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The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of urinary stones in US adults: a cross-sectional NHANES study

  • Nephrology – Original Paper
  • Published:
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Abstract

Background

This study examines the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and urinary stones in American adults.

Methods

We conducted a cross-sectional study utilizing the 2007–2018 National Health and Nutrition Examination Survey (NHANES) data set. The prevalence of urinary stones was determined based on patient-reported experiences of renal colic. We converted NHHR to natural logarithm (ln-NHHR) to align it better with our statistical analyses. Our analysis methods included weighted multivariate logistic regression, generalized additive model (GAM), and application of smoothed curves to better elucidate the association between ln-NHHR and the prevalence of urinary stones. In addition, we conducted subgroup analyses and employed multiple imputation for sensitivity analyses.

Results

This study involved a total of 30,903 participants, with a 9.97% prevalence of urinary stones and reported colic experience. Elevated ln-NHHR levels were linked with a higher likelihood of urinary stones (OR = 1.20, 95% CI 1.07–1.35). Smooth curve fitting revealed an inverted U-shaped relationship, pinpointing a significant increase in urinary stone risk at ln-NHHR levels below 1.43 (OR = 1.40, 95% CI 1.19–1.64, p < 0.001). Notably, this correlation was stronger among Non-Hispanic Whites and those married or living with a partner. Multiple imputation analyses strengthened the confidence in our results.

Conclusions

Our findings suggest a reverse U-shaped association between urinary stone occurrence and NHHR level, with a positive association at ln-NHHR < 1.43. This correlation was more pronounced in the Non-Hispanic White population and among those married or living with a partner.

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Fig. 1
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Data availability

The survey data are publicly available on the internet for data users and researchers throughout the world (www.cdc.gov/nchs/nhanes/).

Abbreviations

NHHR:

Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio

NHANES:

National health and nutrition examination survey

NAFLD:

Non-alcoholic fatty liver disease

NIH:

National institutes of health

CDC:

Centers for disease control and prevention

PIR:

Income to poverty ratio

BMI:

Body mass index

HDL-C:

High-density lipoprotein cholesterol

MI:

Multiple imputation

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Acknowledgements

We would like to thank all participants in this study.

Funding

This work did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Author notes

  1. Heng Liu and Yu Zhou contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People’s Republic of China

    Heng Liu, Yu Zhou, Mingchu **, Haidong Hao, Yutang Yuan & Hongtao Jia

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Contributions

HL and YZ designed the research. MJ, HH, and YY collected, analyzed the data and drafted the manuscript. HJ revised the manuscript. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Hongtao Jia.

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The portions of this study involving human participants, human materials, or human data were conducted in accordance with the Declaration of Helsinki and were approved by the NCHS Ethics Review Board. The patients/participants provided their written informed consent to participate in this study.

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Liu, H., Zhou, Y., **, M. et al. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of urinary stones in US adults: a cross-sectional NHANES study. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04140-3

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