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      Relationship between non–high-density lipoprotein cholesterol and carotid atherosclerosis in normotensive and euglycemic Chinese middle-aged and elderly adults

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          Abstract

          Background

          We investigate whether non–high-density lipoprotein cholesterol (non-HDL-C) provides a better estimate of cardiovascular risk than other lipid profiles in normotensive and euglycemic middle-aged and elderly adults.

          Methods

          A total of 512 males and 958 females were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral carotid intima-media thicknesses (CIMTs) were measured using ultrasonography, and the presence of carotid plaques was assessed.

          Results

          The mean values of non-HDL-C were 3.4 ± 0.8 mmol/l and 3.6 ± 0.9 mmol/l for male and female subjects, respectively. Compared with female subjects with non-HDL-C in the first quartile, female subjects with non-HDL-C in the fourth quartile had 1.317-fold increased risks for carotid plaques after adjusting for conventional cardiovascular disease (CVD) risk factors and increasing quartiles of all lipid levels. Non-HDL-C was positively associated with the CIMT after adjusting for CVD risk factors in female subjects (β = 0.062, P = 0.034).

          Conclusions

          These results suggest that non-HDL-C is independently associated with carotid atherosclerosis in normotensive and euglycemic females.

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          Most cited references19

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          Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women.

          Current guidelines for cardiovascular risk detection are controversial with regard to the clinical utility of different lipid measures, non-high-density lipoprotein cholesterol (non-HDL-C), lipid ratios, apolipoproteins, and C-reactive protein (CRP). To directly compare the clinical utility of total cholesterol, low-density lipoprotein cholesterol (LDL-C), HDL-C, non-HDL-C, apolipoproteins A-I and B(100), high-sensitivity CRP, and the ratios of total cholesterol to HDL-C, LDL-C to HDL-C, apolipoprotein B(100) to apolipoprotein A-I, and apolipoprotein B(100) to HDL-C as predictors of future cardiovascular events in women. Prospective cohort study of 15,632 initially healthy US women aged 45 years or older (interquartile range, 48-59 years) who were enrolled between November 1992 and July 1995. All participants were followed up over a 10-year period for the occurrence of future cardiovascular events. Hazard ratios (HRs) and 95% confidence intervals (CIs) for first-ever major cardiovascular events (N = 464) according to baseline levels of each biomarker. After adjustment for age, smoking status, blood pressure, diabetes, and body mass index, the HRs for future cardiovascular events for those in the extreme quintiles were 1.62 (95% CI, 1.17-2.25) for LDL-C, 1.75 (95% CI, 1.30-2.38) for apolipoprotein A-I, 2.08 (95% CI, 1.45-2.97) for total cholesterol, 2.32 (95% CI, 1.64-3.33) for HDL-C, 2.50 (95% CI, 1.68-3.72) for apolipoprotein B(100), 2.51 (95% CI, 1.69-3.72) for non-HDL-C, and 2.98 (95% CI, 1.90-4.67) for high-sensitivity CRP (P<.001 for trend across all quintiles). The HRs for the lipid ratios were 3.01 (95% CI, 2.01-4.50) for apolipoprotein B(100) to apolipoprotein A-I, 3.18 (95% CI, 2.12-4.75) for LDL-C to HDL-C, 3.56 (95% CI, 2.31-5.47) for apolipoprotein B(100) to HDL-C, and 3.81 (95% CI, 2.47-5.86) for the total cholesterol to HDL-C (P<.001 for trend across all quintiles). The correlation coefficients between high-sensitivity CRP and the lipid parameters ranged from -0.33 to 0.15, and the clinical cut points for CRP of less than 1, 1 to 3, and higher than 3 mg/L provided prognostic information on risk across increasing levels of each lipid measure and lipid ratio. Non-HDL-C and the ratio of total cholesterol to HDL-C were as good as or better than apolipoprotein fractions in the prediction of future cardiovascular events. After adjustment for age, blood pressure, smoking, diabetes, and obesity, high-sensitivity CRP added prognostic information beyond that conveyed by all lipid measures.
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            Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: the Rotterdam Study.

            Several noninvasive methods are available to investigate the severity of extracoronary atherosclerotic disease. No population-based study has yet examined whether differences exist between these measures with regard to their predictive value for myocardial infarction (MI) or whether a given measure of atherosclerosis has predictive value independently of the other measures. At the baseline (1990-1993) examination of the Rotterdam Study, a population-based cohort study among subjects age > or =55 years, carotid plaques and intima-media thickness (IMT) were measured by ultrasound, abdominal aortic atherosclerosis by x-ray, and lower-extremity atherosclerosis by computation of the ankle-arm index. In the present study, 6389 subjects were included; 258 cases of incident MI occurred before January 1, 2000. All 4 measures of atherosclerosis were good predictors of MI independently of traditional cardiovascular risk factors. Hazard ratios were equally high for carotid plaques (1.83 [1.27 to 2.62], severe versus no atherosclerosis), carotid IMT (1.95 [1.19 to 3.19]), and aortic atherosclerosis (1.94 [1.30 to 2.90]) and slightly lower for lower-extremity atherosclerosis (1.59 [1.05 to 2.39]), although differences were small. The hazard ratio for MI for subjects with severe atherosclerosis according to a composite atherosclerosis score was 2.77 (1.70 to 4.52) compared with subjects with no atherosclerosis. The predictive value of MI for a given measure of atherosclerosis was independent of the other atherosclerosis measures. Noninvasive measures of extracoronary atherosclerosis are strong predictors of MI. The relatively crude measures directly assessing plaques in the carotid artery and abdominal aorta predict MI equally well as the more precisely measured carotid IMT.
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              Lipoprotein management in patients with cardiometabolic risk: consensus statement from the American Diabetes Association and the American College of Cardiology Foundation.

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                Author and article information

                Contributors
                ma.hui@zs-hospital.sh.cn
                lin.huandong@zs-hospital.sh.cn
                hu.yu@zs-hospital.sh.cn
                1981_lxm@sina.com
                he.wanyuan@zs-hospital.sh.cn
                jin.xuejuan@zs-hospital.sh.cn
                gao.jian@zs-hospital.sh.cn
                nqzhao@fudan.edu.cn
                pan.boshen@zs-hospital.sh.cn
                +86-21-64041990-8021 , zhongshan_endo@126.com
                Journal
                Lipids Health Dis
                Lipids Health Dis
                Lipids in Health and Disease
                BioMed Central (London )
                1476-511X
                16 March 2017
                16 March 2017
                2017
                : 16
                : 55
                Affiliations
                [1 ]ISNI 0000 0001 0125 2443, GRID grid.8547.e, Department of Geriatrics, , Zhong Shan Hospital, Fudan University, ; Shanghai, 200032 China
                [2 ]ISNI 0000 0001 0125 2443, GRID grid.8547.e, Department of Endocrinology and Metabolism, , Zhong Shan Hospital, Fudan University, ; Shanghai, 200032 China
                [3 ]ISNI 0000 0004 1755 3939, GRID grid.413087.9, Department of Ultrasonography, , Zhongshan Hospital, Fudan University, ; Shanghai, 200032 China
                [4 ]ISNI 0000 0001 0125 2443, GRID grid.8547.e, Clinical Epidemiology Center, , Zhong Shan Hospital, Fudan University, ; Shanghai, 200032 China
                [5 ]ISNI 0000 0001 0125 2443, GRID grid.8547.e, Department of Clinical Nutrition, , Zhong Shan Hospital, Fudan University, ; Shanghai, 200032 China
                [6 ]ISNI 0000 0001 0125 2443, GRID grid.8547.e, Department of Biostatistics, College of Public Health, , Fudan University, ; Shanghai, 200032 China
                [7 ]ISNI 0000 0004 1755 3939, GRID grid.413087.9, Department of Laboratory Medicine, , Zhongshan Hospital, Fudan University, ; Shanghai, 20032 China
                Article
                451
                10.1186/s12944-017-0451-4
                5356399
                28302123
                b48b782b-b4a4-4463-bd91-34753c1e1331
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 31 January 2017
                : 9 March 2017
                Funding
                Funded by: National Key Basic Research Program of China
                Award ID: 2012CB524906
                Award Recipient :
                Funded by: Shanghai Municipal Health Project Grant
                Award ID: 2013ZYJB0802
                Award Recipient :
                Funded by: Shanghai Health and Family Planning Commission Foundation
                Award ID: 12GWZX0103 and 2013SY005
                Award Recipient :
                Funded by: National Ministry of Education Program
                Award ID: 985III-YFX0302
                Award Recipient :
                Funded by: Shanghai Hospital Development Center Foundation
                Award ID: SHDC12012201
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Biochemistry
                non-hdl-c,carotid intima-media thickness (cimt),carotid plaque,carotid atherosclerosis

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