Key result
Higher lymphocyte-to-HDL ratio linked to ~13% higher odds of carotid plaque per 1-unit increase.
Why the study?
The lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) combines an immune-cell count with a lipid measure, but evidence on its association with carotid artery plaque among adults undergoing routine health examinations remains limited.
Is a higher lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) associated with an increased prevalence of carotid artery plaque (CAP) in adults without known clinical vascular disease undergoing routine health examinations?
Cross-Sectional (n=10,925)
Ultrasound images were independently reviewed by two physicians blinded to participants' LHR values and other laboratory results
No
Is a higher lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) associated with an increased prevalence of carotid artery plaque (CAP) in adults without known clinical vascular disease undergoing routine health examinations?
In adults undergoing routine health examinations without known cardiovascular disease, a higher lymphocyte-to-HDL cholesterol ratio is independently associated with a higher prevalence of subclinical carotid artery plaque, particularly in those aged 60 years and older.
Answers are grounded in this paper and cite their sources.
LHR should not yet inform clinical plaque screening; leaves open its incremental predictive value beyond traditional factors in adults ≥60 years.
The lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) combines an immune-cell count with a lipid measure, but evidence on its association with carotid artery plaque (CAP) remains limited. We examined the association between LHR and prevalent CAP among adults undergoing routine health examinations. This single-center cross-sectional study included 10,925 adults who underwent health examinations and carotid ultrasonography at Northern Jiangsu People’s Hospital between January 1, 2024, and August 31, 2025. LHR was calculated by dividing the absolute lymphocyte count by the serum high-density lipoprotein cholesterol concentration. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, and cardiometabolic factors, including dyslipidemia and lipid-lowering medication use. Associations were assessed per 1-unit and 1-standard deviation (SD) increase and across LHR quartiles. Subgroup and sensitivity analyses were also performed. The median age was 53 years (interquartile range [IQR], 45–60), 48.81% of participants were men, and 2,863 (26.21%) had CAP. The median LHR was 1.56 (IQR, 1.18–2.10), with a mean of 1.71 (SD, 0.76) and a range of 0.24–7.28. In the fully adjusted model, each 1-unit increase in LHR was associated with higher odds of prevalent CAP (OR, 1.13; 95% CI, 1.04–1.21); the corresponding OR per 1-SD increase was 1.09 (95% CI, 1.03–1.16). The adjusted association was approximately linear. The association differed by age (P for heterogeneity < 0.001): the OR per 1-unit increase was 1.23 (95% CI, 1.08–1.39) among participants aged ≥ 60 years ( n = 2,906) and 0.91 (95% CI, 0.83–1.00) among those aged < 60 years ( n = 8,019). Estimates were similar across sensitivity analyses. Higher LHR was associated with prevalent CAP after multivariable adjustment, with a stronger positive association among adults aged ≥ 60 years in exploratory subgroup analyses. These findings support further investigation of LHR in relation to subclinical carotid atherosclerosis. Prospective studies are needed to clarify the temporal relationship and assess its potential clinical relevance.
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Sun et al. (2026) conducted a cross-sectional in Prevalent carotid artery plaque (CAP) (n=10,925). Lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR) per 1-unit increase vs. Lower LHR (continuous or lowest quartile Q1 <=1.18) was evaluated on Prevalent carotid artery plaque (CAP) assessed by bilateral carotid ultrasonography (OR 1.13, 95% CI 1.04-1.21, p=0.002). Each 1-unit increase in the lymphocyte-to-HDL cholesterol ratio (LHR) was associated with 13% higher odds of prevalent carotid artery plaque.
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