# Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cognitive impairment in patients with cerebral small vessel disease

**Authors:** Chao Wang, Zhenjie Teng, Mingyue Fan, Xiaohua Xie, Weihong Chen, Yueshan Zhao, Jiayu Zhang, Yanhong Dong, Jing Xu, Wei Jin, Peiyuan Lv

PMC · DOI: 10.3389/fneur.2025.1703244 · Frontiers in Neurology · 2026-01-05

## TL;DR

This study finds that a cholesterol ratio is linked to cognitive impairment in patients with brain small vessel disease.

## Contribution

The study identifies NHHR as an independent predictor of cognitive impairment in cerebral small vessel disease patients.

## Key findings

- NHHR was significantly higher in patients with cognitive impairment compared to those with normal cognition.
- Each unit increase in NHHR was associated with an 184% increased risk of cognitive impairment.
- The NHHR-based model showed moderate accuracy in predicting cognitive impairment.

## Abstract

This study aims to determine the potential association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cognitive impairment in patients with cerebral small vessel disease (CSVD). By collecting data from patients with CSVD in hospital, we will analyze the relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cognitive function in these patients.

This study enrolled 263 CSVD patients, Cognitive function was assessed using Mini-Mental State Examination (MMSE) within 2 weeks, with cognitive impairment defined by education stratified thresholds. Statistical analysis of the baseline was performed. The association between NHHR and cognitive function was evaluated using binary logistic regression. And Receiver Operating Characteristic Curve (ROC) analysis were performed to evaluate the predictive value.

Patients were classified into cognitive impairment group (n = 138) and normal cognition group (n = 125). NHHR in the cognitive impairment group was significantly higher than that in the normal group (3.58 ± 0.98 vs. 2.90 ± 0.92, P < 0.001). There was a dose–response relationship between NHHR quartiles and the incidence of cognitive impairment (trend test P < 0.001). Multivariate regression analysis showed that for each unit increase in NHHR, the risk of cognitive impairment increases by 184% (OR = 2.84, 95% confidence interval 1.97 to 4.12; p < 0.001). The predictive model constructed by combining age and education level has an area under the ROC curve (AUC) of 0.703.

NHHR serves as an independent predictor of cognitive impairment in CSVD patients. The NHHR-derived model exhibits moderate discriminative accuracy, indicating potential clinical applicability.

## Full-text entities

- **Diseases:** cognitive impairment (MESH:D003072), CSVD (MESH:D059345)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

45 references — full list in the complete paper: https://tomesphere.com/paper/PMC12812587/full.md

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Source: https://tomesphere.com/paper/PMC12812587