HDL‐C/LDL‐C Ratio and All‐Cause Mortality in Populations at High CVD Risk: A Prospective Observational Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background The ratio of high‐density lipoprotein cholesterol (HDL‐C) to low‐density lipoprotein cholesterol (LDL‐C) predicts cardiovascular disease (CVD) endpoints, yet its prognostic validity in high‐risk populations and for type 2 diabetes mellitus (T2DM)‐related adverse events remains unestablished. Methods This study included 32,609 people aged 35–75 years in Fujian Province, China, who were at high risk for CVD. The primary endpoint was all‐cause mortality during follow‐up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the HDL‐C/LDL‐C ratio and the endpoints. Result On the basis of the restricted RCS curve, the participants were classified as having a low (< 0.3), middle (0.3–0.5), or high (> 0.5) HDL‐C/LDL‐C ratio. Multivariate Cox regression analyses revealed that the risk of all‐cause mortality (HR = 1.48, 95% CI 1.14–1.93, p < 0.01 for low; HR = 1.30, 95% CI 1.06–1.58, p < 0.05 for high) was increased in the low and high groups. Participants without T2DM who were at high risk for CVD had similar prognoses (HR = 1.65, 95% CI 1.19–2.28, p < 0.01 for low; HR = 1.35, 95% CI 1.05–1.74, p < 0.01 for high). However, this association was not found in participants with T2DM who were at high risk for CVD. Conclusion HDL‐C/LDL‐C can be used to predict the prognosis of individuals at high risk for CVD, and maintaining HDL‐C/LDL‐C ratios between 0.3 and 0.5 may be the most helpful range for this population. Furthermore, maintaining this ratio range holds clinical significance for cohorts without T2DM, although further exploration is needed in this T2DM cohort.
DOI: 10.1002/cdt3.70013
Authors: Biting Lin, Yunzhi Ling, Gengyu Zhou, Ziqing Ruan, Fan Chen, Simiao Chen, Tingting Weng, Yuanfan Zhu, Jingyi Lin, Ling Yu, Kaiyang Lin
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412519377