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. 2025 Feb 11:16:1503780.
doi: 10.3389/fendo.2025.1503780. eCollection 2025.

Association between non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio and macroalbuminuria: evidence from NHANES 1999-2018

Dongli Huang  1 , Yuan He  2
Affiliations

Association between non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio and macroalbuminuria: evidence from NHANES 1999-2018

Dongli Huang et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: The 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 methods: This 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.

Results: A 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.

Conclusion: In 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.

Keywords: ACR - albumin to creatinine ratio; NHANES; cross-sectional study; macroalbuminuria; the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participant selection. NHANES, National Health and Nutrition Examination Survey; NHHR, non-high-density lipoprotein cholesterol to high-density lipoprotein ratio.
Figure 2
Figure 2
The association between In-NHHR and macroalbuminuria. The solid red line represents thesmooth curve fit between variables, Blue bands represent the 95% confidence interval fromthe fit. NHHR, non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol.
Figure 3
Figure 3
Nonlinear relationship between Ln-NHHR and macroalbuminuria across BMI groups.
See this image and copyright information in PMC

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Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

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