Abstract MP70: Conventional and Novel Lipid Measures and Subsequent Risk of Lower-extremity Peripheral Artery Disease: The Atherosclerosis Risk in Communities (aric) Study

Abstract

Introduction: The association of conventional lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides [TG]) with incident peripheral artery diseases (PAD) has been reported. Understanding novel lipids (remnant lipoprotein cholesterol [RLP-C], LDL-TG, small dense LDL-C [sdLDL-C], Apo-E containing HDL [ApoE-HDL]) in this regard could inform risk classification and preventive approaches for PAD. Hypothesis: Some novel lipids will be more evidently related to incident PAD than some conventional lipid measures. Methods: In 8808 ARIC participants (mean age 62.6 [SD 5.7] y) free of PAD at baseline (visit 4, 1996-98), we assessed the associations of each lipid measure (as quartiles and continuous variable) and incident PAD-related hospitalization through 2015 using multivariable Cox models. Since some lipids are closer biologically correlated than others, indicating collective effects among lipids, we used factor analysis to identify underlying factors and modeled them for PAD risk. Results: There were 262 incident PAD cases. After accounting for potential confounders, HDL-C, TG, RLP-C, LDL-TG, and ApoE-HDL were independently associated with incident PAD, with the largest hazard ratio between Q4 and Q1 for HDL-C (Table). LDL-C showed a J-shaped association, and Q4 and Q3 became significant when compared to Q2 (1.57 [1.09-2.25] and 1.46 [1.02-2.11], respectively). The associations of LDL-TG, and ApoE-HDL remained significant after adjusting for LDL-C. The factor analysis identified 3 factors (Factor 1: mainly loaded by TG, RLC, LDL-TG and sdLDL-C; Factor 2: by total cholesterol, LDL-C, and sdLDL-C; Factor 3: by HDL-C and ApoE-HDL), and only Factor 3 showed an independent association with incident PAD (0.78 [0.65-0.93]). Conclusions: These findings suggest the importance of HDL-related and TG-related lipids in the development of PAD, with potential therapeutic implications.