Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study

Abstract Background Ischemic stroke (IS) is one of the leading causes of death and disability worldwide. Early identification of dyslipidemia associated with cerebral atherosclerosis is of great importance for reducing the risk of IS. The non-high-density lipoprotein cholesterol to high-density lipo...

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Main Authors: Yating Han, Yuting Gao, Mengyuan Qiu, Yida Wang, Shenjie Li, Mengmeng Guo, Tao Zheng, Zunjing Liu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02555-0
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author Yating Han
Yuting Gao
Mengyuan Qiu
Yida Wang
Shenjie Li
Mengmeng Guo
Tao Zheng
Zunjing Liu
author_facet Yating Han
Yuting Gao
Mengyuan Qiu
Yida Wang
Shenjie Li
Mengmeng Guo
Tao Zheng
Zunjing Liu
author_sort Yating Han
collection DOAJ
description Abstract Background Ischemic stroke (IS) is one of the leading causes of death and disability worldwide. Early identification of dyslipidemia associated with cerebral atherosclerosis is of great importance for reducing the risk of IS. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel lipid biomarker to assess atherosclerosis. The aim of this study is to investigate the association between NHHR and cerebral atherosclerotic stenosis using DSA imaging data, including intracranial/extracranial stenosis, anterior/posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Methods Patients who underwent DSA examination from July 2022 to December 2024 were included. Participants were divided into four groups based on NHHR levels. Univariable and multivariable logistic regression were applied to assess the association between NHHR and cerebral atherosclerotic stenosis, including intracranial and extracranial stenosis, anterior and posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Restricted cubic splines (RCS) were applied to analyze and visualize the association between NHHR and cerebral atherosclerotic stenosis. Results A total of 853 patients were included in the final analysis. After adjusting for covariables, compared to patients in the lower NHHR groups, those in the higher NHHR groups had a significantly higher occurrence rate of extracranial stenosis, posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Multivariable-adjusted RCS showed a nonlinear association between NHHR and posterior circulation stenosis, and a linear positive association between NHHR and symptomatic stenosis. Conclusions NHHR may serve as a lipid management indicator for patients with extracranial stenosis, posterior circulation stenosis, severe stenosis, or symptomatic stenosis. NHHR could be an independent risk factor for symptomatic stenosis, which can aid in risk stratification and treatment decision-making for cerebral atherosclerotic stenosis patients.
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spelling doaj-art-60a7ec7c0b2d427a92bf99caa4a995a32025-08-20T03:18:23ZengBMCLipids in Health and Disease1476-511X2025-04-0124111510.1186/s12944-025-02555-0Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective studyYating Han0Yuting Gao1Mengyuan Qiu2Yida Wang3Shenjie Li4Mengmeng Guo5Tao Zheng6Zunjing Liu7Department of Neurology, Peking University People’s HospitalDepartment of Neurology, Peking University People’s HospitalDepartment of Neurology, Peking University People’s HospitalDepartment of Neurology, Peking University People’s HospitalDepartment of Neurology, Peking University People’s HospitalDepartment of Neurology, Peking University People’s HospitalBeijing University of Chinese MedicineDepartment of Neurology, Peking University People’s HospitalAbstract Background Ischemic stroke (IS) is one of the leading causes of death and disability worldwide. Early identification of dyslipidemia associated with cerebral atherosclerosis is of great importance for reducing the risk of IS. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel lipid biomarker to assess atherosclerosis. The aim of this study is to investigate the association between NHHR and cerebral atherosclerotic stenosis using DSA imaging data, including intracranial/extracranial stenosis, anterior/posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Methods Patients who underwent DSA examination from July 2022 to December 2024 were included. Participants were divided into four groups based on NHHR levels. Univariable and multivariable logistic regression were applied to assess the association between NHHR and cerebral atherosclerotic stenosis, including intracranial and extracranial stenosis, anterior and posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Restricted cubic splines (RCS) were applied to analyze and visualize the association between NHHR and cerebral atherosclerotic stenosis. Results A total of 853 patients were included in the final analysis. After adjusting for covariables, compared to patients in the lower NHHR groups, those in the higher NHHR groups had a significantly higher occurrence rate of extracranial stenosis, posterior circulation stenosis, severe stenosis, and symptomatic stenosis. Multivariable-adjusted RCS showed a nonlinear association between NHHR and posterior circulation stenosis, and a linear positive association between NHHR and symptomatic stenosis. Conclusions NHHR may serve as a lipid management indicator for patients with extracranial stenosis, posterior circulation stenosis, severe stenosis, or symptomatic stenosis. NHHR could be an independent risk factor for symptomatic stenosis, which can aid in risk stratification and treatment decision-making for cerebral atherosclerotic stenosis patients.https://doi.org/10.1186/s12944-025-02555-0Ischemic strokeCerebral atherosclerotic stenosisDyslipidemiaNon-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratioDigital subtraction angiography
spellingShingle Yating Han
Yuting Gao
Mengyuan Qiu
Yida Wang
Shenjie Li
Mengmeng Guo
Tao Zheng
Zunjing Liu
Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
Lipids in Health and Disease
Ischemic stroke
Cerebral atherosclerotic stenosis
Dyslipidemia
Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio
Digital subtraction angiography
title Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
title_full Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
title_fullStr Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
title_full_unstemmed Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
title_short Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis: a retrospective study
title_sort association between non high density lipoprotein cholesterol to high density lipoprotein cholesterol ratio and cerebral atherosclerotic stenosis a retrospective study
topic Ischemic stroke
Cerebral atherosclerotic stenosis
Dyslipidemia
Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio
Digital subtraction angiography
url https://doi.org/10.1186/s12944-025-02555-0
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