Chen Chen, Li Mingkang, Yan Gaoliang, Zhang Wenkang, Tang Chengchun
School of Cyber Science and Engineering, Southeast University, Nanjing, Jiangsu, China.
School of Medicine, Southeast University, 87 Dingjiaqiao, Nanjing, 210009, Jiangsu, China.
Sci Rep. 2025 Aug 29;15(1):31865. doi: 10.1038/s41598-025-07469-6.
Coronary artery calcification (CAC) is a well-established cardiovascular disease (CVD) pathogenesis marker closely associated with dysregulated glucose and lipid metabolism. The present study investigated the relationship between the glycated hemoglobin A1c (HbA1c)/high-density lipoprotein cholesterol (HDL-C) ratio and CAC. A total of 1608 eligible participants were enrolled in the study. The HbA1c/HDL-C ratio was calculated by dividing HbA1c by HDL-C. LASSO regression, logistic regression, and receiver operating characteristic curve (ROC) analysis were performed to examine the relationship between the HbA1c/HDL-C ratio and CAC. The nomogram incorporating the HbA1c/HDL-C ratio was further established by multivariate logistic regression and evaluated. The HbA1c/HDL-C ratios in the CAC group were significantly higher than the control group [4.73 (4.01, 5.56) vs. 4.34 (3.67, 5.05), p < 0.001]. Subjects with an elevated HbA1c/HDL-C ratio (≥ 4.99) exhibited a higher prevalence of CAC [146/486 (30.04) vs. 200/1122 (17.83), p < 0.001]. Furthermore, an elevated HbA1c/HDL-C ratio was an independent effect factor for CAC [odds ratio, 1.135; 95% confidence interval (CI), 1.008-1.279; p = 0.037]. The area under the ROC curve of the HbA1c/HDL-C ratio was 0.630 (95% CI 0.596-0.663), and the model incorporating age, gender, body mass index, hypertension, diabetes mellitus, and the HbA1c/HDL-C ratio was 0.718 (95% CI 0.686-0.751). The constructed nomogram based on this model demonstrated favorable discrimination and clinical utility. In conclusion, the HbA1c/HDL-C ratio is closely associated with CAC and is an independent factor for CAC in asymptomatic adults without CVD.
冠状动脉钙化（CAC）是一种公认的心血管疾病（CVD）发病机制标志物，与葡萄糖和脂质代谢失调密切相关。本研究调查了糖化血红蛋白A1c（HbA1c）/高密度脂蛋白胆固醇（HDL-C）比值与CAC之间的关系。共有1608名符合条件的参与者纳入本研究。HbA1c/HDL-C比值通过HbA1c除以HDL-C计算得出。采用LASSO回归、逻辑回归和受试者工作特征曲线（ROC）分析来检验HbA1c/HDL-C比值与CAC之间的关系。通过多因素逻辑回归进一步建立并评估纳入HbA1c/HDL-C比值的列线图。CAC组的HbA1c/HDL-C比值显著高于对照组[4.73（4.01，5.56）vs. 4.34（3.67，5.05），p<0.001]。HbA1c/HDL-C比值升高（≥4.99）的受试者CAC患病率更高[146/486（30.04）vs. 200/1122（17.83），p<0.001]。此外，HbA1c/HDL-C比值升高是CAC的独立影响因素[比值比，1.135；95%置信区间（CI），1.008 - 1.279；p = 0.037]。HbA1c/HDL-C比值的ROC曲线下面积为0.630（95%CI 0.596 - 0.663），纳入年龄、性别、体重指数、高血压、糖尿病和HbA1c/HDL-C比值的模型为0.718（95%CI 0.686 - 0.751）。基于该模型构建的列线图显示出良好的辨别能力和临床实用性。总之，HbA1c/HDL-C比值与CAC密切相关，是无CVD的无症状成年人CAC的独立因素。
