A non-linear connection between the total cholesterol to high-density lipoprotein cholesterol ratio and stroke risk: a retrospective cohort study from the China Health and Retirement Longitudinal Study

Xiao，Binhui1; Cao，Changchun2; Han，Yong3; Yang，Fangju2; Hu，Haofei4; Luo，Jiao2

2024-12-01

10.1186/s40001-024-01769-9

European Journal of Medical Research   影响因子和分区

0949-2321

2047-783X

Objective: The connection between total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio and stroke risk is controversial. This study aims to examine the connection between the TC/HDL-C ratio and stroke in middle-aged and older individuals who are part of the China Health and Retirement Longitudinal Study (CHARLS). Methods: This study conducted a retrospective cohort analysis, enrolling a total of 10,184 participants who met the designated criteria from CHARLS between 2011 and 2012. We then used the Cox proportional-hazards regression model to analyze the relationship between the TC/HDL-C ratio and stroke risk. Using a Cox proportional hazards regression model with cubic spline functions and smooth curve fitting, we were able to identify the non-linear relationship between the TC/HDL-C ratio and stroke occurrence. The sensitivity and subgroup analyses were also performed to investigate the connection between TC/HDL-C ratio and stroke. Results: This study revealed a statistically significant association between the TC/HDL-C ratio and stroke risk in subjects aged 45 years or older after adjusting for risk factors (HR: 1.05, 95%CI 1.00–1.10, P = 0.0410). Furthermore, a non-linear connection between the TC/HDL-C ratio and stroke risk was detected, with a TC/HDL-C ratio inflection point of 3.71. We identified a significant positive connection between the TC/HDL-C ratio and stroke risk, when the TC/HDL-C ratio was less than 3.71 (HR: 1.25, 95%CI 1.07–1.45, P = 0.0039). However, their connection was not significant when the TC/HDL-C ratio exceeded 3.71 (HR: 1.00, 95%CI 0.94–1.06, P = 0.9232). The sensitivity analysis and subgroup analyses revealed that our findings were well-robust. Conclusion: Our study demonstrated a positive, non-linear connection between the TC/HDL-C ratio and stroke risk in middle-aged and older individuals. There was a significant positive connection between the TC/HDL-C ratio and stroke risk, when the TC/HDL-C ratio was less than 3.71. The current research can be used as a guideline to support clinician consultation and optimize stroke prevention measures for middle-aged and older adults.

High-density lipoprotein cholesterol Nonlinearity Stroke Total cholesterol Total cholesterol to high-density lipoprotein cholesterol ratio

SCI

英语

第一

CLINICAL MEDICINE

2-s2.0-85187951372

Scopus

1.Department of Neurosurgery,Shenzhen Yantian District People’s Hospital,Southern University of Science and Technology Yantian Hospital,Shenzhen,Guangdong,518081,China
2.Department of Rehabilitation,Shenzhen Second People’s Hospital,Shenzhen Dapeng New District Nan’ao People’s Hospital,Shenzhen,No. 6, Renmin Road, Dapeng New District, Guangdong,518000,China
3.Department of Emergency,The First Affiliated Hospital of Shenzhen University,Shenzhen Second People’s Hospital,Shenzhen,Guangdong,518035,China
4.Department of Nephrology,The First Affiliated Hospital of Shenzhen University,Shenzhen Second People’s Hospital,Shenzhen,No.3002, Sungang West Road, Futian District, Guangdong,518035,China

Xiao，Binhui,Cao，Changchun,Han，Yong,et al. A non-linear connection between the total cholesterol to high-density lipoprotein cholesterol ratio and stroke risk: a retrospective cohort study from the China Health and Retirement Longitudinal Study[J]. European Journal of Medical Research,2024,29(1).

Xiao，Binhui,Cao，Changchun,Han，Yong,Yang，Fangju,Hu，Haofei,&Luo，Jiao.(2024).A non-linear connection between the total cholesterol to high-density lipoprotein cholesterol ratio and stroke risk: a retrospective cohort study from the China Health and Retirement Longitudinal Study.European Journal of Medical Research,29(1).

Xiao，Binhui,et al."A non-linear connection between the total cholesterol to high-density lipoprotein cholesterol ratio and stroke risk: a retrospective cohort study from the China Health and Retirement Longitudinal Study".European Journal of Medical Research 29.1(2024).