Data-driven analysis of the relationship between the HbA1c/HDL-C ratio and coronary artery calcification: a cross-sectional study

• Published in: Scientific reports Vol. 15; no. 1; p. 31865
• Main Authors: Chen, Chen, Li, Mingkang, Yan, Gaoliang, Zhang, Wenkang, Tang, Chengchun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.08.2025; Nature Publishing Group
• Subjects: 692/4019; 692/53/2421; 692/699/317/821; Asymptomatic; Atherosclerosis; Biomarkers; Blood pressure; Body mass index; Calcification; Calcification (ectopic); Cardiovascular disease; Cardiovascular diseases; Cholesterol; Chronic illnesses; Coronary artery; Coronary vessels; Data collection; Diabetes; Diabetes mellitus; Glucose; Glucose metabolism; Hemoglobin; High density lipoprotein; Humanities and Social Sciences; Hyperglycemia; Hypertension; Lipid metabolism; Lipids; Lipoproteins; Metabolic disorders; Mortality; multidisciplinary; Oxidative stress; Pathogenesis; Plasma; Science; Science (multidisciplinary); Software; Veins & arteries; Coronary artery calcification; HbA1c/HDL-C ratio; Cardiovascular disease
• ISSN: 2045-2322
• DOI: 10.1038/s41598-025-07469-6

Coronary artery calcification (CAC) is a well-established cardiovascular disease (CVD) pathogenesis marker closely associated with dysregulated glucose and lipid metabolism. The present study investigated the relationship between the glycated hemoglobin A1c (HbA1c)/high-density lipoprotein cholesterol (HDL-C) ratio and CAC. A total of 1608 eligible participants were enrolled in the study. The HbA1c/HDL-C ratio was calculated by dividing HbA1c by HDL-C. LASSO regression, logistic regression, and receiver operating characteristic curve (ROC) analysis were performed to examine the relationship between the HbA1c/HDL-C ratio and CAC. The nomogram incorporating the HbA1c/HDL-C ratio was further established by multivariate logistic regression and evaluated. The HbA1c/HDL-C ratios in the CAC group were significantly higher than the control group [4.73 (4.01, 5.56) vs. 4.34 (3.67, 5.05), p < 0.001]. Subjects with an elevated HbA1c/HDL-C ratio (≥ 4.99) exhibited a higher prevalence of CAC [146/486 (30.04) vs. 200/1122 (17.83), p < 0.001]. Furthermore, an elevated HbA1c/HDL-C ratio was an independent effect factor for CAC [odds ratio, 1.135; 95% confidence interval (CI), 1.008–1.279; p = 0.037]. The area under the ROC curve of the HbA1c/HDL-C ratio was 0.630 (95% CI 0.596–0.663), and the model incorporating age, gender, body mass index, hypertension, diabetes mellitus, and the HbA1c/HDL-C ratio was 0.718 (95% CI 0.686–0.751). The constructed nomogram based on this model demonstrated favorable discrimination and clinical utility. In conclusion, the HbA1c/HDL-C ratio is closely associated with CAC and is an independent factor for CAC in asymptomatic adults without CVD.