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美国糖尿病患者中非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(NHHR)与糖尿病肾病的相关性:一项横断面研究。

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and diabetic kidney disease in patients with diabetes in the United States: a cross-sectional study.

机构信息

Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People's Republic of China.

Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People's Republic of China.

出版信息

Lipids Health Dis. 2024 Sep 27;23(1):317. doi: 10.1186/s12944-024-02308-5.

Abstract

BACKGROUND

This paper investigated the link between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and diabetic kidney disease (DKD) in adult diabetic patients and identified the optimal NHHR value for impacting DKD.

METHODS

This cross-sectional research made use of records from the National Health and Nutrition Examination Survey (NHANES) executed between 2005 and 2016. The link of NHHR to DKD risk was analyzed by logistic regression and restricted cubic spline (RCS) models. The stability and reliability of the results were assessed by subgroup analysis and sensitivity analysis.

RESULTS

In total, 4,177 participants were involved. As a continuous variable, NHHR was markedly connected to an increased risk of DKD (OR 1.07, 95% CI 1.02, 1.12, P < 0.01). When NHHR was grouped in quartiles, relative to the reference set, the highest NHHR group was also linked to a heightened risk of DKD (OR 1.23, 95% CI 1.01, 1.50, P < 0.05). The outcome of RCS show a "J" shaped correlation between NHHR and DKD risk (P for nonlinear = 0.0136). The risk of developing DKD was the lowest when NHHR equals 2.66. Subgroup analysis revealed that the link of NHHR to DKD persisted in participants aged below 40, females, non-smokers, and those without hyperuricemia. Sensitivity analysis demonstrated a certain robustness in this association.

CONCLUSION

A meaningful link is present between NHHR and DKD. An NHHR value of around 2.66 could represent the ideal cutoff for assessing DKD risk.

摘要

背景

本研究旨在探讨成年糖尿病患者中非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(NHHR)与糖尿病肾病(DKD)之间的关系,并确定影响 DKD 的最佳 NHHR 值。

方法

本横断面研究利用了 2005 年至 2016 年期间进行的国家健康和营养检查调查(NHANES)的记录。采用逻辑回归和限制性立方样条(RCS)模型分析 NHHR 与 DKD 风险的关系。通过亚组分析和敏感性分析评估结果的稳定性和可靠性。

结果

共纳入 4177 名参与者。作为连续变量,NHHR 与 DKD 风险显著相关(OR 1.07,95%CI 1.02,1.12,P<0.01)。当 NHHR 按四分位数分组时,与参考组相比,NHHR 最高组也与 DKD 风险增加相关(OR 1.23,95%CI 1.01,1.50,P<0.05)。RCS 的结果显示 NHHR 与 DKD 风险之间呈“J”形关系(P 非线性=0.0136)。当 NHHR 等于 2.66 时,发生 DKD 的风险最低。亚组分析显示,NHHR 与 DKD 的关联在年龄小于 40 岁、女性、不吸烟者和无高尿酸血症的参与者中仍然存在。敏感性分析表明该关联具有一定的稳健性。

结论

NHHR 与 DKD 之间存在显著关联。NHHR 值约为 2.66 可能代表评估 DKD 风险的理想截止值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bf3/11437633/30f0d29b4344/12944_2024_2308_Fig1_HTML.jpg

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