美国成年人中非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值与死亡率之间的关联：2011 - 2018年美国国家健康与营养检查调查结果

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality in US adults: results from the NHANES 2011-2018.

作者信息

Yang Mengmeng, Zhang Junwei, Feng Zhenyu, Wang Meiling, Feng Quanguan, Zhang Runping, Wu Chuanling, Wu Tian, Zhang Genggeng, Niu Yuanzhi, Dong Qiuju, Han Qinghua, Lin Tao

机构信息

The Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, China.

School of Management, Shanxi Medical University, Jinzhong, China.

出版信息

Front Nutr. 2025 Jun 19;12:1576229. doi: 10.3389/fnut.2025.1576229. eCollection 2025.

DOI:10.3389/fnut.2025.1576229

PMID:40612301

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12224438/

Abstract

BACKGROUND

The NHHR, which is the ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C), has been suggested to have a link to several metabolic diseases and cardiovascular diseases (CVD). However, its association with CVD mortality and all-cause mortality remains uncertain.

METHODS AND RESULTS

Analyzing HDL-C and non-HDL-C used to calculate NHHR were sourced from the National Health and Nutrition Examination Survey (2011-2018). In this experiment, we utilized subgroup analysis to examine the robustness of the results obtained. This study excluded participants under 20 years of age and those with missing NHHR or mortality data, resulting in a final sample of 20,294 participants. We employed logistic regression models to assess the association between NHHR and all-cause mortality and CVD mortality. The NHHR was categorized into four groups (Q1-Q4) according to their values from small to large. In model 3, considering all covariates, individuals in Q4 of NHHR exhibited a 41% higher CVD mortality compared to Q1 (HR = 1.41, 95% CI 1.14, 1.74). To explore the potential non-linear relationships between NHHR and mortality, restricted cubic spline (RCS) and threshold saturation techniques were used. About NHHR and all-cause mortality, the results indicated an L-shaped association, with a breakpoint (K) at 1.18. To the left of this threshold, a negative association was identified (OR = 0.30, 95% CI 0.13, 0.67). But when NHHR is greater than 1.18, the relationship was positive (HR = 1.12, 95% CI 1.06, 1.18).

CONCLUSION

All in all, maintaining NHHR within an optimal range in adults may help reduce the association connected with both all-cause and CVD mortality.

摘要

背景

非高密度脂蛋白胆固醇（non-HDL-C）与高密度脂蛋白胆固醇（HDL-C）的比值即非高密度脂蛋白胆固醇比（NHHR），被认为与多种代谢性疾病和心血管疾病（CVD）存在关联。然而，其与CVD死亡率和全因死亡率的关系仍不明确。

方法与结果

用于计算NHHR的HDL-C和non-HDL-C数据来源于国家健康与营养检查调查（2011 - 2018年）。在本实验中，我们采用亚组分析来检验所得结果的稳健性。本研究排除了20岁以下的参与者以及NHHR或死亡率数据缺失的参与者，最终样本为20294名参与者。我们使用逻辑回归模型来评估NHHR与全因死亡率和CVD死亡率之间的关联。NHHR根据其值从小到大分为四组（Q1 - Q4）。在模型3中，考虑所有协变量，NHHR处于Q4的个体与Q1相比，CVD死亡率高41%（HR = 1.41，95%CI 1.14，1.74）。为探究NHHR与死亡率之间潜在的非线性关系，使用了受限立方样条（RCS）和阈值饱和技术。关于NHHR与全因死亡率，结果表明呈L形关联，断点（K）为1.18。在该阈值左侧，发现呈负相关（OR = 0.30，95%CI 0.13，0.67）。但当NHHR大于1.18时，关系为正相关（HR = 1.12，95%CI 1.06，1.18）。