HDL Cholesterol

ObjectiveThis study aimed to investigate the association between the high-sensitivity C-reactive protein/high-density lipoprotein cholesterol (Hs-CRP/HDL-C) ratio and sarcopenia among U.S. population by using composite marker integrating systemic inflammation and lipid metabolism.MethodThis study included participants from the 2015-2018 of the National Health and Nutrition Examination Survey (NHANES). Sarcopenia was diagnosed based on the skeletal muscle index (SMI) by using dual-energy X-ray absorptiometry (DXA) technology. The Hs-CRP/HDL-C ratio was derived from laboratory examinations, was categorized into quartiles. Multivariate logistic regression models, adjusted for demographic and clinical covariates, were employed to assess the association between the Hs-CRP/HDL-C ratio and sarcopenia. Subgroup analysis and restricted cubic splines (RCS) were used to examine potential nonlinear relationships and threshold effects. Receiver operating characteristic (ROC) curve was used to evaluate the performance of the Hs-CRP/HDL-C ratio, Hs-CRP, and HDL-C indicators in predicting sarcopenia.ResultsThis study finally recorded 4,152 participants from NHANES from 2015-2018 for analysis. Elevated Hs-CRP/HDL-C ratios were significantly associated with an increased risk of sarcopenia, with a dose-response relationship observed across quartiles (p for trend p=0.004). Participants in the highest quartile (≥2.75) of the Hs-CRP/HDL-C ratio had a 122% higher risk of sarcopenia compared to those in the lowest quartile (p=0.005). Subgroup analyses showed a stronger association in adults aged ≥40 years, with notable differences across races, especially among non-Hispanic Whites and other race. RCS model identified a non-linear association, with a threshold effect at a ratio of 0.86. The combined inflammatory and lipid markers Hs CRP/HDL-C showed stronger predictive performance (AUC: 0.685, 95% CI 0.666-0.703).ConclusionThe Hs-CRP/HDL-C ratio can serve as a practical indicator to identify individuals at higher risk of sarcopenia, capturing the combined effects of chronic inflammation and lipid metabolism issues. This ratio may be useful for early detection and prevention efforts targeting sarcopenia. However, more prospective research is needed to confirm these findings..

ObjectiveMetabolic - associated fatty liver disease (MAFLD) is a common hepatic disorder with increasing prevalence, and early detection remains inadequately achieved. This study aims to explore the relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and MAFLD, and to establish a predictive model for MAFLD using NHHR as a key variable.MethodsAll participants were selected from the NHANES cohort, spanning from 2017 to March 2020. Multiple linear regression models were employed to examine the relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and the controlled attenuation parameter (CAP). To explore the non-linear association between NHHR and CAP, smooth curve fitting and restricted cubic splines (RCS) of the adjusted variables were utilized. Subgroup analyses were conducted to identify variations in the relationships between the independent and dependent variables across different populations. Finally, a metabolic - associated fatty liver disease (MAFLD) prediction model was developed using seven machine learning methods, including eXtreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), Multilayer Perceptron (MLP), Random Forest, Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and logistic regression. The SHAP (SHapley Additive exPlanations) value was employed to interpret the importance of various features.ResultWeighted multiple linear regression models revealed a significant positive correlation between the NHHR and the CAP (Beta = 7.42, 95% CI: 5.35-9.50, P ConclusionA significant positive correlation was identified between the NHHR and the CAP. The inclusion of NHHR in the XGBoost predictive model for MAFLD demonstrated robust predictive capability, providing a valuable tool for the early detection of MAFLD with considerable clinical application potential.

BackgroundA sustained oversupply of monocytes and markedly decreased levels of high-density lipoprotein cholesterol (HDL-C) are notable in high-risk groups with residual cardiovascular risk, despite aggressive low-density lipoprotein cholesterol (LDL-C) lowering. This study aimed to explore whether an imbalance in circulating monocyte and HDL-C levels accounts for the residual risk of incident myocardial infarction (MI) within optimal LDL-C levels.MethodsA total of 48,522 participants free of cardiovascular diseases from a real-life, prospective cohort (Kailuan study) were included. The monocyte count, HDL-C level and monocyte-to-HDL-C ratio (MHR), calculated as time-averaged cumulative and baseline values, were used as the exposures. Time-to-event survival analyses were conducted to examine the association between exposure and MI incidence, especially tests for risk heterogeneity across different LDL-C levels and other potential confounders.ResultsDuring a median follow-up of 10.06 years, 573 MI events occurred. An elevated time-averaged MHR was positively correlated with clustering of traditional risk factors but inversely correlated with LDL-C levels. After adjusting for potential confounders, each 1-SD increase in the time-averaged monocyte count, HDL-C level and MHR was significantly associated with a risk of 1.18 (95% CI: 1.08-1.28), 0.86 (95% CI: 0.79-0.93) and 1.27 (95% CI: 1.16-1.38), respectively. Individuals with LDL-C levels between 1.8 and 2.6 mmol/L had the lowest MI incidence but the highest MI risk (1.50, 95% CI: 1.27-1.79) with exposure to time-averaged MHR. In contrast, individuals with LDL-C levels ≥ 3.4 mmol/L had the highest MI incidence, but nonsignificant MI risk (HR: 0.99, 95% CI 0.82-1.19) was associated with time-averaged MHR.ConclusionChronic imbalances in monocyte and HDL-C levels are significantly associated with incident MI among individuals with low LDL-C levels. Longitudinally tracing MHR changes and targeting elevated MHR may help to optimize risk assessment and management of MI.

BackgroundEarly risk stratification in acute ischemic stroke (AIS) is critical for guiding management and improving outcomes. The ratio of non-high-density lipoprotein to high-density lipoprotein cholesterol (NHHR) represents the equilibrium between pro-atherogenic and anti-atherogenic lipoproteins, potentially capturing both lipid metabolism and inflammatory status, but its prognostic value in AIS remains unclear.MethodsWe retrospectively analyzed 812 first-ever AIS patients. Admission NHHR was calculated from routine lipid panels. The study's main outcome was 90-day functional status, determined using the modified Rankin Scale. Associations with NHHR were examined through multivariable logistic regression, quartile analyses, restricted cubic spline (RCS) modeling, and subgroup analyses.ResultsAmong 812 patients, 255 (31.4%) had unfavorable outcomes. Elevated NHHR showed an independent correlation with unfavorable 90-day functional outcomes (adjusted OR per unit increase, 1.233; 95% CI, 1.058-1.439; P = 0.0076). RCS analysis demonstrated a gradual rise in risk with increasing NHHR (P for trend = 0.043; P for nonlinearity = 0.584). Subgroup analyses showed consistent associations across sex, stroke severity, smoking, drinking, hypertension, and diabetes.ConclusionAdmission NHHR is a simple, inexpensive, and robust predictor of 90-day unfavorable outcomes in AIS. It provides a novel integrated lipid-inflammation marker for early risk stratification, warranting further validation in prospective studies.