Li Shiyang, Liu Yuyong, Sun Guangyan, Zhou Jie, Luo Deyun, Mao Guangming, Xu Wenhao
Department of Geriatrics, Panzhihua Central Hospital, Panzhihua, China.
Panzhihua Central Hospital Affiliated to Dali University, Yunnan, China.
Front Nutr. 2025 Jul 10;12:1580904. doi: 10.3389/fnut.2025.1580904. eCollection 2025.
Cardiovascular disease is associated with inflammation and dysregulated lipid metabolism. This study aimed to investigate the predictive value of high-sensitive C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) in assessing the risk of developing cardiometabolic multi-morbidity (CMM) within the Chinese population.
A cohort of 8,187 participants were selected from the China Health and Retirement Longitudinal Study (CHARLS) and divided into four groups based on the quartile of CHR. To evaluate the association between CHR and CMM, we employed multivariable Cox proportional hazards regression, logistic regression, and restricted cubic splines (RCS) analysis. Subgroup analyses and interaction tests were conducted to further explore these relationships.
The mean age of the included participants was 58.64 ± 9.66 years, with 53.7% being female. Over a median follow-up period of 109 months, 858 participants (10.5%) were diagnosed with new-onset CMM. The incidence of CMM across CHR quartiles Q1, Q2, Q3, and Q4 were 6.4, 9.4, 12.0, and 14.2%, respectively. Compared to the lowest quartile, the fully adjusted hazard ratio (with 95% confidence intervals) for CMM for quartiles Q2-Q4 were 1.43 (1.14-1.79), 1.67 (1.35-2.07), and 1.91 (1.55-2.37), respectively. Per 0.01 unit increase in CHR correlates with a 38% increase in the risk of CMM (HR = 1.38, 95% CI = 1.08-1.77, = 0.01) after full adjustment. Additionally, the odds ratios (ORs) (95% CIs) using multivariate logistic regression analysis for participants in quartiles 2 to 4 were 1.47 (1.16-1.86), 1.73 (1.38-2.17), and 2.00 (1.59-2.51), respectively, when compared to participants in Q1 of CHR. Furthermore, a nonlinear relationship was observed between CHR and the risk of CMM (overall < 0.001, nonlinear < 0.001). Subgroup and sensitivity analyses corroborated the robustness of our findings.
A higher CHR was positively associated with the risk of CMM. Our findings suggest that CHR, when considered alongside other risk factors, could serve as a valuable biomarker for identifying individuals at heightened risk of developing CMM.
心血管疾病与炎症及脂质代谢失调相关。本研究旨在探讨高敏C反应蛋白与高密度脂蛋白胆固醇比值（CHR）在中国人群中评估发生心脏代谢多重疾病（CMM）风险的预测价值。
从中国健康与养老追踪调查（CHARLS）中选取8187名参与者，并根据CHR四分位数分为四组。为评估CHR与CMM之间的关联，我们采用了多变量Cox比例风险回归、逻辑回归和受限立方样条（RCS）分析。进行亚组分析和交互作用检验以进一步探究这些关系。
纳入参与者的平均年龄为58.64±9.66岁，女性占53.7%。在中位随访期109个月内，858名参与者（10.5%）被诊断为新发CMM。CHR四分位数Q1、Q2、Q3和Q4的CMM发病率分别为6.4%、9.4%、12.0%和14.2%。与最低四分位数相比，Q2 - Q4四分位数CMM的完全调整风险比（95%置信区间）分别为1.43（1.14 - 1.79）、1.67（1.35 - 2.07）和1.91（1.55 - 2.37）。完全调整后，CHR每增加0.01单位，CMM风险增加38%（HR = 1.38，95% CI = 1.08 - 1.77，P = 0.01）。此外，与CHR四分位数1的参与者相比，使用多变量逻辑回归分析对四分位数2至4的参与者的比值比（OR）（95% CI）分别为1.47（1.16 - 1.86）、1.73（1.38 - 2.17）和2.00（1.59 - 2.51）。此外，观察到CHR与CMM风险之间存在非线性关系（总体P < 0.001，非线性P < 0.001）。亚组和敏感性分析证实了我们研究结果的稳健性。
较高的CHR与CMM风险呈正相关。我们的研究结果表明，CHR与其他风险因素一起考虑时，可作为识别发生CMM风险较高个体的有价值生物标志物。
