Observational Study
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World J Cardiol. Jul 26, 2025; 17(7): 101434
Published online Jul 26, 2025. doi: 10.4330/wjc.v17.i7.101434
Non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol is a predictor for cardiovascular mortality in patients with diabetes mellitus
Deng Pan, Peng-Fei Chen, Si-Yan Ji, Tie-Long Chen, He Zhang
Deng Pan, Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, Zhejiang Province, China
Peng-Fei Chen, He Zhang, Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
Si-Yan Ji, Department of Stomatology, Qiqihar Medical College School, Qiqihar 161000, Heilongjiang Province, China
Tie-Long Chen, Department of Cardiology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, Zhejiang Province, China
Co-corresponding authors: Tie-Long Chen and He Zhang.
Author contributions: Pan D and Ji SY wrote the original manuscript and revised the manuscript; Chen PF conducted the statistical analysis; Chen TL and Zhang H acquired fundings, revised the manuscript, and contributed equally as co-first authors; and all authors read and approved the manuscript.
Supported by Hospital Capability Enhancement Project of Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. XYZX0404-15; and Zhejiang Provincial Medical Association Clinical Medical Research Special Funding Projects, No. 2023ZYC-A13.
Institutional review board statement: The NHANES study was reviewed and approved by the NCHS Research Ethics Review Board.
Informed consent statement: This is a cohort study based on National Health and Nutrition Examination Survey (NHANES) without any intervention. All participants have provided the consent forms according to NHANES official.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from https://www.cdc.gov/nchs/nhanes/.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: He Zhang, PhD, Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing 100091, China. zhhe1112@163.com
Received: September 16, 2024
Revised: December 5, 2024
Accepted: March 28, 2025
Published online: July 26, 2025
Processing time: 311 Days and 6.3 Hours
Core Tip

Core Tip: This study investigates the association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cardiovascular mortality in patients with diabetes mellitus (DM). Analysis of 8425 DM patients from the National Health and Nutrition Examination Survey revealed a non-linear relationship between NHHR and cardiovascular mortality. Patients in the highest NHHR quartile (≥ 4.01) had a 39% higher risk of cardiovascular death compared to the lowest quartile. A predictive model for 5, 8, and 10-year cardiovascular mortality was developed, showing high accuracy. These findings suggest NHHR as a valuable prognostic marker for cardiovascular risk in DM patients.