The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and its combination with obesity indicators as a predictor of all cause and cardiovascular mortality in non-diabetic individuals.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Cardiovascular Diseases*/mortality ; Cardiovascular Diseases*/blood ; Obesity*/blood ; Obesity*/epidemiology ; Cholesterol, HDL*/blood ; Cholesterol*/blood; Biomarkers/blood ; Humans ; Male ; Female ; Middle Aged ; Nutrition Surveys ; Adult ; Cause of Death ; Aged ; Proportional Hazards Models

Background: The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) represents a novel composite lipid marker for atherosclerosis and cardiovascular disease (CVD). Nevertheless, the correlation between NHHR and mortality in the non-diabetic population remains indistinct.
Methods: This study included 20,774 non-diabetic individuals from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). We employed a weighted multivariate Cox proportional hazards model and restricted cubic splines to assess the associations between NHHR, its combination with obesity indicators, and all-cause and CVD mortality.
Results: During a mean follow-up period of 62 months, a total of 897 participant deaths were recorded, of which 155 were attributed to cardiovascular causes. The restricted cubic splines revealed a U-shaped association between NHHR and all-cause mortality, while an L-shaped association was observed for CVD mortality. The analysis of threshold efects revealed that the infection points for NHHR and all-cause and CVD mortality were 2.65 and 2.07, respectively. The cubic spline revealed a nonlinear correlation was observed between NHHR-BMI, NHHR-WC and NHHR-WHtR and all-cause and CVD mortality.
Conclusion: NHHR and its combination with obesity indicators can be a meaningful predictor of all-cause mortality and CVD mortality in non-diabetic individuals.
(© 2025. The Author(s).)

Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by the National Center for Health Statistics Research Ethics Review Board (protocol number: #2021-05). The participants provided written informed consent to participate in this study. The study protocol complied with the Declaration of Helsinki. Consent for publication: Not applicable. Conflict of interest: The authors declare no conflict of interest in the preparation of this manuscript.

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20241321 the Project of Administration of Traditional Chinese Medicine of Guangdong Province of China; WKZX2022JG0118 Development Center for Medical Science & Technology National Health Commission of the People's Republic of China; SKLKY2024B0002 the State Key Laboratory of Traditional Chinese Medicine Syndrome Open Project; HQL2024PZ028 Chinese Medicine Guangdong Laboratory

Keywords: Cardiovascular disease; Mortality; NHANES; NHHR; Non-diabetic

0 (Cholesterol, HDL)
0 (Biomarkers)
97C5T2UQ7J (Cholesterol)

Date Created: 20250424 Date Completed: 20250424 Latest Revision: 20250426

20260130

PMC12016409

10.1186/s12889-025-22789-y

40269817