The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and preserved ratio impaired spirometry: NHANES 2007-2012.

Background: Preserved ratio impaired spirometry (PRISm) refers to a form of lung function deterioration, and previous studies have established the association with Chronic Obstructive Pulmonary Disease (COPD). Research has also shown the association between COPD and lipid metabolism disturbances. Despite these findings, the association between lipid metabolism markers and PRISm remains poorly understood.

Methods: This analysis was conducted on the 2007-2012 data from the National Health and Nutrition Examination Survey (NHANES), including a total of 9,431 participants. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio (NHHR) was calculated based on lipid profiles, and PRISm patients were classified according to pulmonary function tests. To explore the association between NHHR and PRISm, multivariable logistic regression analysis was used.

Results: A strong linear association was observed between NHHR and PRISm. In Adjusted Model 2, the weighted multivariable logistic regression analysis revealed that each unit increase in NHHR increased the chance of developing PRISm by 8% (OR:1.08, 95%CI:1.01-1.16, P = 0.039).Participants within the highest NHHR tertile demonstrated a 1.36-fold increased likelihood of presenting with PRISm compared to those in the lowest NHHR tertile (OR:1.36, 95% CI: 1.01-1.83, P = 0.048). Additionally, weighted Restricted Cubic Spline affirmed a linear association between NHHR and PRISm (P for non-linearity = 0.637), while clear non-linear associations were found between NHHR and FEV% predicted (P for non-linearity = 0.010) and FEV/FVC (P for non-linearity = 0.023). Subgroup analysis and interaction tests revealed a significant interaction effect among different waist circumference categories (P for interaction = 0.020). Notably, in individuals without abdominal obesity, NHHR showed a strong positive association with PRISm (OR = 1.23, 95% CI: 1.07-1.42, P = 0.01).

Conclusion: These results indicate that NHHR is positively associated with PRISm and is significantly associated with the decline in lung function. This study offers distinctive perspectives that may contribute to the avoidance and management of early-stage pulmonary dysfunction.