Associations of the Hs-CRP/HDL-C ratio with stroke among US adults: Evidence from NHANES 2015–2018

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-20 DOI:10.1016/j.jstrokecerebrovasdis.2025.108353

Qinghui Feng , Chanchan Miao , Xuejun Gao

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引用次数: 0

Abstract

Background

The high-sensitivity C-reactive protein (Hs-CRP)-to-high-density lipoprotein cholesterol (HDL-C) ratio, which integrates insights into inflammation and lipid metabolism, serves as a comprehensive indicator. The association between this ratio and stroke prevalence is endeavored to be explored in this research.

Methods

Drawing on information gathered during the 2015-2018 cycles of the NHANES, the association between the Hs-CRP/HDL-C ratio and stroke was examined through multivariate logistic regression. Additionally, subgroup analysis, interaction test, and restricted cubic spline (RCS) were carried out. Multiple machine learning methods were used to identify the key factors affecting stroke and combined with Shap interpretable models to determine the degree of influence of the key factors. Finally, the results of the logistic regression analysis are used to construct a predictive model, which is represented using a nomogram.

Results

This research sample comprised 8,064 participants, yielding a stroke prevalence of 4.04%. A positive correlation was shown between the Hs-CRP/HDL-C ratio and stroke (OR: 1.17, 95% CI: 1.02, 1.35). Interaction tests demonstrated that younger participants were more sensitive to higher Hs-CRP/HDL-C ratios, with a significant interaction in stroke. The RCS analysis indicated a nonlinear association between the exposure variable and to outcome variable. The AUC > 0.8 for a random forest model and an XGBoost model demonstrated their strong predictive value. Ultimately, the generated predictive model is a visual nomogram with an AUC of 0.799.

Conclusion

The results of the study showed a positive correlation between Hs-CRP/HDL and the prevalence of stroke, with higher Hs-CRP/HDL levels associated with a higher likelihood of stroke. As a stroke prediction model incorporating Hs-CRP/HDL, the nomogram may play a significant role in the early identification of high-risk populations.

查看原文本刊更多论文

美国成人Hs-CRP/HDL-C比值与中风的关系：来自NHANES 2015-2018的证据

背景：高敏c反应蛋白（Hs-CRP）与高密度脂蛋白胆固醇（HDL-C）比值是一种综合炎症和脂质代谢的指标。本研究试图探讨这一比例与脑卒中患病率之间的关系。方法：利用NHANES 2015-2018周期收集的信息，通过多变量logistic回归分析Hs-CRP/HDL-C比值与脑卒中的关系。此外，还进行了亚组分析、相互作用试验和限制三次样条（RCS）。采用多种机器学习方法识别影响笔画的关键因素，并结合Shap可解释模型确定关键因素的影响程度。最后，利用逻辑回归分析的结果构建了一个预测模型，该模型用模态图表示。结果：本研究样本包括8064名参与者，卒中患病率为4.04%。Hs-CRP/HDL-C比值与卒中呈正相关（OR: 1.17, 95% CI: 1.02, 1.35）。相互作用测试表明，年轻的参与者对较高的Hs-CRP/HDL-C比率更敏感，与中风有显著的相互作用。RCS分析显示暴露变量和结果变量之间存在非线性关联。随机森林模型和XGBoost模型的AUC为0.8，具有较强的预测价值。最终，生成的预测模型是一个AUC为0.799的视觉nomogram。结论：研究结果显示Hs-CRP/HDL与卒中患病率呈正相关，Hs-CRP/HDL水平越高，卒中患病率越高。作为一种结合Hs-CRP/HDL的脑卒中预测模型，nomogram在高危人群的早期识别中具有重要意义。

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

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.