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Liu H, Liu D, Zuo P. Association Between Insulin Resistance Markers and Poor Prognosis in Patients With Acute Ischemic Stroke After Intravenous Thrombolysis. Neurologist 2024; 29:218-224. [PMID: 38251760 DOI: 10.1097/nrl.0000000000000550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVES This study aims to investigate the significance of insulin resistance markers in predicting poor prognosis in acute ischemic stroke (AIS) patients after intravenous thrombolysis and to establish the corresponding nomogram. METHODS From January 2019 to March 2023, the data of 412 patients with AIS who received intravenous alteplase thrombolytic therapy in the Affiliated Taizhou People's Hospital of Nanjing Medical University were selected. Patients were randomly divided into training groups (70%, 288 cases) and validation groups (30%, 124 cases). In the training group, multivariate logistic regression analysis was used to establish the best nomogram prediction model. The predictive ability of the nomogram was further evaluated by the area under the receiver operating characteristic curve, calibration curve, decision curve analysis, and reclassification analysis. Furthermore, the model was further validated in the validation set. RESULTS Multivariate logistic regression analysis showed that systolic blood pressure, diabetes, National Institutes of Health Stroke Scale score, triglyceride-glucose index, triglyceride-glucose-body mass index, ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol were associated with poor prognosis in AIS patients after intravenous thrombolysis ( P <0.05). Compared with conventional factors, the nomogram showed stronger prognostic ability, area under receiver operating characteristic curves were 0.948 (95% CI: 0.920-0.976, P <0.001) and 0.798 (95% CI: 0.747-0.849, P <0.001), respectively. CONCLUSIONS Triglyceride-glucose index, triglyceride-glucose-body mass index, and low-density lipoprotein cholesterol to high-density lipoprotein cholesterol levels upon admission can serve as markers for poor prognosis in AIS patients after intravenous thrombolysis. The nomogram enables a more accurate prediction of poor prognosis in AIS patients after intravenous thrombolysis.
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Affiliation(s)
- Haimei Liu
- Dalian Medical University Graduate School, Dalian
| | - Denglu Liu
- Yantai Yuhuangding Hospital Affiliated Qingdao University, Yantai
| | - Peng Zuo
- The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China
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Xiao B, Cao C, Han Y, Yang F, Hu H, Luo J. A non-linear connection between the total cholesterol to high-density lipoprotein cholesterol ratio and stroke risk: a retrospective cohort study from the China Health and Retirement Longitudinal Study. Eur J Med Res 2024; 29:175. [PMID: 38491452 PMCID: PMC10943863 DOI: 10.1186/s40001-024-01769-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE The connection between total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio and stroke risk is controversial. This study aims to examine the connection between the TC/HDL-C ratio and stroke in middle-aged and older individuals who are part of the China Health and Retirement Longitudinal Study (CHARLS). METHODS This study conducted a retrospective cohort analysis, enrolling a total of 10,184 participants who met the designated criteria from CHARLS between 2011 and 2012. We then used the Cox proportional-hazards regression model to analyze the relationship between the TC/HDL-C ratio and stroke risk. Using a Cox proportional hazards regression model with cubic spline functions and smooth curve fitting, we were able to identify the non-linear relationship between the TC/HDL-C ratio and stroke occurrence. The sensitivity and subgroup analyses were also performed to investigate the connection between TC/HDL-C ratio and stroke. RESULTS This study revealed a statistically significant association between the TC/HDL-C ratio and stroke risk in subjects aged 45 years or older after adjusting for risk factors (HR: 1.05, 95%CI 1.00-1.10, P = 0.0410). Furthermore, a non-linear connection between the TC/HDL-C ratio and stroke risk was detected, with a TC/HDL-C ratio inflection point of 3.71. We identified a significant positive connection between the TC/HDL-C ratio and stroke risk, when the TC/HDL-C ratio was less than 3.71 (HR: 1.25, 95%CI 1.07-1.45, P = 0.0039). However, their connection was not significant when the TC/HDL-C ratio exceeded 3.71 (HR: 1.00, 95%CI 0.94-1.06, P = 0.9232). The sensitivity analysis and subgroup analyses revealed that our findings were well-robust. CONCLUSION Our study demonstrated a positive, non-linear connection between the TC/HDL-C ratio and stroke risk in middle-aged and older individuals. There was a significant positive connection between the TC/HDL-C ratio and stroke risk, when the TC/HDL-C ratio was less than 3.71. The current research can be used as a guideline to support clinician consultation and optimize stroke prevention measures for middle-aged and older adults.
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Affiliation(s)
- Binhui Xiao
- Department of Neurosurgery, Shenzhen Yantian District People's Hospital, Southern University of Science and Technology Yantian Hospital, Shenzhen, 518081, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Second People's Hospital, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China
| | - Yong Han
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Fangju Yang
- Department of Rehabilitation, Shenzhen Second People's Hospital, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China.
| | - Haofei Hu
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, No.3002, Sungang West Road, Futian District, Shenzhen, 518035, Guangdong, China.
| | - Jiao Luo
- Department of Rehabilitation, Shenzhen Second People's Hospital, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China.
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Liu Y, Jin X, Fu K, Li J, Xue W, Tian L, Teng W. Non-traditional lipid profiles and the risk of stroke: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2023; 33:698-714. [PMID: 36737357 DOI: 10.1016/j.numecd.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/10/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
AIMS An increasing number of studies on non-traditional lipid profiles have been investigated in recent years. However, the associations between non-traditional lipid profiles and the risk of stroke remained inconsistent. Therefore, this meta-analysis aimed to evaluate the associations between non-traditional lipid profiles and the risk of stroke and clarify the dose-response relations. DATA SYNTHESIS We performed a systematic literature search in PubMed, Embase, and Web of Science databases until 1 November 2022 for relevant studies. Relative risks and 95% confidence intervals were pooled by random-effects or fixed-effects models. A total of 26 full-text studies with 676678 participants and 18057 stroke cases were eligible for the final study. We found a positive association between the risk of stroke and total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio (RR = 1.19,95%CI = 1.00-1.40, I2 = 74.6%), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio (RR = 1.24,95%CI = 1.10-1.41, I2 = 62.8%) or low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio (RR = 1.24, 95%CI = 1.11-1.39, I2 = 49.4%). When focusing on the stroke subtype, a more significant association was observed between the risk of ischemic stroke and four non-traditional lipid profiles. In dose-response analysis, we found a linear association between TC/HDL-C ratio and the risk of stroke (RR = 1.16,95%CI = 1.07-1.26). CONCLUSIONS Elevated non-traditional lipid profiles were associated with an increased risk of ischemic stroke. The linear association showed the risk of stroke increased by 16% when the pooled RR of TC/HDL-C ratio per 1-unit increased. REGISTRATION NUMBER IN PROSPERO CRD42022321251.
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Affiliation(s)
- Yueting Liu
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiaolin Jin
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China
| | - Kailei Fu
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China
| | - Jinwei Li
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China
| | - Weishuang Xue
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China
| | - Li Tian
- Department of Geriatrics, Shengjing Hospital, China Medical University, Shenyang, China.
| | - Weiyu Teng
- Department of Neurology, the First Affiliated Hospital, China Medical University, Shenyang, China.
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Zhao Z, Wang H, Hou Q, Zhou Y, Zhang Y. Non-traditional lipid parameters as potential predictors of carotid plaque vulnerability and stenosis in patients with acute ischemic stroke. Neurol Sci 2023; 44:835-843. [PMID: 36301362 DOI: 10.1007/s10072-022-06472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Lipid abnormalities are important risk factors in patients with large atherosclerotic strokes. Recent studies have shown that non-traditional lipid parameters are crucial to the development of atherosclerosis and are closely related to the clinical outcome of acute ischemic stroke (AIS). Therefore, we aimed to investigate the relationship between non-traditional lipid parameters and carotid plaque stability and stenosis degree in patients with large atherosclerotic stroke. METHODS We retrospectively analyzed 336 patients with AIS. All patients were divided into the non-plaque group, stable plaque group, and vulnerable plaque group according to ultrasound examination. At the same time, the patients were divided into non-stenosis, mild stenosis, moderate stenosis, and severe stenosis groups according to the degree of stenosis. Non-traditional lipid parameters, including residual lipoprotein cholesterol (RLP-C), non-high-density lipoprotein cholesterol (non-HDL-C), non-HDL-C to high-density lipoprotein cholesterol ratio (non-HDL-C/HDL-C), triglyceride to HDL-C ratio (TG/HDL-C), Castelli's risk index (CRI), and the atherogenic index of plasma (AIP). Receiver operating characteristic (ROC) curves and multivariate logistic regression analyses were used to investigate the associations between the non-traditional lipid parameters and carotid plaque vulnerability. Spearman linear correlation analysis was used to test the correlation between variables and the degree of carotid plaque stenosis. RESULTS This study population included 336 patients with AIS, of whom 294 had a carotid plaque. Multivariate logistic regression model showed that RLP-C (OR, 3.361; 95%CI, 1.311-8.617), non-HDL-C/HDL-C (OR, 1.699; 95%CI, 1.279-2.258), non-HDL-C (OR, 1.704; 95%CI, 1.143-2.540), CRI-I (OR, 1.573; 95%CI, 1.196-2.068), and CRI-II (OR, 2.022; 95%CI, 1.369-2.985) were independent risk factors for carotid plaque vulnerability. In addition, Spearman correlation analysis showed that the values of RLP-C, non-HDL-C/HDL-C, non-HDL-C, TG/HDL-C, CRI-I, CRI-II, and AIP on admission were positively correlated with the degree of carotid plaque stenosis (all P < 0.001). CONCLUSION This study provides evidence that non-traditional lipid parameters (LP-C, non-HDL-C/HDL-C, non-HDL-C, CRI-I, and CRI-II) were potential predictors of carotid plaque vulnerability in patients with AIS. However, no significant correlation was observed between TG/HDL-C and AIP. RLP-C, non-HDL-C/HDL-C, non-HDL-C, TG/HDL-C, CRI-I, CRI-II, and AIP were closely related to the degree of carotid plaque stenosis. Non-traditional lipid parameters can be used as novel biomarkers of carotid plaque vulnerability and stenosis.
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Affiliation(s)
- Zhao Zhao
- Qinghai University, Xining, 810000, China
| | | | - Qian Hou
- Qinghai Provincial People's Hospital, Xining, 810000, China.
| | - Youting Zhou
- Qinghai Provincial People's Hospital, Xining, 810000, China
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Zheng Q, Wang H, Wang X, Lan Y, Wu W, Yu X, Huang Z, Chen Z, Cai Z, Lin Q, Zhou H, Zhu Y, Liu M, Wu K, Zheng H, Wu S, Chen Y. Individual and combined contributions of non-high-density lipoprotein cholesterol and brachial-ankle pulse wave velocity to cardiovascular disease risk: Results of a prospective study using the Kailuan cohort. Front Cardiovasc Med 2023; 10:1105464. [PMID: 36844718 PMCID: PMC9947564 DOI: 10.3389/fcvm.2023.1105464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE We aimed to characterize the relationship of a combination of circulating non-high-density lipoprotein-cholesterol (non-HDL-C) concentration and brachial-ankle pulse wave velocity (baPWV) with cardiovascular disease (CVD). METHODS We performed a prospective cohort study of the residents of the Kailuan community, with data from a total of 45,051 participants being included in the final analysis. The participants were allocated to four groups according to their non-HDL-C and baPWV status, each of which was categorized as high or normal. Cox proportional hazards models were used to explore the relationships of non-HDL-C and baPWV, individually and in combination, with the incidence of CVD. RESULTS During the 5.04-year follow-up period, 830 participants developed CVD. Compared with the Normal non-HDL-C group independently, the multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD in the High non-HDL-C was 1.25 (1.08-1.46). Compared with the Normal baPWV group independently, the HRs and 95% CIs for CVD in the High baPWV was 1.51 (1.29-1.76). In addition, compared with the Normal both non-HDL-C and baPWV group, the HRs and 95% CIs for CVD in the High non-HDL-C and normal baPWV, Normal non-HDL-C and high baPWV, and High both non-HDL-C and baPWV groups were 1.40 (1.07-1.82), 1.56 (1.30-1.88), and 1.89 (1.53-2.35), respectively. CONCLUSION High non-HDL-C concentration and high baPWV are independently associated with a higher risk of CVD, and individuals with high both non-HDL-C and baPWV are at a still higher risk of CVD.
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Affiliation(s)
- Qiongbing Zheng
- Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Hui Wang
- School of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xianxuan Wang
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Youmian Lan
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Weiqiang Wu
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xinran Yu
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Zegui Huang
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Qi Lin
- Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Houshi Zhou
- Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Yongdong Zhu
- Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Muyuan Liu
- Department of Head and Neck, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Kuangyi Wu
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Huancong Zheng
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
- *Correspondence: Shouling Wu ✉
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Youren Chen ✉
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Association between Metabolic Phenotypes of Body Fatness and Incident Stroke: A Prospective Cohort Study of Chinese Community Residents. Nutrients 2022; 14:nu14245258. [PMID: 36558418 PMCID: PMC9785835 DOI: 10.3390/nu14245258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the association of body mass index (BMI)-based and waist circumference (WC)-based metabolic phenotypes with the risk of stroke among Chinese community residents. A total of 34,294 participants (mean ± standard deviation age: 56.05 ± 11.26 years) with no previous stroke diagnosis history were included in this cohort study. BMI-based metabolic phenotypes were classified into eight groups: metabolically healthy and normal weight (MHNW), metabolically healthy and underweight (MHUW), metabolically healthy and overweight (MHOW), metabolically healthy and obese (MHO), metabolically unhealthy and normal weight (MUNW), metabolically unhealthy and underweight (MUUW), metabolically unhealthy and overweight (MUOW), and metabolically unhealthy and obese (MUO). WC-based metabolic phenotypes were classified into four groups: metabolically healthy and normal WC (MHNWC), metabolically healthy and oversized WC (MHOWC), metabolically unhealthy and normal WC (MUNWC), and metabolically unhealthy and oversized WC (MUOWC). The association of these phenotypes with developing stroke events was examined using proportional hazards models. A total of 546 cases of first-stroke onset were recorded over a median follow-up time of 4.97 years. Compared with the reference group, the obesity phenotypes showed higher risks for stroke. The adjusted HRs (95% CIs) of MHUW, MHOW, MHO, MUNW, MUUW, MUOW, and MUO phenotypes were 1.01 (0.41, 2.49), 1.47 (1.09, 2.00), 1.33 (0.80, 2.22), 2.49 (1.87, 3.30), 3.92 (1.44, 10.72), 2.14 (1.64, 2.79), and 2.60 (1.91, 3.55), respectively. The adjusted HRs (95% CIs) of MHOWC, MUNWC, and MUOWC were 1.41 (1.02, 1.94), 2.25 (1.76, 2.87), and 2.16 (1.63, 2.87), respectively. The metabolic phenotypes defined by an alternative definition all showed significant positive associations (except for MHUW), with the adjusted HR ranging from 1.51 to 3.08 based on BMI and from 1.68 to 2.24 based on WC. The risk of stroke increased with the increase in metabolic abnormality numbers in different BMI and WC groups (all p trend < 0.001). The present study suggests that maintaining normal body weight or WC and improving metabolic health are of great significance in preventing cerebrovascular diseases.
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Wu Q, Guan Y, Xu C, Wang N, Liu X, Jiang F, Zhao Q, Sun Z, Zhao G, Jiang Y. Association of Serum Uric Acid with Diabetes in Premenopausal and Postmenopausal Women-A Prospective Cohort Study in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16137. [PMID: 36498206 PMCID: PMC9737491 DOI: 10.3390/ijerph192316137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
There have been few prospective studies on the association between serum uric acid (SUA) and the risk of diabetes in women, and there have been few large-scale Chinese studies based on menopause to investigate the association. Therefore, the present study aimed to investigate the above relationship in Chinese female adults without diabetes. Methods: Data from 5743 premenopausal women and 11,287 postmenopausal women aged 20−74 years were obtained from the Shanghai Suburban Adult Cohort and Biobank (SSACB) study conducted in China. Cox regression models were applied to evaluate the association between SUA levels and the risk of diabetes. Restricted cubic spline analysis and stratified analysis on the basis of menopausal status were performed to explore the dose−response association between SUA levels and diabetes. Results: Among 17,030 participants, incidence rates of diabetes were 3.44/1000 person-years in premenopausal and 8.90/1000 person-years in postmenopausal women. The SUA levels in postmenopausal women were higher than that in premenopausal women (p < 0.0001). In Cox regression analysis, after adjusting for confounding factors, for each 10 µmol/L increase in SUA levels, the adjusted HR of diabetes was 1.01 (95% CI: 0.97−1.04) in postmenopausal women, and 1.03 (95% CI: 1.01−1.04) in premenopausal women. Compared with the lowest quartile of SUA levels, the HR (95% CI) of diabetes in the highest quartile was 0.99 (0.55−1.79) in premenopausal women and 1.39 (1.07−1.81) in postmenopausal women. Compared with those without hyperuricemia, the HR (95% CI) for diabetes was 1.89 (0.67−5.31) in premenopausal women with hyperuricemia, and 1.55 (1.19−2.02) in postmenopausal women. Moreover, restricted cubic splines models showed that there was a linear relationship between SUA levels and diabetes risk in premenopausal (p for nonlinear = 0.99) and postmenopausal women (p for nonlinear = 0.95). Furthermore, the restricted cubic spline graph showed that the risk of diabetes in postmenopausal women increased with an increase in SUA levels (p = 0.002). Conclusions: In a cohort of Chinese adult women, SUA levels are associated with diabetes risk in postmenopausal women, but this association was not observed in premenopausal women.
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Affiliation(s)
- Qian Wu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Ying Guan
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Chunze Xu
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xing Liu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Feng Jiang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Qi Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Zhongxing Sun
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
| | - Genming Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China
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Wu Z, Li X, Wen Q, Tao B, Qiu B, Zhang Q, Wang J. Serum LDL-C/HDL-C ratio and the risk of carotid plaques: a longitudinal study. BMC Cardiovasc Disord 2022; 22:501. [PMID: 36434516 PMCID: PMC9700971 DOI: 10.1186/s12872-022-02942-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Dyslipidemia contributes to an increased risk of carotid atherosclerosis. However, the association between the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and carotid plaque formation has not been well documented. This study aims to assess the role of LDL-C/HDL-C in the risk of carotid plaque formation in a Chinese population. METHODS We followed 2,191 participants who attended the annual routine health examination. Cox proportional hazards regression, restricted cubic spline (RCS), and subgroup analysis were applied to evaluate the association between the LDL-C/HDL-C ratio and carotid plaques. The hazard ratio (HR) and 95% confidence interval (CI) were used to estimate the strength of the association. RESULTS Among 2,191 participants, 388 had incident carotid plaques detected, with a median follow-up time of 1.05 years. Compared with subjects younger than 45 years, those aged 45 to 59 years (HR: 2.00, 95% CI: 1.55-2.58) and over 60 years (HR: 3.36, 95% CI: 2.47-4.58) had an increased risk of carotid plaque formation. Males (HR: 1.26, 95% CI: 1.01-1.56), diabetes (HR: 1.46, 95% CI: 1.06-2.01) and a high LDL-C/HDL-C ratio (HR: 1.22, 95% CI: 1.07-1.38) were significantly linked with the occurrence of carotid plaques. After adjusting for potential confounding factors, we observed that a high LDL-C/HDL-C ratio promoted carotid plaque events (HR: 1.30, 95% CI: 1.12-1.50). The RCS analysis revealed a significant nonlinear association. The association was stronger among females (P-interaction < 0.05). CONCLUSION A high LDL-C/HDL-C ratio could accelerate the occurrence of carotid plaques. Older men with diabetes and dyslipidemia are the critical target population. Women may be more likely to benefit from lipid-lowering interventions and thus avoid carotid plaque formation.
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Affiliation(s)
- Zhuchao Wu
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Xiaona Li
- grid.412676.00000 0004 1799 0784Department of Health Management Center, the First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China ,grid.89957.3a0000 0000 9255 8984Department of Health Management, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Qin Wen
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Bilin Tao
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Beibei Qiu
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Qun Zhang
- grid.412676.00000 0004 1799 0784Department of Health Management Center, the First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China ,grid.89957.3a0000 0000 9255 8984Department of Health Management, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Jianming Wang
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, 211166 Nanjing, China
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