AbstractHeart failure (HF) is closely linked to platelet counts and lipid levels. The platelet-to-high-density lipoprotein cholesterol ratio (PHR) is a novel marker for assessing cardiovascular disease. This study investigates the relationship between PHR and HF. We analyzed data from ten consecutive NHANES survey cycles (1998–2018), focusing on self-reported HF diagnoses with complete PHR information.

摘要心力衰竭（HF）与血小板计数和血脂水平密切相关。血小板与高密度脂蛋白胆固醇比率（PHR）是评估心血管疾病的新型标志物。这项研究调查了PHR和HF之间的关系。我们分析了连续十个NHANES调查周期（1998-2018）的数据，重点是具有完整PHR信息的自我报告的HF诊断。

PHR was calculated as platelet count divided by HDL-C (mmol/L). A multivariate logistic regression model was used to examine the association between PHR and HF, with subgroup analyses to identify potential influencing factors. RCS curve plotting and threshold effect analysis were employed to describe non-linear relationships.

。使用多变量逻辑回归模型来检查PHR和HF之间的关联，并进行亚组分析以确定潜在的影响因素。RCS曲线绘制和阈值效应分析用于描述非线性关系。

The study included 31,410 adults aged 20–85 years. The multivariate logistic regression indicated that individuals with the highest PHR had 82% increased likelihood of HF compared to those with the lowest PHR (OR = 1.82; 95% CI, 1.37–2.40, P < 0.001). Subgroup analyses revealed no significant interactions between PHR and specific subgroups (P > 0.05), except in those with alcohol consumption (yes/no) and BMI subgroups (P < 0.05).

这项研究包括31410名20-85岁的成年人。多因素logistic回归分析表明，与PHR最低的个体相比，PHR最高的个体患HF的可能性增加了82%（OR＝1.82）；95%可信区间，1.37-2.40，P<0.001）。亚组分析显示，除饮酒（是/否）和BMI亚组（P<0.05）外，PHR与特定亚组之间没有显着的相互作用（P<0.05）。

The association between PHR and HF was non-linear, with a notable turning point at 281.53. Elevated PHR is significantly associated with HF, suggesting it may serve as an effective clinical indicator for monitoring HF risk. Larger prospective cohort studies are needed to validate these findings and further assess the clinical utility of PHR in cardiovascular risk assessment.

PHR和HF之间的关联是非线性的，在281.53处有一个明显的转折点。PHR升高与HF显着相关，表明它可以作为监测HF风险的有效临床指标。需要更大规模的前瞻性队列研究来验证这些发现，并进一步评估PHR在心血管风险评估中的临床应用。

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IntroductionHeart Failure (HF) is characterized by abnormal changes in the structure and function of the heart, leading to increased intracardiac pressure or inadequate cardiac output during rest or exertion. These changes result in a complex clinical syndrome manifesting as dyspnea, edema, fatigue, and elevated jugular venous pressure, representing the end stage of various cardiovascular diseases1.

引言心力衰竭（HF）的特征是心脏结构和功能的异常变化，导致静息或劳累期间心内压升高或心输出量不足。这些变化导致复杂的临床综合征，表现为呼吸困难，水肿，疲劳和颈静脉压升高，代表各种心血管疾病的末期1。

In Europe, the current prevalence of HF in the general population is approximately 0.3%, and about 5% among adults2. In recent years, thanks to better management of cardiovascular diseases, the incidence of HF appears to be declining. However, with the increasing global aging population, the overall prevalence of HF is indeed rising3,4.

在欧洲，目前普通人群中HF的患病率约为0.3%，成年人中约为5%2。近年来，由于更好地管理心血管疾病，HF的发病率似乎正在下降。然而，随着全球老龄化人口的增加，HF的总体患病率确实在上升3,4。

The incidence of HF is approximately 1% among people under 55 years of age, but about 10% in the population around 70 years old5,6. Therefore, the risk and management of HF have become significant public health concerns.Platelets, which are fragments of megakaryocytes in the bone marrow, are enucleated small cellular fragments that play a key role in blood coagulation and hemostasis.

55岁以下人群的HF发病率约为1%，而70岁左右人群的HF发病率约为10%5,6。因此，HF的风险和管理已成为重大的公共卫生问题。血小板是骨髓中巨核细胞的片段，是去核的小细胞片段，在凝血和止血中起关键作用。

Currently, numerous studies have shown an association between platelets and heart failure. Some studies have indicated that heart failure patients exhibit abnormal activation of platelets and thrombin, which increases with the severity of heart failure7,8. A clinical study also pointed out that increased levels of circulating platelets exacerbate oxidative stress in heart failure patients9, which may be a reason for the progression of HF.

目前，许多研究表明血小板与心力衰竭之间存在关联。一些研究表明，心力衰竭患者表现出血小板和凝血酶的异常激活，这随着心力衰竭的严重程度而增加7,8。一项临床研究还指出，循环血小板水平升高会加剧心力衰竭患者的氧化应激9，这可能是HF进展的原因。

Moreover, while the association between lipoproteins and HF has been widely explored, there is still certain controversy. Some studies suggest that high-density lipoprotein cholesterol (HDL-C), with its anti-inflammatory, antiox.

此外，虽然脂蛋白与HF之间的关联已被广泛探索，但仍存在一定的争议。一些研究表明，高密度脂蛋白胆固醇（HDL-C）具有抗炎、抗氧化作用。

Data availability

数据可用性

Data described in the manuscript, code book, and analytic code will be made publicly and freely available without restriction at [https://www.cdc.gov/nchs/nhanes].

手稿、代码手册和分析代码中描述的数据将在不受限制的情况下公开和免费提供[https://www.cdc.gov/nchs/nhanes]。

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Download referencesAcknowledgementsWe would like to express our thanks to the personnel at the National Center for Health Statistics of the Centers for Disease Control for their work in developing, gathering, and organizing the NHANES data, as well as for establishing the publicly accessible database.FundingHeilongjiang Provincial Traditional Chinese Medicine Research Project (ZHY2022-113).Author informationAuthor notesBoyu Wang, Jiameng Wang and Changxing Liu contributed equally to this work.Authors and AffiliationsHeilongjiang University of Chinese Medicine, Harbin, 150040, ChinaBoyu Wang, Jiameng Wang, Changxing Liu & Xinying HuAuthorsBoyu WangView author publicationsYou can also search for this author in.

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PubMed Google ScholarContributionsWBY: Conceptualization, Methodology, Formal Analysis, Writing - Original Draft, Writing - Review & Editing. WJM: Formal Analysis, Validation, Investigation, Data curation. LCX: Methodology, Formal Analysis, Investigation. HXY: Supervision, Project Management, Writing - Review Editing.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献：概念化，方法论，形式分析，写作-原稿，写作-评论和编辑。WJM：正式分析，验证，调查，数据管理。LCX：方法论，形式分析，调查。HXY：监督，项目管理，写作-评论编辑。对应作者对应。

Xinying Hu.Ethics declarations

胡新英。道德宣言

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道德批准和同意参与

This study involving human participants were reviewed and approved by the Research Ethics Review Board of the NCHS, and all participants provided written informed consent during the survey.

这项涉及人类参与者的研究得到了NCHS研究伦理审查委员会的审查和批准，所有参与者在调查期间均提供了书面知情同意书。

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不适用。

Competing interests

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The authors declare no competing interests.

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Additional informationPublisher’s noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Electronic supplementary materialBelow is the link to the electronic supplementary material.Supplementary Material 1Supplementary Material 2Supplementary Material 3Supplementary Material 4Supplementary Material 5Rights and permissions.

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根据本许可证，您无权共享源自本文或其部分的改编材料。本文中的图像或其他第三方材料包含在文章的知识共享许可证中，除非该材料的信用额度中另有说明。如果材料未包含在文章的知识共享许可中，并且您的预期用途不受法律法规的许可或超出许可用途，则您需要直接获得版权所有者的许可。

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Reprints and permissionsAbout this articleCite this articleWang, B., Wang, J., Liu, C. et al. The potential of platelet to high-density lipoprotein cholesterol ratio (PHR) as a novel biomarker for heart failure.

转载和许可本文引用本文Wang，B.，Wang，J.，Liu，C。等人。血小板与高密度脂蛋白胆固醇比（PHR）作为心力衰竭新型生物标志物的潜力。

Sci Rep 14, 23283 (2024). https://doi.org/10.1038/s41598-024-75453-7Download citationReceived: 01 August 2024Accepted: 04 October 2024Published: 07 October 2024DOI: https://doi.org/10.1038/s41598-024-75453-7Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

。https://doi.org/10.1038/s41598-024-75453-7Download引文接收日期：2024年8月1日接受日期：2024年10月4日发布日期：2024年10月7日OI：https://doi.org/10.1038/s41598-024-75453-7Share。复制到剪贴板。

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KeywordsPlatelet-to-high-density lipoprotein cholesterol ratioHeart failureCross-sectional studyNHANESRisk

关键词血小板与高密度脂蛋白胆固醇比率心脏衰竭横断面研究风险

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