Non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol is a predictor for cardiovascular mortality in patients with diabetes mellitus

Table 1 Baseline characteristics, median (interquartile range)

	Male	Female	All participants	P value
Sample size	4365	4060	8425
Age, years	60 (50-69)	60 (49-71)	60 (50-70)	0.39
Body mass index	31.1 (27.2-35.3)	32.6 (28.1-38.6)	31.7 (27.6-36.7)	< 0.01
Ethnicity, n (%)
Mexican American	858 (19.7)	868 (21.4)	1726 (20.5)	< 0.01
Other Hispanic	370 (8.5)	415 (10.2)	785 (9.3)
Non-Hispanic white	1712 (39.2)	1356 (33.4)	3068 (36.4)
Non-Hispanic black	1006 (23.0)	1059 (26.1)	2065 (24.5)
Other	419 (9.6)	362 (8.9)	781 (9.3)
Education, n (%)
Less than 9th grade	1033 (23.7)	1023 (25.2)	2056 (24.4)	< 0.01
9-11th grade	716 (16.4)	726 (17.9)	1442 (17.1)
High school graduate	1097 (25.1)	996 (24.5)	2093 (24.8)
College	864 (19.8)	890 (21.9)	1754 (20.8)
College graduate or above	632 (14.5)	405 (10.0)	1037 (12.3)
Unknown	23 (0.5)	20 (0.5)	43 (0.5)
Poverty-income ratio
< 1	797 (18.3)	978 (24.1)	1775 (21.1)	< 0.01
1-3	2224 (51.0)	2182 (53.7)	4406 (52.3)
> 3	1344 (30.8)	900 (22.2)	2244 (26.6)
Smoke, n (%)
Every day	686 (15.7)	466 (11.5)	1152 (13.7)	< 0.01
Some days	138 (3.2)	85 (2.1)	223 (2.6)
Not at all	1861 (42.6)	986 (24.3)	2847 (33.8)
Unknown	1680 (38.5)	2523 (62.1)	4203 (49.9)
Alcohol use
Non-drinker	1971 (45.2)	2465 (60.7)	4436 (52.7)	< 0.01
Drinker	2393 (54.8)	1592 (39.2)	3985 (47.3)
Unknown	1 (0.02)	3 (0.07)	4 (0.05)
Hypertension, n (%)	2674 (61.3)	2695 (66.4)	5369 (63.7)	< 0.01
Hypercholesterolemia, n (%)	2406 (55.1)	2269 (55.9)	4675 (55.5)	0.49
Plasma fasting glucose, mmol/L	7.55 (6.83-9.66)	7.11 (6.16-8.62)	7.33 (6.44-9.10)	< 0.01
HbA1c, %	6.7 (6.1-7.7)	6.6 (6.0-7.5)	6.7 (6.0-7.6)	0.06
HbA1c, mmol/mol	50 (43-61)	49 (42-58)	50 (42-60)	0.06
NHHR	3.14 (2.28-4.24)	2.72 (1.99-3.77)	2.94 (2.13-4.01)	< 0.01
TC	4.50 (3.83-5.35)	4.91 (4.19-5.69)	4.71 (3.98-5.53)	< 0.01
HDL-C	1.09 (0.91-1.27)	1.27 (1.06-1.53)	1.16 (0.98-1.42)	< 0.01
LDL-C	2.43 (1.81-3.13)	2.69 (2.02-3.41)	2.53 (1.91-3.26)	< 0.01
Triglycerides	0.67 (0.02-1.69)	0.56 (0.02-1.69)	0.67 (0.02-1.69)	0.91

TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; NHHR: Non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio.

Table 2 Association of non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and cardiovascular mortality in patients with diabetes, hazard ratio (95% confidence intervals)

Cardiovascular mortality	Q1	Q2	Q3	Q4	Per SD
Model 1	Reference	0.86 (0.69-1.07)	0.92 (0.74-1.14)	0.86 (0.70-1.07)	0.94 (0.87-1.02)
Model 2	Reference	1.03 (0.82-1.28)	1.25 (1.01-1.55)	1.40 (1.12-1.75)	1.15 (1.06-1.24)
Model 3	Reference	1.02 (0.81-1.27)	1.24 (0.99-1.54)	1.39 (1.11-1.73)	1.14 (1.06-1.24)

Model 1: No adjustment. Model 2: Adjusted for age, ethnicities, education levels, poverty-income ratio. Model 3: Adjusted for age, ethnicities, education levels, poverty-income ratio, history of heart failure.

Table 3 Subgroup analyses on non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and cardiovascular mortality, hazard ratio (95% confidence intervals)

Cardiovascular mortality1	n	Q1	Q2	Q3	Q4	Per SD	P value for interaction
Gender
Male	4365	Reference	0.84 (0.61-1.14)	1.18 (0.89-1.57)	1.19 (0.88-1.59)	1.12 (1.01-1.25)	0.58
Female	4060	Reference	1.18 (0.85-1.63)	1.13 (0.80-1.59)	1.40 (0.99-1.97)	1.09 (0.95-1.24)
Age, years
≥ 60	5161	Reference	1.04 (0.83-1.32)	1.23 (0.97-1.54)	1.31 (1.04-1.67)	1.15 (1.04-1.26)	0.99
< 60	3264	Reference	1.03 (0.46-2.31)	1.46 (0.71-3.03)	1.89 (0.94-3.78)	1.10 (0.96-1.26)
Body mass index
≥ 30 kg/m2	4738	Reference	1.08 (0.79-1.48)	1.19 (0.87-1.63)	1.35 (0.98-1.85)	1.13 (1.02-1.26)	0.64
< 30 kg/m2	3687	Reference	0.93 (0.67-1.28)	1.30 (0.96-1.67)	1.44 (1.06-1.96)	1.16 (1.03-1.31)
Duration of diabetes
≥ 10 years	2865	Reference	1.06 (0.77-1.45)	1.17 (0.85-1.61)	1.60 (1.15-2.22)	1.26 (1.11-1.42)	0.04
< 10 years	5560	Reference	1.00 (0.72-1.37)	1.35 (1.00-1.82)	1.37 (1.01-1.86)	1.11 (1.00-1.24)

¹All adjusted for age, ethnicities, education levels, poverty-income ratio, history of heart failure.