Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018

Abstract Background The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) plays a potential role in cardiovascular diseases. However, its association with angina pectoris remains unclear. Herein, we aimed to explore their relationship. Methods This cross-s...

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Main Authors: Ying Cui, Mankyu Choi
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Lipids in Health and Disease
Subjects:
Online Access:https://doi.org/10.1186/s12944-024-02343-2
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author Ying Cui
Mankyu Choi
author_facet Ying Cui
Mankyu Choi
author_sort Ying Cui
collection DOAJ
description Abstract Background The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) plays a potential role in cardiovascular diseases. However, its association with angina pectoris remains unclear. Herein, we aimed to explore their relationship. Methods This cross-sectional retrospective study included the 2009–2018 data from 22,562 adults diagnosed with angina pectoris, retrieved from the National Health and Nutrition Examination Survey (NHANES) database. NHHR was estimated from laboratory data, and angina pectoris diagnosis was ascertained from the NHANES questionnaire. Results Angina pectoris risk was greater in the highest than in the lowest NHHR tertile (odds ratio [OR] = 1.61; 95% confidence interval (CI), 1.15–2.54; P = 0.006). Weighted logistic regression showed a positive association between NHHR and angina pectoris in the fully adjusted model (OR = 1.17; 95% CI, 1.07–1.28; P = 0.001). Restricted cubic spline analysis showed a linear association (P = 0.6572). Subgroup analyses indicated no significant differences across different stratifications (P > 0.05, all). Random forest analyses and Boruta algorithm corroborated that NHHR is a strong predictor of angina pectoris. Among the eight machine-learning models evaluated for predictive capabilities, the logistic regression model demonstrated the strongest predictive capability, with an area under the curve of 0.831. Conclusions Our study suggests that NHHR is a risk factor for angina pectoris and may be used for risk prediction and to inform future intervention programs to reduce its incidence.
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spelling doaj-art-8f149238d52b424c96ea2c3334ca438b2025-08-20T02:11:50ZengBMCLipids in Health and Disease1476-511X2024-10-0123111210.1186/s12944-024-02343-2Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018Ying Cui0Mankyu Choi1Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea UniversitySchool of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea UniversityAbstract Background The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) plays a potential role in cardiovascular diseases. However, its association with angina pectoris remains unclear. Herein, we aimed to explore their relationship. Methods This cross-sectional retrospective study included the 2009–2018 data from 22,562 adults diagnosed with angina pectoris, retrieved from the National Health and Nutrition Examination Survey (NHANES) database. NHHR was estimated from laboratory data, and angina pectoris diagnosis was ascertained from the NHANES questionnaire. Results Angina pectoris risk was greater in the highest than in the lowest NHHR tertile (odds ratio [OR] = 1.61; 95% confidence interval (CI), 1.15–2.54; P = 0.006). Weighted logistic regression showed a positive association between NHHR and angina pectoris in the fully adjusted model (OR = 1.17; 95% CI, 1.07–1.28; P = 0.001). Restricted cubic spline analysis showed a linear association (P = 0.6572). Subgroup analyses indicated no significant differences across different stratifications (P > 0.05, all). Random forest analyses and Boruta algorithm corroborated that NHHR is a strong predictor of angina pectoris. Among the eight machine-learning models evaluated for predictive capabilities, the logistic regression model demonstrated the strongest predictive capability, with an area under the curve of 0.831. Conclusions Our study suggests that NHHR is a risk factor for angina pectoris and may be used for risk prediction and to inform future intervention programs to reduce its incidence.https://doi.org/10.1186/s12944-024-02343-2NHHRAngina pectorisNHANESRestricted cubic spline modelRandom forest analysisBoruta algorithm
spellingShingle Ying Cui
Mankyu Choi
Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
Lipids in Health and Disease
NHHR
Angina pectoris
NHANES
Restricted cubic spline model
Random forest analysis
Boruta algorithm
title Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
title_full Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
title_fullStr Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
title_full_unstemmed Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
title_short Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and angina pectoris in US adults: a cross-sectional retrospective study based on NHANES 2009–2018
title_sort association between the non high density lipoprotein cholesterol to high density lipoprotein cholesterol ratio nhhr and angina pectoris in us adults a cross sectional retrospective study based on nhanes 2009 2018
topic NHHR
Angina pectoris
NHANES
Restricted cubic spline model
Random forest analysis
Boruta algorithm
url https://doi.org/10.1186/s12944-024-02343-2
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AT mankyuchoi associationbetweenthenonhighdensitylipoproteincholesteroltohighdensitylipoproteincholesterolrationhhrandanginapectorisinusadultsacrosssectionalretrospectivestudybasedonnhanes20092018