Association between nontraditional lipid profiles and peripheral arterial disease in Chinese adults with hypertension

Congcong Ding,Tao Wang,Wei Zhou,Xiao Huang,Xiaoshu Cheng,Huihui Bao,Yumeng Shi,Lihua Hu,Lingjuan Zhu,Yang Chen,Minghui Li

doi:10.1186/s12944-020-01407-3

Abstract

BackgroundData on the relationship between nontraditional lipid profiles [total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio, non-high-density lipoprotein cholesterol (non-HDL-C)] and the risk of peripheral artery disease (PAD) are limited. The present study investigated the relationship of nontraditional lipid indices with PAD in hypertensive patients.MethodsThis cross-sectional study was performed among 10,900 adults with hypertension. Participants were diagnosed with PAD when their ankle-brachial index (ABI) was < 0.9. The association between nontraditional lipid profiles and PAD was examined using multivariate logistic regression analysis and the restricted cubic spline.ResultsAll nontraditional lipid indices were independently and positively associated with PAD in a dose-response fashion. After multivariable adjustment, the per SD increments of the TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C were all significantly associated with 37, 14, 40, and 24% higher risk for PAD, respectively. The adjusted ORs (95% CI) for PAD were 1.77 (1.31, 2.40), 1.71 (1.25, 2.34), 2.03 (1.50, 2.74), and 1.70 (1.25, 2.31) when comparing the highest tertile to the lowest tertile of the TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, respectively.ConclusionsAmong Chinese hypertensive adults, all nontraditional lipid indices were positively associated with PAD, and the LDL-C/HDL-C and TC/HDL-C ratios were better than the other nontraditional lipid indices for predicting PAD. These findings may improve the risk stratification of cardiovascular disease and dyslipidemia management.Trial registrationCHiCTR, ChiCTR1800017274. Registered 20 July 2018.

Highlights

Data on the relationship between nontraditional lipid profiles [total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL-C)/High-density lipoprotein cholesterol (HDLC) ratio, non-high-density lipoprotein cholesterol] and the risk of peripheral artery disease (PAD) are limited
The ankle-brachial index (ABI), which is commonly known as the ratio of the systolic blood pressure (SBP) measured at the ankle and arm, is a reliable, inexpensive, and noninvasive test for the diagnosis of peripheral arterial disease (PAD) [4]
Model 1 was adjusted for age, sex, body mass index (BMI), SBP, diastolic blood pressure (DBP), smoking status, alcohol drinking status, fasting glucose, total homocysteine, estimated glomerular filtration rate (eGFR), self-reported diabetes, selfreported stroke, lipoprotein-lowering drugs, and antihypertensive drugs Abbreviations: PAD Peripheral arterial disease; odds ratio (OR) Odd ratio; 95% confidence interval (CI) 95% Confidence interval; TC Total cholesterol; TG Triglyceride; HDL-C High-density lipoprotein cholesterol; LDL-C Low-density lipoprotein cholesterol; non-HDL-C Non-high-density lipoprotein cholesterol

Summary

Introduction

Data on the relationship between nontraditional lipid profiles [total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL-C)/HDLC ratio, non-high-density lipoprotein cholesterol (non-HDL-C)] and the risk of peripheral artery disease (PAD) are limited. The present study investigated the relationship of nontraditional lipid indices with PAD in hypertensive patients. Peripheral artery disease (PAD) is a clinical manifestation of systemic atherosclerosis. The ankle-brachial index (ABI), which is commonly known as the ratio of the systolic blood pressure (SBP) measured at the ankle and arm, is a reliable, inexpensive, and noninvasive test for the diagnosis of PAD [4]. More than half of patients with PAD are asymptomatic, and an absence of routine ABI measurement in the primary care setting exists in most countries. Agents that reliably indicate subclinical atherosclerosis for patients who are at high risk of suffering from PAD are urgently needed

Methods

Results

Conclusion