Nonlinear association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and hyperuricemia in cancer patients: evidence from NHANES 2007–2018
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SUBMITTER: He R
PROVIDER: S-EPMC11346297 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundAs an innovative lipid parameter, NHHR (the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol) can serve as a valuable tool for assessing cardiovascular disease risk. Nevertheless, the relationship between NHHR and the risk of kidney stones remains unexplored.MethodsA cross-sectional survey utilized data from the National Health and Population Survey (NHANES) database in the United States spanning from 2007 to 2018. Distinct statistical analyses were applied, including weighted logistic regression, stratified and interaction analysis and restricted cubic spline curve (RCS) models, to examine the correlation between NHHR and the incidence of kidney stones.ResultsThis analysis encompassed 24,664 participants, with 9.63% reporting incidents of kidney stones. Following multivariate logistic regression and comprehensive adjustments, participants in NHHR quartile 4 (OR 1.34; 95% CI 1.12, 1.60, P < 0.01) exhibited a significantly increased risk of kidney stones compared to those in NHHR quartile 1 (Q1). The RCS result further illustrated a non-linear correlation between NHHR and the incidence of kidney stones. The result of subgroup analysis manifested that participants without diabetes had a higher risk of kidney stones when measured high NHHR levels compared those with diabetes (p for interaction < 0.05).ConclusionElevated NHHR levels were found to be associated with an increased risk of kidney stones. Based on these findings, NHHR appears to be a promising predictive indicator for the occurrence of kidney stones.
| S-EPMC11232242 | biostudies-literature
Project description:PurposeThe non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a crucial lipid marker associated with various cardiovascular diseases. However, its relationship with kidney injury, particularly albuminuria, remains poorly understood. This study aims to investigate the association between NHHR and macroalbuminuria in U.S. adults.Patients and methodsThis cross-sectional study utilized data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). NHHR was calculated as (Total cholesterol - HDL cholesterol)/HDL cholesterol. Macroalbuminuria was defined by an albumin-creatinine ratio (ACR) >300 mg/g. Logistic regression, smoothed curve fitting, subgroup analyses, and sensitivity analysis were employed to assess the relationship between NHHR and macroalbuminuria.ResultsA total of 41,225 participants were included in the analysis. Higher NHHR was significantly associated with an increased likelihood of macroalbuminuria (OR = 1.34, 95% CI: 1.13-1.59, p=0.0007). Subgroup analysis revealed a stronger association in participants with BMI ≥30 kg/m2(OR = 1.89, 95% CI: 1.44-2.47, p<0.01). Sensitivity analysis revealed that the association remained robust even after excluding participants taking medications that affect lipid metabolism.ConclusionIn U.S. adults, an increased likelihood of incident NHHR levels of macroalbuminuria is positively associated and is more pronounced in those with a BMI ≥30kg/m2.
| S-EPMC11851024 | biostudies-literature
Project description:Background and objectiveThe value of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) assessment in the context of metabolic abnormalities is growing in importance. Nevertheless, the relationship between NHHR and hyperuricemia (HUA) is unknown. This study seeks to investigate the relationship between NHHR and HUA.MethodsThe data derived from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) included 7,876 adult participants. The multivariable logistic regression model, subgroup analysis and smooth fitting curve were utilized in order to investigate the association between NHHR and HUA.ResultsIn the fully adjusted model 3, NHHR was significantly associated with HUA. Specifically, participants in the highest quartile of NHHR had 1.95 times higher odds of HUA prevalence compared to those in the lowest quartile [2.95 (2.39, 3.64), P < 0.0001]. Although the overall trend suggested a positive association, further analysis using smooth fitting curves and threshold effect analysis indicated that this association was nonlinear, with an inflection point at 5.8. The positive association persisted across different HUA definitions and after removing outliers. Subgroup analysis showed significant interactions between NHHR and HUA in different races and diabetes statuses. The odds of HUA prevalence were higher among non-diabetic participants [1.40 (1.32, 1.49), P < 0.0001] compared to diabetic participants [1.18 (1.06, 1.32), P = 0.0031]. Mexican Americans had the lowest odds of HUA prevalence [1.09 (0.92, 1.27), P = 0.2413] compared to other races.ConclusionsThere is a significant positive association between NHHR and HUA, indicating that NHHR may serve as a potential risk assessment maker for HUA, although further prospective studies are needed for validation.
| S-EPMC11370097 | biostudies-literature
Project description: Not available
| S-EPMC11802436 | biostudies-literature
Project description:BackgroundObesity, often accompanied by dyslipidemia and increased cardiovascular risk, poses a significant threat to overall mortality. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has been identified as a valuable parameter for assessing dyslipidemia. The goal of the study was to elucidate the relationship between NHHR and mortality in obese populations.MethodsData for the study cohort were sourced from the National Health and Nutrition Examination Survey (1999-2018). The association between NHHR and mortality from all causes and cardiovascular disease was examined through multivariable Cox regression and restricted cubic splines (RCS). Segmented multivariable Cox regression and subgroup analyses were conducted when segmented effects were identified. The reliability of the results was confirmed through multiple sensitivity analyses.ResultsA total of 7,504 participants were included in the analysis. During a median follow-up of 119 months, 866 subjects died for all causes, of which 318 were related to cardiovascular diseases. A U-shaped association was found utilizing RCS analysis, with cardiovascular mortality and all-cause mortality exhibiting the lowest risk points at 3.409 and 3.369, respectively. The fully adjusted model revealed a negative relationship between the risk of cardiovascular mortality (HR = 0.68, 95% CI: 0.49-0.94) and all-cause mortality (HR = 0.82, 95% CI: 0.67-1.00) for per 1 mmol/L increase in NHHR levels below the cut-off value. On the other hand, above the cut-off point, NHHR was positively correlated with cardiovascular mortality (HR = 1.18, 95% CI: 1.02-1.36) and all-cause mortality (HR = 1.13, 95% CI: 1.01-1.28). The sensitivity results of this study were in accordance with earlier findings, and no significant interactions in NHHR levels were discovered across different subgroups.ConclusionsIn the obese adults, NHHR displayed a U-shaped relationship with cardiovascular and all-cause death. Monitoring and managing NHHR levels in obese population may help mitigate the risk of mortality.
| S-EPMC11759299 | biostudies-literature
Project description:BackgroundObstructive Sleep Apnea (OSA) is a widespread sleep disturbance linked to metabolic and cardiovascular conditions. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratios (NHHR) has been proposed as being a potential biomarker to gauge cardiovascular risk. However, its relationship with OSA remains unclear.MethodsThis survey investigated the link NHHR to OSA in American citizens aged 20 and older using information collected via the National Health and Nutrition Examination Survey (NHANES) during the years 2017 to 2020. Logistic regression models with multivariable adjustments were employed to assess this relationship. Nonlinear associations were explored using smooth curve fitting, with a two-part linear regression model identifying a threshold effect. Subgroup analyses were conducted to evaluate population-specific differences.ResultsThe survey encompassed 6763 participants, with an average age of 50.75 ± 17.32. The average NHHR stood at 2.74, accompanied by a standard deviation of 1.34, while the average frequency of OSA was 49.93%. Upon adjusting for covariates, each unit increase in NHHR may be associated with a 9% rise in OSA incidence. (95% confidence intervals 1.04-1.14; P < 0.0001). Notably, a U-shaped curve depicted the NHHR-OSA relationship, with an inflection point at 4.12. Subgroup analyses revealed consistent associations, with educational attainment and diabetes status modifying the NHHR-OSA relationship.ConclusionThe study highlights NHHR as a potential tool for OSA prediction, presenting avenues for advanced risk evaluation, tailored interventions, personalized treatment approaches, and preventive healthcare.
| S-EPMC11223298 | biostudies-literature
Project description:BackgroundDespite the potential superiority of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) as a diagnostic and predictive marker, no study has investigated the link between different leisure-time physical activity (LTPA) patterns and the NHHR. This study aims to explore this relationship.MethodsData was extracted from the National Health and Nutrition Examination Survey (NHANES) cycles spanning from 2007 to 2008 to 2017-2018. Participants (N = 14,211) were classified into four groups based on their LTPA patterns: (1) inactive (LTPA = 0 min/week); (2) insufficiently active (LTPA < 150 min/week); (3) weekend warrior (LTPA ≥ 150 min/week within 1 or 2 sessions); and (4) regularly active (LTPA ≥ 150 min/week in more than 2 sessions). Weighted multiple linear regression analysis was employed twice, using inactive and regular active groups as reference groups, respectively. Weighted stratification analyses and interaction tests were performed by demographics.ResultsCompared to the inactive group, each additional unit of LTPA time was associated with a significant 0.23-unit greater decrease in the NHHR in the regularly active group [-0.23 (-0.29; -0.16)]. However, no significant decrease was observed in the "Weekend Warrior" [-0.11 (-0.22; 0.008)] or insufficiently active groups [-0.03 (-0.11; 0.04)]. Moreover, compared to the regularly active group, the insufficiently active [0.21 (0.13; 0.29)], "Weekend Warrior" [0.13 (0.004; 0.25)], and inactive [0.26 (0.20; 0.32)] groups had significantly higher NHHR. The associations between the NHHR and various LTPA patterns did not significantly differ by demographic factors, except for race.ConclusionThe regularly active pattern is significantly associated with a lower NHHR, but no significant difference in the NHHR was detected between the insufficiently active and "Weekend Warriors" patterns. The study suggests that frequency and regularity of PA are crucial for optimal lipid management, supporting clinical recommendations to meet or exceed 150 min of PA in more than two sessions per week.
| S-EPMC11476701 | biostudies-literature
Project description:BackgroundThe non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) serves as a novel composite lipid indicator for atherosclerosis. However, the association between NHHR and mortality in patients with diabetes or prediabetes remains unclear. Consequently, the objective of this study was to investigate the relationship between NHHR and both all-cause and cardiovascular mortality in US adults with diabetes or prediabetes.MethodsThis study included 12,578 adult participants with diabetes or prediabetes from the US National Health and Nutrition Examination Survey (1999-2018). Mortality outcomes were ascertained by linking to the National Death Index (NDI) record up to December 31, 2019. We employed a weighted multivariate Cox proportional hazards model and restricted cubic splines to assess the associations between NHHR and all-cause and cardiovascular mortality. A segmented Cox proportional hazards model was used for evaluating threshold effects. Furthermore, a competing risks analysis was performed to explore the relationship between NHHR and cardiovascular mortality.ResultsDuring a median follow-up period of 8.08 years, 2403 participants encountered all-cause mortality, with 662 of them specifically succumbing to cardiovascular mortality. The restricted cubic splines revealed a U-shaped association between NHHR and all-cause mortality, while an L-shaped association was observed for cardiovascular mortality. The analysis of threshold effects revealed that the inflection points for NHHR and all-cause and cardiovascular mortality were 2.72 and 2.83, respectively. Specifically, when the baseline NHHR was below the inflection points, a negative correlation was observed between NHHR and both all-cause mortality (HR: 0.76, 95% CI: 0.68-0.85) and cardiovascular mortality (HR: 0.70, 95% CI: 0.57-0.85). Conversely, when the baseline NHHR exceeded the inflection points, a positive correlation was observed between NHHR and both all-cause mortality (HR: 1.11, 95% CI: 1.06-1.16) and cardiovascular mortality (HR: 1.08, 95% CI: 1.00-1.16).ConclusionsAmong US adults with diabetes or prediabetes, a U-shaped association was observed between NHHR and all-cause mortality, whereas an L-shaped association was identified with cardiovascular mortality. The inflection points for all-cause and cardiovascular mortality were 2.72 and 2.83, respectively.
| S-EPMC11304565 | biostudies-literature
Project description:Recently, the non-high-density to high-density lipoprotein cholesterol ratio (NHHR) has gained growing attention as an indicator for predicting diseases associated with lipid metabolism. Hepatic steatosis and fibrosis are tightly associated lipid metabolism. Our study aims to analyze the correlations among NHHR, hepatic steatosis, and fibrosis. This study analysed data from 14,578 adults in the US National Health and Nutrition Examination Survey (2005-2018). The degree of hepatic steatosis was measured through the Fatty Liver Index (FLI), while liver fibrosis severity was evaluated with the Fibrosis-4 (FIB-4) index. Multivariate linear regression assessed the association between NHHR and the FLI and FIB-4 score. Smooth curve describing the relationship between NHHR and FLI or FIB-4. Additionally, a two-part linear regression model adopted in order to more accurately account for the nonlinear relationship, with threshold effects estimated through its two components. To confirm the robustness of the findings, interaction tests and subgroup analyses were conducted. The multivariate logistic regression analysis demonstrated a significantly positive correlation of lnNHHR with FLI across all three models. In Model 3, the association was (β = 11.14, 95%CI:10.38,11.90). Curve fitting indicated a nonlinear relationship. The positive correlation between lnNHHR and FLI persists across gender, BMI, and physical activity groups. Nevertheless, a notable negative correlation between lnNHHR and FIB-4 was observed in all three models. In Model 3, the relationship between lnNHHR and FIB-4 was as follows: (β = -0.20; 95% CI: -0.22, -0.17). Curve fitting revealed a V-shaped relationship, with threshold effect analysis identifying a breakpoint at 1.51. Above this threshold, the relationship was found to be statistically insignificant (p-value = 0.424). Receiver operating characteristic (ROC) curve analysis demonstrated that NHHR exhibited better predictive performance for MASLD compared to non-HDL-C, HDL-C, and LDL-C/HDL-C. The current study's findings suggest that elevated levels of NHHR correlate with a greater risk of hepatic steatosis among adults in the U.S. Our findings imply that NHHR may be a valuable tool in improving MASLD prevention strategies in the general population.
| S-EPMC11847945 | biostudies-literature
Project description: Not available
| S-EPMC10928332 | biostudies-literature