Associations of the hs-CRP/HDL-C ratio with cardiovascular metabolic multimorbidity: a large cross-sectional study

Globally, cardiovascular metabolic multimorbidity (CMM) is an import contributor to both illness burden and mortality. Identifying reliable biomarkers to facilitate early prevention is of significant clinical importance. 8665 subjects were eligible in the survey. Multiple logistic regression models were employed to assess the association between the hs-CRP/HDL-C ratio and the likelihood of developing CMM. An analysis of mediation was employed to assess the effect of glycated hemoglobin A1c (HbA1c) on the relationship between the two. The CMM group had greater levels of white blood cells, platelets, total cholesterol, uric acid, HbA1c, hs-CRP, and hs-CRP/HDL-C ratio, alongside reduced levels of HDL-C (P < 0.001). After adjusting covariates, each one-unit increase in hs-CRP/HDL-C was related to a 138.3% increase in the risk of CMM (OR = 2.383, 95% CI: 1.744-3.256, P < 0.001). Participants in the highest quartile group were at the highest risk of CMM events as compared to those in the lowest quartile group (OR = 3.414, 95% CI: 2.830-4.119, P < 0.001). Approximately 54.79% of the relationship between hs-CRP/HDL-C and CMM is mediated through HbA1c. The greater hs-CRP/HDL-C levels are independent risk factors for CMM, and HbA1c partially mediated the association. These findings suggest that improving inflammation, lipid, and glucose levels may help reduce the risk of CMM.