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...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| 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!
|
| _version_ | 1849685813654192128 |
|---|---|
| author | Fangfang Shan Mengmeng Ye Haochan Wu Hui Zhou Zhaoxia Zhong Yibo Wu |
| author_facet | Fangfang Shan Mengmeng Ye Haochan Wu Hui Zhou Zhaoxia Zhong Yibo Wu |
| author_sort | Fangfang Shan |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-43d1ada3793945e487dc19d1b4be04fd |
| institution | DOAJ |
| issn | 1476-7058 1476-4954 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | The Journal of Maternal-Fetal & Neonatal Medicine |
| spelling | doaj-art-43d1ada3793945e487dc19d1b4be04fd2025-08-20T03:22:58ZengTaylor & Francis GroupThe Journal of Maternal-Fetal & Neonatal Medicine1476-70581476-49542025-12-0138110.1080/14767058.2025.2516261Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional studyFangfang Shan0Mengmeng Ye1Haochan Wu2Hui Zhou3Zhaoxia Zhong4Yibo Wu5Obstetrics, Gynecology and Reproduction Research Center, Affiliated Hospital of Jiangnan University, Wuxi, P.R. ChinaObstetrics, Gynecology and Reproduction Research Center, Affiliated Hospital of Jiangnan University, Wuxi, P.R. ChinaObstetrics, Gynecology and Reproduction Research Center, Affiliated Hospital of Jiangnan University, Wuxi, P.R. ChinaObstetrics, Gynecology and Reproduction Research Center, Affiliated Hospital of Jiangnan University, Wuxi, P.R. ChinaDepartment of Obstetrics and Gynecology, Donghai People’s Hospital, Donghai, P.R. ChinaObstetrics, Gynecology and Reproduction Research Center, Affiliated Hospital of Jiangnan University, Wuxi, P.R. ChinaPurpose 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.https://www.tandfonline.com/doi/10.1080/14767058.2025.2516261Lipid metabolisminsulin resistancepregnancy complicationsNon-HDL/HDL Cholesterol Ratio (NHHR)Gestational Diabetes Mellitus (GDM) |
| spellingShingle | Fangfang Shan Mengmeng Ye Haochan Wu Hui Zhou Zhaoxia Zhong Yibo Wu Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study The Journal of Maternal-Fetal & Neonatal Medicine Lipid metabolism insulin resistance pregnancy complications Non-HDL/HDL Cholesterol Ratio (NHHR) Gestational Diabetes Mellitus (GDM) |
| title | Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study |
| title_full | Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study |
| title_fullStr | Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study |
| title_full_unstemmed | Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study |
| title_short | Non-HDL/HDL cholesterol ratio (NHHR) as a novel predictor of gestational diabetes mellitus: a NHANES-based cross-sectional study |
| title_sort | non hdl hdl cholesterol ratio nhhr as a novel predictor of gestational diabetes mellitus a nhanes based cross sectional study |
| topic | Lipid metabolism insulin resistance pregnancy complications Non-HDL/HDL Cholesterol Ratio (NHHR) Gestational Diabetes Mellitus (GDM) |
| url | https://www.tandfonline.com/doi/10.1080/14767058.2025.2516261 |
| work_keys_str_mv | AT fangfangshan nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy AT mengmengye nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy AT haochanwu nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy AT huizhou nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy AT zhaoxiazhong nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy AT yibowu nonhdlhdlcholesterolrationhhrasanovelpredictorofgestationaldiabetesmellitusanhanesbasedcrosssectionalstudy |