Department of Nephrology, The Affiliated Hospital, Southwest Medical University, Sichuan Province, P. R. China.
Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Sichuan Province, P. R. China.
PLoS One. 2024 Nov 27;19(11):e0311620. doi: 10.1371/journal.pone.0311620. eCollection 2024.
Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio (NHHR) is a significant indicator of atherosclerosis. However, its association with diabetic kidney disease (DKD) remains unclear. This study aims to explore the relationship between NHHR and the prevalence of DKD among the U.S. adults using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2020. Participants were selected based on the stringent inclusion and exclusion criteria. We utilized single-factor analysis, multivariate logistic regression, and smooth curve fitting to investigate the relationship between NHHR and DKD. Our study included 8,329 diabetic individuals, who were categorized into DKD and non-DKD groups based on the presence or absence of kidney damage. A significant difference in NHHR was observed between these groups. After adjusting for potential confounders, we found that NHHR was positively associated with the prevalence of DKD. Specifically, each one-unit increase in NHHR corresponded to a 6% rise in the prevalence of DKD, with this association remaining significant across stratified NHHR values. Threshold effect analysis revealed an inflection point at an NHHR of 1.75, beyond this point, each unit increase in NHHR was associated with a 7% increase in the prevalence of DKD. Subgroup analysis confirmed the robustness of these findings. Our study demonstrates a significant correlation between NHHR and DKD prevalence, suggesting that monitoring NHHR could be an effective strategy for reducing DKD prevalence.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（NHHR）是动脉粥样硬化的重要指标。然而，其与糖尿病肾病（DKD）的关系尚不清楚。本研究旨在利用 1999 年至 2020 年美国国家健康和营养调查（NHANES）的数据，探讨 NHHR 与美国成年人 DKD 患病率之间的关系。研究对象是根据严格的纳入和排除标准选择的。我们采用单因素分析、多变量逻辑回归和光滑曲线拟合来研究 NHHR 与 DKD 之间的关系。本研究共纳入 8329 例糖尿病患者，根据是否存在肾脏损伤将其分为 DKD 和非 DKD 组。这两组之间的 NHHR 存在显著差异。在调整了潜在的混杂因素后，我们发现 NHHR 与 DKD 的患病率呈正相关。具体来说，NHHR 每增加一个单位，DKD 的患病率就会增加 6%，这种关联在分层的 NHHR 值中仍然显著。阈值效应分析显示，NHHR 为 1.75 时有一个拐点，超过这个点，NHHR 每增加一个单位，DKD 的患病率就会增加 7%。亚组分析证实了这些发现的稳健性。本研究表明 NHHR 与 DKD 患病率之间存在显著相关性，提示监测 NHHR 可能是降低 DKD 患病率的有效策略。
