ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
This article is part of the Research TopicNew Concepts, Advances, and Future Trends in Clinical Research on Eye DiseasesView all 75 articles
Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and age-related macular degeneration: insights from two observational studies
Provisionally accepted
- 1福建中医药大学附属人民医院, 福建省福州市, China
- 2Eye Institute of Integrated Chinese and Western Medicine, Fujian University of traditional Chinese Medicine, Fuzhou, Fuzhou, China
- 3Shanghai Eye Disease Prevention and Treatment Center, Shanghai, Shanghai, China
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**Abstract:** This study investigates the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and age-related macular degeneration (AMD). A cross-sectional analysis of 4,017 participants (≥40 years) from the U.S. NHANES 2005–2008 dataset and external validation with 96 Chinese patients (PHFT Hospital, 2021–2025) were conducted. NHHR was calculated as (Total Cholesterol − HDL-C)/HDL-C. AMD was diagnosed via retinal photography. Logistic regression, stratified analysis, RCS curves, and ROC/AUC were used. Results showed significantly lower NHHR in AMD groups (both studies, P<0.01). In fully adjusted models, each one-unit NHHR increase reduced AMD risk by 33.1% (NHANES, highest tertile) and 76.8% (PHFT). RCS curves confirmed a negative correlation (P<0.05). Subgroup analyses revealed consistent associations across populations. Conclusion: NHHR may be a reliable independent indicator for AMD risk. Large-scale prospective studies are needed to validate these findings.
Keywords: NHHR, age-related macular degeneration, National Health and NutritionExamination Surveys, Lipid Metabolism, Cross-sectional analysis, Retrospective study
Received: 14 Oct 2025; Accepted: 19 Nov 2025.
Copyright: © 2025 Chen, Li, Jiao, Liu, Wu, Qiu, Zou and Liu. 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: Guanghui Liu, latiny@gmail.com
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