Abstract
High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baseline IMT × 100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely, P < 0.05) and to LDL-C/HDL-C ratio (P < 0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone.
Highlights
A low level of high-density lipoprotein cholesterol (HDL-C) is a strong and independent predictor of cardiovascular disease [1,2,3]
Our results showed that changes in intima-media thickness (IMT) after eight years were significantly related to High-density lipoprotein cholesterol (HDL-C) and to low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio (P < 0.05)
When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05)
Summary
A low level of high-density lipoprotein cholesterol (HDL-C) is a strong and independent predictor of cardiovascular disease [1,2,3]. Previous studies reported statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C ratio) predicted atherosclerosis progression [6, 7] It is, important to observe HDL-C or LDL-C alone and their ratio. Whether a high LDL-C/HDL-C ratio is a significant predictor of carotid atherosclerotic burden remains unclear due to a lack of data from a large number of subjects. Several investigators [12, 13] reported that LDL-C/HDL-C ratio is related to IMT or carotid plaque in cross-sectional studies or in relation to baseline data in childhood, no large-scale prospective studies have been done to in adults to evaluate whether elevated levels of the LDL-C/HDL-C ratio is a more significant predictor of the progression of IMT than LDL-C or HDL-C alone. We measured lipid profiles and employed highresolution ultrasonography to determine common carotid IMT at baseline in 1,920 subjects of a community-based cohort, and examined changes in IMT in a follow-up examination 8 years later
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