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Liu Y, Wang Y, Xing Y, Wolters M, Shi D, Zhang P, Dang J, Chen Z, Cai S, Wang Y, Liu J, Wang X, Zhou H, Xu M, Guo L, Li Y, Song J, Li J, Dong Y, Cui Y, Hu P, Hebestreit A, Wang HJ, Li L, Ma J, Yeo YH, Wang H, Song Y. Establish a noninvasive model to screen metabolic dysfunction-associated steatotic liver disease in children aged 6-14 years in China and its applications in high-obesity-risk countries and regions. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 49:101150. [PMID: 39171077 PMCID: PMC11338159 DOI: 10.1016/j.lanwpc.2024.101150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 08/23/2024]
Abstract
Background The prevalence of metabolic-associated steatotic liver disease (MASLD) is rising precipitously among children, particularly in regions or countries burdened with high prevalence of obesity. However, identifying those at high risk remains a significant challenge, as the majority do not exhibit distinct symptoms of MASLD. There is an urgent need for a widely accepted non-invasive predictor to facilitate early disease diagnosis and management of the disease. Our study aims to 1) evaluate and compare existing predictors of MASLD, and 2) develop a practical screening strategy for children, tailored to local prevalence of obesity. Methods We utilized a school-based cross-sectional survey in Beijing as the training dataset to establish predictive models for screening MASLD in children. An independent school-based study in Ningbo was used to validate the models. We selected the optimal non-invasive MASLD predictor by comparing logistic regression model, random forest model, decision tree model, and support vector machine model using both the Beijing and Ningbo datasets. This was followed by serial testing using the best performance index we identified and indices from previous studies. Finally, we calculated the potential MASLD screening recommendation categories and corresponding profits based on national and subnational obesity prevalence, and applied those three categories to 200 countries according to their obesity prevalence from 1990 to 2022. Findings A total of 1018 children were included (NBeijing = 596, NNingbo = 422). The logistic regression model demonstrated the best performance, identifying the waist-to-height ratio (WHtR, cutoff value ≥0.48) as the optimal noninvasive index for predicting MASLD, with strong performance in both training and validation set. Additionally, the combination of WHtR and lipid accumulation product (LAP) was selected as an optimal serial test to improve the positive predictive value, with a LAP cutoff value of ≥668.22 cm × mg/dL. Based on the obesity prevalence among 30 provinces, three MASLD screening recommendations were proposed: 1) "Population-screening-recommended": For regions with an obesity prevalence ≥12.0%, where MASLD prevalence ranged from 5.0% to 21.5%; 2) "Resources-permitted": For regions with an obesity prevalence between 8.4% and 12.0%, where MASLD prevalence ranged from 2.3% to 4.4%; 3) "Population-screening-not-recommended": For regions with an obesity prevalence <8.4%, where MASLD prevalence is difficult to detect using our tool. Using our proposed cutoff for screening MASLD, the number of countries classified into the "Population-screening-recommended" and "Resources-permitted" categories increased from one and 11 in 1990 to 95 and 28 in 2022, respectively. Interpretation WHtR might serve as a practical and accessible index for predicting pediatric MASLD. A WHtR value ≥0.48 could facilitate early identification and management of MASLD in areas with obesity prevalence ≥12.0%. Furthermore, combining WHtR ≥0.48 with LAP ≥668.22 cm × mg/dL is recommended for individual MASLD screening. Moreover, linking these measures with population obesity prevalence not only helps estimate MASLD prevalence but also indicates potential screening profits in regions at varying levels of obesity risk. Funding This study was supported by grants from Capital's Funds for Health Improvement and Research (Grant No. 2022-1G-4251), National Natural Science Foundation of China (Grant No. 82273654), Major Science and Technology Projects for Health of Zhejiang Province (Grant No. WKJ-ZJ-2216), Cyrus Tang Foundation for Young Scholar 2022 (2022-B126) and Sino-German Mobility Programme (M-0015).
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Affiliation(s)
- Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Youxin Wang
- Department of Maternal and Child Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yunfei Xing
- Department of Maternal and Child Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Maike Wolters
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Pingping Zhang
- Ningbo Center for Healthy Lifestyle Research, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Ziyue Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yaqi Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Xinxin Wang
- Linyi University, Linyi, Shandong Province, China
| | - Haoyu Zhou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Lipo Guo
- Changping Health Education Center for Primary and Secondary Schools, Beijing, China
| | - Yuanyuan Li
- Changping Health Education Center for Primary and Secondary Schools, Beijing, China
| | - Jieyun Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanchun Cui
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Peijin Hu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Antje Hebestreit
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
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Xie C, Ren Y, He Q, Wang C, Luo H. Association between arteriosclerosis index and lumbar bone mineral density in U.S adults: a cross-sectional study from the NHANES 2011-2018. Front Cardiovasc Med 2024; 11:1459062. [PMID: 39149583 PMCID: PMC11324549 DOI: 10.3389/fcvm.2024.1459062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 08/17/2024] Open
Abstract
Background The arteriosclerosis index, defined as the ratio of non-high density lipoprotein cholesterol to high density lipoprotein cholesterol (NHHR), has emerged as a novel biomarker for various diseases. The relationship between NHHR and lumbar bone mineral density (BMD) has not been previously examined. Methods This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. NHHR was calculated as (total cholesterol-high-density lipoprotein cholesterol)/high-density lipoprotein cholesterol. Lumbar BMD was calculated to Z scores. Weighted multivariate linear regression, subgroup analysis, interaction analysis, generalized additive model, and two-piecewise linear regression were used. Results A total of 8,602 participants were included. The negative association between NHHR and lumbar BMD was consistent and significant (Model 1: β = -0.039, 95% CI: -0.055, -0.023, p < 0.001; Model 2: β = -0.045, 95% CI: -0.062, -0.027, p < 0.001; Model 3: β = -0.042, 95% CI: -0.061, -0.023, p < 0.001). The linear relationship between NHHR and lumbar BMD was significantly influenced by body mass index (p for interaction = 0.012) and hypertension (p for interaction = 0.047). Non-linear associations between NHHR and lumbar BMD Z scores were observed in specific populations, including U-shaped, reverse U-shaped, L-shaped, reverse L-shaped, and U-shaped relationships among menopausal females, underweight participants, those with impaired glucose tolerance, those with diabetes mellitus and those taking anti-hyperlipidemic drugs, respectively. Conclusions NHHR exhibited a negative association with lumbar BMD, but varying across specific populations. These findings suggest that NHHR should be tailored to individual levels to mitigate bone loss through a personalized approach. Individuals at heightened risk of cardiovascular disease should focus on their bone health.
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Affiliation(s)
- Chengxin Xie
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yu Ren
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Qiang He
- Department of Orthopedics, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Chenglong Wang
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Hua Luo
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
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Momeni A, Yazdi M, Motlagh ME, Qorbani M, Kelishadi R. Glucose and lipid-related indicators in relation to elevated alanine aminotransferase in a pediatric population. J Pediatr Endocrinol Metab 2024; 37:597-604. [PMID: 38934083 DOI: 10.1515/jpem-2024-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To determine the associations between various glucose and lipid-related indicators with elevated alanine aminotransferase (ALT) in pediatric population. METHODS We analyzed the cross-sectional data of 3,771 Iranian children and adolescents aged 7-18 years using the fifth survey of a national school-based surveillance program. The predictive power of 11 different glucose and lipid-related indicators for predicting elevated ALT was examined using receiver operating characteristic (ROC) curve. RESULTS In the total sample non-HDL-C, non-HDL-C/HDL-C, and TC/HDL-C showed the largest area under the curve (AUC) for elevated ALT detection, with 0.731 (cut-off, 129.5 mg/dL), 0.706, and 0.706, respectively. In girls, non-HDL-C had the highest predictive value (AUC, 0.741, cut-off, 129.5 mg/dL). Among boys, non-HDL-C/HDL-C and TC/HDL-C showed the largest AUC of 0.753 with optimum cut-off values of 2.63 and 3.63, respectively. CONCLUSIONS The findings of this study suggest that non-HDL-C, non-HDL-C/HDL-C, and TC/HDL-C can be predictors of elevated ALT in the pediatric population. These indices can be useful in large population-based studies for predicting children and adolescents at risk of fatty liver.
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Affiliation(s)
- Azin Momeni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences 48455 , Isfahan, Iran
| | - Maryam Yazdi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences 48455 , Isfahan, Iran
| | | | - Mostafa Qorbani
- 391934 Non-communicable Diseases Research Center , Alborz University of Medical Sciences, Karaj, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences 48455 , Isfahan, Iran
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He R, Ye Y, Zhu Q, Xie C. Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and sarcopenia in individuals with cancer: a cross-sectional study. Lipids Health Dis 2024; 23:217. [PMID: 39014376 PMCID: PMC11251101 DOI: 10.1186/s12944-024-02205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Cancer and sarcopenia are both closely related to lipid metabolism, but the relationship between lipid metabolism and patients with cancer and sarcopenia has not been thoroughly studied. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a reliable measure of lipid metabolism. The purpose of this study was to determine the possible relationship between the NHHR and sarcopenia in individuals with cancer. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) database for individuals with cancer, with and without sarcopenia was analyzed using weighted multiple regression equations, weighted regression cubic spline (RCS) analysis, and weighted subgroup analysis. RESULTS In total, 1,602 individuals with cancer were included, of whom 17.1% had sarcopenia. In Adjusted Model 2, the occurrence of sarcopenia was found to be significantly associated with a higher NHHR in cancer (95% confidence interval [CI]:1.01-1.39, P = 0.036). Individuals with high a NHHR had a 2.09-fold higher risk of developing sarcopenia in comparison to those with a low NHHR (95% CI:1.12-3.92, P = 0.022). RCS analysis further identified a U-shaped non-linear relationship between females with cancer and the muscle index. Subgroup analysis indicated that sex was a significant stratifying factor, whereas age, race, marital status, smoking and drinking habits, and history of cardiovascular disease, arthritis, hypertension, and diabetes had no significant impact. CONCLUSION From the perspective of lipid metabolism, the NHHR may serve as an indicator for monitoring and preventing the occurrence of sarcopenia in individuals with cancer, particularly for females with cancer who appear to have greater sensitivity.
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Affiliation(s)
- Ran He
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Youjun Ye
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qilei Zhu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Changsheng Xie
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
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Chen T, Cheng Y, Song Z, Zhang G, Zeng T, Chao H. Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stone: evidence from NHANES 2007-2018. BMC Public Health 2024; 24:1818. [PMID: 38978025 PMCID: PMC11232242 DOI: 10.1186/s12889-024-19265-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/25/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND As an innovative lipid parameter, NHHR (the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol) can serve as a valuable tool for assessing cardiovascular disease risk. Nevertheless, the relationship between NHHR and the risk of kidney stones remains unexplored. METHODS A cross-sectional survey utilized data from the National Health and Population Survey (NHANES) database in the United States spanning from 2007 to 2018. Distinct statistical analyses were applied, including weighted logistic regression, stratified and interaction analysis and restricted cubic spline curve (RCS) models, to examine the correlation between NHHR and the incidence of kidney stones. RESULTS This analysis encompassed 24,664 participants, with 9.63% reporting incidents of kidney stones. Following multivariate logistic regression and comprehensive adjustments, participants in NHHR quartile 4 (OR 1.34; 95% CI 1.12, 1.60, P < 0.01) exhibited a significantly increased risk of kidney stones compared to those in NHHR quartile 1 (Q1). The RCS result further illustrated a non-linear correlation between NHHR and the incidence of kidney stones. The result of subgroup analysis manifested that participants without diabetes had a higher risk of kidney stones when measured high NHHR levels compared those with diabetes (p for interaction < 0.05). CONCLUSION Elevated NHHR levels were found to be associated with an increased risk of kidney stones. Based on these findings, NHHR appears to be a promising predictive indicator for the occurrence of kidney stones.
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Affiliation(s)
- Tao Chen
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China
- Medical college of Nanchang University, Nanchang, China
| | - Yu Cheng
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zheng Song
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gan Zhang
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Zeng
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Haichao Chao
- Department of Urology, the second Affiliated Hospital of Nanchang University, Nanchang, China.
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Hong H, He Y, Gong Z, Feng J, Qu Y. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stones: a cross-sectional study. Lipids Health Dis 2024; 23:102. [PMID: 38615008 PMCID: PMC11015599 DOI: 10.1186/s12944-024-02089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND The relationship between the NHHR and kidney stone risk remains unknown. The purpose of this study was to evaluate the association between adult NHHR and kidney stone occurrence in USA. METHODS This study used a variety of statistical techniques such as threshold effects, subgroup analysis, smooth curve fitting, multivariate logistic regression, and data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014. We aimed to clarify the relationship between the NHHR and kidney stone risk. RESULTS The average age of the 21,058 individuals in this research was 49.70 ± 17.64 years. The mean NHHR was 3.00 ± 1.47, and the overall prevalence of kidney stone occurrence was 9.05%. The prevalence within the quartile ranges (Q1-Q4) was 7.01%, 8.71%, 9.98%, and 10.49%, respectively. The overall average recurrence rate of kidney stones was 3.05%, demonstrating a significant increase with increasing NHHR (Q1: 1.92%, Q2: 2.92%, Q3: 3.35%, Q4: 4.00%, P < 0.01). The occurrence of kidney stones increased by 4% (95% CI: 1.00-1.08, P = 0.0373) and the chance of recurrence increased by 9% (95% CI: 1.03-1.14, P < 0.01) with each unit increase in NHHR. The interaction analysis results demonstrated that the relationship between the NHHR and the risk of kidney stones was not significantly impacted by the following factors: sex, body mass index, poverty income ratio, diabetes, or hypertension. Curve fitting and threshold effect analysis also demonstrated a non-linear association, with a breakpoint found at 3.17, between the NHHR and the risk of kidney stones. CONCLUSIONS In adults in the USA, there is a substantial correlation between elevated NHHR levels and a higher probability of kidney stones developing and recurring. Timely intervention and management of NHHR may effectively mitigate the occurrence and recurrence of kidney stones.
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Affiliation(s)
- Hujian Hong
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
- School of Graduate, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yijiang He
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
| | - Zhiqiang Gong
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
| | - Jilong Feng
- Department of Radiotherapy, Shenyang Fifth People's Hospital, No.188 Xingshun Street, Tiexi District, Shenyang, 110023, Liaoning, China
| | - Yanli Qu
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China.
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Hou K, Song W, He J, Ma Z. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of periodontitis among US adults: a cross-sectional NHANES study. Sci Rep 2024; 14:5558. [PMID: 38448487 PMCID: PMC10918089 DOI: 10.1038/s41598-024-56276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/04/2024] [Indexed: 03/08/2024] Open
Abstract
The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a recently developed lipid parameter, but there is currently a lack of research exploring its relationship with periodontitis. This study aims to identify the potential association between NHHR and periodontitis. The association between NHHR and periodontitis were examined through univariate and multivariate weighted logistic regression utilizing the National Health and Nutrition Examination Survey data from 2009 to 2014. The participants were grouped based on the type of periodontitis. This study included a total of 9023 participants, with 1947 individuals having no periodontitis, and an additional 7076 individuals suffering from periodontitis. Patients in periodontitis group demonstrated a statistically significant elevation in NHHR values 2.82 (2.05-3.80) compared to those in no periodontitis group (p < 0.001). Logistic regression analysis of variables demonstrated a positive association between NHHR and periodontitis [1.07 (1.02, 1.12) p = 0.0067]. The study revealed a positive association between NHHR and an elevated prevalence of periodontitis development. For each unit increase in NHHR, there is a 7% increase in the prevalence of periodontitis. Further investigations into NHHR may enhance our understanding of preventing and treating periodontitis. However, additional studies are required to validate these findings.
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Affiliation(s)
- Kegui Hou
- Beijing Shunyi District Hospital, Beijing, 101300, China
| | - Wenpeng Song
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
| | - Jun He
- Beijing Shunyi District Hospital, Beijing, 101300, China
| | - Zhaofeng Ma
- Beijing Shunyi District Hospital, Beijing, 101300, China.
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Qing G, Deng W, Zhou Y, Zheng L, Wang Y, Wei B. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and suicidal ideation in adults: a population-based study in the United States. Lipids Health Dis 2024; 23:17. [PMID: 38218917 PMCID: PMC10788025 DOI: 10.1186/s12944-024-02012-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) (NHHR) serves as a reliable lipid indicator associated with atherogenic characteristics. Studies have indicated a potential connection between suicidality and lipid metabolism. This research aims to investigate any possible association between the NHHR and the emergence of suicidal ideation within the confines of the study. METHODS This study examined the association between NHHR levels and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES), conducted in the United States spanning 2005 and 2016. Calculation of the NHHR corresponds to the proportion of HDL-C to Non-HDL-C. The Patient Health Questionnaire-9's ninth question was implemented for assessing suicidal ideation. Using subgroup analysis, smooth curve fitting, and multivariate logistic regression analysis, the research was conducted. RESULTS Encompassing a cohort of 29,288 participants, the analysis identified that 3.82% of individuals reported suicidal ideation. After using multivariable logistic regression and thorough adjustments, elevated NHHR levels were significantly and positively associated with a heightened likelihood of suicidal ideation, according to the findings (odds ratio [OR] = 1.06; 95% confidence interval [CI]: 1.02-1.11; P = 0.0048). Despite extensive adjustment for various confounding factors, this relationship remained consistent. An inverted U-shaped curve was utilized to illustrate the link between NHHR and suicidal ideation among nonsmokers; the curve's inflection point was situated at 7.80. Subgroup analysis and interaction tests (all P for interaction > 0.05) demonstrated that there was no significant influence of the following variables on this positive relationship: age, sex, race, body mass index, education level, married status, hypertension, diabetes, and smoking status. CONCLUSION Significantly higher NHHR levels were associated with an elevated likelihood of suicidal ideation. Based on these results, it is probable that NHHR may serve as a predictive indicator of suicidal ideation, emphasizing its potential utility in risk assessment and preventive strategies.
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Affiliation(s)
- Guangwei Qing
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
- Third Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Wenpeng Deng
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
- Third Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Yuxin Zhou
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Liyun Zheng
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Yanlai Wang
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Bo Wei
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China.
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, 330029, China.
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Deng J, Tang X, Tang R, Chen J, Guo H, Zhou Q, Zhan X, Long H, Peng F, Wang X, Wen Y, Feng X, Su N, Tian N, Wu X, Xu Q. Atherogenic index predicts all-cause and cardiovascular mortality in incident peritoneal dialysis patients. Atherosclerosis 2023; 387:117389. [PMID: 38011764 DOI: 10.1016/j.atherosclerosis.2023.117389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS Atherosclerosis, the main cause of cardiovascular disease (CVD), is prevalent in patients undergoing peritoneal dialysis (PD). Atherogenic index (AI) is a strong predictor of atherosclerosis. However, its prognostic value in CVD outcomes and all-cause mortality among patients undergoing PD remains uncertain. Therefore, we aimed to evaluate the association between AI and all-cause and CVD mortality in PD patients. METHODS Calculated based on lipid profiles obtained through standard laboratory procedures, AI was evaluated in 2682 patients who underwent PD therapy between January 2006 and December 2017 and were followed up until December 2018. The study population was divided into four groups according to the quartile distribution of AI (Q1: <2.20, Q2: 2.20 to <2.97, Q3: 2.97 to <4.04, and Q4: ≥4.04). Multivariable Cox models were employed to explore the associations between AI and CVD and all-cause mortality was evaluated. RESULTS During a median follow-up of 35.5 months (interquartile range, 20.9-57.2 months), 800 patients died, including 416 deaths from CVD. Restricted cubic splines showed non-linear relationship between AI and adverse clinical outcomes. The risks of all-cause and CVD mortality gradually increased across quartiles (log-rank, p < 0.001). After adjusting for potential confounders, the highest quartile (Q4) showed significantly elevated hazard ratio (HR) for both all-cause mortality (HR 1.54 [95% confidence interval (CI), 1.21-1.96]) and CVD mortality risk (HR 1.78 [95% CI, 1.26-2.52]), compared to the lowest quartile (Q1). CONCLUSIONS AI was independently associated with all-cause and CVD mortality in patients undergoing PD, suggesting that AI might be a useful prognostic marker.
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Affiliation(s)
- Jihong Deng
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Xingming Tang
- Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, DongGuan, China
| | - Ruiying Tang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jiexin Chen
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Huankai Guo
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Qian Zhou
- Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen Univeristy, Guangzhou, China
| | - Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haibo Long
- Department of Nephrology, Zhujiang Hospital, Southern Medical University Guangzhou, China
| | - Fenfen Peng
- Department of Nephrology, Zhujiang Hospital, Southern Medical University Guangzhou, China
| | - Xiaoyang Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Univeristy, ZhengZhou, China
| | - Yueqiang Wen
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoran Feng
- Department of Nephrology, Jiujiang NO.1 People's Hospital, Jiujiang, China
| | - Ning Su
- Department of Hematology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Na Tian
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xianfeng Wu
- Department of Nephrology, Affiliated Sixth People's Hospital, Shanghai Jiao Tong Univeristy, Shanghai, China
| | - Qingdong Xu
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China.
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Lin W, Luo S, Li W, Liu J, Zhou T, Yang F, Zhou D, Liu Y, Huang W, Feng Y, Luo J. Association between the non-HDL-cholesterol to HDL- cholesterol ratio and abdominal aortic aneurysm from a Chinese screening program. Lipids Health Dis 2023; 22:187. [PMID: 37932803 PMCID: PMC10626699 DOI: 10.1186/s12944-023-01939-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) can result in high mortality upon rupture but are usually undiagnosed because of the absence of symptoms in the early stage. Ultrasound screening is regarded as an impactful way to prevent the AAA-related death but cannot be performed efficiently; therefore, a target population, especially in Asia, for this procedure is lacking. Additionally, although dyslipidaemia and atherosclerosis are associated with AAA. However, it remains undetermined whether the non-high-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol ratio (NHHR) is associated with AAA. Therefore, this study was aimed at examining whether NHHR is associated with AAA. METHOD A total of 9559 participants who underwent AAA screening at Guangdong Provincial People's Hospital and through screening in two communities in Dongguan, from June 2019 to June 2021 joined in this screening program. The diagnosis of AAA was confirmed by the ultrasound examination of the abdominal aorta rather than any known or suspected AAA. Clinical and laboratory data of participants were collected. The participants were separated into a normal group and an AAA group according to the abdominal aortic status. To eliminate confounding factors, a propensity score matching (PSM) approach was utilized. The independent relationship between NHHR and AAA was assessed through the utilization of multivariable logistic regression analysis. In addition, internal consistency was evaluated through subgroup analysis, which controlled for significant risk factors. RESULTS Of all the participants, 219 (2.29%) participants were diagnosed with AAA. A significant elevation in NHHR was identified in the AAA group when contrasted with that in the normal group (P < 0.001). As demonstrated by the results of the multivariable logistic regression analysis, AAA was independently associated with NHHR before (odds ratio [OR], 1.440, P < 0.001) and after PSM (OR, 1.515, P < 0.001). Significant extension was observed in the areas under the receiver operating characteristic curves (AUROCs) of NHHR compared to those of single lipid parameters before and after PSM. An accordant association between NHHR and AAA in different subgroups was demonstrated by subgroup analysis. CONCLUSION In the Chinese population, there is an independent association between NHHR and AAA. NHHR might be propitious to distinguish individuals with high risk of AAA.
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Affiliation(s)
- Wenhui Lin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Songyuan Luo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Wei Li
- Department of Cardiology, Guangdong Provincial People's Hospital Zhuhai Hospital (Zhuhai Golden Bay Center Hospital), Zhuhai, China
| | - Jitao Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ting Zhou
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Fan Yang
- Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Dan Zhou
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yuan Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Wenhui Huang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yingqing Feng
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular Disease, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Jianfang Luo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
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Li H, Shi Z, Chen X, Wang J, Ding J, Geng S, Sheng X, Shi S. Relationship Between Six Insulin Resistance Surrogates and Nonalcoholic Fatty Liver Disease Among Older Adults: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2023; 16:1685-1696. [PMID: 37309507 PMCID: PMC10257913 DOI: 10.2147/dmso.s409983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) represents a large and growing public health problem. Insulin resistance (IR) plays a crucial role in the pathogenesis of NAFLD. The aim of this study was to determine the association of triglyceride-glucose (TyG) index, TyG index with body mass index (TyG-BMI), lipid accumulation product (LAP), visceral adiposity index (VAI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c) and metabolic score for IR (METS-IR) with NAFLD in older adults and to compare the discriminatory abilities of these six IR surrogates for NAFLD. Methods This cross-sectional study included 72,225 subjects aged ≥60 years living in Xinzheng, Henan Province, from January 2021 to December 2021. The data were collected from the annual health examination dataset. Logistic regression models were used to examine the relationships between the six indicators and NAFLD risk. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different IR surrogates for NAFLD under the influence of potential risk factors. Results After adjusting for multiple covariates, compared with the first quintile, the odds ratios (ORs) and 95% confidence intervals (CIs) of the highest quintiles of TyG-BMI were the most obvious (OR:43.02, 95% CI:38.89-47.72), followed by the METS-IR (OR:34.49, 95% CI:31.41-37.95). Restricted cubic spline analysis reported that there were non-linear positive association and dose-response relationship between 6 IR surrogates and NAFLD risk. Compared with other IR-related indicators (LAP, TyG, TG/HDL-c and VAI), TyG-BMI showed the highest AUC (AUC:0.8059;95% CI:0.8025-0.8094). Additionally, METS-IR also had a high predictive performance for NAFLD, and the AUC was greater than 0.75 (AUC:0.7959;95% CI:0.7923-0.7994). Conclusion TyG-BMI and METS-IR had pronounced discrimination ability to NAFLD, which are recommended as complementary markers for the assessment of NAFLD risk both in clinic and in future epidemiological studies.
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Affiliation(s)
- Haojie Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Zhan Shi
- Department of Pharmacy, Zhengzhou People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Xuejiao Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Junjie Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Jiacheng Ding
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Shuoji Geng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xinyuan Sheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
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12
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Li G, Zhao Q, Zhang X, Ban B, Zhang M. Association between the uric acid to high density lipoprotein cholesterol ratio and alanine transaminase in Chinese short stature children and adolescents: A cross-sectional study. Front Nutr 2023; 10:1063534. [PMID: 36761217 PMCID: PMC9902588 DOI: 10.3389/fnut.2023.1063534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
Objective Uric acid to high-density lipoprotein cholesterol ratio (UHR), the ratio of uric acid to high-density lipoprotein cholesterol, is a newly proposed marker of metabolic abnormalities. There are few previous studies directly investigating the relationship between UHR and alanine aminotransferase (ALT), especially in short stature populations, however, short stature children and adolescents are more likely to have metabolic disorders. This research aimed to investigate the relationship between the UHR and ALT in children and adolescents with short stature. Methods In this cross-sectional analysis, the clinical data of 1,510 children with height below -2 SD who were evaluated at the Department of Endocrinology, Affiliated Hospital of Jining Medical University from 1 March 2013 to 31 December 2021, were selected. Anthropometric and biochemical indicators were measured. The relationship between UHR and ALT was analysed. Results The univariate analysis results showed that UHR was positively associated with ALT (β = 0.43, P < 0.0001). Furthermore, after adjusting for possible confounding factors, a non-linear relationship was detected between UHR and ALT through smooth curve fitting, and the inflection point of UHR was 10.93% after multivariate piecewise linear regression analysis. ALT increased with UHR elevation when the UHR was greater than 10.93% (β = 0.69, 95% CI 0.39, 0.98; P < 0.0001). However, we did not observe a significant relationship when the UHR was less than 10.93% (P = 0.9229). Conclusion Our study demonstrated that in Chinese children and adolescents with short stature, UHR may be associated with the regulation of ALT levels, and this relationship merits further investigation.
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Affiliation(s)
- Guangxin Li
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China
| | - Xinran Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China,*Correspondence: Bo Ban,
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China,Mei Zhang,
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13
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A Study of Biomarkers Associated with Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes. Diagnostics (Basel) 2022; 12:diagnostics12102426. [PMID: 36292115 PMCID: PMC9600788 DOI: 10.3390/diagnostics12102426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 12/16/2022] Open
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term that no longer excludes patients that consume alcohol or present other liver diseases, unlike nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the role of different biomarkers as predictors of MAFLD in patients with type 2 diabetes mellitus (T2DM). In this regard, a cross-sectional, non-interventional study was conducted over a period of 8 months in patients with T2DM. Liver steatosis displayed by abdominal ultrasound certified the MAFLD diagnosis. A percentage of 49.5% of the studied patients presented MAFLD. Through logistic regression adjusted for gender, age, T2DM duration, lipid-lowering therapy, smoking status, nutritional status, we demonstrated that elevated triglycerides (TG) levels, high non-high-density-lipoprotein (HDL)-cholesterol-to-HDL-cholesterol (non-HDL/HDL) ratio, high atherogenic index of plasma (AIP), and increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) had predictive value for MAFLD in patients with T2DM. Furthermore, we calculated the optimal cut-off values for these biomarkers (184 mg/dL for TG, 0.615 for AIP, 3.9 for the non-HDL/HDL ratio, and 2.01 for HOMA-IR) which can predict the presence of MAFLD in patients with T2DM. To our knowledge, this is the first study to assess the predictive value of the non-HDL/HDL ratio for MAFLD in patients with T2DM.
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14
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Wang A, Li Y, Zhou L, Liu K, Li S, Zong C, Song B, Gao Y, Li Y, Tian C, Xing Y, Xu Y, Wang L. Non-HDL-C/HDL-C ratio is associated with carotid plaque stability in general population: A cross-sectional study. Front Neurol 2022; 13:875134. [PMID: 36188405 PMCID: PMC9520290 DOI: 10.3389/fneur.2022.875134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/15/2022] [Indexed: 12/16/2022] Open
Abstract
Background Carotid atherosclerosis, especially the rupture of unstable plaques, plays an important role in the development of stroke. A novel lipid ratio, the non-high-density lipoprotein cholesterol (non-HDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, contains both atherogenic and anti-atherogenic particle information, and has been shown to be associated with carotid atherosclerosis. However, there is no data on evaluating the association between non-HDL-C/HDL-C ratio and carotid plaque stability. Methods This study was carried out on 27,436 urban workers aged 20 years or older who participated in a comprehensive health screening between January 2016 and December 2017. Carotid plaque stability was assessed using ultrasonography. Multinomial logistic regression models were used to explore the relationship between the non-HDL-C/HDL-C ratio and carotid plaque stability by odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed to verify the robustness of the results. Results Carotid plaque was detected in 7,161 (26.1%) participants, with stable and unstable plaque accounting for 3,277 (11.9%) and 3,884 (14.2%), respectively. The prevalence of stable carotid plaque substantially increased with increasing non-HDL-C/HDL-C ratio quartile levels (p for trend < 0.001) and with a similar association for unstable carotid plaque (p for trend < 0.001). The mean non-HDL-C/HDL-C ratios (mean ± SD) of non-carotid plaque (2.9 ± 1.1), stable carotid plaque (3.2 ± 1.2), and unstable carotid plaque (3.4 ± 1.4) gradually increased (p < 0.001). In multinomial logistic regression, ORs (95% CIs) for the highest vs. lowest quartile of the non-HDL-C/HDL-C ratio were 1.70 (1.48–1.95) between stable carotid plaques and no carotid plaque, 2.34 (2.06–2.67) between unstable carotid plaques and no carotid plaque, and 1.38 (1.18–1.61) between unstable carotid plaques and stable carotid plaque, after adjusting for common cardiovascular risk factors. The results of subgroup analysis and sensitivity analysis were similar. Conclusion Our findings suggested that the non-HDL-C/HDL-C ratio was significantly associated with carotid plaque stability and might be a useful indicator for the early identification of high-risk carotid plaque.
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Affiliation(s)
- Anran Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yapeng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lue Zhou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Kai Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shaohua Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ce Zong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | | | - Yurong Xing
- Physical Examination Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- *Correspondence: Yuming Xu
| | - Longde Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China
- Longde Wang
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Zou ZY, Zeng J, Ren TY, Huang LJ, Wang MY, Shi YW, Yang RX, Zhang QR, Fan JG. The burden and sexual dimorphism with nonalcoholic fatty liver disease in Asian children: A systematic review and meta-analysis. Liver Int 2022; 42:1969-1980. [PMID: 34619026 DOI: 10.1111/liv.15080] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite substantial attention paid to the epidemic of nonalcoholic fatty liver disease (NAFLD) in adults, data on the burden and sexual dimorphism of NAFLD in Asian children have not yet been synthesized. METHODS We conducted a literature search of 735 references up to April 2021. Pooled analyses, stratified analyses and meta-regression were all performed. RESULTS Thirty-three study populations were finally included. Nine of them comprising 20 595 children showed an overall NAFLD prevalence of 5.53% (95% CI 3.46%-8.72%), in which, 36.64% (95% CI, 27.99%-46.26%) NAFLD subjects had elevated levels of ALT. The prevalence rate of NAFLD increased about 1.6-fold from 2004 to 2010 to the last decade. Male predominant trends were observed in paediatric NAFLD (boys: 8.18%, 95% CI 4.93%-13.26%; girls: 3.60%, 95% CI 1.60%-7.87%). Moreover, meta-analysis showed that after 10 years of age, boys were more prone to have NAFLD than girls (OR = 1.75; P = .0012). In addition, the pooled prevalence of NAFLD increased sequentially in normal-weight (1.49%, 95% CI 0.88%-2.51%, n = 2610), overweight (16.72%, 95% CI 7.07%-34.65%, n = 1265) and obese children (50.13%, 95% CI 41.99%-58.27%, n = 6434 individuals). After full covariate adjustment, the multivariate meta-regression also showed that boy percentage (P = .0396) and body mass index (P < .0001) were positively correlated with prevalent NAFLD. CONCLUSIONS In Asia, paediatric NAFLD is becoming prevalent over the recent decades, particularly among obese children and boys after 10 years old. The hormonal and chromosomal origins of paediatric NAFLD dimorphism need further investigation.
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Affiliation(s)
- Zi-Yuan Zou
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Jing Zeng
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Tian-Yi Ren
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Lei-Jie Huang
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Meng-Yu Wang
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Yi-Wen Shi
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Rui-Xu Yang
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Qian-Ren Zhang
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Jian-Gao Fan
- Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
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Zhu W, Liang A, Shi P, Yuan S, Zhu Y, Fu J, Zheng T, Wen Z, Wu X. Higher serum uric acid to HDL-cholesterol ratio is associated with onset of non-alcoholic fatty liver disease in a non-obese Chinese population with normal blood lipid levels. BMC Gastroenterol 2022; 22:196. [PMID: 35448944 PMCID: PMC9027046 DOI: 10.1186/s12876-022-02263-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/30/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies have demonstrated the presence of associations between metabolic syndrome and the onset of nonalcoholic fatty liver disease (NAFLD). Metabolic syndrome, in turn, has been found to be linked to high serum uric acid to HDL-cholesterol ratios (UHR). However, the relationship between UHR values and the occurrence of NAFLD in non-obese individuals remains unknown. The present study aimed to examine the possible correlation between UHR values and NAFLD onset among a non-obese Chinese population without dyslipidemia, as well as comparing the predictive value of UHR versus other NAFLD onset predictors. METHODS A total of 9837 non-obese patients, with normal blood lipid levels, were included in a 5-year retrospective cohort study, and the onset of NAFLD in these patients was diagnosed by liver ultrasound. RESULTS Out of the 9837 patients, 855 were diagnosed with NAFLD during the 5-year follow-up period, for an overall total prevalence of 8.7% at the end of the study period. Across quintiles 1, 2, 3, 4 and 5 of UHR (respectively, ratios of ≤ 120.88, 120.89-154.01, 154.02-189.91, 189.92-240.46, and ≥ 240.47), the prevalence of NAFLD among the patients increased from 2.4%, 5%, 7.9%, 10.3%, and 17.8%, respectively. After adjustments for age, gender, liver and kidney functional markers, as well as metabolic indicators, multivariate Cox proportional hazard regression analysis demonstrated that the hazard ratio (HR) was the highest in quintile 5, at 1.76 (1.12-2.75), and the lowest in quintile 1. The area under the curve (AUC) for UHR (0.690) was higher than that for serum uric acid (UA, 0.666) and HDL-C (0.636), suggesting the predictive ability of UHR for NAFLD onset was better than either alone. This finding was further supported by the presence of an independent association between UHR and NAFLD, even within the normal range of UA and HDL-C; the HR (95% confidence interval, CI) for NAFLD was 1.002 (1.000-1.004). Compared with other significant predictors, AUC for UHR (0.67) was similar to that of low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C, 0.68), non-high-density lipoprotein cholesterol (NHDL-C)/HDL-C (0.68) and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratios (0.7), and was higher than that of LDL-C (0.63), remnant cholesterol (RC,0.59), and albumin (ALB)/alkaline phosphatase (ALP) ratio (0.61). The sensitivity of UHR (71%) was the highest among all indicators. In the subgroup with ALT < 40U/L, the AUC for UHR was 0.70, which was the highest among all predictors; among ALT > 40U/L, UHR was able to predict the occurrence of NAFLD (AUC = 0.61, p = 0.007), which was not the case for RC (P = 0.441), ALB/ALP (P = 0.419), and ALT/AST (P = 0.159). CONCLUSIONS UHR serve as an inexpensive and reliable predictor of NAFLD onset in non-obese Chinese people with normal blood lipid levels, allowing for identification of individuals at high risk for NAFLD.
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Affiliation(s)
- Wentao Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - An Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Pei Shi
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Songsong Yuan
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Ying Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Jiwei Fu
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Ting Zheng
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Zhilong Wen
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China
| | - Xiaoping Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Donghu District, Nanchang, China.
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Liu B, Zheng H, Liu G, Li Z. Adiponectin is Inversely Associated with Insulin Resistance in Adolescents with Nonalcoholic Fatty Liver Disease. Endocr Metab Immune Disord Drug Targets 2021; 22:631-639. [PMID: 34579641 DOI: 10.2174/1871530321666210927153831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Insulin resistance(IR) is confirmed as a key feature of nonalcoholic fatty liver disease (NAFLD) in children and adolescents. Numerous studies report that adiponectin (APN) levels are inversely associated with the status of IR in adults with NAFLD. This study aimed to investigate the relationship between serum total APNand homeostasis model assessment insulin resistance(HOMA-IR) in adolescents with NAFLD. METHODS 382 newly-diagnosed NAFLD adolescents, aged 9-16 years old, were enrolled and divided into 3 subgroups according to the APNtertile. Simple and multiple linear regression analyses were performed to assess the correlation between HOMA-IR and APN in boys and girls, respectively. RESULTS The HOMA-IR values tended to decrease in boys according to APN tertiles: 5.6(4.4-7.3) vs. 5.2(4.6-6.9) vs. 4.9(4.1-5.8) (P<0.01), and there was a significant difference in the HOMA-IR values among three APN tertile subgroups in girls(P<0.01).Univariate analysis showed thatbody mass index, waist circumference, weight-to-height ratio, fasting blood glucose, insulin, triglyceride, and APN were significantly associated with HOMA-IR in boys (P<0.05). In girls, body mass index, fasting blood glucose, insulin, total cholesterol, triglyceride, and APN were significantly associated with HOMA-IR (P<0.05).APN was found to be a significant determinant for HOMA-IR only in boys (β=-0.147, P<0.01). CONCLUSION Our findings showed that APN was an independent and significant determinant for increased HOMA-IR in boys with NAFLD. Further studies are needed to explore the underlying mechanisms.
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Affiliation(s)
- Bin Liu
- Department of Neurology, Shanghai Minhang Hospital, Fudan University, Shanghai. China
| | - Huan Zheng
- Department of Cardiology, Worldpath Clinic International, Shanghai. China
| | - Guanghui Liu
- Department of Endocrinology, Tongji Hospital, School of Medicine, Tongji University, Shanghai. China
| | - Zhiling Li
- Department of Pharmacy, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai. China
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