ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
This article is part of the Research TopicHDL and Cardiovascular Disease: Mechanisms, Clinical Relevance, and Therapeutic ImpactsView all 6 articles
The relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and abdominal aortic calcification in adults: a cross-sectional study
Provisionally accepted
- 1Department of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, China
- 2Department of Vascular Surgery, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
- 3Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel lipid index for assessing atherosclerosis. Although NHHR has been recognized as a biomarker for multiple diseases, its association with abdominal aortic calcification (AAC) remains unexplored. Methods: This study analyzed data from 2,517 participants in the 2013–2014 National Health and Nutrition Examination Survey (NHANES). AAC was assessed using dual-energy X-ray absorptiometry and quantified with the Kauppila score (AAC-24). The relationship between NHHR and AAC was evaluated using multivariate linear and logistic regression models, with nonlinear associations visualized via restricted cubic splines. Subgroup and interaction analyses were conducted to assess the robustness of the findings across different populations. Results: In fully adjusted models, AAC scores and severe AAC prevalence increased with each quartile increment of NHHR (p < 0.05). A one-unit increase in NHHR was associated with a 0.13-unit rise in AAC score (β = 0.13, 95% CI: 0.02–0.24) and a 19% increase in severe AAC risk (OR = 1.19, 95% CI: 1.02–1.40). Subgroup analysis identified a significant interaction between NHHR and gender in relation to AAC. The OR (95% CI) was 0.97 (0.77–1.23) in males and 1.46 (1.18–1.81) in females (p for interaction = 0.008). Conclusion: In adults aged 40 years and older, higher NHHR levels were associated with increased AAC scores and a greater risk of severe AAC, particularly among women. Furthermore, this study highlights the potential clinical value of NHHR in the prevention of AAC and its related complications.
Keywords: NHHR, ABDOMINAL AORTIC CALCIFICATION, Cross-sectional study, NHANES, RCS
Received: 17 Feb 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Zhang, Bai, Ning, Song and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongqin Wang, whq1968hq@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.