为探究非高密度脂蛋白胆固醇（non-high density lipoprotein cholesterol, Non-HDL-C）与高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDL-C）比值NHHR与肾功能快速下降风险之间的关系。通过使用2011年和2015年中国健康与养老追踪调查（China health and retirement longitudinal study, CHARLS）数据，分析了4 055名年龄≥40岁并且基线估计肾小球滤过率（estimated glomerular filtration rate, eGFR）≥60 mL／（min·1.73m²）的参与者（根据血清肌酐和胱抑素C生成估计肾小球滤过率）。肾功能快速下降定义为eGFR下降≥3 mL／（min·1.73m²·a）。采用多因素logistic回归模型探究NHHR与肾功能快速下降的风险的相关性，同时采用限制性立方样条和阈值效应分析评估二者的剂量-效应关系。结果表明：在4年的随访期间，447名（11.02%）参与者肾功能快速下降。在完全调整的多因素Logistic回归模型中，NHHR最高组（T3）肾功能快速下降风险是NHHR最低组（T1）的1.94倍（OR＝1.94，95% CI：1.46~2.61）。当NHHR作为连续变量时，NHHR每升高一个单位，肾功能快速下降风险增加1.21倍（OR＝1.21，95% CI：1.08~1.36）。限制性立方样条结果显示，NHHR与肾功能快速下降呈现近似对数曲线的饱和效应关系（P_nonlinearity<0.05），拐点分析显示NHHR≤3.52时，随着NHHR升高，肾功能快速下降风险增加。当NHHR>3.52，肾功能快速下降风险趋于饱和。可见在中老年人中，较高的NHHR与纵向肾功能快速下降相关且存在非线性关系。

In order to explore the relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the risk of rapid decline in kidney function, data from the China health and retirement longitudinal study(CHARLS) conducted in 2011 and 2015 was utilized. It includes 4 055 participants aged 40 and above with a baseline estimated glomerular filtration rate (eGFR) of at least 60 mL/(min·1.73m²), calculated using serum creatinine and cystatin C levels. Rapid kidney function decline is defined as a decrease in eGFR of 3 mL/(min·1.73m²·a). A multivariable logistic regression model was used to investigate the association between NHHR and the risk of rapid kidney function decline. Additionally, restricted cubic spline and threshold effect analyses were used to evaluate the dose-response relationship. The results show that over the 4-year follow-up, 447 participants (11.02%) experienced rapid decline in kidney function. In the fully adjusted multivariable logistic regression model, those in the highest NHHR group (T3) faced a 1.94-fold increased risk of rapid kidney function decline compared to the lowest NHHR group(T1) (OR = 1.94,95% CI:1.46~2.61). As a continuous variable, each unit increase in NHHR is associated with a 1.21-fold increase in risk (OR = 1.21,95% CI:1.08~1.36). The restricted cubic spline analysis demonstrates a near logarithmic curve saturation effect between NHHR and rapid kidney function decline (P_nonlinearity < 0.05). It is concluded that with NHHR ≤3.52, the risk increases as NHHR rises, while NHHR > 3.52 marks a saturation point. In conclusion, among middle-aged and elderly individuals, a higher NHHR is linked to a greater risk of rapid decline in kidney function, displaying a nonlinear relationship.