Association between neutrophil to high-density lipoprotein cholesterol ratio and abdominal aortic calcification in US adults: A cross-sectional study

Inflammation is involved in abdominal aortic calcification (AAC) pathogenesis. The neutrophil to high-density lipoprotein cholesterol ratio (NHR) is a novel index of inflammation assessment. However, little has been established about the relationship between NHR and AAC. This study aimed to investigate the connection between the NHR and AAC. Using data from the National Health and Nutrition Examination Survey conducted in 2013 to 2014, we analyzed the relationship between AAC score, severe AAC, and NHR through multiple linear and logistic regression models, along with restricted cubic spline (RCS) regression to assess the dose–response relationship. Subgroup analyses were conducted to find effect changes. Sensitivity analyses were performed to ensure study robustness. In fully adjusted model, elevated NHR positively associated with AAC score (β = 0.071, 95% CI: 0.006, 0.136) and severe AAC (OR = 1.094, 95% CI: 1.015, 1.176). Moreover, participants in the highest NHR quartile had an AAC score that was 0.637 units higher (β = 0.637, 95% CI: 0.335, 0.939) and an 69.8% higher risk of severe AAC (OR = 1.698, 95% CI: 1.152, 2.514). RCS showed the relationship between NHR and AAC score was nonlinear. However, the nonlinear relationship between the NHR and severe AAC was not significant. Subgroup analyses revealed no significant interactions regarding the correlation across stratification variable. Three sensitivity analyses demonstrated that the models in this research still yielded similar results. This research establishes a positive association between NHR and AAC prevalence. Our findings imply that NHR has the potential to serve as a biomarker of AAC.