Abstract
Intima-media thickness is a non-invasive arterial marker of early-stage atherosclerosis. Identifying carotid plaque is a superior surrogate endpoint for assessing atherosclerotic lesions. The aim of this study was to investigate the association of carotid intima-media thickness (CIMT) and carotid plaque with lipids among asymptomatic low-income rural residents in China. A total of 3,789 people aged ≥45 years without a history of stroke or cardiovascular disease were recruited to this study. B-mode ultrasonography was performed to measure CIMT and identify carotid plaque for early identification of atherosclerosis. Multivariate analysis was used to assess the association of blood lipid levels with atherosclerosis. The mean CIMT across our cohort was 567 μm. A linear regression analysis showed that low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were risk factors for early-stage atherosclerosis; however, high-density lipoprotein cholesterol and triglycerides protected against early-stage atherosclerosis after adjusting for potential risk factors (P < 0.001). Carotid plaque risk increased by 24 and 62% for each 1-mmol/L increase in TC and LDL-C (P < 0.001). These findings suggest that it is vital to manage and control the dyslipidemia standard levels in China, especially among rural residents, in order to reduce the burden of cardiovascular diseases.
Highlights
Stroke was the leading cause of death and the third most common cause of disability in China between 1990 and 2017 [1, 2]
An increase of the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) associated with a higher risk of late-stage atherosclerosis
Another study explored the correlation between blood lipid profile and atherosclerosis, finding that LDL-C was positively associated with the presence of carotid plaque [26]
Summary
Stroke was the leading cause of death and the third most common cause of disability in China between 1990 and 2017 [1, 2]. Early detection and management of individuals at high risk is critical to prevent or delay otherwise inevitable end-events. Several studies have shown that intracranial or extracranial atherosclerosis is a valid predictor of the presence of a cerebrovascular disease (CVD) or stroke [4]. The measurement of carotid intima media thickness (CIMT) using high-resolution ultrasound is useful for detecting early atherosclerotic changes [5, 6]. Previous studies have demonstrated that increased CIMT was a marker for early atherosclerosis [7, 8] and that carotid plaque was a better parameter for assessing atherosclerotic lesions [9, 10]. The hazard ratio of myocardial infarction or stroke was 1.09 for every 0.1mm increase in CIMT [11]. The association of atherosclerosis with blood lipids has been studied, but the results were controversial [16,17,18]
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