ArticleLipids in health and disease2025
Changes in non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and cardiovascular disease: insights from CHARLS.
Article in Lipids in health and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Leveraging interpretable machine learning to identify sarcopenia in middle-aged and older adults with intrinsic capacity decline: an analysis of CHARLS data under AWGS 2025.BMC medical informatics and decision making · 2026Article
- Association between chrononutrition patterns and metabolic dysfunction-associated steatotic liver disease in adolescents: a population-based study.Eating and weight disorders : EWD · 2026Article
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- Sex-stratified associations of TyG index and HOMA-IR changes with incident type 2 diabetes.Scientific reports · 2026Article
- Article
- Changes in the estimated glucose disposal rate and cardiometabolic multimorbidity in middle-aged and older adults.Cardiovascular diabetology · 2026Article
- Association of a novel triglyceride-glucose and non-HDL-to-HDL cholesterol ratio (TyG-NHHR) index with cardiometabolic multimorbidity: a dual-cohort prospective study in Chinese and European adults.Journal of health, population, and nutrition · 2026Article
- Association Between NHHR and Future Cardiovascular Disease Among Patients With CKM Stages 0-3: A Nationwide Prospective Cohort Study.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and short-term outcomes in hepatitis B virus-related acute-on-chronic liver failure.BMC infectious diseases · 2026Article
- Associations of non-traditional lipid parameters with high-risk plaques characterized by optical coherence tomography in acute myocardial infarction culprit lesions.Frontiers in cardiovascular medicine · 2026Article
- Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is associated with cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes.Frontiers in endocrinology · 2026Article
- Composite Markers Predict Functional Outcomes in Basal Ganglia Hemorrhage in Patients with Cerebral Small Vessel Disease.International journal of general medicine · 2026Article
- Determinants of Liver Steatosis Progression in Chinese Children: A Prospective Cohort Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Association of the non-HDL cholesterol to HDL cholesterol ratio with possible sarcopenic obesity in Chinese adults.Scientific reports · 2025Article
- Relation of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio to residual risk in anticoagulated patients with atrial fibrillation: a report from the prospective Murcia AF Project III cohort.Cardiovascular diabetology · 2025Observational
- Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and early-onset benign prostatic hyperplasia: a cross-sectional analysis based on NHANES.Journal of health, population, and nutrition · 2025Article
- Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cognitive impairment in patients with acute mild ischemic stroke.European journal of medical research · 2025Article
- Association between the atherogenic index of plasma and the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis.Frontiers in neurology · 2025Article
- The association of non-HDL-C, NHHR, RC, and RCII with coronary artery stenosis severity in patients with acute coronary syndrome combined with cardiometabolic multimorbidity.Frontiers in endocrinology · 2025Article
- The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is associated with early onset type 2 diabetes with NAFLD: a cross-sectional study in China.Frontiers in nutrition · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe established association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cardiovascular disease (CVD) risk has been well-documented. Nevertheless, the relationship between changes in NHHR and CVD events remains to be elucidated. The present study aims to clarify the correlation between NHHR change patterns and the incidence of CVD across a broad population.
methodsThe current study recruited participants from the China Health and Retirement Longitudinal Study (CHARLS). The NHHR index was calculated using the formula: NHHR = (TC-HDL-c)/HDL-c. Temporal changes in NHHR were assessed with latent profile analysis, and cumulative NHHR was also evaluated. Multivariable Cox proportional hazards regression models and multivariate-adjusted restricted cubic spline (RCS) analyses were employed to examine the association between the NHHR index and incident CVD.
resultsA total of 4,629 individuals were recruited for the study. The average age of the participants was 57.47 years, with 53.7% being female. Over the follow-up period, 879 cases of CVD were documented. Compared to participants in the lowest tertile, those in the highest tertile for both baseline NHHR and cumulative NHHR exhibited a significantly increased risk of CVD, with adjusted hazard ratios (HRs) of 1.43 (95% confidence interval [CI]: 1.21-1.70) and 1.45 (95% CI: 1.23-1.72), respectively. Participants classified in Class 2 demonstrated a 27% higher risk of CVD, while those in Class 3 showed a 41% greater risk compared to the Class 1 group. Further analysis revealed that this relationship was linear. Stratified analyses corroborated the primary findings.
conclusionBaseline NHHR, cumulative NHHR, and changes in NHHR are significantly associated with an increased risk of CVD among individuals aged 45 years and older, thereby confirming their potential as valuable tools for risk stratification in CVD.
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