Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea.
School of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea.
Lipids Health Dis. 2024 Oct 26;23(1):347. doi: 10.1186/s12944-024-02343-2.
The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) plays a potential role in cardiovascular diseases. However, its association with angina pectoris remains unclear. Herein, we aimed to explore their relationship.
This cross-sectional retrospective study included the 2009-2018 data from 22,562 adults diagnosed with angina pectoris, retrieved from the National Health and Nutrition Examination Survey (NHANES) database. NHHR was estimated from laboratory data, and angina pectoris diagnosis was ascertained from the NHANES questionnaire.
Angina pectoris risk was greater in the highest than in the lowest NHHR tertile (odds ratio [OR] = 1.61; 95% confidence interval (CI), 1.15-2.54; P = 0.006). Weighted logistic regression showed a positive association between NHHR and angina pectoris in the fully adjusted model (OR = 1.17; 95% CI, 1.07-1.28; P = 0.001). Restricted cubic spline analysis showed a linear association (P = 0.6572). Subgroup analyses indicated no significant differences across different stratifications (P > 0.05, all). Random forest analyses and Boruta algorithm corroborated that NHHR is a strong predictor of angina pectoris. Among the eight machine-learning models evaluated for predictive capabilities, the logistic regression model demonstrated the strongest predictive capability, with an area under the curve of 0.831.
Our study suggests that NHHR is a risk factor for angina pectoris and may be used for risk prediction and to inform future intervention programs to reduce its incidence.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（NHHR）在心血管疾病中具有潜在作用。然而，其与心绞痛的关系尚不清楚。在此，我们旨在探讨它们之间的关系。
本横断面回顾性研究纳入了 2009 年至 2018 年期间，从国家健康和营养检查调查（NHANES）数据库中检索到的 22562 例被诊断为心绞痛的成年人的数据。NHHR 是根据实验室数据估算的，心绞痛的诊断是从 NHANES 问卷中确定的。
NHHR 最高三分位组的心绞痛风险高于最低三分位组（比值比[OR] = 1.61；95%置信区间[CI]，1.15-2.54；P = 0.006）。加权逻辑回归显示，在完全调整模型中，NHHR 与心绞痛之间存在正相关（OR = 1.17；95% CI，1.07-1.28；P = 0.001）。限制三次样条分析显示存在线性关联（P = 0.6572）。亚组分析表明，在不同分层中没有显著差异（P > 0.05，均）。随机森林分析和 Boruta 算法证实 NHHR 是心绞痛的一个强有力的预测因子。在评估预测能力的八个机器学习模型中，逻辑回归模型表现出最强的预测能力，曲线下面积为 0.831。
我们的研究表明，NHHR 是心绞痛的一个危险因素，可用于风险预测，并为未来的干预计划提供信息，以降低其发病率。
