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Relationship between novel inflammatory markers derived from high-sensitivity C-reactive protein and heart failure: a
Peng Zhang1,2,3, Degang Mo1,2,3, Fanhui Lin1,2,3
1Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong, China.
Insights
The high-sensitivity C-reactive protein to HDL-C ratio (HCHR) and high-sensitivity C-reactive protein to lymphocyte count ratio (HCLR) are linked to a higher risk of heart failure (HF). These inflammatory markers show a significant association with HF prevalence in US adults.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biomarkers
- Public Health
Background:
- Heart failure (HF) is a significant public health concern associated with chronic inflammation.
- Novel inflammatory indicators, such as the high-sensitivity C-reactive protein to HDL-C ratio (HCHR) and high-sensitivity C-reactive protein to lymphocyte count ratio (HCLR), may offer insights into HF pathogenesis.
Purpose of the Study:
- To investigate the association between HCHR, HCLR, and the prevalence of heart failure (HF) in a US adult population.
- To explore the nature of this relationship, including potential nonlinear associations and diagnostic efficacy.
Main Methods:
- A cross-sectional analysis of 8751 participants from the National Health and Nutrition Examination Survey (NHANES, 2015-2018).
- Multivariate logistic regression, smoothed curve fitting, threshold effect analysis, subgroup analyses, and receiver operating characteristic (ROC) curve analysis were employed.
- Ln-transformed HCHR and HCLR were used to assess associations with HF.
Main Results:
- Higher tertiles of Ln(HCHR) and Ln(HCLR) were significantly associated with an increased risk of HF (OR=1.45 and OR=1.52, respectively).
- A nonlinear relationship was observed between Ln(HCHR) and HF, with an inflection point at -2.71.
- Ln(HCLR) demonstrated higher diagnostic efficacy for HF (AUC: 0.638) compared to Ln(HCHR) (AUC: 0.620).
Conclusions:
- Both Ln(HCHR) and Ln(HCLR) are positively associated with the prevalence of heart failure among US adults.
- These inflammatory ratios may serve as potential indicators for HF risk stratification and diagnosis.
Objective:
High-sensitivity C-reactive protein to HDL-C ratio (HCHR) and high-sensitivity C-reactive protein to lymphocyte count ratio (HCLR) are two novel inflammatory indicators, and heart failure (HF) is linked to chronic inflammation. This study sought to evaluate the link between HCHR, HCLR, and HF.
Methods:
We carried out a cross-sectional investigation using the National Health and Nutrition Examination Survey (NHANES, 2015-2018). We used multivariate logistic regression to determine the association between HCHR, HCLR, and HF, followed by smoothed curve fitting and threshold effect analysis, as well as subgroup analyses of the underlying demographic variables to investigate potential impacts. The receiver operating characteristic curves were employed to examine the correlation between each index and HF.
Results:
This study included 8751 subjects, and multivariate logistic regression after Ln conversion for HCHR and HCLR showed that subjects in the highest tertile of Ln(HCHR) had a significantly higher risk of 45% than those in the lowest tertile in the fully adjusted model 3 (OR = 1.45, 95% CI 1.02-2.07; P for trend = 0.0269), whereas subjects in the highest tertile of Ln(HCLR) had a significantly higher risk of 52% (OR = 1.52, 95% CI 1.07-2.17; P for trend = 0.0184) than those in the lowest tertile. Ln(HCHR) and HF exhibited a nonlinear relationship, with an inflection point of -2.71 and a log-likelihood ratio of 0.024. Subgroup analyses revealed no significant interactions between Ln(HCHR), Ln(HCLR), and specific subgroups (all P for interactions > 0.05). The ROC curve indicated that Ln(HCLR) had the greatest diagnostic efficacy for HF (AUC: 0.638, 95% CI 0.607-0.669), succeeded by Ln(HCHR) (AUC: 0.620, 95% CI 0.589-0.652).
Conclusion:
Our findings indicate that Ln(HCHR) and Ln(HCLR) are positively linked with the prevalence of HF among US adults. Specifically, Ln(HCHR) levels demonstrated a nonlinear correlation with HF, featuring an inflection point at -2.71.
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