Relationship between Non-high-density Lipoprotein Cholesterol to High-density Lipoprotein Cholesterol Ratio and Left Ventricular Hypertrophy in a Community-based Hypertensive Population postprint

Abstract: Background　Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio （NHHR），a novel composite lipid index，is a potential biomarker for assessing cardiovascular disease risk. Still，its relationship with left ventricular hypertrophy（LVH）is unclear. Objectives　To explore the correlation between NHHR and LVH in hypertensive patients. Methods　This is a cross-sectional study based on rural areas，and a stratified whole cluster sampling method was adopted in 2004-2005，in which 7 out of 22 townships in a county in Henan Province were selected using the simple random number method，and 63 out of the 180 villages under its jurisdiction were chosen randomly，and screening was performed among the long-staying rural residents aged 40-75 years，and finally 4，551 patients with hypertension were integrated. Patients were categorized into Q1（NHHR ≤ 2.05），Q2（2.06 ≤ NHHR ≤ 2.58），Q3（2.59 ≤ NHHR ≤ 3.20）and Q4（NHHR ≥ 3.21）groups according to NHHR quartiles. The clinical data of the patients in the four groups were compared. Logistic regression analysis was used to explore the association between NHHR and LVH. The consistency of the associations was confirmed using subgroup analyses. Results　The differences were statistically significant in the comparison of BMI，diastolic blood pressure（DBP），alanine aminotransferase（ALT），fasting blood glucose（FBG），total cholesterol（TC），triglycerides（TG），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），serum uric acid（UA），serum creatinine（Scr），stroke history，coronary heart disease history and diabetes history indicators in the four groups（P<0.05）. In the fully adjusted model，NHHR was associated with the risk of LVH，with the probability of LVH risk in groups Q2，Q3，and Q4 compared with group Q1 being 1.140（95%CI=0.950~1.368，P=0.159），1.346（95%CI=1.102~1.644，P=0.004），1.344 （95%CI=1.053~1.717，P=0.018）；after controlling for all covariates except grouping variables，this relationship remained significant in subgroup analyses in the subgroups of females，<60 years of age，≥ 60 years of age，no history of coronary artery disease，no history of stroke，and history of diabetes mellitus（P<0.05）. Conclusion　This study，based on hypertensive patients in rural areas and using cross-sectional studies，revealed that high levels of NHHR were independently associated with LVH in hypertensive patients. The association was stronger in women and older subgroups，suggesting that NHHR can be used to identify patients at high risk of LVH in hypertensive populations and provide a basis for stratified management of those at high risk of LVH.