Association between Non-HDL-C/HDL-C Ratio and Carotid Intima-Media Thickness in Post-Menopausal Women.

Arcangelo Iannuzzi,Maria Ausilia Giusti,Gilanluigi Cuomo,Alessandro Bresciani,Gabriella Iannuzzo,Paolo Rubba,Maria Tripaldella,Camilla Panico,Marco Gentile,Giuseppe Covetti,Alessandro Mattina,Emilio Aliberti,Francesco Giallauria

doi:10.3390/jcm11010078

Abstract

Atherogenic lipoproteins (particularly, very low-density lipoproteins, VLDL) are associated with subclinical atherosclerosis. The present study aims at evaluating whether routinely analysed lipid parameters are associated with carotid intima–media thickness, a proxy for subclinical atherosclerosis. Lipid parameters from 220 post-menopausal women undergoing ultrasound investigation of the carotid arteries were analysed. Forty-five percent of women showed subclinical atherosclerosis on carotid ultrasound. The mean carotid intima–media thickness was 1.26 ± 0.38 mm. The mean value of the non-HDL-C/HDL-C ratio was 3.1 ± 1.2. Univariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (r = 0.21, p = 0.001). After adjusting for cardiovascular risk factors (age, systolic blood pressure, smoking, body mass index Homeostasis model assessment: insulin resistance and high-sensitivity C-Reactive-Protein), multivariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (β = 0.039, p = 0.04). Logistic regression analysis showed that the highest tertile of the non-HDL-C/HDL-C ratio was associated with the presence of carotid plaques (OR = 3.47, p = 0.003). Finally, a strong correlation between non-HDL-C/HDL-C ratio and cholesterol bound to VLDL (r = 0.77, p < 0.001) has been found. Non-HDL-C/HDL-C ratio is associated with the presence of carotid atherosclerosis in post-menopausal women and is strongly correlated to VLDL-C levels.

Highlights

IntroductionWomen lose the characteristic protection from cardiovascular events from which they benefit in their fertile years, probably due to the action of oestrogens [1]
This study aimed at identifying whether lipid parameters present in routine investigations are associated with carotid plaques in post-menopausal women, and at verifying if these parameters were associated to VLDL-C levels, the lipid subfraction most strongly correlated to carotid intima–media thickness (IMT)
The main findings suggest that the non-HDL-C/HDL-C ratio, which is and routinely calculated, is associated with increased carotid intima–media thickness more than other lipid parameters; those higher values of the non-HDL-C/HDL-C

Summary

Introduction

Women lose the characteristic protection from cardiovascular events from which they benefit in their fertile years, probably due to the action of oestrogens [1]. It is well known that low-density lipoproteins (LDL) are the main determinant of atherosclerosis and of its clinical sequelae [2]. There are other cardiovascular risk factors, which promote atherosclerosis even when LDL levels are normal or when they are controlled pharmacologically, so it has been coined ‘residual risk’ [3]. Metabolic syndrome strongly impacts cardiovascular risk [4,5] LDL-C levels are not included among its definition criteria. In Southern Italy, there is a high prevalence of obese women, who often present with metabolic syndrome, with insulin resistance and a prevalence of cardiovascular disease comparable to males of the same age.

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