Lipoprotein Cholesterol Ratio Research Articles

Association of cardiometabolic index with sleep quality in adults: a population‑based study

The Cardiometabolic Index (CMI) represents an innovative metric that encompasses abdominal obesity and lipid levels, offering a comprehensive assessment of cardiometabolic health. It is derived through the multiplication of the waist-to-height ratio by the triglyceride-to-high-density lipoprotein cholesterol ratio. Although obesity and blood lipid levels are known factors affecting sleep quality, the direct correlation between CMI and sleep quality has yet to be elucidated. This study uses NHANES data to explore the potential correlation between CMI and sleep quality. Our research employed a cross-sectional design, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2014. CMI was used as the exposure variable, with sleep quality assessed through three self-reported measures: trouble sleeping, sleep disorders, and sleep duration. We employed multivariate logistic regression models and linear regression model as well as subgroup analyses to explore the independent relationship between CMI and sleep quality. Additionally, interaction tests were conducted to examine differences across various subgroups. The study included 4298 participants, comprising 2134 males and 2164 females. There was a positive correlation between CMI and trouble sleeping (OR = 1.63, 95% CI 1.28–2.08) and sleep disorders (OR = 1.96, 95% CI 1.43–2.67), while there was a negative correlation between CMI and sleep duration (β = − 0.17, 95% CI − 0.31 to − 0.03), indicating that a higher CMI was associated with shorter sleep duration. Subgroup analyses and interaction tests revealed a consistently positive association between CMI and sleep difficulty across various populations, including gender, age, hypertension, diabetes, and cardiovascular disease history. However, the relationship between CMI and sleep disorders was more prominent among participants aged 50 and above. In American adults, a higher CMI is linked to an increased prevalence of sleep disturbances. In clinical practice, CMI can be considered as a supplementary factor in the assessment and management of sleep problems. Our study also provided new insights for improving sleep quality.

Comparison of SPISE and METS-IR and Other Markers to Predict Insulin Resistance and Elevated Liver Transaminases in Children and Adolescents.

Studies on predictive markers of insulin resistance (IR) and elevated liver transaminases in children and adolescents are limited. We evaluated the predictive capabilities of the single-point insulin sensitivity estimator (SPISE) index, metabolic score for insulin resistance (METS-IR), homeostasis model assessment of insulin resistance (HOMA-IR), the triglyceride (TG)/ high-density lipoprotein cholesterol (HDL-C) ratio, and the triglyceride-glucose index (TyG) for IR and alanine aminotransferase (ALT) elevation in this population. Data from 1,593 participants aged 10 to 18 years were analyzed using a nationwide survey. Logistic regression analysis was performed with IR and ALT elevation as dependent variables. Receiver operating characteristic (ROC) curves were generated to assess predictive capability. Proportions of IR and ALT elevation were compared after dividing participants based on parameter cutoff points. All parameters were significantly associated with IR and ALT elevation, even after adjusting for age and sex, and predicted IR and ALT elevation in ROC curves (all P<0.001). The areas under the ROC curve of SPISE and METS-IR were higher than those of TyG and TG/HDL-C for predicting IR and were higher than those of HOMA-IR, TyG, and TG/HDL-C for predicting ALT elevation. The proportions of individuals with IR and ALT elevation were higher among those with METS-IR, TyG, and TG/ HDL-C values higher than the cutoff points, whereas they were lower among those with SPISE higher than the cutoff point. SPISE and METS-IR are superior to TG/HDL-C and TyG in predicting IR and ALT elevation. Thus, this study identified valuable predictive markers for young individuals.

Association between platelet-to-high-density lipoprotein cholesterol ratio and cognitive function in older americans: insights from a cross-sectional study

The main aim of this study was to explore the correlation between the platelet/high-density lipoprotein cholesterol ratio (PHR) and cognitive function in elderly individuals from the United States. This investigation leveraged data encompassing 2299 participants, all aged 60 years and above, from the National Health and Nutrition Examination Survey conducted from 2011 to 2014. Inclusion criteria were based on the availability of complete datasets for PHR and cognitive function assessments. The analytical approach incorporated multivariate logistic regression to discern the association between PHR and cognitive function. Additionally, the study employed restricted cubic splines (RCS) to explore potential non-linear relationships and subgroup analyses to identify variations in the observed associations across different demographic and clinical subgroups. In the fully adjusted model, an increment of 10 units in PHR was associated with a decline of 0.014 in cognitive scores (β=-0.014, 95% CI: -0.025, -0.002; P < 0.05). Compared to the lowest quartile, participants in the highest quartile exhibited a 38.4% increased prevalence of cognitive impairment per one-unit increase in PHR (OR = 1.384, 95% CI: 1.012, 1.893; P < 0.05). Subgroup analysis revealed consistent results regarding the relationship between PHR and cognitive impairment across all subgroups. A non-linear relationship between PHR and cognitive impairment was observed using RCS, indicating that an increase in PHR above 111.49 significantly elevated the incidence of cognitive impairment (P < 0.05). Our study demonstrates that a higher PHR is associated with a greater risk of cognitive decline in an older U.S. population, and although further validation is needed, this warrants consideration in clinical assessments and interventions.

Utility of the triglycerides/HDL cholesterol ratio in older adult patients in Colombia

Abstract Introduction Alterations in lipid metabolism are responsible for atherogenesis and an increased risk of atherosclerotic cardiovascular disease. The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) is used to assess the risk of cardiovascular diseases; however, it has not been evaluated in older adults. The aim of the present study is to evaluate the TG/HDL-C ratio in elderly patients and analyze its correlation and discriminatory capacity with cardiovascular risk factors according to data from the SABE Colombia survey. Purpose Describe the sociodemographic characteristics, cardiovascular history, lifestyle, and cardiovascular risk score in the older adult population included in the SABE Colombia Study.Describes the distribution of triglyceride levels, cholesterol, and the TAG-HDL ratio in the older adult population included in the SABE Colombia Study. Evaluate the relationship between the TAG/HDL Cholesterol Index and cardiovascular risk factors such as hypertension, prediabetes, type 2 diabetes mellitus, cardiovascular disease, cerebrovascular disease Determine if there is a correlation and the degree of correlation between the TAG/HDL Cholesterol ratio and variables related to higher cardiovascular risk and stablish cutoff points of the triglyceride to HDL cholesterol ratio as indicators of the onset of risk factors Materials and Methods Cross-sectional study in adults aged 60 years and older included in the national SABE Colombia survey (National Survey of Health, Well-being, and Ageing conducted in Colombia in 2015), which included 244 municipalities from all departments of the country. A correlation test was performed to assess the presence and degree of correlation between the TAG/HDL index and cardiovascular risk factors, and ROC curve analysis was conducted to evaluate the performance of the TAG/HDL index in identifying risk factors. Results A total of 23,694 patients with the necessary information for the study were included. The median age was 69 years, 57.3% were women, and 34.3% were of white race. 23.5% had hypertension, and 16.4% had diabetes mellitus. 13.4% had a history of cardiovascular disease, and 2.5% had cerebrovascular disease. While the specific correlation between the index and different cardiovascular risk factors is generally low to moderate, good discriminatory capacity was found for diabetes and metabolic syndrome with the following values: diabetes, with an area under the curve (AUC) of 0.871 and a cut-off point of 9.17; and for metabolic syndrome, the AUC was 0.840, with a cut-off point of 8.81. Conclusions Our findings show that the TG/HDL ratio has intermediate correlation for different cardiovascular risk factors; however, it has excellent predictive ability for the presence of diabetes and metabolic syndrome. These findings are very useful in the clinical evaluation, screening, and detection of cardiovascular risk factors in the population aged 60 years and older in Colombia.Scatter plots of TAG/HDL ratio comparedROC curves for diabetes and metabolic s

Measures of insulin resistance and aortic valve calcification in the general population

Abstract Background Insulin resistance (IR) is a key component in several cardiovascular risk factors. The triglyceride-glucose index (TyG index), triglyceride to high density lipoprotein-cholesterol ratio (TG/HDL-C) and visceral adiposity index (VAI) are easily accessible surrogate measures of IR and have been associated with coronary artery calcification and other cardiovascular diseases. Less is known about IR and aortic valve calcification (AVC). Purpose To investigate the association between different measures of IR (TyG index, TG/HDL-C, VAI) and AVC. Method The Swedish Cardiopulmonary Bioimage Study (SCAPIS) recruited 30 154 randomly selected individuals aged 50 to 64 years from the general population in Sweden between 2013 to 2018. AVC was assessed visually on cardiac computed tomography and categorized as present or absent. TyG index was calculated based on triglyceride and glucose levels, TG/HDL-C ratio using triglyceride and HDL-C levels and VAI using waist circumference, triglyceride and HDL-C levels. The association between IR indexes (as continuous variables by 1 unit increment and categorical variables by quartiles) and AVC was assessed using multivariable logistic regression models. Results In total, measures of IR were available in 29 268 participants of whom 2118 (7%) had AVC. Mean IR index levels were higher in participants with compared to without AVC (TyG index: 8.65 vs. 8.49; p&amp;lt;0.01; TG/HDL-C: 1.11 vs. 0.91; p&amp;lt;0.01 and VAI: 1.73 vs. 1.48; p&amp;lt;0.01). All three indices of IR were associated with AVC in continuous analyses. Subsequently, in multivariable logistic regressions adjusted for age, sex, study site and smoking, there was a stepwise increase in the risk of AVC with increasing quartiles of TyG index, TG/HDL-C and VAI (Figure 1). Conclusion Three different surrogate measures of IR (TyG index, TG/HDL-C and VAI) were all associated with AVC in a middle-aged general population suggesting that they could all be used as risk markers in clinical practice.

Association between platelet to high-density lipoprotein cholesterol ratio (PHR) and hypertension: evidence from NHANES 2005–2018

BackgroundThe Platelet to High-Density Lipoprotein cholesterol Ratio (PHR) is a novel indicator of inflammatory response and metabolic disorders, linked to various chronic diseases. This study aims to investigate the relationship between PHR and hypertension.MethodsData from the National Health and Nutrition Examination Survey (NHANES), collected across seven consecutive cycles from 2005 to 2018, were analyzed. The dataset included participants’ hypertension status as reported by a doctor, their use of antihypertensive medications, and the average of three blood pressure measurements to identify hypertensive adults, along with complete information for PHR calculation. PHR was calculated based on Platelet (PLT) count and High-Density Lipoprotein cholesterol (HDL-C) using the following formula: PHR = [PLT (1000 cells/µL) / HDL-C (mmol/L)]. A multivariable logistic regression model was employed to assess the association between PHR and hypertension, and subgroup analyses were conducted to explore potential influencing factors. Additionally, Restricted Cubic Spline (RCS) curves were applied for threshold effect analysis to describe nonlinear relationships.ResultsHigher PHR was associated with an increased prevalence of hypertension. After adjusting for various covariates, including race, education level, Family Poverty Income Ratio (PIR), smoking, alcohol consumption, sleep disturbances, waist circumference, diabetes, coronary heart disease, angina, heart attack, and stroke, the results remained significant (OR = 1.36; 95% CI, 1.32, 1.41, P < 0.001). Participants with the highest PHR levels had a 104% higher risk of hypertension compared to those with the lowest PHR levels (OR = 2.04; 95% CI, 1.89, 2.21, P < 0.001).ConclusionElevated PHR levels are strongly associated with an increased risk of hypertension. Specifically, when PHR is below 280, the risk of hypertension increases in proportion to PHR. This suggests that regular monitoring of PHR may help identify patients at risk of hypertension early, allowing for timely interventions to slow disease progression. Larger cohort studies are necessary to confirm these findings.

Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018

BackgroundThe non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) plays a potential role in cardiovascular diseases. However, its association with angina pectoris remains unclear. Herein, we aimed to explore their relationship.MethodsThis cross-sectional retrospective study included the 2009–2018 data from 22,562 adults diagnosed with angina pectoris, retrieved from the National Health and Nutrition Examination Survey (NHANES) database. NHHR was estimated from laboratory data, and angina pectoris diagnosis was ascertained from the NHANES questionnaire.ResultsAngina pectoris risk was greater in the highest than in the lowest NHHR tertile (odds ratio [OR] = 1.61; 95% confidence interval (CI), 1.15–2.54; P = 0.006). Weighted logistic regression showed a positive association between NHHR and angina pectoris in the fully adjusted model (OR = 1.17; 95% CI, 1.07–1.28; P = 0.001). Restricted cubic spline analysis showed a linear association (P = 0.6572). Subgroup analyses indicated no significant differences across different stratifications (P > 0.05, all). Random forest analyses and Boruta algorithm corroborated that NHHR is a strong predictor of angina pectoris. Among the eight machine-learning models evaluated for predictive capabilities, the logistic regression model demonstrated the strongest predictive capability, with an area under the curve of 0.831.ConclusionsOur study suggests that NHHR is a risk factor for angina pectoris and may be used for risk prediction and to inform future intervention programs to reduce its incidence.

Association between the triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular diseases in people living with HIV: Evidence from a retrospectively cohort study 2005-2022.

The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, a novel biomarker for metabolic syndrome (MetS), has been validated in the general population as being significantly correlated with cardiovascular disease (CVD) risk. However, its capabilities to predict CVD in people living with HIV (PLWH) remain underexplored. We conducted a retrospective cohort study of 16,081 PLWH who initiated antiretroviral therapy (ART) at the Third People's Hospital of Shenzhen (China) from 2005 to 2022. The baseline TG/HDL-C ratio was calculated as TG (mmol/L) divided by HDL-C (mmol/L). We employed a multivariate Cox proportional hazards model to assess the association between the TG/HDL-C ratio and CVD occurrence, using Kaplan-Meier curves and log-rank tests to compare survival distributions. The increase in prediction risk upon the addition of the biomarker to the conventional risk model was examined through the assessment of changes in net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Nonlinear relationships were investigated using a restricted cubic spline plot, complemented by a two-piecewise Cox proportional hazards model to analyze threshold effects. At the median follow-up of 70 months, 213 PLWH developed CVD. Kaplan-Meier curves demonstrated a significant association between the increased risk of CVD and a higher TG/HDL-C ratio (log-rank P <0.001). The multivariate-adjusted Cox proportional hazards regression model indicated that the CVD hazard ratios (HR) [95% confidence intervals (95% CI)] for Q2, Q3, and Q4 versus Q1 of the TG/HDL-C ratio were 2.07 (1.24, 3.45), 2.17 (1.32, 3.57), and 2.20 (1.35, 3.58), respectively (P <0.05). The consideration of the TG/HDL-C ratio in the model, which included all significant factors for CVD incidence, improved the predictive risk, as indicated by the reclassification metrics (NRI 16.43%, 95%CI 3.35%-29.52, P = 0.014). The restriction cubic spline plot demonstrated an upward trend between the TG/HDL-C ratio and the CVD occurrence (P for non-linear association = 0.027, P for overall significance = 0.009), with the threshold at 1.013. Significantly positive correlations between the TG/HDL-C ratio and CVD were observed below the TG/HDL-C ratio threshold with HR 5.88 (95% CI 1.58, 21.88, P = 0.008), but not above the threshold with HR 1.01 (95% CI 0.88, 1.15, P = 0.880). Our study confirms the effectiveness of the TG/HDL-C ratio as a predictor of CVD risk in PLWH, which demonstrates a significant nonlinear association. These findings indicate the potential of the TG/HDL-C ratio in facilitating early prevention and treatment strategies for CVD among PLWH.

Assessing systemic inflammatory markers in psoriasis: A retrospective study.

Psoriasis is a chronic inflammatory disease often associated with serious cardiovascular comorbidities. The aim of this study was to investigate the systemic inflammatory burden in psoriasis by examining various inflammatory markers and to assess the relationship between these markers and the severity of the disease. This retrospective study was conducted on medical records of patients who visited the dermatology outpatient clinic between 1 January 2016 and 31 December 2022. The study included patients with psoriasis vulgaris and healthy volunteers. Demographic data, Psoriasis Area and Severity Index score, C-reactive protein, monocyte-high-density lipoprotein cholesterol ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and Systemic Inflammation Response Index were analysed and compared. A total of 278 psoriasis patients and 90 healthy volunteers were analysed. Compared to the control group, psoriasis patients showed significantly higher systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, serum C-reactive protein levels, neutrophil count, monocyte count, body mass index, and waist circumference (p < 0.001, p = 0.001, p < 0.001, p = 0.014, p < 0.001, p < 0.001, p = 0.046, p < 0.001, and p = 0.011, respectively). Among patients with severe psoriasis (Psoriasis Area and Severity Index >10), systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and serum C-reactive protein levels were significantly higher compared to patients with mild/moderate psoriasis (Psoriasis Area and Severity Index ≤10). In the ROC curve analysis, the optimal cut-off (AUC, sensitivity, specificity) values for neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and platelet-to-lymphocyte ratio were found to be 2.11 (0.592, 62%, 57%), 552.9 (0.579, 61%, 58%), and 111.9 (0.578, 64%, 46%), respectively. The inflammatory parameters that showed correlation with Psoriasis Area and Severity Index were systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, monocyte-to-lymphocyte ratio, and C-reactive protein. The findings of this study suggest that systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, and C-reactive protein values have the potential to serve as simple and cost-effective markers for assessing the inflammatory burden in individuals with psoriasis.

Association of Triglyceride-Glucose Index, Triglyceride to High-Density Lipoprotein Cholesterol Ratio, and Related Parameters With Prehypertension and Hypertension.

The objective of this study was to investigate the association between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c), triglyceride-glucose index (TyG), and related parameters (TyG-BMI, TyG-WC) with prehypertension and hypertension over 45years old. According to the blood pressure diagnosis, the enrolled individuals were divided into two groups, which were prehypertension and hypertension. In multivariate logistic regression analysis, after adjusting for confounders, the highest quartile groups of TG/HDL-c, TyG, and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups, and there was associated with hypertension when comparing the highest TG/HDL-c to the lowest TG/HDL-c and corresponding ORs were 1.416 (1.234, 1.625) and 1.029 (0.893, 1.187), respectively. Furthermore, when comparing the fourth quartile to the first quartile of TG/HDL-c, TyG index, and related parameters, respectively, both corresponding ORs of hypertension were higher than prehypertension. Elevated TyG, TyG-BMI, TyG-WC index, and TG/HDL-c ratio levels were associated with hypertension in individuals over 45years. Moreover, the receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension suggested that the TyG-WC index ([Area under the curve] AUC: 0.601 [CI: 0.588-0.615]), TyG-BMI, and TyG were more significant than TG/HDL-c in distinguishing hypertension. However, in the prehypertension population, the area under the ROC curve for TyG-BMI (0.543 [CI: 0.530-0.556]) was better than that of other parameters. They have the potential to become cost-effective monitors in the hierarchical management of hypertension.

The triglyceride glucose: high-density lipoprotein cholesterol ratio is associated with coronary artery calcification evaluated via non-gated chest CT

BackgroundCoronary artery calcification (CAC) is a common risk factor of cardiovascular disease. Although triglyceride glucose (TYG) index and high-density lipoprotein cholesterol (HDL-c) are both associated with CAC, no study has evaluated the correlation between the TYG/HDL-c ratio and CAC. In the present study, we investigated the relationships between CAC and the TYG index and the TYG/HDL-c ratio.MethodsA total of 9585 participants who underwent computed tomography (CT) screening for lung cancer from 2018 to 2020 were included in this cross-sectional study. Demographic data, laboratory test data and medical history data were collected from medical records. TYG = Ln[fasting glucose (mg/dL)×fasting TG (mg/dL/2]. The triglyceride glucose-HDL-c ratio was calculated as TYG/HDL-c. CAC was evaluated on chest CT images. Multivariate logistic regression analysis and restricted cubic splines were used to determine the relationships among the TYG index, TYG/HDL-c ratio and risk of CAC. The receiver operating characteristic (ROC) curve was used to evaluate the performance of the TYG index and TYG/HDL-c ratio in identifying CACs in individuals aged 60 years and above.ResultsCAC was detected in 2515 of 9585 participants (mean age 51.8 ± 15.5 years, 61.2% men). The prevalence of CAC was significantly greater in participants with a high TYG/HDL-c ratio (32.6% in the fourth quartile vs. 19.1% in the first quartile, p < 0.001). Multivariate logistic regression revealed that both the TYG index (odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.02–1.10) and the TYG/HDL-c ratio were associated with coronary artery calcification (OR = 1.32, 95% CI: 1.14–1.51). No such association was observed between the TYG index and CAC when further adjusted for the serum lipid level (OR = 1.23, 95% CI: 0.99–1.54). The TYG/HDL-c ratio was still associated with CAC after further adjustment for low-density lipoprotein cholesterol and total cholesterol (OR = 1.21, 95% CI: 1.09–1.35). TYG/HDL-c ratio was associated both with single vessel and multivessel calcification (OR = 1.14, 95%CI:1.05–1.23; OR = 1.15, 95%CI: 1.05–1.21). Similar trends were observed when we categorized individuals by TYG index and TYG/HDL-c quartiles and in subjects older than 60 years. Restricted cubic splines revealed that the TYG/HDL ratio had a better dose‒responsive relationship than did the TYG index. Subgroup analysis revealed that the association between the TYG/HDL-c ratio and coronary artery calcification was mainly observed in nondiabetic or nonhypertensive participants, regardless of low-density lipoprotein cholesterol levels. The ROC curve also revealed that the TYG/HDL-c ratio was better able to identify CAC than the TYG index was (area under the curve = 0.54 vs. 0.52, p < 0.01) in subjects older than 60 years.Conclusion An increase in the TYG/HDL-c ratio is significantly positively associated with the risk of CAC, and the TYG/HDL-c ratio has a more stable association with CAC than TYG.

Association of platelet-to-HDL cholesterol ratio with frailty and all-cause mortality

BackgroundFrailty often requires intensive care, and the admission outcomes of frail patients are often poor. However, owing to the lack of reliable diagnostic indicators, quickly identifying frailty is challenging. The present study aimed to explore the associations of the platelet/high-density lipoprotein cholesterol ratio (PHR; a novel inflammatory indicator) with frailty and all-cause mortality.MethodsThe present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Frailty was assessed on the basis of the 49-item Frailty Index. The associations of the PHR with frailty and long-term survival prognosis were explored through weighted logistic regression, weighted restricted cubic spline (RCS), and weighted Cox regression, with adjustments for demographic factors, lifestyle, blood lipids, medication history, and complications. In addition, subgroup and interaction analyses were conducted. Finally, several sensitivity analyses were performed.ResultsA total of 15,615 adult participants were included, with 7,928 women (53.63%) and an average age of 60.76 years. After fully adjusting for confounding variables, the prevalence of frailty in the highest PHR quartile group of was significantly greater than that in the lowest quartile group (OR: 1.23, 95% CI: 1.04–1.47; P = 0.02). The RCS showed that the inflection point was 166.7. Before and after the inflection point, the PHR was negatively associated (OR: 0.88, 95% CI: 0.80–0.97, P = 0.01) and positively associated (OR: 1.10, 95% CI: 1.02–1.19, P = 0.01) with frailty, respectively. Subgroup analysis suggested that the association between PHR and frailty was stronger in women than in men. A total of 5,544 frail participants were included in the survival analysis. The RCS revealed that the PHR was associated with the all-cause mortality risk of frail participants in a U-shaped manner, with an inflection point of 240.4. Before and after the inflection point, the PHR decreased (HR: 0.89, 95% CI: 0.81–0.97, P = 0.01) and the all-cause mortality risk increased (HR: 1.08, 95% CI: 1.02–1.14, P = 0.01), respectively.ConclusionThe present study suggests that there is a J-shaped association between PHR and frailty in the adult population of the United States and that the association between the PHR and frailty is stronger in women. In addition, the PHR has a U-shaped relationship with the all-cause mortality risk of frail patients.

Nonlinear association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and risk of gestational diabetes mellitus

Previous studies have indicated a potential association between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and the risk of Type 2 Diabetes Mellitus, but its relation with gestational diabetes mellitus (GDM) remains uncertain. This study aims to investigate the correlation between the ALT/HDL-C ratio in early pregnancy and the risk of GDM. This study is a secondary analysis based on an open-source cohort study. A total of 590 single pregnant women attending two hospitals in Korea up to 14 weeks gestation were included between November 2014 and July 2016. Logistic regression analysis, subgroup analysis, and smooth curve fitting were employed to explore the association between the ALT/HDL-C ratio and GDM risk. The predictive capability of the ALT/HDL-C ratio for GDM was assessed using ROC curve analysis. The average age of participants was 32.06 ± 3.80 years, with a GDM incidence rate of 6.27%. Multifactorial logistic regression analysis revealed that the serum ALT/HDL-C ratio is an independent influencing factor for GDM (OR = 1.08, 95% CI: 1.02–1.16). Furthermore, a non-linear relationship between the ALT/HDL-C ratio and GDM risk was observed, with a turning point at 5.51. The effect size (OR) on the left and right sides of the turning point were 0.75 (95% CI: 0.37–1.59) and 1.55 (95% CI: 1.18-2.00), respectively. Additionally, when combined with age, pre-pregnancy body mass index, parity, and insulin resistance index in a prediction model for GDM, the ALT/HDL-C ratio demonstrated improved sensitivity of prediction by reaching up to 67.6%, specificity of prediction by reaching up to 87.3%, and an area under curve value of 0.819 (95%CI: 0.743–0.894). In early pregnancy, the serum ALT/HDL-C ratio shows a positive correlation with maternal risk in a nonlinear manner. The combination of ALT/HDL-C ratio with maternal characteristics and metabolic indicators provides good predictive value for GDM. This study may facilitate optimization of GDM prevention in pregnant women and enable timely and effective intervention to enhance their prognosis.

Associations between inflammatory markers and carotid plaques in CKD: mediating effects of eGFR–a cross-sectional study

BackgroundChronic kidney disease (CKD) is a significant public health concern associated with a high prevalence of carotid plaques, which are indicators of atherosclerosis and predictors of adverse cardiovascular outcomes. Inflammation is a hallmark of CKD, contributing to both renal dysfunction and cardiovascular complications. This study aims to investigate the association between inflammatory markers—systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), aggregate inflammatory status index (AISI), monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR)—and carotid plaques in CKD patients, and to explore the potential mediating role of estimated glomerular filtration rate (eGFR) in this relationship.MethodsA cross-sectional analysis was conducted on patients admitted to the Division of Nephrology between January 2023 and June 2023. The primary endpoint was the presence of carotid plaques assessed using ultrasound imaging. Multivariable logistic regression models were used to examine the associations between inflammatory markers and carotid plaques, and trend tests were performed to evaluate the trending association of carotid plaques risk and inflammatory markers in tertiles. Restricted cubic spline (RCS) analysis was used to assess potential non-linear relationships, and subgroup analyses were conducted to examine consistency across different strata. Mediation analysis was performed to explore the role of eGFR.ResultsOf the 609 participants, 387 were included in the final analysis after applying exclusion criteria. Elevated levels of LnSIRI (OR = 1.87, 95% CI = 1.25–2.80), LnSII (OR = 1.67, 95% CI = 1.09–2.56), LnAISI (OR = 1.70, 95% CI = 1.22–2.37), LnMHR (OR = 1.94, 95% CI = 1.15–3.26), LnNHR (OR = 1.82, 95% CI = 1.10–3.02), and LnMLR (OR = 2.26, 95% CI = 1.18–4.34) were significantly associated with the presence of carotid plaques. There were significant trends for increasing tertiles of SIRI, AISI, MHR and NHR. RCS analysis showed no significant non-linear associations. Subgroup analyses indicated similar associations across most strata. eGFR partially mediated these relationships, with proportions mediated ranging from 14.7 to 17.5%.ConclusionsInflammatory markers are significantly associated with carotid plaques in CKD patients, with eGFR playing a partial mediating role. These findings highlighted the importance of managing inflammation and maintaining renal function to mitigate the risk of atherosclerosis in CKD patients.Trial registrationNot applicable.

The association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and non-alcoholic fatty liver disease in US adults: a cross-sectional study

The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to HDL-C (NHHR) is a novel lipid parameter used to assess the risk of cardiovascular disease. Previous studies have demonstrated an association between the NHHR and risk of non-alcoholic fatty liver disease (NAFLD). Owing to the lack of research exploring this relationship in specific populations, this study aimed to determine the potential link between the NHHR and risk of NAFLD among American adults in the United States. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES) spanning 2017–2020. After excluding individuals with other liver diseases, alcohol abuse, and missing lipid data, a total of 6809 eligible adults were included for analysis. The NHHR was calculated as the ratio of (non-HDL-C) to HDL-C, while NAFLD was identified by liver steatosis detected by transient elastography. Multivariable weighted logistic regression models and restricted cubic spline (RCS) models were employed to investigate the relationship between the NHHR and risk of NAFLD. Subgroup and sensitivity analyses were also conducted to test the robustness of the results. As the NHHR increased, the prevalence of NAFLD rose progressively (5.88% vs. 8.75% vs. 12.24% vs. 15.77%, p < 0.001). In the overall population, after adjusting for confounding factors, each unit increase in the NHHR was associated with a 25% increase in NAFLD risk (OR = 1.25, 95% CI: 1.03–1.53, p = 0.0372). When the NHHR was analyzed as a categorical variable (quartiles), participants in the highest quartile had a significantly higher risk of NAFLD than those in the lowest quartile (OR = 2.6, 95% CI: 1.75–3.85, p = 0.009). RCS analysis further indicated a nonlinear dose–response relationship between the NHHR and risk of NAFLD (p non-linearity < 0.0001). This association remained significant in both subgroup and sensitivity analyses. This study confirmed that the NHHR, particularly at higher levels, was an independent risk factor for NAFLD. As a comprehensive lipid indicator, the NHHR had the potential to predict NAFLD risk. These findings provided new insights for the prevention and clinical management of NAFLD.

Assessment of Paraoxonase 1 and Arylesterase Activities and Lipid Profile in Bodybuilders: A Comparative Study of Physical Activity and Anthropometry on Atherosclerosis.

Background and Objectives: Atherosclerosis, driven by dyslipidaemia and oxidative stress, is a leading cause of cardiovascular morbidity and mortality. This study evaluates the effects of vigorous-intensity bodybuilding exercise (VIBBE) on atherosclerosis biomarkers-including paraoxonase-1 (PON1) and arylesterase (ARE) activities-and lipid profiles in male bodybuilders who do not use anabolic-androgenic steroids. Comparisons were made with individuals engaged in moderate-intensity aerobic exercise (MIAE), as well as overweight/obese sedentary (OOS) and normal-weight sedentary (NWS) individuals. Materials and Methods: A cross-sectional study was conducted involving 122 healthy male participants aged 18-45 years, divided into four groups: VIBBE (n = 31), OOS (n = 30), MIAE (n = 32), and NWS (n = 29). Anthropometric assessments were performed, and fasting blood samples were collected for biochemical analyses, including lipid profiles and PON1 and ARE activities. Statistical analyses compared the groups and evaluated correlations between adiposity measures and atherosclerosis biomarkers. Results: The VIBBE group exhibited significantly lower levels of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and logarithm of the TG to high-density lipoprotein cholesterol (HDL-C) ratio [log(TG/HDL-C)] compared to the OOS group (p < 0.05 for all), indicating improved lipid profiles. However, these improvements were not significant when compared to the NWS group (p > 0.05), suggesting that VIBBE may not provide additional lipid profile benefits beyond those associated with normal weight status. PON1 and ARE activities were significantly lower in the VIBBE group compared to the MIAE group (p < 0.05 for both), suggesting that VIBBE may not effectively enhance antioxidant defences. Correlation analyses revealed significant inverse relationships between PON1 and ARE activities and adiposity measures, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), fat mass index (FMI), and obesity degree (OD) (p < 0.05 for all). Positive correlations were observed between oxLDL and log(TG/HDL-C) and adiposity measures (p < 0.05 for all). Conclusions: Vigorous-intensity bodybuilding exercise improves certain lipid parameters compared to sedentary obese individuals but does not significantly enhance antioxidant enzyme activities or further improve lipid profiles beyond those observed in normal-weight sedentary men. Conversely, moderate-intensity aerobic exercise significantly enhances PON1 and ARE activities and improves lipid profiles, offering superior cardiovascular benefits. These findings underscore the importance of incorporating moderate-intensity aerobic exercise into physical activity guidelines to optimize cardiovascular health by balancing improvements in lipid metabolism with enhanced antioxidant defences.

Lipid metabolism and hearing loss: association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with adolescent hearing health

BackgroundThe ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is a novel lipid measure for assessing the risk of cardiovascular disease. Lipid metabolism disorders are reportedly associated with hearing impairment. This study aimed to investigate the potential association between NHHR and hearing.MethodsThe data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) cycles of 2005–2010 and 2017–2018, including 4,296 participants aged 6–19 years. The NHHR was calculated from lipid profiles, and hearing was assessed using pure-tone audiometry. Weighted multivariate logistic regression analyses were used to investigate the association between the NHHR and hearing loss. Subgroup and sensitivity analyses were performed to verify the robustness of the results.ResultsUnivariate analysis revealed significant associations between the NHHR and hearing threshold at all categorized frequency (low, speech, or high-frequency) (P < 0.001). Three models were used: an unadjusted model, a model adjusted for age, sex, and race, and a model further adjusted for PIR, BMI, and diabetes. Multiple regression analysis confirmed these associations consistently across all models. When considered as a continuous variable, NHHR had a significant association with enhanced hearing thresholds at all categorized frequencies: low-frequency (β:0.56, 95% CI: 0.36–0.75), speech-frequency (β:0.55, 95% CI: 0.36–0.7), and high-frequency (β:0.55, 95% CI: 0.36–0.74). The adjusted models showed persistent positive correlations after controlling for covariates. The NHHR was consistently positively associated with hearing loss. The NHHR and auditory thresholds showed a general dose-response association across all frequencies.ConclusionsNHHR is a promising biomarker for predicting adolescent hearing threshold shifts and hearing loss. The study highlights the importance of early lipid monitoring and management as strategies to prevent or reduce hearing impairment.

A cross-sectional study of factors associated with carotid atherosclerosis.

The aim of this work was to study the relationship between carotid atherosclerosis (CAS) and several indexes and provide a basis for the prevention and treatment of cardiovascular and cerebrovascular diseases. There were 11,028 adults who underwent physical examination at the Guangzhou Cadre and Talent Health Management Center from January 2023 to December 2023 and were selected as research subjects. Retrospective analysis was used to understand the carotid atherosclerosis of the examined population and analyze its relationship with sex, age, blood pressure, blood glucose, blood lipids, renal function, 25-hydroxyvitamin D, neutrophil to lymphocyte count ratio (NLR), platelet to lymphocyte count ratio (PLR), systemic immune inflammation index (SII), monocyte count to high-density lipoprotein cholesterol ratio (MHR), triglyceride glucose body mass index (TyG-BMI), insulin resistance metabolic index (METS-IR), and other indicators. Among 11,028 subjects, the detection rate of carotid atherosclerotic thickening (CAT) was 12.00% and carotid atherosclerotic plaque (CAP) was 25.11%. The CAT and CAP detection rates in men were 13.32% and 28.78%, respectively, which were higher than the CAT detection rate of 8.28% and CAP detection rate of 14.80% in women, and the differences were statistically significant (both p < 0.001). Multivariate logistic regression analysis using TyG-BMI and METS-IR as two indicators was modeled separately, and the results showed that CAS was associated with men, increasing age, and systolic blood pressure. The area under the curve (AUC) was analyzed using the subject's work characteristic (ROC) curve in the descending order of METS-IR, TyG-BMI, and MHR. The combination of the three indexes of sex, age, and METS-IR predicted atherosclerosis with the highest AUC values. Carotid atherosclerosis is highly prevalent in men. Elevation of systolic blood pressure, fasting glucose, MHR, and TyG-BMI (or METS-IR) with age are independent influences on carotid atherosclerosis. The three indexes of MHR, TyG-BMI, and METS-IR, respectively, in combination with sex and age, can be used as a new and effective index to predict CAS.

Association of non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio with cardiovascular outcomes in patients with type 2 diabetes mellitus: Evidence from the ACCORD cohort.

To explore the association between the non-high-density lipoprotein cholesterol (HDL-C)/HDL-C ratio (NHHR) and the risk of major adverse cardiovascular events (MACEs) and overall mortality in patients with type 2 diabetes mellitus (T2DM). NHHR, calculated as (total cholesterol - HDL-C)/HDL-C, was evaluated in 10,188 participants. Cox proportional hazard regression models were employed to assess the association of NHHR with future risk of MACEs and overall mortality. Restricted cubic spline analysis, smooth curve fitting and piecewise regression models were utilized to explore the non-linear correlation and establish the threshold. Subgroup and interaction analyses verified the robustness of the findings. The area under the receiver operating characteristic area under the curve assessed the additional predictive value of NHHR beyond conventional risk factors. After adjusting for confounding factors, each 1-unit increase in NHHR was associated with a 12% increased risk of MACEs (hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.07-1.16; p < 0.0001), a 5% increase in overall mortality (HR: 1.05, 95% CI: 1.01-1.10; p = 0.0256), a 10% increase in cardiovascular disease mortality (HR 1.10, 95% CI: 1.03-1.18; p = 0.0074), an 12% increase in non-fatal myocardial infarction (HR: 1.12, 95% CI: 1.05-1.18; p = 0.0002), and an 11% increase in non-fatal stroke (HR: 1.11, 95% CI: 1.02-1.20; p = 0.0123). Analyses showed a non-linear relationship between NHHR and MACEs in patients with T2DM (non-linearity p < 0.001). A two-stage linear regression model identified a threshold for MACEs at 6.28. Integration NHHR into the conventional model significantly enhanced predictive accuracy for MACEs. NHHR is a predictor of the risk of developing MACEs and overall mortality in patients with T2DM, with higher NHHR values independently associated with increased future MACE risks after full adjustment for confounders.

Elevated non-HDL-C to HDL-C ratio as a marker for NAFLD and liver fibrosis risk: a cross-sectional analysis.

Dyslipidemia is a known independent risk factor for Nonalcoholic fatty liver disease (NAFLD). However, the relationship between NAFLD and the serum non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio remains unclear. This study examined the association between the non-HDL-C to HDL-C ratio and NAFLD prevalence, including liver steatosis and fibrosis levels in the population. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 4798 participants. Liver ultrasound and Transient Elastography (TE) were used to assess fibrosis and steatosis. Adjusted multivariable regression analyses, subgroup analyses based on BMI and sex, and a generalized additive model were employed to investigate the relationship between the non-HDL-C/HDL-C ratio and NAFLD. Among the 4798 participants, 39.27% (n = 1,884) had NAFLD. Significant positive correlations between non-HDL-C/HDL-C and NAFLD risk were found across all models, with sex-stratified analyses indicating higher risk in men. Liver fibrosis was also associated with non-HDL-C/HDL-C ratios. The Receiver operating characteristic (ROC) analysis shows non-HDL-C/HDL-C as a better predictor for NAFLD than non-HDL-C or HDL-C alone. Elevated non-HDL-C/HDL-C levels are independently associated with increased NAFLD and liver fibrosis risk in the American population, suggesting its utility in predicting NAFLD and related liver fibrosis.