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The relationship between the triglyceride to high-density lipoprotein cholesterol ratio and positive blood or pus cultures in patients with pyogenic liver abscess

Lipids Health Dis. 2025 Aug 26;24(1):267. doi: 10.1186/s12944-025-02682-8.

ABSTRACT

BACKGROUND/AIMS: High triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL-C), and an elevated TG/HDL-C ratio are linked to increased systemic inflammation and impaired immune function. However, the clinical significance of the TG/HDL-C ratio in pyogenic liver abscess (PLA) remains poorly defined.

METHODS: In this multicenter, cross-sectional study of 2,201 cases of PLA, logistic regression, smoothed curve fitting, and comprehensive sensitivity analyses were employed to assess the relationship between the baseline TG/HDL-C ratio and positive blood or pus cultures. Subgroup analyses and interaction tests were performed to evaluate the robustness of the findings.

RESULTS: Logistic regression showed that the TG/HDL-C ratio was positively associated with blood or pus culture positivity in PLA [odds ratio (OR) = 1.04, 95% confidence interval (CI): 1.02-1.06, P < 0.001. Smoothed curve fitting revealed a nonlinear dose-response relationship, with an inflection point at 9.2. Below this threshold, the TG/HDL-C ratio remained significantly associated with culture positivity (OR = 1.1, 95% CI: 1.1-1.2, P < 0.001). Sensitivity analyses and interaction tests confirmed these results.

CONCLUSIONS: The TG/HDL-C ratio demonstrates a nonlinear relationship with the risk of positive blood or pus cultures in patients with PLA, with a pivotal threshold value identified at 9.2. This readily obtainable ratio may help clinicians individualize management strategies and facilitate timely interventions for PLA patients in this at-risk group, leading to improved health outcomes for this vulnerable population.

PMID:40859300 | DOI:10.1186/s12944-025-02682-8

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