HDL-C/LDL-C and Risk of Cerebral White Matter Hyperintensities: A Cross-Sectional Study

Background and Purpose: At present, there is still a lack of metabolic indices to predict white matter hyperintensities. This study aimed to explore the correlations of the high-density lipoprotein cholesterol (HDL-C)/low-density lipoprotein cholesterol (LDL-C) ratio with the risk of white matter hyperintensities. Methods: Hospitalized patients who underwent inpatient treatment or physical examination due to various chronic diseases between January 18, 2018, and March 20, 2023, were enrolled. Fazekas scores were used to assess the severity of white matter hyperintensities. Logistic regression analysis was used to adjust for possible confounders. Results: Of the 1162 enrolled patients, 770 (66.27%) patients were classified as having no or mild WMHs, and 392 (33.73%) were classified as having moderate or severe WMHs. After adjusting for covariates, the logistic regression analysis indicated that the ratio of HDL-C to LDL-C was related to the severity of WMHs (Model 1, OR = 0.23, 95% CI: 0.07-0.73, P=0.012; Model 2, OR = 2.03, 95% CI: 1.12-3.67, P=0.019). Conclusion: Our findings suggest that the ratio of HDL-C to LDL-C is related to the severity of WMHs and that a high ratio of HDL-C to LDL-C is a protective factor against WMHs. This suggests that the ratio of HDL-C to LDL-C could be used as a metabolic prediction index of WMH severity.