ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1609891
Association between fasting glucose/high-density lipoprotein cholesterol ratio and cardiovascular disease risk in Chinese middle-aged and older adults: a longitudinal study
Provisionally accepted
- 1Second Affiliated Hospital of Nanchang University, Nanchang, China
- 2Yongcheng people's hospital, Shangqiu, Henan Province, China
- 3Jiujiang First People's Hospital, Jiujiang, Jiangxi Province, China
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Background: There is currently no information on the association between the fasting blood glucose/high-density lipoprotein cholesterol ratio (FBG/HDL-C) and cardiovascular disease (CVD) incidence.Methods: Participants in our study, sourced from the China Health and Retirement Longitudinal Study, were grouped into quartiles by FBG/HDL-C ratio. CVD included self-reported heart disease and stroke. The ability of the FBG/HDL-C ratio to predict CVD was assessed using receiver operating characteristic (ROC) curves. Multivariate Cox regression was used to assess the association of FBG/HDL-C ratios with CVD, and potential nonlinear associations were explored using restricted cubic splines.Results: During the follow-up period from 2012 to 2018, 1,277 out of 6,995 participants (18.26%) developed CVD. There was a nonlinear association between the FBG/HDL-C ratio and CVD incidence in middle-aged and older adults (P for nonlinearity < 0.05). Compared to the Q1 of the FBG/HDL-C ratio, the adjusted HRs and 95% CIs for CVD in the Q2 to Q4 were 1.17 (0.98-1.40), 1.41 (1.18-1.68), and 1.56 (1.28-1.90), respectively. ROC curve analysis showed that FBG/HDL-C ratio had the highest diagnostic accuracy for CVD than either FBG or HDL-C alone. Furthermore, incorporating the ratio of FBG/HDL-C into the basic model significantly enhanced the prediction of CVD risk.Conclusions: We found that FBG to HDL-C ratio was significantly associated with an increased incidence of CVD in middle-aged and older adults. The FBG/HDL-C ratio was shown to be more effective in assessing cardiovascular risk than the use of FBG or HDL-C alone.
Keywords: High-density lipoprotein cholesterol, Fasting blood glucose, cardiovascular disease, CHARLS, Middle-aged and older adults
Received: 15 Apr 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Chen, Yan and Chen. 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:
Jintao Chen, Second Affiliated Hospital of Nanchang University, Nanchang, China
Jianhai Chen, Jiujiang First People's Hospital, Jiujiang, Jiangxi Province, China
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