Association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with all-cause mortality and cardio-cerebrovascular disease mortality in elderly patients with cardiovascular-kidney-metabolic syndrome stages 0–3: a cohort study

Figures

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  Figure 1. Flowchart of study population.

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  Figure 2. Restrictive cubic splines plot between NHHR and mortality in elderly participants with CKM stages 0–3. Restricted cubic splines were used to evaluate the hypothesis of potential nonlinear relationships between NHHR and all-cause mortality (A) and cardio-cerebrovascular disease mortality (B) in elderly participants with CKM stages 0–3. The NHHRs of 2.95 for A and 2.89 for B were chosen as reference estimates for each hazard ratio (HR). The analysis was adjusted for sex, age groups, marital status, BMI, education level, smoking status, drinking status, PA, antihypertensive medication, and antidiabetic medication. BMI: Body mass index, PA: Physical activity, CKM stages: Cardiovascular-kidney-metabolic syndrome stages. The restricted cubic spline analysis suggested a U-shaped association between NHHR and mortality risks, with relatively lower risk estimates observed around the third quartile (Q3). Accordingly, Q3 was used as the reference category for illustrative comparisons in the categorical analyses.

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  Figure 3. Subgroup analysis of the association between NHHR and mortality in the elderly population with CKM stages 0–3. (A) Subgroup analysis of the association between NHHR and all-cause mortality risk in the elderly population with CKM stages 0–3. (B) Subgroup analysis of the association between NHHR and cardio-cerebrovascular disease mortality risk in the elderly population with CKM stages 0–3. The HR was calculated using the Cox proportional hazards model with the adjustments including sex, age groups, marital status, BMI, education level, smoking status, drinking status, PA, antihypertensive medication, and antidiabetic medication. HR: hazard ratio, 95% CI: 95% confidence interval. BMI: body mass index, PA: physical activity, CKM stages: cardiovascular-kidney-metabolic syndrome stages.

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  Figure 4. Subgroup interaction effect plots. (A) Interaction between sex in NHHR and all-cause mortality; (B) Interaction between age groups in NHHR and all-cause mortality; (C) Interaction between smoking status in NHHR and all-cause mortality; (D) Interaction between CKM stages in NHHR and all-cause mortality; (E) Interaction between sex in NHHR and cardio-cerebrovascular disease mortality; (F) Interaction between age groups in NHHR and cardio-cerebrovascular disease mortality; (G) Interaction between smoking status in NHHR and cardio-cerebrovascular disease mortality; (H) Interaction between CKM stages in NHHR and cardio-cerebrovascular disease mortality. CKM stages: Cardiovascular-kidney-metabolic syndrome stages.

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  Figure 5. Mediation of the association between NHHR and mortality by ePWV. (A) Mediation of the association between NHHR and all-cause mortality risk by ePWV. (B) Mediation of the association between NHHR and cardio-cerebrovascular disease mortality risk by ePWV. Adjusted for sex, age groups, marital status, BMI, education level, smoking status, drinking status, PA, antihypertensive medication, and antidiabetic medication. BMI, Body mass index; PA, Physical activity.