Relationships between the platelet/high-density lipoprotein cholesterol ratio and anemia among adults in the USA: An NHANES analysis

Abstract

Aims The platelet/high-density lipoprotein cholesterol ratio (PHR) has been proposed as a viable biomarker of disease, but its relationship with the prevalence of anemia has yet to be established. This study was thus devised to examine the relationships between PHR and anemia. Methods Data from the 2007–2020 NHENES cycles were used to conduct this study, including any non-pregnant subjects 18 + years of age for whom anemia and PHR-related data were provided. Weighted multivariate logistic regression and subgroup analyses were conducted to clarify the degree to which there is an independent relationship between PHR and anemia. Results This study included 6048 individuals of whom 7.33% had anemia with a mean PHR of 18.69 ± 0.18. Anemia prevalence increased with higher PHR tertiles. Using a fully adjusted model, subjects in the highest PHR tertile presented with a 59% (OR: 1.53, 95%CI: 1.06–2.38, P = 0.02) higher risk of anemia as compared to those in the lowest tertile. In two-piece-wise regression analyses, a PHR breakpoint of 14.53 was computed, with a positive relationship being more apparent at PHR values at or above 14.53 (OR = 1.05, 95%CI: 1.03–1.07, P < 0.0001). Below this threshold, this correlation was no longer evident (P = 0.07). Subgroup and interaction analyses confirmed that PHR and anemia prevalence were consistently related across population settings. Conclusions A positive correlation was noted between higher PHR and anemia, suggesting that this index can be employed in clinical settings as an indicator for assessing the prevalence of anemia.