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The relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and
Jiawei Zhang1, Yijie Ning2,3, Rui Bai1
1Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, China.
Insights
Higher non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is linked to increased abdominal aortic calcification (AAC) and severe AAC risk, especially in women. This lipid index may aid in preventing AAC.
Area of Science:
- Cardiovascular Health
- Lipid Metabolism
- Atherosclerosis Research
Background:
- The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is an emerging lipid index for assessing atherosclerosis.
- While NHHR is a known biomarker for various diseases, its connection to abdominal aortic calcification (AAC) has not been previously investigated.
Purpose of the Study:
- To investigate the association between NHHR and AAC in adults.
- To determine if NHHR can serve as a predictive marker for AAC and its severity.
Main Methods:
- Analysis of data from 2,517 participants in the 2013-2014 National Health and Nutrition Examination Survey (NHANES).
- AAC assessment using dual-energy x-ray absorptiometry and quantification via the Kauppila score (AAC-24).
- Multivariate regression models and restricted cubic splines were used to evaluate the relationship between NHHR and AAC, with subgroup analyses performed.
Main Results:
- Higher NHHR levels correlated with increased AAC scores and a greater prevalence of severe AAC (sAAC) across NHHR quartiles (p < 0.05).
- A one-unit increase in NHHR was associated with a 0.13-unit rise in AAC score and a 19% increase in sAAC risk.
- A significant interaction between NHHR and gender was observed, with a stronger association between NHHR and AAC in women (OR=1.46) compared to men (OR=0.97).
Conclusions:
- Elevated NHHR is significantly associated with increased abdominal aortic calcification and a higher risk of severe AAC in adults aged 40 and older.
- The association between NHHR and AAC is particularly pronounced in women, suggesting a potential gender-specific role.
- NHHR may hold clinical value for the prevention of AAC and its associated cardiovascular complications.
Background:
The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel lipid index for assessing atherosclerosis. Although NHHR has been recognized as a biomarker for multiple diseases, its association with abdominal aortic calcification (AAC) remains unexplored.
Methods:
This study analyzed data from 2,517 participants in the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). AAC was assessed using dual-energy x-ray absorptiometry and quantified with the Kauppila score (AAC-24). The relationship between NHHR and AAC was evaluated using multivariate linear and logistic regression models, with nonlinear associations visualized via restricted cubic splines. Subgroup and interaction analyses were conducted to assess the robustness of the findings across different populations.
Results:
In fully adjusted models, AAC scores and severe AAC (sAAC) prevalence increased with each quartile increment of NHHR (p < 0.05). A one-unit increase in NHHR was associated with a 0.13-unit rise in AAC score (β = 0.13, 95% CI: 0.02-0.24) and a 19% increase in sAAC risk (OR = 1.19, 95% CI: 1.02-1.40). Subgroup analysis identified a significant interaction between NHHR and gender in relation to AAC. The OR (95% CI) was 0.97 (0.77-1.23) in males and 1.46 (1.18-1.81) in females (p for interaction = 0.008).
Conclusion:
In adults aged 40 years and older, higher NHHR levels were associated with increased AAC scores and a greater risk of sAAC, particularly among women. Furthermore, this study highlights the potential clinical value of NHHR in the prevention of AAC and its related complications.
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