Han Fengjiao, Guo Haiyang, Zhang Hao, Zheng Yang
First Affiliated Hospital of Jilin University, Changchun, China.
Front Endocrinol (Lausanne). 2025 Apr 10;16:1552219. doi: 10.3389/fendo.2025.1552219. eCollection 2025.
The precise function of the hs-CRP/HDL-C ratio in forecasting the long-term mortality risk of patients with stages 1-4 of Cardiovascular-Kidney-Metabolic (CKM) syndrome remains inadequately delineated. This study investigates the potential correlation between the hs-CRP/HDL-C ratio and long-term mortality risk in individuals with CKM syndrome stages 1-4.
This prospective cohort study utilises data from the China Health and Retirement Longitudinal Study (CHARLS) project, encompassing 6,719 people who satisfied stringent criteria. We developed three Cox proportional hazards regression models to investigate the potential relationship between the hs-CRP/HDL-C ratio and long-term mortality risk in patients with CKM stages 1-4. We employed Restricted Cubic Spline (RCS) curves for analysis to identify any potential nonlinear correlations. Furthermore, we performed Receiver Operating Characteristic (ROC) curve analysis to evaluate predictive performance and identify the appropriate cut-off value. To enhance the research findings, we conducted a stratified analysis to investigate the influence of various sociodemographic factors on this association.
In individuals with CKM syndrome stages 1-4, the 10-year incidence of all-cause mortality was 14.1%. Upon controlling for additional potential confounding variables, the outcomes of the Cox proportional hazards regression model distinctly demonstrated a statistically significant linear positive association between the hs-CRP/HDL-C ratio and the long-term mortality risk in patients. For each quartile increase in the hs-CRP/HDL-C ratio, the probability of poor outcomes (i.e., mortality) escalated by 15% (Hazard Ratio, HR = 1.15, 95% Confidence Interval, CI: 1.09-1.22, p-value < 0.001). Moreover, the integration of the hs-CRP/HDL-C ratio into the baseline risk prediction model, with all pertinent factors thoroughly adjusted, markedly enhanced the model's predictive capacity, facilitating a more precise assessment of long-term mortality risk in patients with CKM syndrome stages 1-4.
This study identified a positive linear association between the hs-CRP/HDL-C ratio and long-term mortality risk in patients with stages 1 to 4 of CKM syndrome. This remarkable discovery not only offers a crucial reference for enhancing early individualised treatment options but also greatly aids in the early identification of patients with poor prognoses, hence presenting a novel perspective for improving clinical management pathways for these individuals.
高敏C反应蛋白（hs-CRP）与高密度脂蛋白胆固醇（HDL-C）的比值在预测心血管-肾脏-代谢（CKM）综合征1-4期患者的长期死亡风险方面的精确功能仍未得到充分阐明。本研究调查了hs-CRP/HDL-C比值与CKM综合征1-4期个体长期死亡风险之间的潜在相关性。
这项前瞻性队列研究利用了中国健康与养老追踪调查（CHARLS）项目的数据，该项目涵盖了6719名符合严格标准的人。我们开发了三个Cox比例风险回归模型，以研究hs-CRP/HDL-C比值与CKM 1-4期患者长期死亡风险之间的潜在关系。我们采用受限立方样条（RCS）曲线进行分析，以识别任何潜在的非线性相关性。此外，我们进行了受试者工作特征（ROC）曲线分析，以评估预测性能并确定合适的临界值。为了加强研究结果，我们进行了分层分析，以调查各种社会人口学因素对这种关联的影响。
在CKM综合征1-4期的个体中，全因死亡率的10年发生率为14.1%。在控制了其他潜在的混杂变量后，Cox比例风险回归模型的结果清楚地表明，hs-CRP/HDL-C比值与患者的长期死亡风险之间存在统计学上显著的线性正相关。hs-CRP/HDL-C比值每增加一个四分位数，不良结局（即死亡）的概率就会增加15%（风险比，HR = 1.15，95%置信区间，CI：1.09-1.22，p值<0.001）。此外，将hs-CRP/HDL-C比值纳入基线风险预测模型，并对所有相关因素进行全面调整，显著提高了模型的预测能力，有助于更精确地评估CKM综合征1-4期患者的长期死亡风险。
本研究发现hs-CRP/HDL-C比值与CKM综合征1至4期患者的长期死亡风险之间存在正线性关联。这一显著发现不仅为加强早期个体化治疗方案提供了关键参考，还极大地有助于早期识别预后不良的患者，从而为改善这些个体的临床管理途径提供了新的视角。
