Xu Yaying
Department of Endocrinology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Front Nutr. 2025 Jun 4;12:1594041. doi: 10.3389/fnut.2025.1594041. eCollection 2025.
Cardiovascular-kidney-metabolic (CKM) syndrome is a novel multi-system disease defined by the American Heart Association (AHA). This study aims to investigate the associations between the neutrophil/high-density lipoprotein cholesterol ratio (NHR) and CKM syndrome and its association with cardiovascular disease (CVD) mortality.
The data for this study were derived from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2018 and the National Death Index (NDI) database. Weighted multivariate logistic regression and Cox regression were the primary analytical methods. restricted cubic spline (RCS) and subgroup analyses were also carried out.
A total of 13,165 participants were included in this study. The weighted mean of NHR was 3.14 ± 0.03. The prevalence rate of CKM syndrome was 17.36%. The results of the weighted logistic regression indicated that there was a positive association between NHR and CKM syndrome (OR: 1.25, 95% CI: 1.10-1.42, < 0.001). Among the quartile groups of NHR, the prevalence rate of CKM syndrome showed an increase ( for trend <0.0001). Among individuals with CKM syndrome, the results of the weighted Cox regression demonstrated that NHR also significantly predicted CVD mortality (HR: 1.31, 95% CI: 1.14-1.50, < 0.001). Among the quartile groups of NHR, the risk of CVD mortality also increased in a trend ( for trend = 0.01). Furthermore, RCS analysis showed a positive linear association between NHR and CKM syndrome (non-linear = 0.075) and between NHR and CVD mortality (non-linear = 0.300). The subgroup analysis suggested that the relationship between NHR and the outcomes was robust, and there was no significant interaction.
Our study demonstrates that NHR is not only associated with an increased prevalence of CKM syndrome but also serves as an effective predictor for CVD mortality in patients with CKM syndrome. This provides new insights into the clinical identification and prognostic evaluation of CKM syndrome.
心血管-肾脏-代谢（CKM）综合征是美国心脏协会（AHA）定义的一种新型多系统疾病。本研究旨在探讨中性粒细胞/高密度脂蛋白胆固醇比值（NHR）与CKM综合征之间的关联及其与心血管疾病（CVD）死亡率的关系。
本研究的数据来自2005年至2018年进行的美国国家健康和营养检查调查（NHANES）以及国家死亡指数（NDI）数据库。加权多变量逻辑回归和Cox回归是主要分析方法。还进行了受限立方样条（RCS）分析和亚组分析。
本研究共纳入13165名参与者。NHR的加权平均值为3.14±0.03。CKM综合征的患病率为17.36%。加权逻辑回归结果表明，NHR与CKM综合征之间存在正相关（OR：1.25，95%CI：1.10-1.42，P<0.001）。在NHR的四分位数组中，CKM综合征的患病率呈上升趋势（趋势P<0.0001）。在患有CKM综合征的个体中，加权Cox回归结果表明，NHR也显著预测CVD死亡率（HR：1.31，95%CI：1.14-1.50，P<0.001）。在NHR的四分位数组中，CVD死亡率风险也呈上升趋势（趋势P=0.01）。此外，RCS分析显示NHR与CKM综合征之间存在正线性关联（非线性P=0.075），NHR与CVD死亡率之间也存在正线性关联（非线性P=0.300）。亚组分析表明，NHR与结局之间的关系是稳健的，且无显著交互作用。
我们的研究表明，NHR不仅与CKM综合征患病率增加有关，而且是CKM综合征患者CVD死亡率的有效预测指标。这为CKM综合征的临床识别和预后评估提供了新的见解。
