UNASSIGNED: In this study, the association between the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) at diagnosis and poor outcomes of atherosclerosis-related antineutrophil cytoplasmic antibody-associated vasculitis (AAV) during follow-up in patients with AAV was investigated.
UNASSIGNED: This retrospective study included 138 patients diagnosed with AAV. Their comprehensive medical records were meticulously reviewed. All-cause mortality, cerebrovascular accident (CVA), and acute coronary syndrome (ACS) were evaluated as atherosclerosis-related poor outcomes of AAV. MHR was obtained by dividing monocyte counts (/mm3) by high-density lipoprotein cholesterol (mg/dL) levels.
UNASSIGNED: The median age of the 138 patients was 58.3 years with 44 being male (31.9%). Among the 138 patients, 11 (8.0%) died, and 11 (8.0%) and 9 (6.5%) had CVA, and ACS, respectively. MHR at diagnosis was significantly correlated with the Birmingham vasculitis activity score, erythrocyte sedimentation rate, and C-reactive protein at diagnosis. Among the three poor outcomes of AAV, only CVA during follow-up was significantly associated with MHR at diagnosis, and thus, only CVA was considered an atherosclerosis-related poor outcome of AAV. In the multivariable Cox hazards model analysis, MHR (hazard ratio [HR] 1.195) and serum albumin (HR 0.203) at diagnosis were independently associated with CVA during follow-up. Additionally, patients with MHR at diagnosis ≥3.0 exhibited a significantly higher risk for CVA and lower cumulative CVA-free survival rate than those with MHR at diagnosis <3.0.
UNASSIGNED: This study is the first to demonstrate clinical implications of MHR suggesting that MHR at diagnosis is significantly and independently associated with CVA during follow-up in patients with AAV.

UNASSIGNED: This article explores the association between fractures, particularly in the elderly, and elevated plasma high-density lipoprotein cholesterol (HDL-C) levels. The study challenges the conventional idea of HDL-C as \"good cholesterol\" by revealing its potential role as a risk factor for fractures. Factors contributing to fractures in the elderly, such as diminishing bone strength due to aging-related tissue breakdown, are discussed. Sedentary lifestyles, low bone mineral density (BMD), and habits like smoking and alcohol consumption compound fracture susceptibility.
UNASSIGNED: The study delves into mechanisms linking elevated HDL-C to fractures, using data from the ASPREE-Fracturesub-study of the ASPREE trial involving Australian and American participants aged 65 and above.
UNASSIGNED: The study showed that over a 4-year period, elevated HDL-C levels in healthy older people were linked to a 14% higher fracture risk. This revelation expands the understanding of fracture risk factors beyond the established norms.
UNASSIGNED: The article emphasizes the need to reconsider HDL-C\'s traditional role as an indicator of cardiovascular health, particularly in light of medications like Statins and Anacetrapib that raise HDL-C levels. It calls for further exploration into the relationship between HDL-C, fractures at varying sites, and different age groups. Practical implications involve incorporating fracture risk associated with high HDL-C into clinical considerations, alongside advocating lifestyle changes for optimal HDL-C levels. In summary, this study prompts a reevaluation of HDL-C\'s implications in clinical practice, demanding further investigation into the intricacies of this relationship.

UNASSIGNED: Cardiometabolic index (CMI) has been suggested as innovative measures for assessing the cardiometabolic status. However, there is a lack of relevant studies on exploring the relationship between CMI and insulin resistance (IR). Consequently, this study aims to examine the relationship between CMI and IR in subjects with type 2 diabetes mellitus (T2DM).
UNASSIGNED: A cross-sectional study was performed on 2493 patients with T2DM (including 1505 males and 988 females). IR was measured through the homeostatic model assessment of insulin resistance (HOMA-IR), which was defined as HOMI-IR≥2.69. The relationship between CMI and IR was evaluated with Spearman\'s correlation, ROC analysis, multiple logistic regression, generalized smooth curve fitting and subgroup analysis.
UNASSIGNED: CMI was correlated with HOMA-IR in patients with T2DM (Spearman correlation coefficient = 0.391 in females and 0.346 in males, P<0.001). Through the multiple logistic regression analysis, CMI was significantly correlated with IR (OR=1.30, 95% CI=1.15-1.47 in males and OR=1.62, 95% CI=1.32-1.99 in females). In addition, a non-linear correlation between CMI and IR risk was identified. The AUC of CMI (AUC = 0.702 for males and 0.733 for females, all p < 0.01) was the largest compared with traditional indexes of adiposity and blood lipids. According to the subgroup analysis, the two had a more significantly positive correlation in females, the elderly and subjects with HbA1c < 7%.
UNASSIGNED: In patients with T2DM, elevated CMI is significantly correlated with IR, as a useful index of IR.

UNASSIGNED: We investigate the correlation between glucose and lipid metabolism and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and its diagnostic and predictive value.
UNASSIGNED: A retrospective analysis involved 620 patients diagnosed with T2DM, categorized into two groups based on fundus examination results: the non-diabetic retinopathy group (NDR, n=340) and the diabetic retinopathy group (DR, n=280). We collected baseline patient data, calculated the ratio of glycated hemoglobin (HbA1c) to high-density lipoprotein cholesterol (HDL-C), and analyzed its association with Type 2 Diabetic Retinopathy.
UNASSIGNED: HbA1c/HDL-C in DR group exhibited significantly higher than the NDR group (P<0.001). Mantel-Haenszel\'s chi-square trend analysis indicated a notable linear trend (P<0.001) between HbA1c/HDL-C and DR. HbA1c/HDL-C revealed moderate positive correlations with DR, r=0.342, P<0.001. Binary logistic regression analysis showed systolic blood pressure (SBP), diabetes course, fasting blood glucose (FBG) and HbA1c/HDL-C as independent risk factors for DR in T2DM patients. Restrictive cubic spline analysis demonstrated a significant nonlinear relationship between HbA1c/HDL-C and DR (P total trend <0.001, P nonlinear = 0.0196). ROC curve analysis identified that HbA1c/HDL-C had the highest diagnostic accuracy for DR, with an area under the ROC curve (AUC) of 0.711, 53.2% sensitivity, and 78.2% specificity.
UNASSIGNED: Our study shows that HbA1c/HDL-C is an independent risk factor for DR in patients with type 2 diabetes. HbA1c/HDL-C has good diagnostic value for DR and can be used as a biological index for early screening of DR.

BACKGROUND: Previous studies have shown that the serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is related to metabolic syndrome. However, no existing study has examined the relationship between UHR and insulin resistance (IR). Therefore, this study aims to explore the association between the UHR and IR in patients with type 2 diabetes mellitus (T2DM).
METHODS: Patients with type 2 diabetes mellitus (1,532 males and 1,013 females) were enrolled. Insulin resistance was measured by homeostatic model assessment of insulin resistance (HOMA-IR) and was defined as HOMI-IR ≥ 2.69. Pearson correlation, multiple logistic regression, ROC analysis, and subgroup analysis were used to evaluate the association between UHR and IR.
RESULTS: UHR was associated with HOMA-IR in patients with type 2 diabetes mellitus (pearson\'s correlation coefficient = 0.274 in males and 0.337 in females, P < 0.001). Multiple logistic regression analysis showed that UHR was significantly correlated with insulin resistance (OR = 1.06, 95%CI = 1.03-1.08 in males and OR = 1.11, 95%CI = 1.08-1.15 in females). The area under the ROC curve (AUC) of UHR (AUC = 0.665 for males and 0.717 for females, all P < 0.01) was the largest compared with that of UA and HDL-C in insulin resistance. Subgroup analysis showed that there was a more significantly positive correlation among subjects with BMI ≥ 24 kg/m2 , age < 60 years old, HbA1c < 7%, non-hypertension, or in female subjects.
CONCLUSIONS: Elevated UHR is significantly correlated with insulin resistance, which can be used as an indicator of insulin resistance in patients with type 2 diabetes mellitus.

UNASSIGNED: Diabetic nephropathy (DN) is a common complication of type 2 diabetes mellitus (T2DM) that significantly impacts the quality of life for affected patients. Dyslipidemia is a known risk factor for developing cardiovascular complications in T2DM patients. However, the association between serum lipoprotein(a) (Lp(a)) and high-density lipoprotein cholesterol (HDL-C) with DN requires further investigation.
UNASSIGNED: For this cross-sectional study, we randomly selected T2DM patients with nephropathy (DN, n = 211) and T2DM patients without nephropathy (T2DM, n = 217) from a cohort of 142,611 patients based on predefined inclusion and exclusion criteria. We collected clinical data from the patients to identify potential risk factors for DN using binary logistic regression and machine learning. After obtaining the feature importance score of clinical indicators by building a random forest classifier, we examined the correlations between Lp(a), HDL-C and the top 10 indicators. Finally, we trained decision tree models with top 10 features using training data and evaluated their performance with independent testing data.
UNASSIGNED: Compared to the T2DM group, the DN group had significantly higher serum levels of Lp(a) (p < 0.001) and lower levels of HDL-C (p = 0.028). Lp(a) was identified as a risk factor for DN, while HDL-C was found to be protective. We identified the top 10 indicators that were associated with Lp(a) and/or HDL-C, including urinary albumin (uALB), uALB to creatinine ratio (uACR), cystatin C, creatinine, urinary ɑ1-microglobulin, estimated glomerular filtration rate (eGFR), urinary β2-microglobulin, urea nitrogen, superoxide dismutase and fibrinogen. The decision tree models trained using the top 10 features and with uALB at a cut-off value of 31.1 mg/L showed an average area under the receiver operating characteristic curve (AUC) of 0.874, with an AUC range of 0.870 to 0.890.
UNASSIGNED: Our findings indicate that serum Lp(a) and HDL-C are associated with DN and we have provided a decision tree model with uALB as a predictor for DN.

UNASSIGNED: Uric acid to high-density lipoprotein cholesterol ratio (UHR), the ratio of uric acid to high-density lipoprotein cholesterol, is a newly proposed marker of metabolic abnormalities. There are few previous studies directly investigating the relationship between UHR and alanine aminotransferase (ALT), especially in short stature populations, however, short stature children and adolescents are more likely to have metabolic disorders. This research aimed to investigate the relationship between the UHR and ALT in children and adolescents with short stature.
UNASSIGNED: In this cross-sectional analysis, the clinical data of 1,510 children with height below -2 SD who were evaluated at the Department of Endocrinology, Affiliated Hospital of Jining Medical University from 1 March 2013 to 31 December 2021, were selected. Anthropometric and biochemical indicators were measured. The relationship between UHR and ALT was analysed.
UNASSIGNED: The univariate analysis results showed that UHR was positively associated with ALT (β = 0.43, P < 0.0001). Furthermore, after adjusting for possible confounding factors, a non-linear relationship was detected between UHR and ALT through smooth curve fitting, and the inflection point of UHR was 10.93% after multivariate piecewise linear regression analysis. ALT increased with UHR elevation when the UHR was greater than 10.93% (β = 0.69, 95% CI 0.39, 0.98; P < 0.0001). However, we did not observe a significant relationship when the UHR was less than 10.93% (P = 0.9229).
UNASSIGNED: Our study demonstrated that in Chinese children and adolescents with short stature, UHR may be associated with the regulation of ALT levels, and this relationship merits further investigation.

UNASSIGNED: We assessed the TG/HDL-C ratio as a predictor for the presence of coronary artery calcifications (CACs).
UNASSIGNED: We collected demographic characteristics (age and gender), physical examination (height, weight, BMI, SBP, DBP), comorbidities, medication use, and laboratory variables Triglyceride to High-Density Lipoprotein (TG, HDL-C, TG/HDL-C, UA, TBG, 25-OH-VitD3); and we used coronary angiography to determine the presence of CACs. We performed univariate and multivariate analyses to evaluate the correlation between the TG/HDL-C ratio and CACs and established a predictive model.
UNASSIGNED: CAC was present in 121 patients (25.80%). The levels of TG and TG/HDL-C ratio in the CAC group were higher than those in the non-CAC group, while the level of HDL-C in the CAC group was lower than that in the non-CAC group. The univariate analysis showed that the TG/HDL-C ratio was associated with CAC (OR, 0.021; 95% CI, 0.008 to 0.052; P<0.001), and the multivariate analysis indicated that the ratio was an independent risk factor for CAC (OR, 4.088; 95% CI, 2.787-5.996; P<0.001). Using the ratio to establish a prediction model, the area under the ROC curve was 0.814 (95% CI, 0.775-0.853; P<0.001), suggesting that the TG/HDL-C ratio has a high diagnostic efficiency. The diagnostic threshold was 1.037, and the corresponding sensitivity and specificity were 89.3% and 60.5%, respectively.
UNASSIGNED: The Triglyceride to High-Density Lipoprotein TG/HDL-C ratio is an independent risk factor for CAC with good diagnostic efficacy.

Many patients with acute ischemic stroke (AIS) are found to accompany with leukoaraiosis (LA) in brain imaging. The risk factors of LA in patients with AIS were examined in this study. Patients with AIS were recruited and underwent head magnetic resonance imaging. According to Fazekas scores, patients were divided into LA group and non-LA group. We compared demographic and laboratory characteristics in two groups. Multivariate logistic regression analysis demonstrated that high-density lipoprotein (HDL), age, stroke history, admission SBP, and homocysteine were independent risk factors for LA in patients with AIS (P < 0.05). Multinomial logistic regression analysis demonstrated that HDL was an independent risk factor for moderate LA (OR 4.151, 95% CI 1.898-9.078, P < 0.001) and severe LA (OR 3.151, 95% CI 1.350-7.358, P = 0.008). In order to further explore the correlation between HDL level and the severity of LA, HDL was categorized in quartiles and multinomial logistic regression analysis was presented. Regression analysis showed that HDL ≥ 1.34 mmol/L was correlated with moderate and severe LA after adjusting for corresponding confounding factors in different models. After 1-year follow-up, patients were divided into regular statin therapy group and irregular statin therapy group. There was no significant difference in HDL level between two groups; however, the proportion of patients with increased Fazekas scores in regular statin therapy group was significantly less than that in the irregular statin therapy group (P < 0.05). In conclusion, HDL was an independent risk factor for LA and associated with the severity of LA in patients with AIS; regular statin therapy may be negatively related with the progress of LA. These results provide more evidences for controlling risk factors and severity of LA in patient with AIS.

BACKGROUND: Triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-c) is crucial when researching metabolic and vascular diseases, and its involvement in COVID-19 was sparsely elaborated on. The purpose of the study was to explore the inflammatory associations between the TG/HDL-c ratio and COVID-19 prognosis.
METHODS: A total of 262 COVID-19 patients consisting of 244 survivors and 18 non-survivors were retrospectively investigated. The clinical features and baseline hematological parameters were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to explore the role of TG/HDL-c in predicting the mortality of COVID-19, the Spearman\'s rank correlation coefficients were used to measure the correlation between TG/HDL-c and inflammatory indicators, and the Kaplan-Meier (KM) curve was used to estimate the survival of COVID-19 patients with high and low TG/HDL-c ratio. Logistic regression analyses were performed to investigate the role of TG/HDL-c ratio on mortality of COVID-19 with no underlying diseases.
RESULTS: Compared with the survivors, the non-survivors of COVID-19 had significantly higher levels of white blood cells (4.7 vs 13.0 × 109/L; P < 0.001), neutrophils (3.0 vs 11.6 × 109/L; P < 0.001), C-reactive proteins (15.7 vs 76.7 mg/L; P < 0.001) and TG/HDL-c ratio (1.4 vs 2.5; P = 0.001). The ROC curve [area under the curve (AUC), 0.731; 95% confidence interval (CI), 0.609-0.853; P = 0.001] suggested that the TG/HDL-c ratio could predict the mortality of COVID-19. The TG/HDL-c ratio was positively correlated with white blood cells (r = 0.255, P < 0.001), neutrophils (r = 0.243, P < 0.001) and C-reactive proteins (r = 0.170, P < 0.006). Patients with high TG/HDL-c ratio showed a worse survival compared with those with low TG/HDL-c ratio (Log rank P = 0.003). Moreover, TG/HDL-c ratio was an independent factor in predicting the mortality of COVID-19 patients with no underlying diseases.
CONCLUSIONS: Our study demonstrated that TG/HDL-c ratio might potentially be a predictive marker for mortality in COVID-19 patients.