Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cognitive impairment in patients with cerebral small vessel disease

Objective This study aims to determine the potential association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and cognitive impairment in patients with cerebral small vessel disease (CSVD). By collecting data from patients with CSVD in hospital, we will analyze the relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cognitive function in these patients. Methods This study enrolled 263 CSVD patients, Cognitive function was assessed using Mini-Mental State Examination (MMSE) within 2 weeks, with cognitive impairment defined by education stratified thresholds. Statistical analysis of the baseline was performed. The association between NHHR and cognitive function was evaluated using binary logistic regression. And Receiver Operating Characteristic Curve (ROC) analysis were performed to evaluate the predictive value. Results Patients were classified into cognitive impairment group ( n = 138) and normal cognition group ( n = 125). NHHR in the cognitive impairment group was significantly higher than that in the normal group (3.58 ± 0.98 vs. 2.90 ± 0.92, P < 0.001). There was a dose–response relationship between NHHR quartiles and the incidence of cognitive impairment (trend test P < 0.001). Multivariate regression analysis showed that for each unit increase in NHHR, the risk of cognitive impairment increases by 184% (OR = 2.84, 95% confidence interval 1.97 to 4.12; p < 0.001). The predictive model constructed by combining age and education level has an area under the ROC curve (AUC) of 0.703. Conclusion NHHR serves as an independent predictor of cognitive impairment in CSVD patients. The NHHR-derived model exhibits moderate discriminative accuracy, indicating potential clinical applicability.