The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and suicidal ideation in adults: a population-based study in the United States

Abstract

Background The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) (NHHR) serves as a reliable lipid indicator associated with atherogenic characteristics. Studies have indicated a potential connection between suicidality and lipid metabolism. This research aims to investigate any possible association between the NHHR and the emergence of suicidal ideation within the confines of the study. Methods This study examined the association between NHHR levels and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES), conducted in the United States spanning 2005 and 2016. Calculation of the NHHR corresponds to the proportion of HDL-C to Non-HDL-C. The Patient Health Questionnaire-9’s ninth question was implemented for assessing suicidal ideation. Using subgroup analysis, smooth curve fitting, and multivariate logistic regression analysis, the research was conducted. Results Encompassing a cohort of 29,288 participants, the analysis identified that 3.82% of individuals reported suicidal ideation. After using multivariable logistic regression and thorough adjustments, elevated NHHR levels were significantly and positively associated with a heightened likelihood of suicidal ideation, according to the findings (odds ratio [OR] = 1.06; 95% confidence interval [CI]: 1.02–1.11; P = 0.0048). Despite extensive adjustment for various confounding factors, this relationship remained consistent. An inverted U-shaped curve was utilized to illustrate the link between NHHR and suicidal ideation among nonsmokers; the curve’s inflection point was situated at 7.80. Subgroup analysis and interaction tests (all P for interaction > 0.05) demonstrated that there was no significant influence of the following variables on this positive relationship: age, sex, race, body mass index, education level, married status, hypertension, diabetes, and smoking status. Conclusion Significantly higher NHHR levels were associated with an elevated likelihood of suicidal ideation. Based on these results, it is probable that NHHR may serve as a predictive indicator of suicidal ideation, emphasizing its potential utility in risk assessment and preventive strategies.

The relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and hyperuricaemia

“…This study revealed that compared with the individual measurements of non-HDL-c and HDL-c, the NHHR has superior diagnostic predictive value for the risk of developing HUA. Additionally, further RCS analysis indicated a nonlinear, inverse U-shaped association between the NHHR and the risk of developing HUA, consistent with previous studies on the connection between the NHHR and suicidal ideation [ 31 ]. This study extends the use of lipid ratios and fills the gaps in previous research, suggesting that the NHHR might be a promising marker for predicting HUA.…”

Prevalence and related factors of first-time suicide attempts in the past 14 days in Chinese adult patients with first-episode drug-naïve major depressive disorder

“…MDD patients with higher TC levels were more likely to undergo FSA in the past 14 days. In recent years, there have been an increasing number of studies on biomarkers associated with suicidal behavior, and lipid levels have emerged as a potential factor in this regard (52)(53)(54)(55). Metabolic syndrome is common in patients with MDD, and it is associated with suicide attempts (56).…”

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with type 2 diabetes mellitus: recent findings from NHANES 2007–2018

“…In this study, NHHR was utilized as the exposure variable. As described in previous literature [ 14 , 21 ], NHHR represents the ratio of non-HDL-C to HDL-C. Non- HDL-C is determined by subtracting HDL-C from the total cholesterol (TC) level.…”

“…Drawing from prior studies [ 14 , 21 ], we incorporated variables potentially impacting the link between NHHR and T2DM. Included covariates encompass age, sex, race, PIR, marital status, BMI, waist circumference, education level, smoking, alcohol consumption, creatinine, moderate recreational activities, blood urea nitrogen, serum uric acid, dietary cholesterol on the first day, stroke, and hypertension.…”

“…The ratio of non-HDL-C to HDL-C (NHHR) is increasingly regarded as an innovative and comprehensive marker for evaluating atherosclerosis lipid composition [ 14 ]. Research has shown that NHHR not only effectively assesses atherosclerosis severity but also closely correlates with its relevance and predictive value for various diseases.…”