Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study

Purpose To investigate the association between the non-HDL/HDL cholesterol ratio (NHHR) and gestational diabetes mellitus (GDM) risk, and assess NHHR’s predictive utility as a novel biomarker in U.S. pregnant women.Patients and methods A cross-sectional analysis of 1590 pregnant women from NHANES (1...

Full description

Saved in:
Bibliographic Details
Main Authors: Fangfang Shan, Mengmeng Ye, Haochan Wu, Hui Zhou, Zhaoxia Zhong, Yibo Wu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:The Journal of Maternal-Fetal & Neonatal Medicine
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/14767058.2025.2516261
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To investigate the association between the non-HDL/HDL cholesterol ratio (NHHR) and gestational diabetes mellitus (GDM) risk, and assess NHHR’s predictive utility as a novel biomarker in U.S. pregnant women.Patients and methods A cross-sectional analysis of 1590 pregnant women from NHANES (1999–2018) was conducted. GDM was defined as fasting glucose ≥5.1 mmol/L. NHHR was calculated as (total cholesterol – HDL-C)/HDL-C. Multivariable logistic regression, restricted cubic spline (RCS) models, and ROC analysis were used to evaluate associations, threshold effects, and diagnostic accuracy, incorporating NHANES sampling weights.Results The highest NHHR quartile was associated with 4.48-fold higher odds of GDM (95% CI: 2.72–7.39, p < 0.001) after full adjustment. A nonlinear dose-response relationship with a threshold at NHHR = 2.267 was identified; above this threshold, GDM odds rose sharply (OR = 2.6, 95% CI: 2.0–3.3). Subgroup analyses confirmed consistency across age, ethnicity, and BMI (p for interaction > 0.05). NHHR demonstrated limited standalone diagnostic accuracy (AUC = 0.549, 95% CI: 0.510–0.587).Conclusion While NHHR demonstrates limited standalone diagnostic accuracy (AUC = 0.549), its specificity for metabolic dysregulation suggests potential as a complementary biomarker in multi-parameter models.
ISSN:1476-7058
1476-4954