Liu Bo, Fan Fangfang, Zheng Bo, Yang Ying, Jia Jia, Sun Pengfei, Jiang Yimeng, Li Kaiyin, Liu Jiahui, Chen Chuyun, Li Jianping, Zhang Yan, Huo Yong
Department of Cardiology, Peking University First Hospital, Beijing, China.
Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.
Front Cardiovasc Med. 2022 Aug 30;9:903390. doi: 10.3389/fcvm.2022.903390. eCollection 2022.
Remnant lipoprotein cholesterol (RC) is an independent risk factor for cardiovascular disease (CVD). However, the relationships of remnant cholesterol and other conventional lipid parameters with new-onset carotid plaque are not fully understood in the Chinese community-based population.
A total of 872 plaque-free participants (51.39 ± 4.96 years old) with no history of CVD were included in this study. The plasma concentrations of RC were calculated by subtracting low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) from total cholesterol (TC). Multivariate regression models were used to evaluate and compare the associations between RC and other lipid parameters and new-onset carotid plaque.
After a mean 6.77-year follow-up, the incidence of new-onset carotid plaque was 188 (21.56%). RC was significantly associated with new-onset carotid plaque [Odd ratio (OR) = 1.57 per 1 mmol/L increase, 95% confidence interval (CI): 1.03-2.41, = 0.038]. The highest tertile of RC (T3 group) had the highest risk of new-onset carotid plaque ( = 2.53, 95% CI: 1.63-3.95). Similar results were seen for increased other lipid parameters, but decreased HDL-C levels. When adding another lipid parameter into the adjusted model with RC simultaneously, only RC remained significantly associated with new-onset carotid plaque after adjusting for other lipid parameters (all value < 0.005). Furthermore, RC was strongly associated with new-onset carotid plaque in participants with lower baseline LDL-C levels.
Increased RC levels were superior to other conventional lipid parameters to be associated with new-onset carotid plaque in the Chinese community-based population. Furthermore, RC should be considered in participants with lower LDL-C levels for the purpose of early atherosclerosis prevention.
残留脂蛋白胆固醇(RC)是心血管疾病(CVD)的独立危险因素。然而,在中国社区人群中,残留胆固醇及其他传统脂质参数与新发颈动脉斑块的关系尚未完全明确。
本研究纳入了872名无CVD病史的无斑块参与者(年龄51.39±4.96岁)。通过从总胆固醇(TC)中减去低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)来计算血浆RC浓度。采用多变量回归模型评估和比较RC及其他脂质参数与新发颈动脉斑块之间的关联。
经过平均6.77年的随访,新发颈动脉斑块的发生率为188例(21.56%)。RC与新发颈动脉斑块显著相关[每增加1 mmol/L的比值比(OR)=1.57,95%置信区间(CI):1.03 - 2.41,P = 0.038]。RC最高三分位数组(T3组)新发颈动脉斑块的风险最高(P = 2.53,95% CI:1.63 - 3.95)。其他脂质参数升高及HDL-C水平降低时也观察到类似结果。当在调整模型中同时加入另一个脂质参数与RC时,在调整其他脂质参数后,只有RC仍与新发颈动脉斑块显著相关(所有P值<0.005)。此外,在基线LDL-C水平较低的参与者中,RC与新发颈动脉斑块密切相关。
在中国社区人群中,RC水平升高比其他传统脂质参数更易与新发颈动脉斑块相关。此外,对于基线LDL-C水平较低的参与者,为早期预防动脉粥样硬化应考虑RC。