Correlation between high density lipoprotein-related ratio index and in-stent restenosis in diabetic patients after percutaneous coronary intervention

doi:10.12092/j.issn.1009-2501.2026.06.008

Abstract

Abstract:

AIM: To explore the relationship between neutrophil/high density lipoprotein ratio (NHR), lymphocyte/high density lipoprotein ratio (LHR), monocyte/high density lipoprotein ratio (MHR) and platelet/high density lipoprotein ratio (PHR) and in-stent restenosis in diabetic patients after percutaneous coronary intervention. METHODS: From November 2021 to November 2024, 110 diabetic patients underwent percutaneous coronary intervention and re-examined coronary angiography were included. They were divided into non-restenosis group (62 cases) and restenosis group (48 cases). The correlation and predictive value of NHR, LHR, MHR and PHR for restenosis were evaluated by univariate/multivariate regression analysis, restricted cubic spline curves, correlation analysis, ROC analysis and decision curve analysis. Nomogram was established. RESULTS: Compared with the non-restenosis group, the levels of low-density lipoprotein cholesterol, lipoprotein (a), NHR, MHR and PHR in the restenosis group increased significantly (P<0.05). Logistic regression analysis showed that NHR, MHR and PHR were independently correlated with the restenosis in diabetic patients after percutaneous coronary intervention, and the levels of NHR, MHR and PHR were positively correlated with the occurrence of restenosis. There was no significant correlation between LHR and restenosis. ROC curve showed that MHR and PHR levels have a good predictive effect on the occurrence of restenosis in diabetic patients after percutaneous coronary intervention. CONCLUSION: NHR, MHR and PHR are significantly correlated with restenosis in diabetic patients after percutaneous coronary intervention, and they are effective indicators for predicting restenosis.

Key words: high density lipoprotein related ratio index, in-stent restenosis, coronary artery disease, diabetes

CLC Number:

Yao WU, Xuan ZHOU, Xiaoyan WANG, Daidi WANG, Zhen SUN. Correlation between high density lipoprotein-related ratio index and in-stent restenosis in diabetic patients after percutaneous coronary intervention[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(6): 789-797.

Figures/Tables 8

References 24

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Item	No restenosis group	Restenosis group	χ²/Z/t	P
Number of cases	62	48	-	-
Male	48 (77.4%)	36 (75%)	0.09	0.77
Age	61.56±11.36	62.19±12.61	0.28	0.78
History of hypertension	40 (64.5%)	35 (72.9%)	0.90	0.35
Smoking history	16 (25.8%)	13 (27.1%)	0.02	0.88
Duration of diabetes mellitus	9 (5, 11.25)	9.5 (6.25, 14)	1.12	0.26
BMI （kg/m²）	25.34±5.14	25.52±5.52	1.15	0.25
Total cholesterol (mmol/L)	3.88±1.24	4.05±1.29	0.71	0.48
Triglycerides (mmol/L)	1.22 (0.94, 1.56)	1.29 (0.97, 1.82)	1.01	0.31
High-density lipoprotein cholesterol (mmol/L)	1.08 (0.91, 1.29)	1.08 (0.91, 1.25)	0.29	0.78
Low-density lipoprotein cholesterol (mmol/L)	2.36±0.89	2.84±1.07	2.57	0.012
Lipoprotein(a) [Lp(a)]	96.65 (50.30, 248.25)	202.35 (106.15, 344.85)	3.08	0.003
White blood cell count (×10?/L)	7.06 (5.65, 7.97)	6.54 (5.50, 7.76)	0.73	0.46
Neutrophil count (×10?/L)	4.54 (3.60, 5.19)	4.97 (3.89, 6.21)	1.88	0.06
Lymphocyte count (×10?/L)	1.69±0.61	1.86±0.58	1.42	0.16
Monocyte count (×10?/L)	0.41 (0.36, 0.52)	0.50 (0.35, 0.60)	1.66	0.10
Platelet count (×10?/L)	203 (178.25, 254)	221 (198.25, 273.5)	1.83	0.07
Glomerular filtration rate (GFR)	96.50 (87.75, 108.00)	99.00 (88.50, 111.50)	0.69	0.49
Creatinine (μmol/L)	89.10±26.50	90.79±31.03	0.18	0.76
Blood urea nitrogen (mmol/L)	7.35±1.87	7.14±1.80	0.89	0.56
Alanine aminotransferase (U/L)	22.50 (13.75, 36.63)	18.65 (12.23, 32.58)	1.35	0.18
Aspartate aminotransferase (U/L)	24.00 (18.50, 32.25)	21.11 (16.10, 29.50)	1.50	0.13
D-dimer	0.25 (0.18, 0.36)	0.27 (0.16, 0.37)	0.26	0.80
Glycated hemoglobin (HbA1c)	6.50 (6.00, 7.30)	6.55 (6.00, 7.95)	0.15	0.88
Fasting blood glucose (mmol/L)	5.69 (4.37, 7.63)	7.62 (5.30, 10.39)	2.86	0.004
Ejection fraction (%)	58 (53, 61.25)	58.50 (54.25, 62.00)	0.47	0.64
NHR	3.91 (2.88, 5.59)	4.70 (3.71, 6.03)	2.10	0.036
LHR	1.49 (1.11, 2.03)	1.60 (1.19, 2.15)	1.31	0.19
MHR	0.40 (0.29, 0.49)	0.46 (0.36, 0.56)	2.43	0.015
PHR	200.15 (165.26, 229.70)	216.68 (179.50, 256.80)	2.46	0.014

Item	No restenosis group	Restenosis group	χ²/Z/t	P
Number of cases	62	48	-	-
Male	48 (77.4%)	36 (75%)	0.09	0.77
Age	61.56±11.36	62.19±12.61	0.28	0.78
History of hypertension	40 (64.5%)	35 (72.9%)	0.90	0.35
Smoking history	16 (25.8%)	13 (27.1%)	0.02	0.88
Duration of diabetes mellitus	9 (5, 11.25)	9.5 (6.25, 14)	1.12	0.26
BMI （kg/m²）	25.34±5.14	25.52±5.52	1.15	0.25
Total cholesterol (mmol/L)	3.88±1.24	4.05±1.29	0.71	0.48
Triglycerides (mmol/L)	1.22 (0.94, 1.56)	1.29 (0.97, 1.82)	1.01	0.31
High-density lipoprotein cholesterol (mmol/L)	1.08 (0.91, 1.29)	1.08 (0.91, 1.25)	0.29	0.78
Low-density lipoprotein cholesterol (mmol/L)	2.36±0.89	2.84±1.07	2.57	0.012
Lipoprotein(a) [Lp(a)]	96.65 (50.30, 248.25)	202.35 (106.15, 344.85)	3.08	0.003
White blood cell count (×10?/L)	7.06 (5.65, 7.97)	6.54 (5.50, 7.76)	0.73	0.46
Neutrophil count (×10?/L)	4.54 (3.60, 5.19)	4.97 (3.89, 6.21)	1.88	0.06
Lymphocyte count (×10?/L)	1.69±0.61	1.86±0.58	1.42	0.16
Monocyte count (×10?/L)	0.41 (0.36, 0.52)	0.50 (0.35, 0.60)	1.66	0.10
Platelet count (×10?/L)	203 (178.25, 254)	221 (198.25, 273.5)	1.83	0.07
Glomerular filtration rate (GFR)	96.50 (87.75, 108.00)	99.00 (88.50, 111.50)	0.69	0.49
Creatinine (μmol/L)	89.10±26.50	90.79±31.03	0.18	0.76
Blood urea nitrogen (mmol/L)	7.35±1.87	7.14±1.80	0.89	0.56
Alanine aminotransferase (U/L)	22.50 (13.75, 36.63)	18.65 (12.23, 32.58)	1.35	0.18
Aspartate aminotransferase (U/L)	24.00 (18.50, 32.25)	21.11 (16.10, 29.50)	1.50	0.13
D-dimer	0.25 (0.18, 0.36)	0.27 (0.16, 0.37)	0.26	0.80
Glycated hemoglobin (HbA1c)	6.50 (6.00, 7.30)	6.55 (6.00, 7.95)	0.15	0.88
Fasting blood glucose (mmol/L)	5.69 (4.37, 7.63)	7.62 (5.30, 10.39)	2.86	0.004
Ejection fraction (%)	58 (53, 61.25)	58.50 (54.25, 62.00)	0.47	0.64
NHR	3.91 (2.88, 5.59)	4.70 (3.71, 6.03)	2.10	0.036
LHR	1.49 (1.11, 2.03)	1.60 (1.19, 2.15)	1.31	0.19
MHR	0.40 (0.29, 0.49)	0.46 (0.36, 0.56)	2.43	0.015
PHR	200.15 (165.26, 229.70)	216.68 (179.50, 256.80)	2.46	0.014

Influencing factors	OR (95% CI)	P
Low-density lipoprotein cholesterol	1.68 (1.03-2.56)	0.016
Lipoprotein(a) [Lp(a)]	1.02 (1.00-1.04)	0.012
Fasting blood glucose	1.14 (1.01-1.28)	0.03
NHR	1.25 (1.01-1.56)	0.02
LHR	1.79 (0.97-3.33)	0.06
MHR	1.33 (1.03-1.71)	0.03
PHR	1.12 (1.04-1.21)	0.003

Influencing factors	OR (95% CI)	P
Low-density lipoprotein cholesterol	1.68 (1.03-2.56)	0.016
Lipoprotein(a) [Lp(a)]	1.02 (1.00-1.04)	0.012
Fasting blood glucose	1.14 (1.01-1.28)	0.03
NHR	1.25 (1.01-1.56)	0.02
LHR	1.79 (0.97-3.33)	0.06
MHR	1.33 (1.03-1.71)	0.03
PHR	1.12 (1.04-1.21)	0.003

	Model 1		Model 2		Model 3
Influencing factors	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
NHR	1.27 (1.01-1.59)	0.04	1.27 (1.01-1.60)	0.04	1.26 (0.97-1.64)	0.077
LHR	1.70 (0.90-3.22)	0.10	1.64 (0.86-3.12)	0.13	1.31 (0.67-2.56)	0.43
MHR	1.42 (1.07-1.87)	0.014	1.41 (1.07-1.87)	0.016	1.48 (1.08-2.03)	0.014
PHR	1.14 (1.05-1.24)	0.002	1.14 (1.04-1.24)	0.004	1.10 (1.01-1.2)	0.035