and 7.9% of changes in triglyceride (TG), 9.6%, 8.4%, and 6.0% of the variability observed in the high-density lipoprotein cholesterol (HDL), as well as 1%, 1.6%, and 1.5 of change in low-density lipoprotein cholesterol (LDL), and 7.0%, 8.6%, and 6.6% in LDL/HDL ratio; respectively (p&lt;0.001). AVI, BRI, and WWI among obesity indices had the highest impact on blood glucose and lipid profile. The most affected tests were TG, HDL, and LDL / HDL ratio. These indices may be used as noninvasive rapid indicators for high glucose and lipid profiles.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and sarcopenia based on NHANES

The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, or NHHR, has garnered increased attention because of its connection to metabolic diseases. It is yet unknown, nevertheless, how NHHR and sarcopenia relate to one another in the US population. Examining the relationship between NHHR and the prevalence of sarcopenia in the US population is the main goal of this study. Utilizing information gathered from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, a study was conducted to look at the connection between NHHR and sarcopenia in the US population. The individuals’ baseline features were categorized based on whether or not sarcopenia was present. We used subgroup analysis, restricted cubic spline (RCS), and weighted logistic regression to examine the connection between NHHR and sarcopenia prevalence. Sensitivity analysis was used to confirm that the study’s findings were reliable and consistent. R (version 4.2.3) was used for all analyses, and P < 0.05 was used to indicate statistical significance. There were 10,087 individuals in all, 9,187 of whom were not sarcopenic and 900 of whom were. Sarcopenic patients were generally older, predominantly of Mexican American descent, and had lower educational levels. These patients were generally less active and exhibited higher levels of total cholesterol and BMI, along with lower HDL levels. Following complete adjustment, the weighted logistic regression model indicated that a 7% increased risk of sarcopenia was linked to every unit rise in NHHR (OR = 1.07, 95% CI = 1.02–1.13). An inflection point was identified at 2.90 by RCS analysis, which revealed a nonlinear association between NHHR and the prevalence of sarcopenia. Subgroup analysis showed that, regardless of the demographic group, there was a continuous positive correlation between NHHR and the prevalence of sarcopenia. The results of the interaction test provided evidence in favor of NHHR functioning as a stand-alone risk factor for sarcopenia. Our research suggests that a higher prevalence of sarcopenia may be linked to an increase in NHHR. Consequently, NHHR may function as a separate risk factor for sarcopenia.

Monocyte to high-density lipoprotein cholesterol ratio predicts restenosis of drug-eluting stents in patients with unstable angina pectoris

Several studies have shown that the monocyte count to high-density lipoprotein cholesterol ratio (MHR) serves as a predictive marker for in-stent restenosis (ISR) of bare-metal stents (BMSs). However, the ability of the MHR to predict ISR in patients with drug-eluting stents (DESs) remains uncertain. This study aimed to investigate the predictive value of the MHR for ISR in patients with unstable angina pectoris who have undergone primary DES implantation. A total of 474 consecutive patients with unstable angina pectoris who underwent successful DES-based percutaneous coronary intervention (PCI) from 01-12-2014 to 01-12-2022 were enrolled in the study. Patients were divided into the ISR group and the non-ISR group on the basis of the follow-up results of coronary angiography. The demographic and clinical characteristics of the patients were documented. The MHR was calculated via the following formula: . Multivariate logistic regression models were developed to evaluate the predictive value of the MHR for DES-ISR. The baseline MHR was notably greater in the ISR group than in the non-ISR group (P < 0.001). After adjusting for confounding factors, the MHR emerged as an independent predictor of ISR (OR = 1.244; 95%CI 1.171–1.321). Receiver operating characteristic (ROC) curve analysis revealed that MHR for predicting ISR had an AUC of 0.752 (95% CI 0.708–0.796). For a MHR > 7.32, the sensitivity was estimated to be 59.8% (95% CI 47.2-66.5%) and the specificity was 81.2% (95% CI 71.2-86.4%). Including the MHR in the predictive model for ISR improved the area under the curve (0.698 vs. 0.782, P < 0.001), categorical net reclassification improvement (0.703; 95%CI 0.536–0.871), and integrated discrimination improvement (0.121; 95%CI 0.092–0.151). The MHR can be used to predict DES-ISR in patients with unstable angina pectoris, indicating that the MHR may serve as a valuable marker for risk stratification and prognosis in individuals undergoing DES implantation.

Association between uric acid to high-density lipoprotein cholesterol ratio and chronic kidney disease among Chinese middle-aged and older adults with abnormal glucose metabolism: a nationwide cohort study.

Previous research has demonstrated a correlation between uric acid to high-density lipoprotein cholesterol ratio (UHR) and chronic kidney disease (CKD), yet the evidence remains unclear in individuals with abnormal glucose metabolism. The objective of this research was to investigate the correlation between UHR and the occurrence of CKD, as well as the rapid kidney function decline among individuals aged over 45years with abnormal glucose metabolism, using data from the China Health and Retirement Longitudinal Study (CHARLS). This study employed K-means clustering to categorize individuals based on UHR control levels into four classes. Subsequently, multivariate logistic regression analyses were utilized to explore the relationships between UHR and the occurrence of CKD as well as rapid kidney function decline. To examine the potential nonlinear relationship, restricted cubic spline (RCS) analyses were employed. Subgroup analyses and various sensitivity analyses were applied to validate the reliability of the results. This study encompassed 3902 participants, all of whom had prediabetes or diabetes. In the fully adjusted logistic regression model assessing the risk of CKD development, the odds ratios (ORs) for Class 2, Class 3, and Class 4, versus Class 1, were 1.08 (0.71 to 1.67), 1.71 (1.06 to 2.77), and 2.13 (1.02 to 4.35), respectively. For every 1 standard deviation (SD) increase in cumulative UHR exposure, there was a 32% elevation in the risk of CKD incidence (OR: 1.32, 95% CI 1.12 to 1.56). RCS curves suggested a linear association between cumulative UHR (CumUHR) and CKD occurrence, but a nonlinear association with rapid renal function progression. Subgroup analysis indicated an interaction between age and UHR on the development of CKD. The application of multiple sensitivity analyses yielded consistent outcomes, suggesting the robustness of the findings. In individuals with abnormal glucose metabolism, suboptimal control of UHR signifies an elevated risk of rapid kidney function decline and the incidence of CKD in the future. Therefore, close monitoring of long-term variations in UHR can facilitate early identification of the risk for CKD development.

Cross-sectional analysis of non-HDL/HDL cholesterol ratio as a marker for cardiovascular disease risk in middle-aged and older adults: Evidence from the CHARLS study

While cardiovascular disease is linked to abnormal lipid metabolism, the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio), a new lipid metric, and cardiovascular disease in middle-aged and older adults in China is still unclear. This cohort study, based on a population sample, examined the incidence of cardiovascular disease (CVD) events, including stroke and heart disease. It utilized self-reported diagnoses from the study's inception and during Wave 4, involving 9259 participants from the China Health and Retirement Longitudinal Study (CHARLS). The research employed restricted cubic spline models and multivariate logistic regression to investigate possible non-linear relationships. Additionally, subgroup analyses were conducted to assess the influence of socio-demographic factors on the outcomes. During the seven-year follow-up period, 1,139 participants developed CVD, including 742 cases of heart problems and 582 strokes. In Model 3, it was observed that for each unit increase in the highest NHHR group, the risk of developing CVD increased by 98%, the risk of stroke increased by 48%, and the risk of heart problems increased by 115%. Subgroup analyses indicated that this correlation was more pronounced among individuals under 60 years of age and those with hypertension. According to the current study, elevated NHHR ratio is an important risk factor for CVD in middle-aged and elderly Chinese. Early intervention in patients with higher NHHR ratios may help to further reduce the incidence of CVD.

Prognostic Value of Monocyte-to-High-Density Lipoprotein Cholesterol Ratio in COVID-19 Patients

Aims: A significant portion of individuals infected with COVID-19 experience severe illness and require intensive care. Especially in these cases, the disease may ultimately be fatal. Monocyte to high-density lipoprotein cholesterol ratio (MHR) has been reported to be a novel marker for major adverse outcomes in many diseases. In this study, we aimed to reveal the relationship of MHR with the prognostic markers of COVID-19 and its role in predicting the severity of disease and in-hospital mortality in COVID-19. Materials and Methods: This single-center, retrospective, and cross-sectional study included 195 hospitalized patients diagnosed with COVID-19. The patients who were discharged from the hospital formed the survivor group, whereas those who were deceased were categorized as the non-survivor group. Clinical and biochemical data of patients were retrospectively collected from medical records. Results: The age of the patients ranged from 19 to 92 years and the mean age was 57.0±16.3 years. Ninety-eight (50.3%) of the patients were female. Forty-one of the patients died during hospitalization due to COVID-19 and related complications. Median MHR was significantly higher in the non-survivor group than in the survivor group. MHR was significantly correlated with age, ferritin, uric acid, urea, and creatinine levels. Univariate logistic regression analysis demonstrated no significant association between MHR and in-hospital mortality (p=0.132). Conclusion: MHR is increased in COVID-19 survivors compared to non-survivors and correlates with age, ferritin, uric acid, urea, and creatinine levels. However, MHR cannot be used as a prognostic marker to predict the severity of the disease and in-hospital mortality in COVID-19 patients.

Characterising the lipid profile of paediatric patients with anomalous aortic origins of a coronary artery.

Lipid levels in paediatric patients with anomalous aortic origin of a coronary artery (AAOCA) have not previously been explored. Patients with CHD have an increased risk of atherosclerotic cardiovascular disease later in life compared to the general population. We aim to characterise the lipid profiles in paediatric patients with AAOCA and explore its relation to diagnosis, race/ethnicity, and exercise. Single institution retrospective cohort of 180 AAOCA paediatric patients (median age 13.7 years interquartile range 9.7-15.6, 66% male). Total cholesterol, HDL, LDL, triglycerides, total cholesterol to HDL ratio, and non-HDL cholesterol were evaluated across race/ethnicity, sex, type of AAOCA, documented ischaemia on imaging, exercise level, and surgery status. Normality of the data distribution for each lipid parameter was evaluated using Kolmogorov-Smirnov testing. Accordingly, Mann-Whitney U and t-tests were used to compare variables. The proportion of abnormal lipid levels by sex and race/ethnicity was calculated. Total cholesterol was elevated in 29%, (51/177) of patients, HDL 37% (64/174), triglycerides 44% (72/165), LDL 16% (28/170), total cholesterol-HDL ratio 29%, (48/163), and non-HDL cholesterol 28% (47/165). Across subgroups categorised on the basis of surgery status, exercise level, AAOCA type, and sex, the mean and median levels for individual lipid parameters were normal. By race/ethnicity, Hispanic patients had significantly higher triglyceride (median 99, interquartile range 71-136.5, p = <0.001) and total cholesterol to HDL ratios (median 3.2, interquartile range 2.7-4.5, p = 0.014) versus non-Hispanic White and Black patients. Two-thirds of patients exercise recreationally. Hispanic patients have significantly elevated triglycerides and total cholesterol to HDL ratios compared to others. Longitudinal follow-up evaluating differences in long-term lipid status in patients with AAOCA and risk for cardiovascular events is warranted.

Association of cumulative non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with the risk of cardiometabolic disease.

One measurement of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is considered to be associated with insulin resistance and cardiovascular disease (CVD) risk. This study aimed to exploring the association between cumulative non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol (Cum NHHR) exposure levels and the risk of cardiometabolic disease (CMD). This prospective cohort study included 43,735 participants, who participated in three consecutive health examinations in 2006, 2008, 2010 and had no history of CMD or cancer. The participants were divided into quartiles bases on their cum NHHR. Multivariate Cox proportional hazards model was used to assess the association between cum NHHR and the risk of CMD. Additionally, the direct method of standardized ratios was employed to calculate the absolute risk of CMD attributable to cum NHHR. Over a median follow-up period of 10.92 years (IQR: 10.22-11.26 years), 7,388 participants were newly diagnosed with CMD. In the multivariate-adjusted model, participants in quartiles Q2, Q3 and Q4 showed a progressively increased relative risk of CMD compared to those in Q1, The fully adjusted hazard ratios (95% confidence intervals) for the risk of CMD in the Q2, Q3, and Q4 groups were 1.11 (1.04-1.20), 1.23 (1.14-1.32), and 1.29 (1.20-1.38), respectively, compared with the Q1 group. This association remained significant even after further adjustment for single measurements of NHHR. Moreover, cum NHHR was positively correlated with the absolute risk of CMD, cardiovascular diseases (CVD), and type 2 diabetes (T2DM). Higher cum NHHR is significantly associated with an increased risk of CMD, independent of single-point NHHR level. Additionally, there are significant different strengths of correlations between cum NHHR and different diseases.

Correlation between cardiometabolic index and female infertility: a cross-sectional analysis

BackgroundObesity and adverse lipid profile leads to female infertility. The cardiometabolic index (CMI) is a promising indicator for predicting obesity-related diseases. The correlation between CMI and female infertility merits further investigation.MethodsThe data for this study were acquired from the 2013–2020 National Health and Nutrition Examination Survey (NHANES), with 2333 women enrolled. The cardiometabolic index (CMI) of each participant was calculated as the ratio of triglycerides and high-density lipoprotein cholesterol multiplied by waist-to-height ratio. Weighted multivariate logistic regression models were used to assess the independent correlation between the log-transformed CMI and infertility. Subgroup analyses were carried out to assess the reliability of the findings. Interaction tests were employed to determine whether variables affected infertility by interacting with log CMI.ResultsA total of 2333 participants aged 18–45 years were enrolled, 274 of whom were infertile. Log CMI of the infertility group was significantly higher than that of the non-infertility group (P < 0.001). After adjustment for potential confounders, women with higher CMI were at an increased risk of infertility (OR = 2.411, 95% CI: 1.416–4.112), and this correlation was still consistent in subgroups aged under 35 years (P < 0.001). Furthermore, restricted cubic spline analysis showed a positive non-linear relationship between log CMI and infertility.ConclusionsCardiometabolic index levels are positively correlated with increased risk of infertility in American females. Our study demonstrates the predictive capacity of CMI for female infertility.

The nonlineard association between triglyceride to HDL cholesterol ratio and long-term heart disease risk: findings from China Health and Retirement Longitudinal Study (CHARLS)

ObjectiveThe aim of this study was to investigate the relationship between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and the risk of cardiovascular disease (CVD) in middle-aged and elderly Chinese population. CVD has high morbidity and mortality in China, with 5.09 million CVD deaths in 2019 and a mortality rate of 364.5 cases per 100,000 people. Existing studies have focused on specific populations and lack studies on the general population.MethodsThis study used data from the China Health and Aged Care Tracking Survey (CHARLS) to analyse the middle-aged and elderly population between 2011 and 2020. The exposure variable was TG/HDL-C ratio, the outcome variable was the occurrence of heart disease (including myocardial infarction, coronary heart disease, etc.), and the covariates included age, gender, education level, and body mass index. The final sample size was 4,551 participants. Weighted Cox regression models were used to assess the association between TG/HDL-C and CVD risk, and nonlinear associations and stratified analyses were performed.ResultsThe results demonstrated a significant association between TG/HDL-C ratios and cardiac morbidity, with a risk ratio of 0.71 (95% CI: 0.71–0.71) in the adjusted model II. Nonlinear analysis revealed a threshold effect. Within the TG/HDL-C 0.15–1.5 interval (inflection point LnTG/HDL-C 0.41), each 1-unit increase in Ln (TG/HDL-C) was associated with a 17% reduction in the risk. The inflection point was associated with a 0.83-fold reduction in the risk of CVD (95% CI: 0.75, 0.92; p = 0.0003), but beyond this point, the association was no longer significant (1.00-fold reduction in risk; 95% CI: 0.95, 1.05; p = 0.9701). In contrast, stratified analyses demonstrated that the results were more applicable to women and those younger than 65 years.ConclusionIn summary, the study found a significant inverse relationship between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and the risk of cardiovascular disease in the middle-aged and elderly Chinese population, with a nonlinear threshold effect observed at a TG/HDL-C ratio of around 1.5.

Triglyceride-glucose index predicts postoperative overall survival in hepatocellular carcinoma: a retrospective cohort study

BackgroundInsulin resistance is important in hepatocellular carcinoma (HCC) carcinogenesis and progression. The triglyceride-glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio or TyG-body mass index (TyG-BMI) are three non-invasive parameters for insulin resistance. However, their prognostic role in HCC patients undergoing hepatectomy remains unclear.Materials and methodsHCC patients who underwent hepatectomy at the Meizhou People’s Hospital from May 2011 to February 2023 were retrospectively explored. Patients were classified into high and low groups based on different TyG, TG/HDL-c, and TyG-BMI indices. The prognostic role of TyG, TG/HDL-c, and TyG-BMI was evaluated using Kaplan–Meier analysis and Cox regression models. A nomogram incorporating significant prognostic factors was constructed and validated.ResultsA lower TyG, lower TG/HDL-c, and lower TyG-BMI were linked to worse overall survival (OS) in HCC patients. Multivariate analysis indicated the TyG index, but not the TG/HDL-c and TyG-BMI index, could independently predict HCC OS. The nomogram incorporating the TNM stage and TyG index demonstrated good calibration, discriminative ability, and clinical benefit for predicting OS in HCC patients.ConclusionsThe TyG index could independently predict HCC OS after hepatectomy in this cohort. The nomogram incorporating the TyG index may aid in the prognosis management of HCC.

Abstract 4125511: L-shaped association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and arterial stiffness: a cross-sectional study

Background: Serum lipids and ratios are known to be associated with cardiovascular disease (CVD). However, studies on NHHR and the association with arterial stiffness in the US population have not been reported. We sought to investigate the relationship between NHHR and arterial stiffness by arterial stiffness in subjects from the US population assessed by ePWV. Methods: This study included 23, 456 adults from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. Multivariate linear regression analysis, threshold effects, smooth curve fitting, and subgroup analysis. We aimed to elucidate the relationship between NHHR and risk of arterial stiffness. Results: The mean age of the population in this study was 49.56 ± 17.58 yrs. The mean NHHR was 2.97 ± 1.48, and in the fully adjusted model, a negative correlation was observed between NHHR and ePWV scores (β = -0.01, 95% CI: -0.02, -0.00), with the highest tertile of the NHHR having a mean ePWV score that was 0.06 units lower than the lowest quartile of the NHHR by 0.06 units (β = -0.06, 95% CI: -0.09, -0.02; P for trend = 0.0068). An L-shaped relationship between NHHR and ePWV scores was found by using smoothed curve fitting. The cutoff value was 2.13, and in the hypertensive population, the cutoff value was 1.93. Conclusions: There is an L-shaped association between NHHR levels and atherosclerosis in adults in the United States, and controlling NHHR is clinically important for reducing the risk of developing atherosclerosis.

High-density lipoprotein cholesterol to c-reactive protein ratio predicts atrial fibrillation recurrence after electrical cardioversion.

Atrial fibrillation (AF) recurrence after cardioversion is common, and inflammation plays a critical role in its pathophysiology. We aimed to elucidate the predictive role of the ratio of high-density lipoprotein cholesterol to c-reactive protein (HDL-C/CRP) as an inflammatory marker in AF recurrence after electrical cardioversion (ECV). We analyzed patients who underwent elective ECV for atrial fibrillation between June 2020 and December 2023. Baseline levels of HDL-C and CRP were obtained. Ninety-six patients were included. The median age was 59 years, and 48% were female. Atrial fibrillation recurred after ECV in 56 patients (58%). In the AF recurrence group, CHA2DS2-VASc score was higher (2 [1-3] vs. 1[0-2]; p = 0.013), left atrial diameter was larger (43 ± 5 vs. 40 ± 6 mm; p = 0.015), and HDL-C/CRP ratio was lower (5.6 [2.7-13.0] vs. 14.0 [4.8-38.0]; p = 0.003) compared with the sinus rhythm group. Cox regression analysis showed that HDL-C/CRP was a predictor of AF recurrence at follow-up (unadjusted HR = 0.97; CI 95%: 0.95-0.99; p = 0.004; adjusted HR = 0.98; CI 95%: 0.96-0.99; p = 0.030). ROC curve showed that HDL-C/CRP ratio was able to predict AF recurrence after ECV (AUC = 0.68; p = 0.003). Kaplan-Meier analysis showed that patients with baseline HDL-C/CRP <7.4 had higher AF recurrence (log-rank test p = 0.013). Our research demonstrated that the lower HDL-C/CRP ratio predicted AF recurrence after ECV during follow-up.

The serum uric acid/high-density lipoprotein cholesterol ratio: a novel predictor for the presence of abdominal aortic aneurysm.

Robust evidence has demonstrated that inflammation plays an important role in the occurrence and development of abdominal aortic aneurysms (AAA). The serum uric acid (UA)/high-density lipoprotein cholesterol (HDL-C) ratio (UHR) has recently been recognized as a new biomarker for evaluating inflammatory and anti-inflammatory interactions. However, whether UHR is associated with AAA remains unclear. This study aimed to explore the association between UHR and presence of AAA. We prospectively performed a hospital-based and community-based AAA screening program using ultrasonography in 9,064 individuals at Guangdong Provincial People's Hospital and two communities in China. Logistic regression analysis was used to explore the association between UHR and presence of AAA. In addition, the restricted cubic spline (RCS) regression method was used to visually investigate the dose-response relationship between UHR and the presence of AAA. Propensity score matching (PSM) analysis was conducted to adjust for baseline variations and diminish selection bias, and subgroup analysis was performed to investigate the consistency of the conclusions. The prevalence of AAA was 2.45% (222/9,064) in the present study. The optimal cut-off value of UHR was 17.0%, which was selected according to the receiver operator characteristic curve. The prevalence of AAA was 3.96% in the high-UHR group (UHR ≥ 17%) and 1.54% in the low-UHR group (UHR < 17%) (P < 0.001). After adjusting for other relevant clinical covariates, UHR was independently associated with the presence of AAA, either as a continuous variable (odds ratio [OR] 1.03, 95% confidence intervals [CI] 1.01-1.05, P < 0.001) or as a categorical variable (OR 1.63, 95% CI 1.18-2.26, P = 0.003). The RCS curve showed a nonlinear dose-response relationship between UHR and the presence of AAA. Moreover, the positive correlation between UHR and the presence of AAA remained significant after PSM and subgroup analyses. UHR was positively associated with the presence of AAA, and there was a non-linear dose-response relationship between them. Thus, UHR may serve as a novel and reliable predictor of AAA.

Triglyceride to high-density lipoprotein cholesterol ratio is associated with diabetes incidence in non-obese individuals with normoglycemia: a retrospective cohort study based on individuals from East Asia.

Although several studies have explored the association between the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c) and diabetes risk, most of these studies are cross-sectional and typically involve small sample sizes, limiting the ability to draw causal inferences. Additionally, there is currently a few studies specifically focusing on non-obese individuals. Consequently, we conducted a retrospective cohort study to investigate the impact of TG/HDL-c on the risk of developing diabetes among non-obese, normoglycemic individuals across East Asian countries. This secondary retrospective cohort study recruited 85,029 non-obese individuals with normal glycemic levels from East Asian countries (China and Japan). We employed Cox proportional hazards regression models, incorporating cubic splines function for smooth curve fitting and using two-piecewise Cox regression for threshold effect analysis, to evaluate the nonlinear associations between baseline TG/HDL-c ratios and diabetes risk in non-obese individuals with normoglycemia. In addition, A range of subgroup and sensitivity analyses were performed to confirm the robustness of our results. Among the individuals included, the average age was 42.14 ± 11.88 years, and 37,944 participants (44.62%) were male. After adjusting for covariates, the study revealed a significant correlation between the TG/HDL-c ratio and the risk of diabetes among non-obese individuals (HR=1.37, 95%CI: 1.22-1.54). Furthermore, a non-linear correlation was observed between the TG/HDL-c ratios and the incidence of non-obese diabetes, with an inflection point of 1.36. Under this threshold, the TG/HDL-c ratio notably boosts diabetes risk in non-obese populations, with an HR of 2.38 (95% CI: 1.57-3.59). Conversely, beyond the critical juncture, the upsurge in diabetes risk seems to level off, displaying no significant variation, with an HR of 1.18 (95% CI: 0.98-1.41). This study reveals a non-linear association between the TG/HDL-c ratios and the likelihood of diabetes in non-obese individuals from East Asia. Maintaining a ratio of TG/HDL-C below 1.36 significantly reduces diabetes risk. However, once the ratio of TG/HDL-C exceeds 1.36, reducing it does not substantially lower diabetes onset risk.