Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS
Abstract Background The established association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cardiovascular disease (CVD) risk has been well-documented. Nevertheless, the relationship between changes in NHHR and CVD events remains to b...
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BMC
2025-03-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-025-02536-3 |
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| author | Bingxue Wang LiYing Li Ying Tang Ting Lin Jing Wu Guoqi Wang Xingwu Ran |
| author_facet | Bingxue Wang LiYing Li Ying Tang Ting Lin Jing Wu Guoqi Wang Xingwu Ran |
| author_sort | Bingxue Wang |
| collection | DOAJ |
| description | Abstract Background The established association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cardiovascular disease (CVD) risk has been well-documented. Nevertheless, the relationship between changes in NHHR and CVD events remains to be elucidated. The present study aims to clarify the correlation between NHHR change patterns and the incidence of CVD across a broad population. Methods The current study recruited participants from the China Health and Retirement Longitudinal Study (CHARLS). The NHHR index was calculated using the formula: NHHR = (TC-HDL-c)/HDL-c. Temporal changes in NHHR were assessed with latent profile analysis, and cumulative NHHR was also evaluated. Multivariable Cox proportional hazards regression models and multivariate-adjusted restricted cubic spline (RCS) analyses were employed to examine the association between the NHHR index and incident CVD. Results A total of 4,629 individuals were recruited for the study. The average age of the participants was 57.47 years, with 53.7% being female. Over the follow-up period, 879 cases of CVD were documented. Compared to participants in the lowest tertile, those in the highest tertile for both baseline NHHR and cumulative NHHR exhibited a significantly increased risk of CVD, with adjusted hazard ratios (HRs) of 1.43 (95% confidence interval [CI]: 1.21–1.70) and 1.45 (95% CI: 1.23–1.72), respectively. Participants classified in Class 2 demonstrated a 27% higher risk of CVD, while those in Class 3 showed a 41% greater risk compared to the Class 1 group. Further analysis revealed that this relationship was linear. Stratified analyses corroborated the primary findings. Conclusion Baseline NHHR, cumulative NHHR, and changes in NHHR are significantly associated with an increased risk of CVD among individuals aged 45 years and older, thereby confirming their potential as valuable tools for risk stratification in CVD. |
| format | Article |
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| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Lipids in Health and Disease |
| spelling | doaj-art-28cd7b48e4bd4c0fa2225a940551940c2025-08-20T02:10:21ZengBMCLipids in Health and Disease1476-511X2025-03-0124111010.1186/s12944-025-02536-3Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLSBingxue Wang0LiYing Li1Ying Tang2Ting Lin3Jing Wu4Guoqi Wang5Xingwu Ran6Department of Endocrinology and Metabolism, West China Hospital of Sichuan UniversityDepartment of Cardiology, Fuwai Yunnan Cardiovascular HospitalDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan UniversityDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan UniversityDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan UniversityWest China Hospital, General Practice Medical Center, Sichuan UniversityDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan UniversityAbstract Background The established association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cardiovascular disease (CVD) risk has been well-documented. Nevertheless, the relationship between changes in NHHR and CVD events remains to be elucidated. The present study aims to clarify the correlation between NHHR change patterns and the incidence of CVD across a broad population. Methods The current study recruited participants from the China Health and Retirement Longitudinal Study (CHARLS). The NHHR index was calculated using the formula: NHHR = (TC-HDL-c)/HDL-c. Temporal changes in NHHR were assessed with latent profile analysis, and cumulative NHHR was also evaluated. Multivariable Cox proportional hazards regression models and multivariate-adjusted restricted cubic spline (RCS) analyses were employed to examine the association between the NHHR index and incident CVD. Results A total of 4,629 individuals were recruited for the study. The average age of the participants was 57.47 years, with 53.7% being female. Over the follow-up period, 879 cases of CVD were documented. Compared to participants in the lowest tertile, those in the highest tertile for both baseline NHHR and cumulative NHHR exhibited a significantly increased risk of CVD, with adjusted hazard ratios (HRs) of 1.43 (95% confidence interval [CI]: 1.21–1.70) and 1.45 (95% CI: 1.23–1.72), respectively. Participants classified in Class 2 demonstrated a 27% higher risk of CVD, while those in Class 3 showed a 41% greater risk compared to the Class 1 group. Further analysis revealed that this relationship was linear. Stratified analyses corroborated the primary findings. Conclusion Baseline NHHR, cumulative NHHR, and changes in NHHR are significantly associated with an increased risk of CVD among individuals aged 45 years and older, thereby confirming their potential as valuable tools for risk stratification in CVD.https://doi.org/10.1186/s12944-025-02536-3Cardiovascular diseaseNHHR indexDynamic changesAtherosclerosisCHARLS |
| spellingShingle | Bingxue Wang LiYing Li Ying Tang Ting Lin Jing Wu Guoqi Wang Xingwu Ran Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS Lipids in Health and Disease Cardiovascular disease NHHR index Dynamic changes Atherosclerosis CHARLS |
| title | Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS |
| title_full | Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS |
| title_fullStr | Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS |
| title_full_unstemmed | Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS |
| title_short | Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS |
| title_sort | changes in non high density lipoprotein to high density lipoprotein ratio nhhr and cardiovascular disease insights from charls |
| topic | Cardiovascular disease NHHR index Dynamic changes Atherosclerosis CHARLS |
| url | https://doi.org/10.1186/s12944-025-02536-3 |
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