Yang Xiuming, Chen Qiuyun, Zhang Qingyu, Yu Zongliang
Department of Cardiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China.
Department of Cardiology, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Kunshan, Jiangsu, China.
Front Nutr. 2025 Apr 17;12:1529223. doi: 10.3389/fnut.2025.1529223. eCollection 2025.
The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) has been introduced as a novel indicator to evaluate lipid metabolism. The study explored the association between NHHR and cardiovascular disease (CVD).
A cross-sectional study was achieved by utilizing data obtained from the NHANES (2003-2016). The association between NHHR and CVD was assessed by multivariate logistic regression analysis (LRA) and the restricted cubic spline (RCS) analysis. Also, interaction tests and subgroup analyses were employed to explore whether the associations differ by subgroups. Then, threshold analysis were conducted for interval delineation and detection of threshold effects with two-segment piecewise LR model.
A cohort of 11,471 individuals was involved. The results indicated that the linear relationship between NHHR and CVD was not significant ( for trend >0.05). The RCS analysis revealed a non-linear J-shaped association of NHHR with CVD risk. A two-segment LR model was established to assess the threshold effect of the NHHR. A log-likelihood ratio test ( < 0.001) suggested that the two-segment LR model exhibited better performances compared with the single-line LR model. Additionally, a tangent point of the NHHR occurred at 2.82, and the likelihood of CVD increased by 21% as the NHHR increased by one unit (OR = 1.21, 95% CI = 1.10-1.34).
A J-shaped association was detected between NHHR and the prevalence of CVD, suggesting that NHHR could serve as a novel assessment marker for identifying high-risk CVD populations. However, further cohort studies are needed to confirm this finding.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值（NHHR）已被引入作为评估脂质代谢的新指标。本研究探讨了NHHR与心血管疾病（CVD）之间的关联。
利用从美国国家健康与营养检查调查（NHANES，2003 - 2016年）获得的数据进行横断面研究。通过多变量逻辑回归分析（LRA）和受限立方样条（RCS）分析评估NHHR与CVD之间的关联。此外，采用交互作用检验和亚组分析来探讨这些关联在不同亚组中是否存在差异。然后，使用两段式分段逻辑回归模型进行阈值分析以进行区间划分和阈值效应检测。
纳入了11471名个体的队列。结果表明，NHHR与CVD之间的线性关系不显著（趋势>0.05）。RCS分析显示NHHR与CVD风险呈非线性J形关联。建立了两段式逻辑回归模型来评估NHHR的阈值效应。对数似然比检验（<0.001）表明，与单一线性逻辑回归模型相比，两段式逻辑回归模型表现更好。此外，NHHR的切点为2.82，随着NHHR每增加一个单位，CVD的发生风险增加21%（OR = 1.21，95%CI = 1.10 - 1.34）。
检测到NHHR与CVD患病率之间存在J形关联，表明NHHR可作为识别CVD高危人群的新评估标志物。然而，需要进一步的队列研究来证实这一发现。
