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The following is a summary of “Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cardiovascular disease mortality in patients with type 2 diabetes mellitus and diabetic kidney disease Linear Correlation Between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and Mortality in Patients with Type 2 Diabetes Mellitus (T2DM) and Diabetic Kidney Disease (DKD) Related Cardiovascular Disease,” published in the February 2025 issue of Frontiers in Endocrinology by Li and Xu. 

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) served as an important lipid index and was closely associated with the development of diabetes and cardiovascular diseases (CVDs).  

Researchers conducted a retrospective study to examine the relationship between the NHHR index and CVDs mortality in individuals with type 2 diabetes mellitus (T2DM) and diabetic kidney disease (DKD).  

They analyzed data from the National Health and Nutrition Examination Survey (NHANES) database, including 5,136 individuals grouped by NHHR index quartiles. Restricted cubic plots and COX regression models assessed NHHR index thresholds and patterns linked to CVD mortality in T2DM and DKD. Subgroup analyses and P-values determined interactions among variables.  

The results showed a nonlinear, L-shaped association between the NHHR index and cardiovascular mortality in individuals with T2DM and DKD. In T2DM, an NHHR index below 1.68 correlated with higher mortality risk, with a 72.8% reduction in death risk per unit increase below this threshold. In DKD, an NHHR index under 1.82 was linked to increased cardiovascular mortality, showing a 48.2% risk reduction per unit increase beneath this level. The third NHHR quartile in T2DM was linked with lower mortality risk [Hazard Ratio (HR), 0.82; 95% CI (0.69-0.97); P=0.019]. In DKD, cardiovascular mortality was notably higher in the third and fourth NHHR quartiles [Quartile3 HR, 1.57; 95% CI (1.10-2.24), P=0.013; Quartile4 HR, 2.04; 95% CI (1.28-3.26), P=0.003].  

Investigators concluded that in patients with T2DM and NHHR below 1.68 and in those with DKD and NHHR below 1.82, an increased NHHR index was related with a reduced risk of CVD mortality. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1509752/abstract