Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018

Abstract This study aims to investigate the association between the platelet-to-high-density lipoprotein cholesterol ratio (PHR) and diabetes/prediabetes in US adults. Data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. The PHR was calculate...

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Main Authors: Pengfei Chen, Meilin Zhu, Ming Guo, Dazhuo Shi, Zhuhong Chen, Jianpeng Du
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-81637-y
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author Pengfei Chen
Meilin Zhu
Ming Guo
Dazhuo Shi
Zhuhong Chen
Jianpeng Du
author_facet Pengfei Chen
Meilin Zhu
Ming Guo
Dazhuo Shi
Zhuhong Chen
Jianpeng Du
author_sort Pengfei Chen
collection DOAJ
description Abstract This study aims to investigate the association between the platelet-to-high-density lipoprotein cholesterol ratio (PHR) and diabetes/prediabetes in US adults. Data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. The PHR was calculated by dividing platelet count by HDL-C concentration. Diabetes and prediabetes were classified according to established clinical criteria. Multivariate logistic regression analyses were employed to estimate odds ratios (ORs) and 95% CIs. We used a two-stage logistic regression model with restricted cubic splines (RCS) to evaluate potential non-linear relationships and to identify inflection points. The discriminative ability of the model was evaluated using receiver operating characteristic (ROC) curves, with the area under the curve (AUC) used to measure model performance. Sensitivity and specificity at the optimal threshold were also reported. Furthermore, subgroup and interaction analyses were conducted to determine variations across different population groups. The study included 20,229 eligible participants, with a mean age of 47.84 years, and 51.80% being female. Among the participants, 14.29% were diagnosed with diabetes, and 44.36% with prediabetes. A positive association was observed between PHR and diabetes/prediabetes. After adjusting for model 3, the OR for the combined outcome of diabetes and prediabetes associated with a per-unit increase in PHR was 1.17 (95% CI: 1.05–1.30). Participants in the highest PHR quartile had an OR of 2.55 (95% CI: 1.52–4.28) compared to those in the lowest quartile. Two-stage regression analysis identified a breakpoint at PHR = 4.55, with a positive association observed when PHR was below this value (OR = 1.33, 95% CI: 1.03–1.70). ROC analysis demonstrated good discriminatory ability of the model, with an AUC of 0.824 (95% CI: 0.803–0.845), sensitivity of 83.2%, and specificity of 66.5%. Stratified analyses revealed significant associations between PHR and diabetes/prediabetes across most demographic groups, with interactions observed for sex, alcohol consumption, and BMI, suggesting these factors may modify the association. This study suggests that an elevated PHR may be associated with a higher likelihood of diabetes and prediabetes. Consequently, PHR could serve as a valuable marker for estimating the association of diabetes and prediabetes development.
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spelling doaj-art-89bae8424d044de7ab9a0b20dbe353e82024-12-08T12:26:44ZengNature PortfolioScientific Reports2045-23222024-12-0114111210.1038/s41598-024-81637-yPlatelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018Pengfei Chen0Meilin Zhu1Ming Guo2Dazhuo Shi3Zhuhong Chen4Jianpeng Du5Xiyuan Hospital, China Academy of Chinese Medical SciencesXiyuan Hospital, China Academy of Chinese Medical SciencesXiyuan Hospital, China Academy of Chinese Medical SciencesXiyuan Hospital, China Academy of Chinese Medical SciencesXiyuan Hospital, China Academy of Chinese Medical SciencesXiyuan Hospital, China Academy of Chinese Medical SciencesAbstract This study aims to investigate the association between the platelet-to-high-density lipoprotein cholesterol ratio (PHR) and diabetes/prediabetes in US adults. Data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. The PHR was calculated by dividing platelet count by HDL-C concentration. Diabetes and prediabetes were classified according to established clinical criteria. Multivariate logistic regression analyses were employed to estimate odds ratios (ORs) and 95% CIs. We used a two-stage logistic regression model with restricted cubic splines (RCS) to evaluate potential non-linear relationships and to identify inflection points. The discriminative ability of the model was evaluated using receiver operating characteristic (ROC) curves, with the area under the curve (AUC) used to measure model performance. Sensitivity and specificity at the optimal threshold were also reported. Furthermore, subgroup and interaction analyses were conducted to determine variations across different population groups. The study included 20,229 eligible participants, with a mean age of 47.84 years, and 51.80% being female. Among the participants, 14.29% were diagnosed with diabetes, and 44.36% with prediabetes. A positive association was observed between PHR and diabetes/prediabetes. After adjusting for model 3, the OR for the combined outcome of diabetes and prediabetes associated with a per-unit increase in PHR was 1.17 (95% CI: 1.05–1.30). Participants in the highest PHR quartile had an OR of 2.55 (95% CI: 1.52–4.28) compared to those in the lowest quartile. Two-stage regression analysis identified a breakpoint at PHR = 4.55, with a positive association observed when PHR was below this value (OR = 1.33, 95% CI: 1.03–1.70). ROC analysis demonstrated good discriminatory ability of the model, with an AUC of 0.824 (95% CI: 0.803–0.845), sensitivity of 83.2%, and specificity of 66.5%. Stratified analyses revealed significant associations between PHR and diabetes/prediabetes across most demographic groups, with interactions observed for sex, alcohol consumption, and BMI, suggesting these factors may modify the association. This study suggests that an elevated PHR may be associated with a higher likelihood of diabetes and prediabetes. Consequently, PHR could serve as a valuable marker for estimating the association of diabetes and prediabetes development.https://doi.org/10.1038/s41598-024-81637-yDiabetesPrediabetesPlateletHigh-density lipoproteinPHRNHANES
spellingShingle Pengfei Chen
Meilin Zhu
Ming Guo
Dazhuo Shi
Zhuhong Chen
Jianpeng Du
Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
Scientific Reports
Diabetes
Prediabetes
Platelet
High-density lipoprotein
PHR
NHANES
title Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
title_full Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
title_fullStr Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
title_full_unstemmed Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
title_short Platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in NHANES 2005 to 2018
title_sort platelet to high density lipoprotein cholesterol ratio is associated with diabetes and prediabetes in nhanes 2005 to 2018
topic Diabetes
Prediabetes
Platelet
High-density lipoprotein
PHR
NHANES
url https://doi.org/10.1038/s41598-024-81637-y
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