Evidence mapPaperPMID 39415313Full record

ArticleDiabetes, obesity & metabolism2025

Association of non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio with cardiovascular outcomes in patients with type 2 diabetes mellitus: Evidence from the ACCORD cohort.

Maojun Liu, Junyu Pei, Cheng Zeng, Ying Xin, Yifeng Zhang, Peiqi Tang, Simin Deng, Xinqun Hu

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Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

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15citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Maojun LiuDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Junyu PeiDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Cheng ZengDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Ying XinDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Yifeng ZhangDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Peiqi TangDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Simin DengDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Xinqun HuDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0003-1430-4833

Funding

National Natural Science Foundation of China 82370467
6 · The paper itself

Abstract

aimTo explore the association between the non-high-density lipoprotein cholesterol (HDL-C)/HDL-C ratio (NHHR) and the risk of major adverse cardiovascular events (MACEs) and overall mortality in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND

methodsNHHR, calculated as (total cholesterol - HDL-C)/HDL-C, was evaluated in 10,188 participants. Cox proportional hazard regression models were employed to assess the association of NHHR with future risk of MACEs and overall mortality. Restricted cubic spline analysis, smooth curve fitting and piecewise regression models were utilized to explore the non-linear correlation and establish the threshold. Subgroup and interaction analyses verified the robustness of the findings. The area under the receiver operating characteristic area under the curve assessed the additional predictive value of NHHR beyond conventional risk factors.

resultsAfter adjusting for confounding factors, each 1-unit increase in NHHR was associated with a 12% increased risk of MACEs (hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.07-1.16; p < 0.0001), a 5% increase in overall mortality (HR: 1.05, 95% CI: 1.01-1.10; p = 0.0256), a 10% increase in cardiovascular disease mortality (HR 1.10, 95% CI: 1.03-1.18; p = 0.0074), an 12% increase in non-fatal myocardial infarction (HR: 1.12, 95% CI: 1.05-1.18; p = 0.0002), and an 11% increase in non-fatal stroke (HR: 1.11, 95% CI: 1.02-1.20; p = 0.0123). Analyses showed a non-linear relationship between NHHR and MACEs in patients with T2DM (non-linearity p < 0.001). A two-stage linear regression model identified a threshold for MACEs at 6.28. Integration NHHR into the conventional model significantly enhanced predictive accuracy for MACEs.

conclusionsNHHR is a predictor of the risk of developing MACEs and overall mortality in patients with T2DM, with higher NHHR values independently associated with increased future MACE risks after full adjustment for confounders.

Indexed as

Cardiovascular DiseasesCholesterol, HDLDiabetes Mellitus, Type 2AgedCholesterolCohort StudiesDiabetic AngiopathiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsRisk FactorsCholesterolCholesterol, HDLmajor adverse cardiovascular eventsnon‐high‐density lipoprotein cholesterol/high‐density lipoprotein cholesterol ratiototal mortalitytype 2 diabetes mellitus

Identifiers

PMID39415313
PMCPMC11618286

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.