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Updated: Sep 9, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

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Data-driven analysis of the relationship between the HbA1c/HDL-C ratio and coronary artery calcification: a

Chen Chen1, Mingkang Li2,3, Gaoliang Yan2,3

  • 1School of Cyber Science and Engineering, Southeast University, Nanjing, Jiangsu, China.

Scientific Reports
|August 29, 2025
PubMed

Insights

The glycated hemoglobin A1c (HbA1c)/high-density lipoprotein cholesterol (HDL-C) ratio is linked to coronary artery calcification (CAC) in adults. An elevated HbA1c/HDL-C ratio independently predicts CAC, suggesting its utility in cardiovascular risk assessment.

Area of Science:

  • Cardiovascular Disease Research
  • Metabolic Syndrome Studies
  • Biomarker Discovery

Background:

  • Coronary artery calcification (CAC) is a key marker for cardiovascular disease (CVD) development.
  • Dysregulated glucose and lipid metabolism are closely linked to CAC pathogenesis.
  • Identifying novel biomarkers for CAC risk is crucial for preventative strategies.

Purpose of the Study:

  • To investigate the association between the glycated hemoglobin A1c (HbA1c)/high-density lipoprotein cholesterol (HDL-C) ratio and CAC.
  • To determine if the HbA1c/HDL-C ratio is an independent predictor of CAC in asymptomatic adults.
  • To develop and evaluate a predictive model and nomogram for CAC incorporating the HbA1c/HDL-C ratio.

Main Methods:

  • Cross-sectional study involving 1608 eligible participants.
  • Calculation of the HbA1c/HDL-C ratio.
  • Statistical analyses including LASSO regression, logistic regression, and ROC curve analysis.
  • Development and validation of a predictive nomogram.

Main Results:

  • The HbA1c/HDL-C ratio was significantly higher in the CAC group compared to the control group (p < 0.001).
  • An elevated HbA1c/HDL-C ratio (≥ 4.99) was associated with a higher prevalence of CAC (30.04% vs. 17.83%, p < 0.001).
  • The HbA1c/HDL-C ratio emerged as an independent risk factor for CAC (OR, 1.135; 95% CI, 1.008-1.279; p = 0.037).
  • The predictive model incorporating the HbA1c/HDL-C ratio achieved an AUC of 0.718.

Conclusions:

  • The HbA1c/HDL-C ratio is significantly associated with the presence of CAC.
  • This ratio serves as an independent predictor of CAC in asymptomatic adults without pre-existing CVD.
  • The developed nomogram demonstrates favorable clinical utility for CAC risk assessment.

Keywords:
Cardiovascular diseaseCoronary artery calcificationHbA1c/HDL-C ratio

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