Abstract
BACKGROUND: Inflammatory responses and lipid metabolism make vital impacts on the development of gallstones. This study investigated the relationship between gallstone disease (GSD) and the neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) in American patients with gallstones. METHODS: The data analyzed were sourced from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) and comprised of participants with complete data on GSD and NHR. The relationship between NHR and GSD was evaluated with weighted multivariable logistic regression analysis. Additionally, subset analyses, interaction tests, smoothed curve fitting, and threshold effect analyses were conducted. RESULTS: Among the 7894 participants analyzed in this study, the prevalence of GSD was 10.98%, and the average NHR value was 3.41 ± 0.06. The fully adjusted multivariable logistic regression results demonstrated an obvious positive association between NHR and the likelihood of GSD (OR = 1.09, 95% CI: 1.01, 1.16; P = 0.0197). Consistency of this association was confirmed through subset analyses and interaction tests across various subgroups, including those categorized by smoking status and asthma. Furthermore, smoothed curve fitting and threshold effect analyses revealed a nonlinear relationship with a threshold of 2.86. CONCLUSIONS: NHR shows a positive relationship to an increased likelihood of GSD among Americans. It can act as an easy and cost-effective tool for the early detection and management of individuals at risk for GSD.