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Association Between the Non-High-Density Lipoprotein Cholesterol-to-High-Density Lipoprotein Cholesterol Ratio (NHHR)
Yuhua Zhong1, Kesi Zhou2, Sheng Li1
1Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Insights
The non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio (NHHR) predicts higher all-cause mortality in COPD patients. This lipid index demonstrates superior performance in forecasting mortality risk compared to other biomarkers.
Area of Science:
- Cardiology
- Pulmonology
- Biomarkers
Background:
- Chronic Obstructive Pulmonary Disease (COPD) is a major cause of mortality.
- Novel biomarkers are needed to predict mortality risk in COPD patients.
- The non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio (NHHR) is a new composite blood lipid index.
Purpose of the Study:
- To investigate the association between NHHR and mortality from all-causes, cardiovascular disease (CVD), and chronic lower respiratory disease (CLRD).
- To evaluate the NHHR's efficiency in predicting mortality risk in US patients with COPD.
Main Methods:
- Weighted multivariate Cox proportional hazards regression models with restricted cubic splines (RCSs) were used.
- Kaplan-Meier (KM) curves and Log rank tests compared survival rates.
- Receiver operating characteristic (ROC) curves assessed predictive performance.
Main Results:
- Higher NHHR showed a tendency towards increased all-cause, CVD, and CLRD mortality, with a U-shaped association for all-cause mortality.
- Patients in the high-NHHR group had significantly lower survival rates (Log rank test P<0.001).
- NHHR demonstrated superior predictive performance for all-cause, CVD, and CLRD mortality at 5 and 10 years (AUCs ranging from 0.765 to 0.883).
Conclusions:
- Elevated NHHR is associated with increased all-cause mortality risk in COPD patients.
- NHHR exhibits superior predictive capability for mortality compared to other hematological biomarkers.
Purpose:
The non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio (NHHR) is a new composite blood lipid index. We aimed to investigate the relationships of the NHHR with mortality from all-causes, cardiovascular disease (CVD), and chronic lower respiratory disease (CLRD) in US patients with COPD.
Methods:
We assessed the association between the NHHR and mortality via weighted multivariate Cox proportional hazards regression models with restricted cubic splines (RCSs). Between-group survival rates at specific time points were compared via Kaplan‒Meier (KM) curves and Log rank tests. Receiver operating characteristic (ROC) curves were constructed to evaluate the efficiency of the NHHR for predicting mortality risk in COPD patients.
Results:
After adjusting for confounding factors, weighted multivariate Cox proportional hazards regression model showed that higher NHHR was not significantly associated with all-cause mortality (HRs = 1.74), CVD mortality (HRs = 1.19), and CLRD-related mortality (HRs = 0.65), but HRs tended to increase as NHHR increased. RCS revealed U-shaped associations between the NHHR and all-cause mortality. KM survival analysis revealed a significantly lower survival rate for patients in the high-NHHR group (Log rank test P<0.001). In addition, the NHHR had superior performance in predicting mortality, with AUC values of 0.85 and 0.883 for all-cause mortality, 0.769 and 0.815 for CVD mortality, and 0.765 and 0.815 for CLRD-related mortality at 5 and 10 years, respectively.
Conclusion:
The higher the NHHR is, the greater the risk of all-cause mortality in COPD patients. The NHHR was significantly superior to other haematological biomarkers in predicting mortality.
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