Association of LDL-C/HDL-C Ratio With Stroke Outcomes Within 1 Year After Onset: A Hospital-Based Follow-Up Study

Liu, Li; Yin, Ping; Lu, Chong; Li, Jingxin; Zang, Zhaoxia; Liu, Yongdan; Liu, Shuang; Wei, Yafen

doi:10.3389/fneur.2020.00408

Cited by 27 publications

(30 citation statements)

References 26 publications

(26 reference statements)

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“…In contrast, You et al [9] included 356 patients with intracranial hemorrhage (mean age 64.1 ± 13.7 years, mean follow-up =0.22 years) and found that the LDL-C/HDL-C ratio was negatively correlated with all-cause mortality, they suggested that the LDL-C/HDL-C ratio should be controlled above 2.96. Liu et al [10] recruited 3250 stroke patients (mean age 63.72 ± 11.33 years, mean follow-up =1.00 years) and found a negative relationship between the LDL-C/HDL-C ratio and all-cause mortality. Mortality was lowest when the LDL-C/HDL-C ratio was between 2.23 and 2.88.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous studies on the LDL-C/HDL-C ratio have drawn inconsistent conclusions. Some studies have suggested that the LDL-C/HDL-C ratio is positively associated with CVD [5][6][7][8], while others have found a negative correlation between the LDL-C/HDL-C ratio and all-cause mortality [9,10]. The reasons for these inconsistencies can be attributed to differences in the study population, follow-up, and study endpoints.…”

Section: Introductionmentioning

confidence: 99%

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A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

Huang

et al. 2020

Lipids Health Dis

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Background The low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking the LDL-C/HDL-C ratio to mortality have yielded inconsistent results and been limited by short follow-up periods. Therefore, the aim of the present study was to determine whether the LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients. Methods A total of 6941 hypertensive patients aged 65 years or older who were not treated with lipid-lowering drugs were selected from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between the LDL-C/HDL-C ratio and all-cause mortality was determined using multivariate Cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve analysis. Results During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between the LDL-C/HDL-C ratio and all-cause mortality. Patients were divided according to the quintiles of the LDL-C/HDL-C ratio. Compared to the reference group (Q3: 1.67–2.10), patients with both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios had higher all-cause mortality (< 1.67: HR 1.81, 95% CI: 1.08–3.03; ≥2.10: HR 2.00, 95% CI: 1.18–3.39). Compared with the lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratios of 1.67–2.10 had a significantly higher survival probability (log-rank P = 0.038). Conclusions The results suggest that there is a U-shaped association between the LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

Huang

et al. 2020

Lipids Health Dis

View full text Add to dashboard Cite

show abstract

“…By contrast, You et al [9] included 356 patients with intracranial hemorrhage (mean age 64.1 ± 13.7, mean follow-up years = 0.22) and found that LDL-C/HDL-C ratio was negatively correlated with all-cause mortality, and considered that LDL-C/HDL-C ratio should be controlled at more than 2.96. Liu et al [10] recruited 3,250 stroke patients (mean age 63.72 ± 11.33, mean follow-up years = 1.00) for analysis and found a negative relationship between LDL-C/HDL-C ratio and all-cause mortality, mortality was lowest as LDL-C/HDL-C ratio was between 2.23 and 2.88. The above studies suggest that the relationship between LDL-C/HDL-C ratio and all-cause mortality may be negative, and propose an inconsistent optimal range of LDL-C/HDL-C ratio.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous studies on LDL-C/HDL-C ratio have inconsistent conclusions. Some studies have suggested LDL-C/HDL-C ratio was positively associated with CVD [5][6][7][8], while others have found a negative correlation between LDL-C/HDL-C ratio and all-cause mortality [9,10]. The reasons for these inconsistencies can be attributed to differences in the study population, follow-up, and study endpoints.…”

Section: Introductionmentioning

confidence: 99%

A U-Shaped Association between LDL-C/HDL-C Ratio and all-Cause Mortality in Elderly Hypertensive Patients: A Prospective Cohort Study

Yan

Huang

et al. 2020

Preprint

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Background: Low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking LDL-C/HDL-C ratio to mortality have been inconsistent and limited by short follow-up. Therefore, the aim of the present study was to determine whether LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.Methods: We selected 6,941 hypertensive patients aged 65 years or older and untreated with lipid-lowering drugs from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between LDL-C/HDL-C ratio and all-cause mortality by using multivariate cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve to address.Results: During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between LDL-C/HDL-C ratio and all-cause mortality. The LDL-C/HDL-C ratio was divided into five groups according to quintiles. Compared to the reference group (Q3: 1.67-2.10), both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios were associated with higher all-cause mortality (<1.67: HR 1.81, 95% CI: 1.08-3.03; ≥2.10: HR 2.00, 95% CI: 1.18-3.39). Compare with lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratio of 1.67-2.10 had a significant higher survival probability (log-rank P = 0.038).Conclusion: Our results suggested that there was a U-shaped association between LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

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“…These lipoproteins have been recommended for screening people with a high risk of NAFLD in clinical practice [18]. Recently, some studies have pointed out that the LDL/HDL cholesterol ratio can simultaneously evaluate LDL cholesterol and HDL cholesterol, and its performance in predicting the risk of cardiovascular and cerebrovascular metabolic-related diseases is better than that of a single lipoprotein [19][20][21]. At present, there are no research data on the association between NAFLD and the LDL/HDL cholesterol ratio.…”

Section: Introductionmentioning

confidence: 99%

LDL/HDL cholesterol ratio is associated with new-onset NAFLD in Chinese non-obese people with normal lipids: a 5-year longitudinal cohort study

Zou

Zhong

et al. 2021

Lipids Health Dis

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Background Low-density lipoprotein to high density lipoprotein (LDL/HDL) cholesterol ratio has been reported to predict the risk of many metabolic diseases. However, the association between the LDL/HDL cholesterol ratio and nonalcoholic fatty liver disease (NAFLD) has not been established. Methods A longitudinal cohort design was adopted in this study; 9767 non-obese subjects without NAFLD were included and analyzed. The subjects were grouped according to the quintile of LDL/HDL cholesterol ratio. The cumulative incidence of NAFLD and the independent effect of the LDL/HDL cholesterol ratio on NAFLD during 5 years of follow-up were calculated using the Kaplan-Meier method and Cox proportional-hazards regression model. Results During the 5-year follow-up period, 841 subjects were diagnosed with new-onset NAFLD, and the 1-, 2-, 3-, 4-, and 5-year cumulative incidence rates of NAFLD were 1.16, 4.65, 8.33, 12.43, and 25.14%, respectively. In the multivariable-adjusted Cox proportional-hazards regression model, the LDL/HDL cholesterol ratio was significantly associated with the risk for NAFLD (HR: 1.66, 95% CI: 1.38–1.99, P trend< 0.001), especially among young people (HR: 3.96, 95% CI: 1.50–10.46, P interaction< 0.05). Additionally, receiver operating characteristic curve analysis showed that the LDL/HDL cholesterol ratio was better than HDL cholesterol and LDL cholesterol in predicting new-onset NAFLD. Conclusions LDL/HDL cholesterol ratio is an independent predictor of NAFLD in Chinese non-obese people with normal lipids, and its predictive value is higher than that of other lipoproteins. In clinical practice, the LDL/HDL cholesterol ratio can be used to identify people at high risk of NAFLD.

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Association of LDL-C/HDL-C Ratio With Stroke Outcomes Within 1 Year After Onset: A Hospital-Based Follow-Up Study

Cited by 27 publications

References 26 publications

A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

A U-shaped association between the LDL-cholesterol to HDL-cholesterol ratio and all-cause mortality in elderly hypertensive patients: a prospective cohort study

A U-Shaped Association between LDL-C/HDL-C Ratio and all-Cause Mortality in Elderly Hypertensive Patients: A Prospective Cohort Study

LDL/HDL cholesterol ratio is associated with new-onset NAFLD in Chinese non-obese people with normal lipids: a 5-year longitudinal cohort study

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