{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T03:43:40Z","timestamp":1768535020617,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Chronic Diseases and Translational Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The ratio of high\u2010density lipoprotein cholesterol (HDL\u2010C) to low\u2010density lipoprotein cholesterol (LDL\u2010C) predicts cardiovascular disease (CVD) endpoints, yet its prognostic validity in high\u2010risk populations and for type 2 diabetes mellitus (T2DM)\u2010related adverse events remains unestablished.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 32,609 people aged 35\u201375 years in Fujian Province, China, who were at high risk for CVD. The primary endpoint was all\u2010cause mortality during follow\u2010up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the HDL\u2010C\/LDL\u2010C ratio and the endpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>On the basis of the restricted RCS curve, the participants were classified as having a low (&lt;\u20090.3), middle (0.3\u20130.5), or high (&gt;\u20090.5) HDL\u2010C\/LDL\u2010C ratio. Multivariate Cox regression analyses revealed that the risk of all\u2010cause mortality (HR\u2009=\u20091.48, 95% CI 1.14\u20131.93, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01 for low; HR\u2009=\u20091.30, 95% CI 1.06\u20131.58, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 for high) was increased in the low and high groups. Participants without T2DM who were at high risk for CVD had similar prognoses (HR\u2009=\u20091.65, 95% CI 1.19\u20132.28, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01 for low; HR\u2009=\u20091.35, 95% CI 1.05\u20131.74, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01 for high). However, this association was not found in participants with T2DM who were at high risk for CVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HDL\u2010C\/LDL\u2010C can be used to predict the prognosis of individuals at high risk for CVD, and maintaining HDL\u2010C\/LDL\u2010C ratios between 0.3 and 0.5 may be the most helpful range for this population. Furthermore, maintaining this ratio range holds clinical significance for cohorts without T2DM, although further exploration is needed in this T2DM cohort.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cdt3.70013","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T11:19:01Z","timestamp":1753096741000},"page":"213-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["HDL\u2010C\/LDL\u2010C Ratio and All\u2010Cause Mortality in Populations at High CVD Risk: A Prospective Observational Cohort Study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7594-4696","authenticated-orcid":false,"given":"Biting","family":"Lin","sequence":"first","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine Fuzhou Fujian China"},{"name":"Department of Cardiology Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, 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