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. 2025 Dec;57(1):2522317.
doi: 10.1080/07853890.2025.2522317. Epub 2025 Jun 20.

Association of hs-CRP/HDL, AIP and NHHR with chronic obstructive pulmonary disease: a cross-sectional NHANES study

Jiangyue Qin  1   2 , Bi Ran  1 , Yanqiu Wu  1 , Dan Xu  1 , Lian Liu  1 , Diandian Li  1 , Lei Chen  1 , Fuqiang Wen  1
Affiliations

Association of hs-CRP/HDL, AIP and NHHR with chronic obstructive pulmonary disease: a cross-sectional NHANES study

Jiangyue Qin et al. Ann Med. 2025 Dec.

Abstract

Background: Inflammation and dyslipidemia have been proven to be associated with chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the relationships between hS-CRP/HDL, AIP, NHHR and COPD.

Materials and methods: The data was obtained from the National Health and Nutrition Examination Survey. Participants were classified into two groups based on self-reported COPD diagnosis. The hS-CRP/HDL, AIP and NHHR were evaluated for their potential correlation with COPD using the univariate and multivariable logistic regression models. Subsequently, restricted cubic spline (RCS) model was used to further explore the associations between hS-CRP/HDL, AIP, NHHR and COPD. Finally, subgroup analysis and interaction tests were applied.

Results: 10419 participants were included, and 1168 of them were self-reported COPD. lg(hs-CRP/HDL) and AIP were statistically significantly elevated in the COPD group compared to those in non-COPD group, while NHHR was not significantly different between the two groups. In a multivariate logistic regression model that adjusted for all relevant factors, there was a 64% increase in the prevalence of COPD for every unit rise in hs-CRP/HDL (OR 1.64 [CI 1.31-2.05]). A significant positive association between hs-CRP/HDL and COPD was observed in most subgroups. However, the AIP and NHHR were not associated with COPD after adjusted for all relevant factors. RCS model supported a positive linear association of hs-CRP/HDL with COPD , and no linear or non-linear association of AIP, or NHHR and COPD.

Conclusions: The study suggests elevated hs-CRP/HDL may related to COPD, suggesting its potential as diagnostic marker for COPD.

Keywords: AIP; COPD; NHANES; NHHR; cross-sectional study; hsCRP/HDL.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow chart of patient selection from the NHANES 2013–2018.
Figure 2.
Figure 2.
The dose–response relationships between the lipid parameters and COPD. (a)lg(hs-CRP/HDL), (b) AIP, and (c) NHHR.
Figure 3.
Figure 3.
Subgroup analysis of the relationship between lipid-related indicators and COPD at different levels. (a)lg(hs-CRP/HDL), (b) AIP, and (c) NHHR.
See this image and copyright information in PMC

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