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Background <p>Coronary Heart Disease (CHD) is a leading cause of mortality worldwide. The De-Ritis ratio has not been fully elucidated for its value in cardiometabolic risk assessment. This study aimed to evaluate the association of De-Ritis ratio with CHD prevalence and all-cause mortality in a large, nationally representative sample.</p> Methods <p>This study utilized a cross-sectional and prospective cohort design, with data sourced from the U.S. National Health and Nutrition Examination Survey (NHANES). We employed weighted multivariate logistic regression models to assess CHD prevalence and weighted Cox proportional hazards regression models to analyze all-cause mortality. The primary exposure was the De-Ritis ratio, categorized into quartiles. The outcomes were self-reported CHD status and mortality status confirmed via linkage to the National Death Index.</p> Results <p>A total of 8,068 participants were included in the prevalence analysis, and 8,063 in the mortality analysis. After full adjustment for confounding factors, participants in the highest quartile (Q4) of the De-Ritis ratio had significantly higher odds of CHD prevalence compared to those in the lowest quartile (Q1) (odds ratio [OR] = 5.01, 95% confidence interval: 2.89–8.69, <i>P</i> &lt; 0.001). In the prospective analysis, the Q4 group had a 58% significantly increased risk of all-cause mortality compared to the Q1 group (hazard ratio = 1.58, 95% CI: 1.12–2.22, <i>P</i> = 0.010).</p> Conclusion <p>An elevated De-Ritis ratio is independently and robustly associated with higher CHD prevalence and increased risk of all-cause mortality. This suggests that De-Ritis ratio may be a valuable and cost-effective biomarker for enhancing CHD risk stratification.</p>

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Association of the De-Ritis (AST/ALT) ratio with coronary heart disease prevalence and all-cause mortality in U.S. adults: a national health and nutrition examination survey analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月12日

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  • Hongguang Zhang,
  • Shuo Feng

摘要

Background

Coronary Heart Disease (CHD) is a leading cause of mortality worldwide. The De-Ritis ratio has not been fully elucidated for its value in cardiometabolic risk assessment. This study aimed to evaluate the association of De-Ritis ratio with CHD prevalence and all-cause mortality in a large, nationally representative sample.

Methods

This study utilized a cross-sectional and prospective cohort design, with data sourced from the U.S. National Health and Nutrition Examination Survey (NHANES). We employed weighted multivariate logistic regression models to assess CHD prevalence and weighted Cox proportional hazards regression models to analyze all-cause mortality. The primary exposure was the De-Ritis ratio, categorized into quartiles. The outcomes were self-reported CHD status and mortality status confirmed via linkage to the National Death Index.

Results

A total of 8,068 participants were included in the prevalence analysis, and 8,063 in the mortality analysis. After full adjustment for confounding factors, participants in the highest quartile (Q4) of the De-Ritis ratio had significantly higher odds of CHD prevalence compared to those in the lowest quartile (Q1) (odds ratio [OR] = 5.01, 95% confidence interval: 2.89–8.69, P < 0.001). In the prospective analysis, the Q4 group had a 58% significantly increased risk of all-cause mortality compared to the Q1 group (hazard ratio = 1.58, 95% CI: 1.12–2.22, P = 0.010).

Conclusion

An elevated De-Ritis ratio is independently and robustly associated with higher CHD prevalence and increased risk of all-cause mortality. This suggests that De-Ritis ratio may be a valuable and cost-effective biomarker for enhancing CHD risk stratification.