Association between Non-High-Density Lipoprotein to High-Density Lipoprotein Cholesterol Ratio (NHHR) and α-1 Acid Glycoprotein Levels in Adult Women (NHANES 2015-2020)

Background Currently, an important lipid marker for assessing the risk of chronic inflammation and metabolic disorders is considered to be the non-HDL cholesterol to HDL cholesterol ratio (NHHR). This study aimed to examine the association between NHHR and the inflammatory biomarker alpha-1 acid glycoprotein (AGP) and assess the potential of NHHR as an inflammatory marker for chronic inflammation. Methods This cross-sectional analysis used serum samples from adult women participating in the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2020. The NHHR was treated as the independent variable, with AGP as the dependent variable. Multivariate linear regression was used to analyze the association between NHHR and AGP. Nonlinear associations were examined using spline regression and threshold effect analysis. Furthermore, subgroup and sensitivity evaluations were performed to evaluate the reliability of the findings. Results The analysis included 3,027 adult women, revealing a significant positive correlation between NHHR and AGP levels. Each incremental increase in NHHR was correlated with a 0.605 mg/dL increase in square-root-transformed AGP levels, as found in the fully adjusted model. Nonlinear analysis revealed a threshold effect at a critical value of 3.167, suggesting that the relationship between the NHHR and AGP was more pronounced below this threshold. Further subgrouping and sensitivity analyses confirmed that the connection between NHHR and AGP was consistent across most of the population. Conclusions For the first time, this research reveals a direct relationship between NHHR and AGP, and also shows that a novel biomarker that can assess chronic inflammation is NHHR. These findings underscore the critical importance of regular monitoring of NHHR and AGP levels to enhance health management, particularly in the realm of chronic disease prevention and intervention strategies.