Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Lipids in Health and Disease Pub Date : 2025-02-04 DOI:10.1186/s12944-025-02459-z

Yuchen Liu, Houxin Fu, Yue Wang, Yi Zhong, Rongting Zhang, Jingxuan Sun, Tianquan Yang, Yong Han, Yongjun Xiang, Bin Yuan, Ruxuan Zhou, Min Chen, Hangzhou Wang

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Abstract

Background: The relationship between lipid profiles and intracranial hemorrhage (ICH) has garnered increasing attention. The ratio of low-density lipoprotein to high-density lipoprotein (LHR) is one of the key lipid profile indices. However, studies investigating the association between LHR and the prognosis of critically ill ICH patients remain limited.

Methods: Data for this study were obtained from the MIMIC-IV 3.1 database. Initially, the association between LHR and short-term outcomes in ICH patients, including ICU mortality, in-hospital mortality, and 28-day mortality, was analyzed using Cox regression in both continuous and categorical models. Additionally, restricted cubic spline (RCS), subgroup, and sensitivity analyses were conducted to further validate our findings.

Results: The study included 873 critically ill ICH patients, among whom 20.3% (177/873) succumbed within 28 days. Higher LHR was independently associated with lower short-term mortality in ICH patients (28-day mortality: HR = 0.82, 95% CI: 0.68 ~ 0.99, P = 0.039; In-hospital mortality: HR = 0.7, 95% CI: 0.55 ~ 0.89, P = 0.004; ICU mortality: HR = 0.66, 95% CI: 0.48 ~ 0.92, P = 0.015). The RCS revealed a linear relationship between LHR and short-term all-cause mortality. Subgroup analyses demonstrated consistent results. The optimal cutoff value for LHR was determined to be 1.21. Comparing the mortality risk between the low-LHR and high-LHR groups, the high-LHR group exhibited higher survival rates (28-day mortality, P = 0.0052; In-hospital mortality, P = 0.019; ICU mortality, P = 0.044). Furthermore, higher LHR was also correlated with lower disease severity scores (SAPS-II: r = -0.158, P < 0.001, OASIS: r = -0.117, P = 0.006).

Conclusion: LHR was negatively associated with short-term mortality in critically ill ICH patients. It may aid clinicians in identifying high-risk individuals and providing timely interventions.

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危重脑出血患者低密度脂蛋白与高密度脂蛋白比值与预后的关系：来自MIMIC-IV数据库的回顾性队列研究

背景：脂质谱与颅内出血（ICH）之间的关系越来越受到关注。低密度脂蛋白与高密度脂蛋白（LHR）之比是重要的血脂指标之一。然而，关于LHR与脑出血危重症患者预后之间关系的研究仍然有限。方法：本研究数据来自MIMIC-IV 3.1数据库。首先，在连续和分类模型中使用Cox回归分析了LHR与脑出血患者短期结局（包括ICU死亡率、住院死亡率和28天死亡率）之间的关系。此外，限制性三次样条（RCS）、亚组和敏感性分析进一步验证了我们的发现。结果：纳入脑出血危重患者873例，其中20.3%（177/873）在28天内死亡。高LHR与脑出血患者较低的短期死亡率独立相关(28天死亡率：HR = 0.82, 95% CI: 0.68 ~ 0.99, P = 0.039；住院死亡率:HR = 0.7, 95% CI: 0.55 ~ 0.89, P = 0.004;ICU死亡率:HR = 0.66, 95% CI: 0.48 ~ 0.92, P = 0.015)。RCS显示LHR与短期全因死亡率之间存在线性关系。亚组分析结果一致。LHR的最佳临界值为1.21。比较低lhr组和高lhr组的死亡风险，高lhr组生存率更高(28天死亡率，P = 0.0052；住院死亡率，P = 0.019；ICU死亡率，P = 0.044)。LHR越高，疾病严重程度评分越低（sap - ii: r = -0.158， P）。结论：LHR与ICH危重患者短期死亡率呈负相关。它可以帮助临床医生识别高危人群，并提供及时的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.