Association between the hemoglobin A1c/High-density lipoprotein cholesterol ratio and stroke incidence: a prospective nationwide cohort study in China

Lipids in Health and Disease, Год журнала: 2025, Номер 24(1)

Опубликована: Янв. 25, 2025

Abstract Background Stroke has emerged as an escalating public health challenge among middle-aged and older individuals in China, closely linked to glycolipid metabolic abnormalities. The Hemoglobin A1c/High-Density Lipoprotein Cholesterol (HbA1c/HDL-C) ratio, integrated marker of homeostasis, may serve a novel predictor stroke risk. Methods Our investigation utilized data from the China Health Retirement Longitudinal Study cohort (2011–2018). cases were identified based on self-reported, physician-confirmed diagnoses. Logistic regression models established determine correlation between HbA1c/HDL-C prevalence (2011) well cumulative mean (2011–2015) new incidence (2015–2018). Additionally, smoothed curve fitting, subgroup analyses, interaction tests conducted ensure robustness findings. Results In cross-sectional analysis, 8,502 participants enrolled, whom 189 had history stroke. findings revealed significant positive linear relationship after adjusting for covariates (OR: 1.26, 95% CI: 1.09–1.45). When was categorized into tertiles, only highest tertile (T3) showed with compared lowest (T1) (OR:1.71, 1.05–2.77). longitudinal analysis 5,165 participants, 336 new-onset over follow-up period 7 years. Adjusting confounders, higher exhibited increased likelihood 1.14, 1.01–1.29). Using T1 reference, fully adjusted OR 1.65 (95% 1.21–2.24) T2 1.54 1.08–2.19) T3. predictive value risk assessment have been significantly improved traditional HDL-C HbA1c. Consistent associations observed across most stratified subgroups. Conclusions Elevated baseline levels are associated underscoring potential clinical long-term prevention strategies.

Язык: Английский

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Association of the Atherogenic Index of Plasma and High-Sensitivity C-Reactive Protein with Incident Stroke Among Individuals Without Diabetes: A National Cohort Study

Research Square (Research Square), Год журнала: 2025, Номер unknown

Опубликована: Янв. 20, 2025

Background Both the atherogenic index of plasma (AIP), a surrogate marker insulin resistance, and high-sensitivity C-reactive protein (hsCRP) are predictors stroke risk clinical outcomes. However, most existing evidence is derived from studies involving diabetic patients, which may lead to overestimation impact AIP hsCRP on due confounding effects diabetes. This study aimed assess combined interactive events in individuals without Methods A total 8,909 participants China Health Retirement Longitudinal Study (CHARLS) 2011 who were free diabetes at baseline included. The was calculated as lg[total cholesterol (mmol/L)/high-density lipoprotein (mmol/L)]. subset 5,954 studied investigate relationship between cumulative (CumAIP) exposure incidence.The CumAIP CumCRP also using same algorithm.The primary outcome physician-diagnosed occurring before 2020. We employed adjusted Cox proportional hazards regression mediation analysis associations AIP, hsCRP, events. Results Over nine years follow-up, 696 new cases recorded.Compared with low (<0.302 [median level]) <1 mg/L, those elevated levels both had highest overall (adjusted HR [aHR]: 1.69; 95% CI: 1.36–2.10). In 5-year analysis, 497 suffered stroke. Compared (CumAIP<1.29 level] CumhsCRP < 4.02 mg/L level]), high 1.41; 1.10-1.82). Moreover, significantly mediated 5.61% association stroke, whereas 1.86% Conclusions exhibit coexposure mutual regard assessment should be promoted for residual stratification prevention diabetes, particularly among middle-aged populations.

Язык: Английский

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Joint association of remnant cholesterol and lipoprotein‐associated phospholipase A2 with composite adverse events: A 12‐year follow‐up study from Asymptomatic Polyvascular Abnormalities Community study

Diabetes Obesity and Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Март 4, 2025

Abstract Aims To explore the association of remnant cholesterol (RC) and lipoprotein‐associated phospholipase A2 (Lp‐PLA2) with composite adverse events in a large‐scale prospective study. Methods All data were collected from Asymptomatic Polyvascular Abnormalities Community study between 2010 2022. Serum levels Lp‐PLA2 determined by enzyme‐linked immunosorbent assay. The participants categorized into four groups based on their RC levels: low‐RC/Lp‐PLA2−, high‐RC/Lp‐PLA2−, low‐RC/Lp‐PLA2+ high‐RC/Lp‐PLA2+. endpoint was combination first‐ever stroke, myocardial infarction or all‐cause mortality. Cox regression analyses performed to evaluate associations events. Results Of 1864 eligible participants, average age 60.6 years, 74.3% male. Over follow‐up 12 we identified 500 events, including 210 major cardiovascular 342 deaths. When compared group hazard ratios 95% confidence intervals high‐RC/Lp‐PLA2+ for infarction, event, death endpoints 1.37 (0.87–2.16), 0.72 (0.28–1.82), 1.29 (0.85–1.95), 1.61 (1.10–2.38) 1.43 (1.07–1.91), respectively. A significant interaction status has been found ( p <0.05). In addition, joint modified sex <60 versus ≥60 years interaction: 0.035 0.01, respectively). Conclusions Elevated associated an increased risk these significantly influenced age. Our highlights synergistic effect

Язык: Английский

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Joint association of sleep duration and depression with new-onset hearing loss: a national cohort study

Frontiers in Nutrition, Год журнала: 2025, Номер 12

Опубликована: Март 14, 2025

Hearing loss, a global health burden, is closely associated with depression and sleep disorders. However, the combined effects of duration on hearing loss risk remain unclear. Data from China Health Retirement Longitudinal Study (CHARLS) were analyzed, including 6,374 adults aged 45 older. Cox proportional hazards models assessed relationship between depression, duration, loss. Mediation analysis explored potential mediating roles CESD-10 score new-onset Subgroup analyses by age, sex, BMI also conducted. Over 7-year follow-up, 1,422 participants developed Both short high scores independently increased Participants long but had ratio (HR) 1.59 (95% CI: 1.35, 1.87) for showed that mediated 10.1% association while 70.8% This study highlights significant interconnected in development Interventions addressing both may offer more effective strategies preventing managing

Язык: Английский

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Joint Association of Remnant Cholesterol and Body Mass Index with Hypertension: A National Cohort Study in Chinese Adults.

PubMed, Год журнала: 2025, Номер 18, С. 1813 - 1825

Опубликована: Янв. 1, 2025

Hypertension, a major global health concern, is closely associated with obesity and lipid abnormalities. Remnant cholesterol (RC), triglyceride-rich lipoprotein component, has been linked to cardiovascular diseases, but its joint impact body mass index (BMI) on hypertension risk remains unclear. We analyzed data from 3805 participants (mean age: 57 years; 44.3% male) in the China Health Retirement Longitudinal Study (CHARLS) 2011-2020. Inclusion criteria were adults aged over 45 years complete blood lipids BMI. Participants baseline or missing covariate excluded. Cox proportional hazard models assessed associations, while mediation analysis explored RC's role BMI-hypertension linkage. Over 9-year follow-up, 590 developed hypertension. Obesity (BMI ≥28.0 kg/m²) high RC levels independently (HR: 2.18; 95% CI: 1.48-3.21 for highest tertile). mediated 7.07% of BMI's effect hypertension, BMI 29.3% effect. This study highlights intertwined roles development. Targeting both factors may enhance prevention strategies.

Язык: Английский

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Remnant cholesterol inflammatory index and its association with all-cause and cause-specific mortality in middle-aged and elderly populations: evidence from US and Chinese national population surveys

Lipids in Health and Disease, Год журнала: 2025, Номер 24(1)

Опубликована: Апрель 24, 2025

The remnant cholesterol inflammatory index (RCII) is a novel metric that combines and high-sensitivity C-reactive protein, reflecting the metabolic risk. This study investigates association between RCII long-term risks of all-cause cause-specific mortality in middle-aged elderly populations US China. We analyzed data from National Health Nutrition Examination Survey (NHANES) China Retirement Longitudinal Study (CHARLS), including 7,565 12,932 participants aged 45 years older, respectively. were categorized into quartiles based on natural log-transformed (lnRCII) values. Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic splines (RCS) mediation analysis used to examine relationship lnRCII outcomes, adjusting for potential covariates. mean age was 59.90 ± 10.44 58.64 9.78 with 53.28% 52.50% female, showed higher (≥ 0.79 NHANES, ≥ -0.13 CHARLS) significantly associated increased risk (p < 0.001). Each standard deviation (SD) increase corresponded mortality, hazard ratios (HRs) 95% confidence interval (CI) 1.29 (95% CI: 1.21-1.36) NHANES 1.26 1.15-1.38) CHARLS. In also elevated cardiovascular (HR = 1.21, 1.08-1.35) cancer 1.30, 1.09-1.55). RCS indicated J-shaped both linear mortality. Mediation systolic blood pressure fasting plasma glucose partially mediated these associations. Subgroup analyses suggested stronger interaction 0.010). Elevated levels are population, By integrating factors, may serve as valuable tool stratification clinical decision-making.

Язык: Английский

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Joint association of estimated glucose disposal rate and body mass index with new-onset stroke

Frontiers in Neurology, Год журнала: 2025, Номер 16

Опубликована: Май 9, 2025

Background Stroke is a major global health concern, and understanding its modifiable risk factors critical for prevention. Body mass index (BMI) estimated glucose disposal rate (eGDR), indicators of adiposity insulin sensitivity, respectively, are independently associated with stroke risk. However, the combined effects these remain underexplored. Methods This study utilized data from China Health Retirement Longitudinal Study (CHARLS), including 7,212 adults aged over 45 years. Cox proportional hazards models assessed independent joint associations BMI eGDR new-onset stroke. Mediation analysis evaluated BMI’s role in eGDR-stroke relationship. Subgroup analyses by age, sex, categories were conducted. Results Over 7-year follow-up, 587 participants (8.14%) experienced Higher was positively incidence, while lower linked to increased Participants both obesity (BMI 28 kg/m 2 ) faced highest (HR: 2.63; 95% CI: 1.78–3.89). revealed that significantly mediated 16.78% association between showed consistent across categories. Conclusion highlights significant interconnected roles risk, compounding effect observed individuals low eGDR. Addressing resistance through targeted interventions could effectively reduce particularly high-risk populations.

Язык: Английский

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Predictive value of remnant cholesterol inflammatory index for stroke risk: Evidence from the China health and Retirement Longitudinal study

Journal of Advanced Research, Год журнала: 2024, Номер unknown

Опубликована: Дек. 1, 2024

Remnant cholesterol (RC) and high-sensitivity C-reactive protein (hs-CRP) are established stroke risk factors, but their joint impact remains unclear.

Язык: Английский

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Remnant cholesterol has a nonlinear association with non-alcoholic fatty liver disease: A secondary retrospective cohort study in non-obese Chinese adults

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Окт. 7, 2024

Objective Evidence linking non-obese non-alcoholic fatty liver disease (NAFLD) with residual cholesterol (RC) is weak. In this study, Chinese adults who were not obese examined for a relationship between NAFLD and RC levels. Methods 16,004 volunteers included in retrospective cohort study at clinic the start of 2010 end 2014. The correlation initial levels likelihood developing was investigated using proportional hazards regression (Cox) model. Using cubic spline functions smooth curve fitting technique, two-piecewise method used to investigate nonlinear associations NAFLD. There numerous sensitivity assessments carried out. information posted on DATADRYAD website. Results results showed positive incidence after controlling variables (HR = 1.061, 95% CI 1.045–1.078). Between NAFLD, connection found, turning point 98.29 mg/dL. effect sizes (HR) 1.150 (95% 1.106, 1.194) 1.009 0.982, 1.037) either side point, respectively. A examination further supported stability findings. Conclusion sample that obese, research emphasizes potentially favorable risk. When below mg/dL, substantially associated risk Thus, from therapeutic standpoint, keeping cutoff would be advantageous.

Язык: Английский

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Intraindividual Discordance Between Remnant Cholesterol and Low‐Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts

Journal of the American Heart Association, Год журнала: 2024, Номер 13(20)

Опубликована: Окт. 11, 2024

The atherogenic effect of remnant cholesterol is being increasingly acknowledged. This study aimed to explore the association discordance between and low-density lipoprotein with stroke onset using 2 Chinese national cohorts.

Язык: Английский

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