Triglyceride/High-Density Lipoprotein Cholesterol Ratio is Associated with the Mortality of COVID-19: A Retrospective Study in China

Overview

Journal Int J Gen Med

Publisher Dove Medical Press

Specialty General Medicine

Date 2022 Feb 9

PMID 35136352

Authors

Fei Peng

Si Lei

Quan Zhang

Yanjun Zhong

Shangjie Wu

Affiliations

Soon will be listed here.

Abstract

Background: Triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-c) is crucial when researching metabolic and vascular diseases, and its involvement in COVID-19 was sparsely elaborated on. The purpose of the study was to explore the inflammatory associations between the TG/HDL-c ratio and COVID-19 prognosis.

Methods: A total of 262 COVID-19 patients consisting of 244 survivors and 18 non-survivors were retrospectively investigated. The clinical features and baseline hematological parameters were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to explore the role of TG/HDL-c in predicting the mortality of COVID-19, the Spearman's rank correlation coefficients were used to measure the correlation between TG/HDL-c and inflammatory indicators, and the Kaplan-Meier (KM) curve was used to estimate the survival of COVID-19 patients with high and low TG/HDL-c ratio. Logistic regression analyses were performed to investigate the role of TG/HDL-c ratio on mortality of COVID-19 with no underlying diseases.

Results: Compared with the survivors, the non-survivors of COVID-19 had significantly higher levels of white blood cells (4.7 vs 13.0 × 10/L; < 0.001), neutrophils (3.0 vs 11.6 × 10/L; < 0.001), C-reactive proteins (15.7 vs 76.7 mg/L; < 0.001) and TG/HDL-c ratio (1.4 vs 2.5; = 0.001). The ROC curve [area under the curve (AUC), 0.731; 95% confidence interval (), 0.609-0.853; = 0.001] suggested that the TG/HDL-c ratio could predict the mortality of COVID-19. The TG/HDL-c ratio was positively correlated with white blood cells ( = 0.255, < 0.001), neutrophils ( = 0.243, < 0.001) and C-reactive proteins ( = 0.170, < 0.006). Patients with high TG/HDL-c ratio showed a worse survival compared with those with low TG/HDL-c ratio (Log rank = 0.003). Moreover, TG/HDL-c ratio was an independent factor in predicting the mortality of COVID-19 patients with no underlying diseases.

Conclusion: Our study demonstrated that TG/HDL-c ratio might potentially be a predictive marker for mortality in COVID-19 patients.

Citing Articles

Stadler J, Habisch H, Pruller F, Mangge H, Barnthaler T, Kargl J Antioxidants (Basel). 2023; 12(11).

PMID: 38001862 PMC: 10669705. DOI: 10.3390/antiox12112009.

Inflammation and Venous Thromboembolism in Hospitalized Patients with COVID-19.

Liontos A, Biros D, Matzaras R, Tsarapatsani K, Kolios N, Zarachi A Diagnostics (Basel). 2023; 13(22).

PMID: 37998613 PMC: 10670045. DOI: 10.3390/diagnostics13223477.

HDL-C/LDL-C and Risk of Cerebral White Matter Hyperintensities: A Cross-Sectional Study.

Wei C, Chen Y, Yu X, Yang T, Li J, Chen X Int J Gen Med. 2023; 16:5175-5182.

PMID: 37954651 PMC: 10638942. DOI: 10.2147/IJGM.S439150.

Biomarkers of glucose homeostasis as mediators of the relationship of body mass index and waist circumference with COVID-19 outcomes among postmenopausal women: The Women's Health Initiative.

Beydoun H, Ng T, Beydoun M, Shadyab A, Jung S, Costanian C Clin Nutr. 2023; 42(9):1690-1700.

PMID: 37523800 PMC: 10529929. DOI: 10.1016/j.clnu.2023.07.004.

Association of triglyceride/high-density lipoprotein cholesterol ratio with severe complications of COVID-19.

Chang Y, Jeon J, Song T, Kim J Heliyon. 2023; 9(6):e17428.

PMID: 37366523 PMC: 10275776. DOI: 10.1016/j.heliyon.2023.e17428.

References

Bellia A, Andreadi A, Giudice L, De Taddeo S, Maiorino A, DIppolito I . Atherogenic Dyslipidemia on Admission Is Associated With Poorer Outcome in People With and Without Diabetes Hospitalized for COVID-19. Diabetes Care. 2021; 44(9):2149-2157. DOI: 10.2337/dc20-2838. View

Alcantara-Alonso E, Molinar-Ramos F, Gonzalez-Lopez J, Alcantara-Alonso V, Munoz-Perez M, Lozano-Nuevo J . High triglyceride to HDL-cholesterol ratio as a biochemical marker of severe outcomes in COVID-19 patients. Clin Nutr ESPEN. 2021; 44:437-444. PMC: 8103772. DOI: 10.1016/j.clnesp.2021.04.020. View

Lu B, Moser A, Shigenaga J, Grunfeld C, Feingold K . The acute phase response stimulates the expression of angiopoietin like protein 4. Biochem Biophys Res Commun. 2010; 391(4):1737-41. DOI: 10.1016/j.bbrc.2009.12.145. View

Wang X, Dong Y, Qi X, Huang C, Hou L . Cholesterol levels and risk of hemorrhagic stroke: a systematic review and meta-analysis. Stroke. 2013; 44(7):1833-9. DOI: 10.1161/STROKEAHA.113.001326. View

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506. PMC: 7159299. DOI: 10.1016/S0140-6736(20)30183-5. View

Baker J, Ayenew W, Quick H, Hullsiek K, Tracy R, Henry K . High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection. J Infect Dis. 2009; 201(2):285-92. PMC: 2798007. DOI: 10.1086/649560. View

Wu Z, McGoogan J . Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242. DOI: 10.1001/jama.2020.2648. View

Tanaka S, de Tymowski C, Assadi M, Zappella N, Jean-Baptiste S, Robert T . Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: Results from the ApoCOVID study. PLoS One. 2020; 15(9):e0239573. PMC: 7514065. DOI: 10.1371/journal.pone.0239573. View

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H . Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020; 130(5):2620-2629. PMC: 7190990. DOI: 10.1172/JCI137244. View

10.

Rezaei A, Neshat S, Heshmat-Ghahdarijani K . Alterations of Lipid Profile in COVID-19: A Narrative Review. Curr Probl Cardiol. 2021; 47(3):100907. PMC: 8161768. DOI: 10.1016/j.cpcardiol.2021.100907. View

11.

Ding X, Zhang J, Liu L, Yuan X, Zang X, Lu F . High-density lipoprotein cholesterol as a factor affecting virus clearance in covid-19 patients. Respir Med. 2020; 175:106218. PMC: 7647897. DOI: 10.1016/j.rmed.2020.106218. View

12.

Ma X, Li X, Wan B, Miao Z . Triglyceride regulate ACE2 level through MTHFD1. J Biosci. 2021; 46. PMC: 8192271. View

13.

Le Lay S, Simard G, Martinez M, Andriantsitohaina R . Oxidative stress and metabolic pathologies: from an adipocentric point of view. Oxid Med Cell Longev. 2014; 2014:908539. PMC: 4131099. DOI: 10.1155/2014/908539. View

14.

Rose H, Hoy J, Woolley I, Tchoua U, Bukrinsky M, Dart A . HIV infection and high density lipoprotein metabolism. Atherosclerosis. 2007; 199(1):79-86. PMC: 2518204. DOI: 10.1016/j.atherosclerosis.2007.10.018. View

15.

Levy B, Kohli P, Gotlinger K, Haworth O, Hong S, Kazani S . Protectin D1 is generated in asthma and dampens airway inflammation and hyperresponsiveness. J Immunol. 2006; 178(1):496-502. PMC: 3005704. DOI: 10.4049/jimmunol.178.1.496. View

16.

Prasad M, Sara J, Widmer R, Lennon R, Lerman L, Lerman A . Triglyceride and Triglyceride/ HDL (High Density Lipoprotein) Ratio Predict Major Adverse Cardiovascular Outcomes in Women With Non-Obstructive Coronary Artery Disease. J Am Heart Assoc. 2019; 8(9):e009442. PMC: 6512120. DOI: 10.1161/JAHA.118.009442. View

17.

Meilhac O, Tanaka S, Couret D . High-Density Lipoproteins Are Bug Scavengers. Biomolecules. 2020; 10(4). PMC: 7226336. DOI: 10.3390/biom10040598. View

18.

Talasaz A, Sadeghipour P, Aghakouchakzadeh M, Dreyfus I, Kakavand H, Ariannejad H . Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review. J Am Coll Cardiol. 2021; 78(16):1635-1654. PMC: 8504484. DOI: 10.1016/j.jacc.2021.08.021. View

19.

Zavaroni I, Bonora E, Pagliara M, DallAglio E, Luchetti L, Buonanno G . Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med. 1989; 320(11):702-6. DOI: 10.1056/NEJM198903163201105. View

20.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. PMC: 7270627. DOI: 10.1016/S0140-6736(20)30566-3. View