The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio (NHHR) as a Prognostic Factor for Stroke in Chinese Adults: A Study of Two National Cohorts

Objective The association between the ratio of non-high-density lipoprotein (NHDL) cholesterol to high-density lipoprotein cholesterol (HDL-C)—referred to as the NHHR—and stroke has yet to be elucidated. This study aimed to probe the correlation between NHHR in adults and the occurrence of stroke in China. Methods To elucidate the relationship between NHHR and stroke risk, this study employed a polyvariable logistic regression model and a restricted cubic spline (RCS) model, which were used to analyze the correlation between the NHHR and stroke using data from two major, all-encompassing national surveys in China: the China Health and Nutrition Survey (CHNS) and the China Health and Retirement Longitudinal Study (CHARLS). Additionally, subgroup examinations were conducted the sturdiness of the findings. Results The research comprised 16,447 adult participants, with 798 reporting a past occurrence of stroke. logistic regression examination analysis method revealed an affirmative relationship between NHHR and stroke. Specifically, for each interquartile range (IQR) increase in NHHR, the odds ratio (OR) was 1.28 in the CHNS cohort (95% CI: 1.01–1.54, P = 0.020) and 1.16 in the CHARLS cohort (95% CI: 1.09–1.23, P < 0.001).When compared to the lowest NHHR reference group, participants in the second, third, and fourth quartiles exhibited a considerably elevated risk of stroke after sufficient adjustments. In the CHNS cohort, the odds ratios (OR) were 1.55 (95% CI: 0.73–3.42) for the second quartile, 1.83 (95% CI: 0.89–3.96) for the third quartile, and 2.66 (95% CI: 1.37–5.59) for the fourth quartile. In the CHARLS cohort, the corresponding ORs were 1.54 (95% CI: 1.22–1.96) for the second quartile, 1.60 (95% CI: 1.27–2.03) for the third quartile, and 1.95 (95% CI: 1.56–2.46) for the fourth quartile. Among the entire population, a nonlinear a link was identified between NHHR and stroke risk, indicating a dose-response relationship. Additional exploration of the NHHR may improve our comprehension of preventing strokes and management. Conclusion Our findings indicate a favorable correlation between NHHR and stroke spread, suggesting that NHHR may act as a potential fresh prescriptive biomarker for stroke. Prompt mitigation and oversight of NHHR may significantly reduce the incidence of stroke. Further Anticipatory studies are needed to confirm this association and elucidate the fundamental biological mechanisms.