Wei Cuimei, Huang Yaohui, Xi Ping, Shen Zhilan, Liu Wenjing, Li Tong, Chen Gang, Xiao Xiaohua, Hu Haofei
Department of Geriatrics, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong, China.
Department of Geriatrics, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China.
Diabetol Metab Syndr. 2025 May 26;17(1):172. doi: 10.1186/s13098-025-01719-3.
The strong correlation between the ratio of residual cholesterol to high-density lipoprotein cholesterol (RC/HDL-c) and major cardiovascular events has been extensively studied. However, the role of this ratio in diabetic retinopathy (DR) has not been investigated. Hence, this present study aims to examine the association between the RC/HDL-c ratio and DR in patients diagnosed with type 2 diabetes mellitus (T2DM).
This study conducted a cross-sectional analysis involving a total of 1942 patients diagnosed with T2DM in two Taiwanese hospitals, spanning from April 2002 to November 2004. The primary objective was to explore the independent association between the RC/HDL-c ratio and the presence of DR, as well as proliferative diabetic retinopathy (PDR), using a binary logistic regression model. To accurately determine the shape of the association between these variables, we utilized a generalized additive model (GAM) and employed smooth curve fitting techniques. The data was downloaded from the website: https://journals.plos.org/plosone .
Our study comprised participants with an average age of 64.06 ± 11.32 years, with males accounting for 43.05% of the total. Among the patients, 35.12% were found to have DR, while PDR was present in 18.23% of cases. The average RC/HDL-c ratio was calculated as 0.67 ± 0.39. Utilizing a fully adjusted logistic regression model, we investigated the potential association between the TC/HDL-c ratio and both DR and PDR. However, no statistically significant association was observed (DR: OR 1.060; 95% CI 0.707, 1.588; PDR: OR 1.258; 95% CI 0.773, 2.047). Interestingly, we did discover a non-linear association between the RC/HDL-c ratio and DR. Employing a two-piece logistic regression model and a recursive algorithm, we identified an inflection point at 0.460. When the RC/HDL-c ratio fell below 0.460, each 1-unit increase in the ratio was associated with an 11.8-fold increase in the adjusted odds of developing DR (OR = 12.824; 95% CI 3.583, 45.897). Moreover, a non-linear association between the RC/HDL-c ratio and PDR was observed, with an inflection point occurring at 0.90. When the RC/HDL-c ratio was below 0.90, a one-unit increase in the ratio was linked to a 1.46-fold increase in the adjusted odds of PDR (OR = 2.459; 95% CI: 1.245, 4.857).
This study contributes valuable insights into the intricate association between the RC/HDL-c ratio and both DR and PDR in individuals diagnosed with T2DM. By identifying a non-linear association, our findings enhance the existing knowledge surrounding the link between the RC/HDL-c ratio and the development of DR and PDR.
残余胆固醇与高密度脂蛋白胆固醇比值（RC/HDL-c）和主要心血管事件之间的强相关性已得到广泛研究。然而，该比值在糖尿病视网膜病变（DR）中的作用尚未得到研究。因此，本研究旨在探讨RC/HDL-c比值与2型糖尿病（T2DM）患者DR之间的关联。
本研究进行了一项横断面分析，涉及2002年4月至2004年11月期间在两家台湾医院诊断为T2DM的1942例患者。主要目的是使用二元逻辑回归模型探讨RC/HDL-c比值与DR以及增殖性糖尿病视网膜病变（PDR）之间的独立关联。为了准确确定这些变量之间关联的形式，我们使用了广义相加模型（GAM）并采用了平滑曲线拟合技术。数据从网站：https://journals.plos.org/plosone下载。
我们的研究包括平均年龄为64.06±11.32岁的参与者，男性占总数的43.05%。在患者中，发现35.12%患有DR，而18.23%的病例存在PDR。平均RC/HDL-c比值计算为0.67±0.39。使用完全调整的逻辑回归模型，我们研究了TC/HDL-c比值与DR和PDR之间的潜在关联。然而，未观察到统计学上的显著关联（DR：OR 1.060；95% CI 0.707，1.588；PDR：OR 1.258；95% CI 0.773，2.047）。有趣的是，我们确实发现RC/HDL-c比值与DR之间存在非线性关联。使用两段式逻辑回归模型和递归算法，我们确定了一个拐点为0.460。当RC/HDL-c比值低于0.460时，比值每增加1个单位，发生DR的调整后比值增加11.8倍（OR = 12.824；95% CI 3.583，45.897）。此外，观察到RC/HDL-c比值与PDR之间存在非线性关联，拐点出现在0.90。当RC/HDL-c比值低于0.90时，比值增加1个单位与PDR的调整后比值增加1.46倍相关（OR = 2.459；95% CI：1.245，4.857）。
本研究为RC/HDL-c比值与诊断为T2DM的个体的DR和PDR之间的复杂关联提供了有价值的见解。通过识别非线性关联，我们的发现增强了围绕RC/HDL-c比值与DR和PDR发展之间联系的现有知识。
