目的:总胆固醇与高密度脂蛋白胆固醇(TC/HDL-C)比值与卒中风险之间的关系存在争议。这项研究旨在研究中国健康与退休纵向研究(CHARLS)的中老年人的TC/HDL-C比值与中风之间的联系。
方法:本研究进行了回顾性队列分析,在2011年至2012年期间,共招募10,184名符合CHARLS指定标准的参与者。然后,我们使用Cox比例风险回归模型来分析TC/HDL-C比率与卒中风险之间的关系。使用具有三次样条函数和平滑曲线拟合的Cox比例风险回归模型,我们能够确定TC/HDL-C比值与卒中发生率之间的非线性关系.还进行了敏感性和亚组分析以研究TC/HDL-C比值与卒中之间的联系。
结果:这项研究显示,在校正危险因素后,45岁或以上的受试者中,TC/HDL-C比值与卒中风险之间存在统计学上的显著关联(HR:1.05,95CI1.00-1.10,P=0.0410)。此外,检测到TC/HDL-C比值与卒中风险之间的非线性关系,TC/HDL-C比值拐点为3.71。我们发现TC/HDL-C比值与卒中风险之间存在显著正相关,当TC/HDL-C比值小于3.71(HR:1.25,95CI1.07-1.45,P=0.0039)。然而,当TC/HDL-C比值超过3.71时,两者间的联系不显著(HR:1.00,95CI0.94-1.06,P=0.9232).敏感性分析和亚组分析显示,我们的研究结果非常可靠。
结论:我们的研究表明,TC/HDL-C比值与中老年人卒中风险之间的非线性联系。TC/HDL-C比值与卒中风险之间存在显著正相关,当TC/HDL-C比值小于3.71。当前的研究可以作为指导临床医生咨询和优化中老年人中风预防措施的指南。
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.
CONCLUSIONS: 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.