The CCR/WC ratio as a predictor of dyslipidemia and Its mediating effect on hypertension in middle-aged and older adults

BACKGROUND: The creatinine-to-cystatin C/waist circumference ratio (CCR/WC) combines renal function and adiposity metrics, yet its predictive value for dyslipidemia remains undefined. This research examined CCR/WC’s capacity as a dyslipidemia biomarker and its mediating role in hypertension pathogenesis. METHODS: Utilizing the China Health and Retirement Longitudinal Study (CHARLS) cohort, we employed multivariable-adjusted logistic regression and Cox proportional hazards models to quantify CCR/WC-dyslipidemia associations. Nonlinear patterns were assessed using restricted cubic splines, and mediation analysis was conducted to evaluate the role of dyslipidemia in the relationship between CCR/WC and hypertension. RESULTS: Among 7,117 participants, elevated CCR/WC demonstrated a 36% reduced dyslipidemia risk (fully adjusted OR = 0.64; 95%CI: 0.43–0.95). No nonlinear relationship between CCR/WC and dyslipidemia was observed. Cox proportional hazards analysis revealed progressive risk reduction with higher CCR/WC quartiles (vs. Q1): Q2(HR = 0.82), Q3(HR = 0.72), Q4(HR = 0.76). Dyslipidemia mediated CCR/WC’s effect on hypertension (indirect effect=-0.017; 95%CI: -0.033 to -0.006). CONCLUSION: The CCR/WC ratio serves as a composite biomarker for dyslipidemia and hypertension risk stratification, highlighting its potential clinical utility.