Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and the risk of early-onset post-stroke depression: a prospective study

Mingzhu Deng¹Kangping Song²Gao Li-Chen³Zhen Wang²Wei Zhao²Wei Xu²Tieqiao Feng²Fangyi Li^2*

• ¹Department of neurology, Brain Hospital of Hunan Province, Changsha, China
• ²Department of neurology, Changsha Central Hospital, Changsha, China
• ³Department of Pharmacy, School of Pharmacy, Phase I Clinical Trial Centre, Changsha Central Hospital, Changsha, China

Background: The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a recently developed composite indicator of atherogenic lipids. Nevertheless, few studies concern the relationship between NHHR and early-onset post-stroke depression (PSD). Methods: After two weeks of acute ischemic stroke (AIS), early-onset PSD was identified. The Hamilton Depression Scale-17 items (HAMD-17) was used to assess the severity of depression. Patients with HAMD-17 scores ≥7 were divided into an early-onset PSD group. Spearman rank correlation analysis was employed to evaluate the associations between NHHR and HAMD scores across all patients. Logistic regression analysis was conducted to investigate the associations between the NHHR and early-onset PSD. Sensitivity analyses were performed to test the robustness of our findings. Receiver operating characteristic curve (ROC) analysis was used to determine the predictive value of the NHHR for early-onset PSD. Results: Among the 846 patients who were enrolled prospectively, a total of 283 (33.45%) patients were diagnosed with early-onset PSD. The NHHR showed a positive correlation with the HAMD-17 scores (r=0.498, P<0.001). A binary logistic regression model demonstrated that the NHHR (odds ratio [OR], 1.796; 95% confidence interval [CI] 1.452-1.996, P<0.001) was an independent factor for early-onset PSD. The NHHR for early-onset PSD had an area under the curve (AUC) value of 0.798. Conclusions: The findings suggest that the NHHR may be an independent risk factor for early-onset PSD, providing valuable insights for prevention and prognostic management in affected patients.