# Non-HDL/HDL-verhouding voorspelt sterfte bij cardiorenale syndroom — NHANES

*geplaatst 2026-10-16 · Cholesterol · Medicine · doi 10.1097/MD.0000000000051101 · https://hartvaat.nl/2026/10/09/non-hdl-hdl-verhouding-voorspelt-sterfte-bij-cardiorenale-syndroom-nhanes/*

In een cohort van 1408 Amerikaanse volwassenen met cardiorenale syndroom (CVD en chronische nierinsufficiëntie) onderzochten onderzoekers de prognostische waarde van de non-HDL/HDL-verhouding (NHHR). Tijdens een mediane follow-up van 75 maanden werd een L-vormige associatie gevonden met alle-oorzaak- en cardiovasculaire sterfte: onder de drempelwaarde van 3,09 daalde het sterfterisico met 36% (HR 0,64), terwijl het boven deze waarde slechts licht daalde. Deze bevindingen suggereren dat de NHHR een eenvoudige en onafhankelijke prognostische marker kan zijn om patiënten met een verhoogd sterfterisico in deze kwetsbare groep te identificeren.

## English: Association between the non-HDL-c to HDL-c ratio and mortality risk in cardiorenal syndrome: A population-based study from 1999 to 2018 NHANES.

This population-based cohort study of 1,408 US adults with cardiorenal syndrome (concurrent cardiovascular and chronic kidney disease) evaluated the non-HDL/HDL cholesterol ratio (NHHR) as a prognostic biomarker. Over a median 75-month follow-up, an L-shaped association with all-cause and cardiovascular mortality was observed, with a 36% lower hazard ratio (HR 0.64) for all-cause mortality below an NHHR threshold of 3.09. The findings indicate that NHHR may serve as a practical, independent marker to identify high-risk cardiorenal patients for closer monitoring or intensified risk factor management.

## Abstract (original, from the publication)

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel biomarker that integrates atherogenic and atheroprotective lipoprotein profiles. We aimed to examine the prognostic significance of NHHR in patients with cardiorenal syndrome (CRS), a vulnerable population with significantly increased risk of mortality. We analyzed data from 1408 US adults with CRS, defined as the coexistence of cardiovascular disease (CVD) and chronic kidney disease, from the 1999 to 2018 National Health and Nutrition Examination Survey. The primary and secondary outcomes were all-cause and CVD mortality, respectively. The relationships between NHHR and mortality outcomes were analyzed using Cox proportional hazards regression analysis, restricted cubic spline modeling, and subgroup analyses. Over a median follow-up of 75 months, 802 deaths (53.63%) occurred, including 373 from CVD. We identified a significant nonlinear, L-shaped association between NHHR and both all-cause and CVD mortality, with inflection points at NHHR = 3.09 and 3.16, respectively. Piecewise regression analysis indicated that the multivariate-adjusted hazard ratios (95% confidence intervals) for all-cause and CVD mortality were 0.64 (0.53-0.76) and 0.60 (0.45-0.79), respectively, below the inflection points, and 0.83 (0.73-0.95) and 0.91 (0.78-1.05), respectively, above the inflection points. Results remained consistent across subgroups stratified by age, sex, body mass index, diabetes status, physical activity, estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio. NHHR demonstrates an independent, L-shaped relationship with all-cause and CVD mortality in a nationally representative cohort of adults with CRS. This simple ratio may serve as a valuable prognostic biomarker to identify high-risk CRS patients.

Auteurs: Qiaoyun Ge, Hao Jiang, Hu Lu, Wei Zhou, Xuechen Zhang

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Bron: Medicine, https://doi.org/10.1097/MD.0000000000051101. Bijgewerkt 2026-10-10T01:02:09Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.