# Evaluating the Link Between High‐Density Lipoprotein‐Related Inflammatory Indices and Gallstone Disease in U.S. Adults

## TL;DR

This study finds that higher HDL-related inflammatory indices are linked to a greater risk of gallstone disease in U.S. adults, especially in certain subgroups.

## Contribution

The study introduces HDL-related inflammatory indices as low-cost, accessible tools for gallstone disease risk assessment.

## Key findings

- Higher quartiles of LHR, MHR, NHR, and PHR were associated with increased odds of gallstone disease.
- The association was stronger in females, nonsmokers, and individuals without diabetes or hypertension.
- HDL-related inflammatory indices offer a practical and cost-effective method for early risk stratification.

## Abstract

Gallstone disease is a condition affecting the digestive system, strongly linked to inflammation and lipid metabolism. Inflammatory markers derived from high‐density lipoprotein (HDL), incorporating both immune cells and HDL‐C, play a crucial role in assessing inflammatory responses. This study aims to explore the relationship between these HDL‐related inflammatory indices and gallstone disease.

The study population was derived from the National Health and Nutrition Examination Survey (NHANES) 2017–2020 and 2021–2023 datasets. To assess the association between HDL‐related inflammatory indices and gallstone disease, weighted multivariable logistic regression and restricted cubic spline (RCS) analysis were utilized. Additionally, subgroup analysis was conducted to confirm the consistency of the results across different subpopulations.

Among the 16,871 participants included in the study, 11.0% were diagnosed with gallstone disease. When compared to the lowest quartile, those in the highest quartile of lymphocyte‐to‐HDL cholesterol ratio (LHR), monocyte‐to‐HDL cholesterol ratio (MHR), neutrophil‐to‐HDL cholesterol ratio (NHR), and platelet‐to‐HDL cholesterol ratio (PHR) faced an elevated risk of gallstone disease by 58.6% (OR = 1.586, 95% CI: 1.143–2.2), 67.6% (OR = 1.676, 95% CI: 1.275–2.204), 68.7% (OR = 1.687, 95% CI: 1.244–2.287), and 42.7% (OR = 1.427, 95% CI: 1.101–1.849), respectively. The correlation between HDL‐related inflammatory indices and gallstone disease was more pronounced in females, individuals without diabetes or hypertension, nonsmokers, and those who consumed alcohol.

This research identified a positive correlation between HDL‐related inflammatory indices and gallstone disease in a nationally representative sample. These indices can be derived from routine blood tests at no additional cost, making them practical and cost‐effective tools for early risk stratification and potential large‐scale screening.