Associations of Platelet to High-Density Lipoprotein Cholesterol Ratio with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study from the US National Health and Nutrition Examination Survey.

Background: The platelet to high-density lipoprotein cholesterol ratio (PHR) is a novel biomarker for inflammation and hypercoagulability. This study aimed to explore the potential association between PHR and prevalence of chronic obstructive pulmonary disease (COPD). Methods: Participants aged between 40 and 85 years from the 1999-2018 US National Health and Nutrition Examination Survey with COPD were included. Multivariable logistic regression and restricted cubic spline analysis were applied to evaluate the associations between PHR and COPD. Propensity score matching (PSM) was performed to reduce the impact of potential confounding factors. Results: A total of 25751 participants, including 753 with COPD, at a mean age of 57.19 years and 47.83% men, were included. The multivariable-adjusted model showed that the odds ratio (OR) and 95% confidence interval (CI) for PHR to predict COPD was 1.002 (1.001-1.003). Compared with the lowest quartile, the ORs and 95% CIs for the Q2, Q3, and Q4 PHR quartile were 1.162 (0.874-1.546), 1.225 (0.924-1.625), and 1.510 (1.102-2.069), respectively (P for trend = 0.012). Restricted cubic spline analysis demonstrated a linear association between PHR and COPD prevalence both before and after PSM. Significant association between PHR and COPD prevalence was observed only in participants without hypertension. Receiver-operating characteristic curves showed significantly higher area under the curve for distinguishing COPD from non-COPD by PHR than platelet count and high-density lipoprotein cholesterol. Conclusion: PHR is significantly associated with COPD prevalence in US adults aged 40 to 85 years without hypertension, supporting the effectiveness of PHR as a potential biomarker for COPD.