Abstract
To explore whether non-high-density-lipoprotein cholesterol (non-HDL-c) is associated with depression, a total of 26 819 Canadians aged 45–85 from the Canadian Longitudinal Study on Aging (CLSA) were included in analysis. Non-HDL-c, the difference between total-c and HDL-c, was categorized into five levels, i.e., <2.6, 2.6 to <3.7, 3.7 to <4.8, 4.8 to 5.7, and ≥5.7 mmol/L. History of clinical depression was collected by questionnaire at an in-home interview, and current potential depression status was determined by CES-D10 (Center for Epidemiological Studies Depression Scale 10 questions version) score, i.e., ≥10 vs. <10. Logistic continuation ratio model for ordinal data was used to estimate the odds of being at or above a higher non-HDL-c category for depression status. Compared with those without clinical depression history and currently undepressed, the adjusted odds ratios (95% CI) were 1.09 (1.02, 1.17) for those without clinical depression history but currently depressed, 1.05 (0.98, 1.12) for those had clinical depression history but currently undepressed, and 1.21 (1.10, 1.32) for those had clinical depression history and currently depressed. The average of non-HDL-c for four depression groups were 3.64, 3.71, 3.69, and 3.82 mmol/L, respectively, and group 4 was statistically higher than others ( p < 0.001). In conclusion, people with both current depression and a history clinical depression are at an increased risk of having high level of non-HDL-c.
Highlights
Individuals with high levels of nonhigh-density-lipoprotein cholesterol are at an increased risk for coronary heart disease (CHD) (Liu et al 2006; Brunner et al 2019)
Non-HDL cholesterol level is the difference between total cholesterol and HDL cholesterol, which includes all proatherogenic lipoproteins containing apolipoproteins B located in very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), lipoprotein (a), and low-density lipoprotein (LDL) (Emerging Risk Factors Collaboration et al 2009)
More than 90% of plasma apolipoproteins B (apo B) is associated with LDL particles (Barter et al 2006) and lowering LDL cholesterol levels does lower the risk for CHD; LDL cholesterol levels are used as the primary target of treatment of CHD (Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults 2001)
Summary
Individuals with high levels of nonhigh-density-lipoprotein (non-HDL) cholesterol are at an increased risk for coronary heart disease (CHD) (Liu et al 2006; Brunner et al 2019). Clinical laboratory tests do not estimate LDL cholesterol levels directly, instead approximating it by the Friedewald formula, which estimates the levels of LDL cholesterol as total cholesterol—HDL cholesterol—2.2 × triglycerides (Friedewald et al 1972) Of concern, this approach becomes increasingly inaccurate when triglyceride levels are measured using nonfasted blood specimen (Demacker et al 1984). This approach becomes increasingly inaccurate when triglyceride levels are measured using nonfasted blood specimen (Demacker et al 1984) For this reason, non-HDL cholesterol is considered to be superior to LDL cholesterol as the treatment target for CHD risk management because the levels of total cholesterol and HDL cholesterol are less likely to be affected by fasting status (Emerging Risk Factors Collaboration et al 2009). The Canadian Cardiovascular Society 2016 guidelines recommend that all men and women of 40 years of age and older have their lipids levels measured every five years; LDL cholesterol levels are of greatest concern for physicians; non-HDL cholesterol is addressed as an alternative marker (Anderson et al 2016)
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