Li Jinyue, Ma Han
Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China; National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, 100730, China.
Nutr Metab Cardiovasc Dis. 2025 Apr;35(4):103814. doi: 10.1016/j.numecd.2024.103814. Epub 2024 Dec 3.
Inflammation, lipid signaling, and their interplay are involved in the pathogenesis and development of cardiovascular diseases (CVDs), while the relationships of composite indices combining inflammation and lipids with CVD remained inexplicit.
Our study enrolled 8581 adults from the National Health and Nutrition Examination Survey 2015-2018. Logistic regression model was applied to assess the associations of high-sensitivity C-reactive protein (hs-CRP)-to-high-density lipoprotein cholesterol (HDL-C) ratio with CVD prevalence. Potential mediating effects of hypertension, diabetes, hypercholesterolemia, and obesity on significant associations were explored. Receiver operating characteristic (ROC) curves were generated to compare diagnostic values of the hs-CRP/HDL-C ratio, HDL-C, and hs-CRP. Compared with those in the first quartile of the hs-CRP/HDL-C ratio, participants in the fourth quartile presented higher risks of CVD subtypes and total CVD. Each one-unit increment of the log-transformed hs-CRP/HDL-C ratio was associated with a 25 % increase in CVD risk (95 % confidence interval: 1.11, 1.41) with significant uptrends across the hs-CRP/HDL-C ratio quartiles. Four metabolic disorders significantly mediated associations of the hs-CRP/HDL-C ratio with CVDs. Younger participants were more sensitive to higher hs-CRP/HDL-C ratio with significant interactions in CVD. ROC curves further illustrated the relatively good diagnostic efficacy of the hs-CRP/HDL-C ratio for CVD.
The hs-CRP/HDL-C ratio was a significant risk factor for CVD among US adults, in which hypertension, diabetes, hypercholesterolemia, and obesity played important mediating roles. Early attention to people with elevated hs-CRP/HDL-C ratio would be helpful for CVD risk reduction.
炎症、脂质信号传导及其相互作用参与了心血管疾病（CVD）的发病机制和发展过程，而炎症与脂质综合指标和CVD之间的关系仍不明确。
我们的研究纳入了2015 - 2018年国家健康与营养检查调查中的8581名成年人。应用逻辑回归模型评估高敏C反应蛋白（hs-CRP）与高密度脂蛋白胆固醇（HDL-C）比值与CVD患病率之间的关联。探讨了高血压、糖尿病、高胆固醇血症和肥胖对显著关联的潜在中介作用。生成受试者工作特征（ROC）曲线以比较hs-CRP/HDL-C比值、HDL-C和hs-CRP的诊断价值。与hs-CRP/HDL-C比值第一四分位数的参与者相比，第四四分位数的参与者患CVD亚型和总CVD的风险更高。log转换后的hs-CRP/HDL-C比值每增加一个单位，CVD风险增加2%（95%置信区间：1.11，1.41），在hs-CRP/HDL-C比值四分位数间呈显著上升趋势。四种代谢紊乱显著介导了hs-CRP/HDL-C比值与CVD之间的关联。年轻参与者对较高的hs-CRP/HDL-C比值更敏感，在CVD中存在显著的交互作用。ROC曲线进一步说明了hs-CRP/HDL-C比值对CVD具有相对较好的诊断效能。
hs-CRP/HDL-C比值是美国成年人CVD的一个重要危险因素，其中高血压、糖尿病、高胆固醇血症和肥胖起到了重要的中介作用。早期关注hs-CRP/HDL-C比值升高的人群将有助于降低CVD风险。
