Abstract

BackgroundDespite current interest in the unfavorable impact of nontraditional lipid profiles on cardiovascular disease, information regarding its relations to abnormal left ventricular (LV) geometry has not been systemically elucidated. This study sought to understand predictive implication of nontraditional lipid profiles in specific LV geometric patterns in the general population of rural China.MethodsAnalyses were based upon a cross-sectional study of 10,756 participants (mean age 53.8 years; 54.0% females) who underwent assessment of biochemical, anthropometric, and blood pressure variables in rural areas of China. Participants were classified into four groups of LV morphologic pattern according to left ventricular mass index (LVMI) and relative wall thickness with quantitative echocardiographic data.ResultsBy multivariable-adjusted linear regression models, nontraditional lipid profiles were positive determinants of concentricity index and LV wall thickness (all P < 0.05), with modest effects on LVMI. Non-high-density lipoprotein cholesterol (non-HDL-C) emerged as an independent correlate of concentric LV hypertrophy (LVH) (adjusted odds ratio [OR]: 1.174 per 1 SD increment in non-HDL-C, 95% confidence interval [CI]: 1.075–1.281), followed by low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio (1.158 [1.059–1.266]), total cholesterol (TC)/HDL-C ratio (1.150 [1.050–1.260]), and triglyceride (TG)/HDL-C ratio (1.134 [1.030–1.249]). The ORs for concentric LVH by tertiles further provided insight into that excess risk was associated with the highest tertile of nontraditional lipid profiles. The areas under the ROC curves to predict concentric LVH were statistically identical among nontraditional lipid parameters.ConclusionNontraditional lipid profiles, easily measured in the everyday routine examination, were responsible for increased risk of concentric LVH, potentially providing enhanced clinical utility at no additional cost, which emphasized the beneficial effect of these markers to supplement and improve CVD risk stratification.

Highlights

  • Despite current interest in the unfavorable impact of nontraditional lipid profiles on cardiovascular disease, information regarding its relations to abnormal left ventricular (LV) geometry has not been systemically elucidated

  • Previous studies revealed that total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio could represent a simple atherogenic particle burden tool informing on lipoprotein particle concentration and size not available in cholesterol-based measurements [22, 23]

  • Antihypertensive medication use and history of cardiovascular disease (CVD) was highest in concentric Left ventricular hypertrophy (LVH)

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Summary

Introduction

Despite current interest in the unfavorable impact of nontraditional lipid profiles on cardiovascular disease, information regarding its relations to abnormal left ventricular (LV) geometry has not been systemically elucidated. This study sought to understand predictive implication of nontraditional lipid profiles in specific LV geometric patterns in the general population of rural China. Recent emphasis has been placed in the clinical implications of nontraditional lipid profiles as powerful and independent predictors of cardiovascular disease (CVD) outcomes [17,18,19,20,21]. Previous studies revealed that TC/HDL-C ratio could represent a simple atherogenic particle burden tool informing on lipoprotein particle concentration and size not available in cholesterol-based measurements [22, 23]. It has recently been proposed that nonHDL-C that includes all of the atherogenic lipoproteins, such as TG-rich lipoproteins, intermediate-density lipoprotein cholesterol, LDL-C, and lipoprotein(a) could better predict cardiovascular outcomes in patients on LDLC-lowering therapy [20, 24]

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